title: Long-Term Incisal Relationships After Palatoplasty in Patients With Isolated Cleft Palate.
abstract: OBJECTIVE
  Various palatoplasty techniques have limited incisions in the hard palate due to concerns that these incisions may limit maxillary growth. There is little convincing long-term evidence to support this. Our purpose is to determine incisal relationships, an indicator for future orthognathic procedure, in patients after repair of an isolated cleft of the secondary palate.
  
  
  METHODS
  Our craniofacial database was used to identify patients aged 10 years or greater with an isolated cleft of the secondary palate who underwent palatoplasty between 1985 and 2002. Data collected included age at palatoplasty and follow-up, cleft type, associated syndrome, Robin sequence, surgeon, repair technique, number of operations, and occlusion. Incisal relationship was determined through clinical observation by a pediatric dentist and orthodontist.
  
  
  RESULTS
  Seventy eligible patients operated on by 9 surgeons were identified. Class III incisal relationship was seen in 5 patients (7.1%). Palatoplasty techniques over the hard palate (63 of 70 patients) included 2-flap palatoplasty, VY-pushback, and Von Langenbeck repair. There was an association between class III incisal relationship and syndromic diagnosis (P <0.001). Other study variables were not associated with class III incisal relationships.
  
  
  CONCLUSIONS
  In patients with an isolated cleft of the secondary palate, there was no association between class III incisal relationship and surgeon, age at repair, cleft type, palatoplasty technique, or number of operations. Increased likelihood of class III incisal relationship was associated primarily with syndromic diagnosis.
authors.affiliation: Division of Plastic and Reconstructive Surgery, St. Louis Children's Hospital, St. Louis, MO.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Odom
authors.forename: Albert S
authors.initials: AS
authors.lastname: Woo
authors.forename: Derick A
authors.initials: DA
authors.lastname: Mendonca
authors.forename: Donald V
authors.initials: DV
authors.lastname: Huebener
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Nissen
authors.forename: Gary B
authors.initials: GB
authors.lastname: Skolnick
authors.forename: Kamlesh B
authors.initials: KB
authors.lastname: Patel
mesh_terms: D000293:Adolescent; D002648:Child; D002972:Cleft Palate / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000209:etiology / Q000601:surgery*; D021362:Palate, Hard / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome