title: One- or two-stage palate closure in patients with unilateral cleft lip and palate: comparing cephalometric and occlusal outcomes.
abstract: OBJECTIVE
  To assess facial growth and dentoalveolar development in two groups of patients with complete unilateral cleft lip and palate. Primary surgical treatment differed in the timing of hard palate closure.
  
  
  METHODS
  Forty-three patients with unilateral cleft lip and palate were examined. Twenty-two patients underwent early one-stage closure of the hard and soft palate cleft (mean age 23.0 +/- 4.7 months); in 21 patients, the hard palate closure was delayed to 86.3 +/- 39.2 months of age. Lateral cephalograms and dental casts were consecutively analyzed at four stages between 6 and 18 years of age.
  
  
  RESULTS
  Lateral cephalometric analysis revealed no significant intergroup differences in the sagittal and vertical craniofacial dimensions at any time. Dental cast analysis showed constriction of the upper anterior arch width at the ages of 6 and 10 years in patients with one-stage surgical palate closure, but a difference could no longer be verified at the ages of 15 and 18 years.
  
  
  CONCLUSIONS
  The transverse distances in the upper jaw developed initially more positively in the group with delayed hard palate closure, but it became apparent later that the transverse deficiency after one-stage palate closure could be compensated for. When considering surgical treatment in general, the advantages of the delayed hard palate closure must be weighed against criteria favoring the early one-stage closure of the hard and soft palate.
authors.affiliation: Department of Orthodontics, University of Freiburg, Germany. silke.ammann@web.de
authors.forename: Silke
authors.initials: S
authors.lastname: Stein
authors.forename: Anton
authors.initials: A
authors.lastname: Dunsche
authors.forename: Nils-Claudius
authors.initials: NC
authors.lastname: Gellrich
authors.forename: Franz
authors.initials: F
authors.lastname: Härle
authors.forename: Irmtrud
authors.initials: I
authors.lastname: Jonas
mesh_terms: D000293:Adolescent; D000539:Alveolar Process / Q000254:growth & development; D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D003724:Dental Arch / Q000254:growth & development; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008310:Malocclusion / Q000145:classification; D008334:Mandible / Q000254:growth & development; D008437:Maxilla / Q000254:growth & development; D008445:Maxillofacial Development / Q000502:physiology; D003765:Models, Dental; D021362:Palate, Hard / Q000254:growth & development / Q000601:surgery*; D010160:Palate, Soft / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014716:Vertical Dimension