title: Presurgical orthopedics has no effect on archform in unilateral cleft lip and palate.
abstract: OBJECTIVE
  Evaluation of the effect of presurgical orthopedics on maxillary archform up to 6 months of age. DeSIGN: Retrospective, single-blinded, case-control study.
  
  
  METHODS
  Study model sets of 75 infants with consecutive, nonsyndromic, complete unilateral cleft lip and palate (excluding Simonart bands) from 1995 to 2005.
  
  
  METHODS
  All patients (PSO group, n  =  14; non-PSO group, n  =  61) received lip repair/vomer flap at 3 months and soft palate repair at 6 months by the same consultant surgeon. The two groups were comparable at birth (p > .01) in all archform variables.
  
  
  METHODS
  Sixteen variables were computed, following single-blinded analysis using the Reflex Microscope to describe the archform in the transverse, anteroposterior, and vertical dimensions and the arch circumference. Data were analyzed using a repeated-measures hierarchical analysis of variance with a significance level of 1%.
  
  
  RESULTS
  Repeatability studies showed good measurement precision. Presurgical orthopedics produced no statistically significant mean change in any archform variable when compared with the non-PSO group. The difference in the mean reduction in the alveolar cleft width between the groups was 0.69 mm (95% confidence interval, -0.89 to 2.28 mm, p  =  .52). Lip repair produced greater change in archform than did presurgical orthopedics, reducing the mean alveolar cleft width by 4.45 mm (95% confidence interval, 3.53 to 5.37 mm; p < .001).
  
  
  CONCLUSIONS
  There was no evidence that presurgical orthopedics produced any significant effect on archform, raising questions for its continued use in this context. Lip repair had a greater impact on arch dimensions than did presurgical orthopedics.
authors.affiliation: University College London Hospitals (UCLH) National Health Service (NHS) Foundation Trust, UCL Eastman Dental Institute, London, United Kingdom. nazanadali@yahoo.co.uk
authors.forename: Nazan
authors.initials: N
authors.lastname: Adali
authors.forename: Michael
authors.initials: M
authors.lastname: Mars
authors.forename: Aviva
authors.initials: A
authors.lastname: Petrie
authors.forename: Joe
authors.initials: J
authors.lastname: Noar
authors.forename: Brian
authors.initials: B
authors.lastname: Sommerlad
mesh_terms: D002971:Cleft Lip / Q000601:surgery / Q000628:therapy*; D002972:Cleft Palate / Q000601:surgery / Q000628:therapy*; D003724:Dental Arch / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010158:Palatal Obturators; D011300:Preoperative Care; D016896:Treatment Outcome