title: Presurgical orthopedics by drink plates does not significantly normalize deglutition in infants with cleft lip and palate.
abstract: OBJECTIVE
  To test the null hypothesis of no significant difference between intraoral pressure characteristics in infants with cleft lip and palate (CLP) with or without presurgical orthopedic (PSO) plates (groups CLP and CLP-PSO), compared with noncleft infants.
  
  
  METHODS
  Intraoral atmospheric pressure assessments were performed on 17 subjects with preoperative CLP (m/f, 11/6; mean/SD, 4.76/0.92 months) and a matched control group (n = 24; m/f, 15/9; mean/SD, 4.88/0.9 months), for 200 seconds, simultaneously at the vestibulum (vestibular space [VS]) and at the palate (subpalatal space [SPS]), using a prepared pacifier connected to a digital manometer. Areas under the pressure curves (AUC), frequencies, durations, and magnitudes of swallowing peaks and pressure resting plateaus were compared between trial groups and locations (VS, SPS) using a two-factor analysis of variance for repeated measures, Kruskal-Wallis test, and Mann-Whitney U-test (α = .05).
  
  
  RESULTS
  The null hypothesis was rejected: Globally, there were statistically significant differences in intraoral pressure characteristics between groups CLP, CLP-PSO, and control (all P < .01), with significantly higher negative pressures (AUC) in the control subjects compared with those of CLP or CLP-PSO. There were significant effects by the location of pressure recordings (VS, SPS) and their interaction with all treatment groups. Differences between noncleft and CLP subjects were more pronounced in the VS than in the SPS. There was no significant effect by PSO.
  
  
  CONCLUSIONS
  PSO does not improve deviated swallowing characteristics during suction in CLP infants.
authors.affiliation: a  Professor, Department of Orthodontics, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Knösel
authors.affiliation: b  Research Fellow and Medical Student, University Medical Center Giessen & Marburg, Giessen, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Fendel
authors.affiliation: c  Senior Lecturer and Biostatistician, Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Jung
authors.affiliation: d  Professor and Department Chair, Department of Orthodontics, Universidad de la Frontera, Temuco, Chile.
authors.forename: Paulo
authors.initials: P
authors.lastname: Sandoval
authors.affiliation: e  Professor, Department of Orthodontics, Universidad de la Frontera, Temuco, Chile.
authors.forename: Wilfried G
authors.initials: WG
authors.lastname: Engelke
mesh_terms: D016022:Case-Control Studies; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D003679:Deglutition; D006801:Humans; D007223:Infant; D009985:Orthopedics / Q000379:methods*
keywords: Cleft lip and palate; Drink plate; Infants; Intraoral pressure monitoring; Pathophysiology of deglutition; Swallowing