A Comparative Study on Vertical and Transverse Orthodontic Relapse in Patients with and Without Cleft Lip and Palate

Abstract

Objective

To compare the 2-year post-treatment stability of vertical and transverse dimensions in orthodontic patients with non-syndromic cleft lip and palate (CLP) versus non-cleft controls (NC).

Design

Retrospective comparative study.

Patients/Participants

Twenty-eight patients divided into CLP (n = 14) and NC (n = 14) groups matched for age and sex.

Interventions

Orthodontic fixed appliance therapy followed by removable vacuum-formed retainers.

Main Outcome Measures

Vertical changes were assessed with lateral cephalograms, and transverse relationships were analyzed using the Modified Huddart-Bodenham (MHB) Index. Intragroup changes (T0-T1) were analyzed with paired t-tests and intergroup differences with unpaired t-tests (P < .05).

Results

At 2-year post-treatment, the cleft group showed significant reductions in anterior facial height (−1.06 ± 0.59 mm, P < .001), U1-NF (−0.31 ± 0.48 mm, P = .01), L1-MP (−0.54 ± 0.63 mm, P = .004), and U6-NF (−0.66 ± 0.70 mm, P < .001). Transverse relapse was evident at the incisors (−0.36 ± 0.50, P = .006), molars (−0.43 ± 0.51, P = .002), and in total scores (−0.29 ± 0.47, P = .007). The NC group showed minimal changes (P > .05).

Conclusions

Patients with CLP demonstrate greater vertical and transverse orthodontic relapse 2-year post-treatment compared to non-cleft patients. These findings underscore the necessity for potential permanent retention protocols tailored to the unique anatomical and physiological challenges of the cleft population.

Keywords

cleft lip and palate cephalometry dental arch orthodontics

Get full access to this article

View all access options for this article.

References

Little

. Stability and relapse of dental arch alignment. Br J Orthod. 1990;17(3):235–241. doi:10.1179/bjo.17.3.235

Proffit

Fields

Sarver

. Contemporary Orthodontics. 6th ed. Elsevier; 2018.

Shi

Losee

. The impact of cleft lip and palate repair on maxillofacial growth. Int J Oral Sci. 2015;7(1):14–17. doi:10.1038/ijos.2014.59

Ross

. Treatment variables affecting facial growth in complete unilateral cleft lip and palate. Cleft Palate J. 1987;24(1):5–77.

Caballero

Pucciarelli

MGR

Pazmiño

VFC

, Curvêllo, V. P., Menezes, M., Sforza, C., Soares, S. 3D Comparison of dental arch stability in patients with and without cleft lip and palate after orthodontic/rehabilitative treatment. J Appl Oral Sci. 2019;27:e20180434. doi:10.1590/1678-7757-2018-0434

Marcusson

Paulin

. Changes in occlusion and maxillary dental arch dimensions in adults with treated unilateral complete cleft lip and palate: A follow-up study. Euro J Orthodontics. 2004;26(4):385–390. doi:10.1093/ejo/26.4.385

Ramstad

Jendal

. A long-term study of transverse stability of maxillary teeth in patients with unilateral complete cleft lip and palate. J Oral Rehabil. 1997;24(9):658–665. doi:10.1046/j.1365-2842.1997.00551.x

Schultes

Gaggl

Kärcher

. A comparison of growth impairment and orthodontic results in adult patients with clefts of palate and unilateral clefts of lip, palate and alveolus. Br J Oral Maxillofac Surg. 2000;38(1):26–32. doi:10.1054/bjom.1999.0132

Achterrath

Graf

Guevara

Braumann

Kruse

. Predictors for long-term relapse of orthodontic treatment in patients with cleft lip and palate. A clinical follow-up study. Clin Oral Investig. 2024;28(4):239. doi:10.1007/s00784-024-05632-3

10.

Burstone

James

Legan

Murphy

Norton

. Cephalometrics for orthognathic surgery. J Oral Surg. 1978;36(4):269–277.

11.

Mossey

Clark

Gray

. Preliminary investigation of a modified Huddart/Bodenham scoring system for assessment of maxillary arch constriction in unilateral cleft lip and palate subjects. Euro J Orthod. 2003;25(3):251–257. doi:10.1093/ejo/25.3.251

12.

de Bernabé

Montiel-Company

Paredes-Gallardo

Gandía-Franco

Bellot-Arcís

. Orthodontic treatment stability predictors: A retrospective longitudinal study. Angle Orthod. 2017;87(2):223–229. doi:10.2319/053116-435.1

13.

Kahl-Nieke

Fischbach

Schwarze

. Treatment and postretention changes in dental arch width dimensions—a long-term evaluation of influencing cofactors. Am J Orthod Dentofacial Orthop. 1996;109(4):368–378. doi: 10.1016/s0889-5406(96)70118-x

14.

Jahanbin

Kamyabnezhad

Raisolsadat

Farzanegan

Bardideh

. Long-term stability of alveolar bone graft in cleft lip and palate patients: Systematic review and meta-analysis. J Craniofac Surg. 2022;33(2):e194–e200. doi:10.1097/SCS.0000000000008254

15.

Dos Santos

CCO

Bastos

RTDRM

Normando

. Orthodontic retainers and the stability of the maxillary arch in unilateral cleft lip and palate patients: A systematic review. Cleft Palate Craniofac J. 2024;61(3):433–442. doi:10.1177/10556656221133954

16.

Zachrisson

. Important aspects of long-term stability. J Clin Orthod. 1997;31(9):562–583.

17.

Santos

SRB

Araujo

Vogel

Oliveira

Bittencourt

MAV

Braga

. Evaluation of anteroposterior and vertical stability 25 years after angle class II division 1 treatment with cervical headgear. J Orofac Orthop. 2021;82(6):382–390. doi: 10.1007/s00056-020-00277-9

18.

Thilander

. Biological basis for orthodontic relapse. Semin Orthod. 2000;6(3):195–205. doi:10.1053/sodo.2000.8085

19.

Gray

Mossey

. Evaluation of a modified Huddart/Bodenham scoring system for assessment of maxillary arch constriction in unilateral cleft lip and palate subjects. Eur J Orthod. 2005;27(5):507–511. doi:10.1093/ejo/cji019

20.

Dobbyn

Gillgrass

McIntyre

Macfarlane

Mossey

. Validating the clinical use of the modified Huddart and Bodenham scoring system for outcome in cleft lip and/or palate. Cleft Palate Craniofac J. 2015;52(6):671–675. doi:10.1597/12-170

21.

Berkowitz

. Cleft Lip and Palate: Perspectives in Management. Singular Pub. Group; 1996.

22.

Reitan

. Principles of retention and avoidance of post-treatment relapse. Am J Orthod. 1969;55(6):776–790. doi:10.1016/0002-9416(69)90050-5

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.01 MB