title: Facial growth in children with complete cleft of the primary palate and intact secondary palate.
abstract: OBJECTIVE
  Children with unoperated cleft lip/palate have nearly normal facial growth, whereas patients who have had labiopalatal repair often exhibit midfacial retrusion. The aim of this study was to compare cephalometric data in patients with repaired unilateral or bilateral complete cleft lip/alveolus (UCCLA or BCCLA) with patients with repaired unilateral or bilateral complete cleft lip/palate (UCCLP or BCCLP). This study might provide insight into the etiology of impaired facial growth in patients with repaired cleft lip/palate.
  
  
  METHODS
  This was a retrospective, cross-sectional analysis of nonsyndromic patients with UCCLA, BCCLA, UCCLP, and BCCLP. Angular and linear measurements of the midfacial region were made on traced lateral cephalograms. Paired t tests were used to compare each group with normative controls from the Michigan Growth Study. Multivariate analysis of variance was used to determine possible differences among the groups.
  
  
  RESULTS
  There were 77 patients (38 male and 39 female) with a mean age of 11.2 years (range, 6 to 16 years; UCCLA, n = 25; BCCLA, n = 7; UCCLP, n = 18; and BCCLP, n = 27). There was no significant difference in midfacial position between the UCCLA and BCCLA groups and noncleft age-matched controls. In contrast, the maxilla in patients with UCCLP and BCCLP was significantly smaller and more retruded (P < .05) compared with patients with UCCLA and BCCLA and controls.
  
  
  CONCLUSIONS
  Children with UCCLA and BCCLA appear to have normal midfacial growth, whereas the maxilla in children with UCCLP and BCCLP is small and retrusive. This study suggests that the presence and/or repair of the secondary palate is responsible for midfacial hypoplasia in these patients.
authors.affiliation: Department of Orthodontics and Pediatric Dentistry, The University of Michigan, Ann Arbor, MI, USA.
authors.forename: Elliot L
authors.initials: EL
authors.lastname: Saperstein
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Kennedy
authors.forename: John B
authors.initials: JB
authors.lastname: Mulliken
authors.forename: Bonnie L
authors.initials: BL
authors.lastname: Padwa
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000543:Alveoloplasty / Q000379:methods; D016025:Bone Transplantation / Q000379:methods; D016022:Case-Control Studies; D002508:Cephalometry / Q000379:methods; D002648:Child; D002971:Cleft Lip / Q000503:physiopathology* / Q000601:surgery; D002972:Cleft Palate / Q000145:classification / Q000503:physiopathology* / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000601:surgery; D008297:Male; D008334:Mandible / Q000473:pathology; D008437:Maxilla / Q000254:growth & development / Q000473:pathology; D008445:Maxillofacial Development / Q000502:physiology*; D009666:Nose / Q000473:pathology / Q000601:surgery; D010156:Palatal Muscles / Q000637:transplantation; D010159:Palate / Q000254:growth & development / Q000473:pathology; D012189:Retrospective Studies; D013524:Surgical Flaps