To compare the maxillofacial morphology in the early mixed dentition phase between two patient groups with unilateral cleft lip, alveolus, and palate who underwent different types of palatoplasty.
Design
Cross-sectional study.
Setting
An institutional study.
Patients and Interventions
Seventy-one patients with unilateral cleft lip and palate (UCLP) treated at Osaka University Dental Hospital, Japan, were divided into two groups: 33 patients were treated by early two-stage palatoplasty by the modified Furlow Technique (ETS), and 38 patients were treated by one-stage Wardill-Kilner push-back palatoplasty (PB). Intergroup comparisons were performed.
Main Outcome Measures
The dental, skeletal, and soft-tissue features were evaluated. For intergroup comparisons, Mann-Whitney U test was used for the statistical analyses.
Result
No significant differences existed between the ETS and PB groups regarding the skeletal features except for the mandibular ridge height. Meanwhile, the upper central incisor and upper lip of the ETS group showed a more anterior position than those in the PB group.
Conclusions
Early two-stage Furlow palatoplasty leads to more protruded upper lip, providing more anteriorly positioned upper incisors compared with PB, at least at the early mixed dentition stage.
ChenL., LiuJ., XuT., LinJ.Longitudinal study of relative growth rates of the maxilla and the mandible according to quantitative cervical vertebral maturation.Am J Orthod Dentofacial Orthop.2010; 137: 736–737.
3.
CorboM., DujardinT., de MaertelaerV., MalevezC., GlineurR.Dentocraniofacial morphology of 21 patients with unilateral cleft lip and palate: a cephalometric study.Cleft Palate Craniofac J.2005; 42: 618–624.
4.
DeguchiT., KanomiR., AshizawaY., RosensteinS.W.Very early face mask therapy in Class III children.Angle Orthod.1999; 69: 349–355.
5.
FriedeH.Maxillary growth controversies after two-stage palatal repair with delayed hard palate closure in unilateral cleft lip and palate patients: perspectives from literature and personal experience.Cleft Palate Craniofac J.2007; 44: 129–136.
6.
FriedeH., PerssonE.C., LiljaJ., ElanderA., Lohmander-AgerskovA., SöderpalmE.Maxillary dental arch and occlusion in patients with repaired clefts of the secondary palate. Influence of push back palatal surgery.Scand J Plast Reconstr Surg Hand Surg.1993; 27: 297–305.
7.
FriedeH., PriedeD., MöllerM., MaulinaI., LiljaJ., BarkaneB.Comparisons of facial growth in patients with unilateral cleft lip and palate treated by different regimens for two-stage palatal repair.Scand J Plast Reconstr Surg Hand Surg.1999; 33: 73–81.
KajiyamaK., MurakamiT., SuzukiA.Comparison of orthodontic and orthopedic effects of a modified maxillary protractor between deciduous and early mixed dentitions.Am J Orthod Dentofacial Orthop.2004; 126: 23–32.
10.
KitagawaT., KoharaH., SohmuraT., TakahashiJ., TachimuraT., WadaT., KogoM.Dentoalveolar growth of patients with complete unilateral cleft lip and palate by early two-stage Furlow and push-back method: preliminary results.Cleft Palate Craniofac J.2004; 41: 519–525.
11.
MapesA.H., MazaheriM., HardingR.L., MeierJ.A., CanterH.E.A longitudinal analysis of the maxillary growth increments of cleft lip and palate patients (CLP).Cleft Palate J.1974; 11: 450–462.
12.
MarkusA.F., SmithW.P., DelaireJ.Primary closure of cleft palate: a functional approach.Br J Oral Maxillofac Surg.1993; 31: 71–77.
13.
MolstedK., Asher-McDadeC., BrattstromV., DahlE., MarsM., McWilliamJ., PlintD.A., Prahl-AndersenB., SembG., ShawW.C.A six-center international study of treatment outcome in patients with clefts of the lip and palate: part 2. Craniofacial form and soft tissue profile.Cleft Palate Craniofac J.1992; 29: 398–404.
14.
NishioJ., AdachiT., KashimaY., HiranoY., SakoM.A new designed two-stage palatoplasty using Furlow's veloplasty. In: Lilja J, ed. Transactions of the 9th International Conference on Cleft Palate and Related Craniofacial Anomalies. Göteborg, Sweden; 2001: 173–276.
RossR.B.Treatment variables affecting facial growth in complete unilateral cleft lip and palate.Cleft Palate J.1987; 24: 5–77.
19.
SembG., ShawW.C.Facial growth after different methods of surgical intervention in patients with cleft lip and palate.Acta Odontol Scand.1998; 56: 352–355.
20.
SteinS., DunscheA., GellrichN.C., HarleF., JonasI.One- or two-stage palate closure in patients with unilateral cleft lip and palate: comparing cephalometric and occlusal outcomes.Cleft Palate Craniofac J.2007; 44: 13–22.
21.
TakadaK., PetdachaiS., SakudaM.Changes in dentofacial morphology in skeletal Class III children treated by a modified protraction headgear and a chin cup: a longitudinal cephalometric appraisal.Eur J Orthod.1993; 15: 211–221.
22.
WadaK.A study of the individual growth of maxillofacial skeleton by means of lateral cephalometric roentgenograms.J Osaka Univ Dent Sch.1977; 22: 239–269.
23.
WardillW.E.M.The technique of operation for cleft palate.Br J Surg.1937; 25: 117–130.
24.
YamanishiT., NishioJ., KoharaH., HiranoY., SakoM., YamanishiY., AdachiT., MiyaS., MukaiT.Effect on maxillary arch development of early 2-stage palatoplasty by modified Furlow technique and conventional 1-stage palatoplasty in children with complete unilateral cleft lip and palate.J Oral Maxillofac Surg.2009; 67: 2210–2216.
YangI.Y., LiaoY.F.The effect of 1-stage versus 2-stage palate repair on facial growth in patients with cleft lip and palate: a review.Int J Oral Maxillofac Surg.2010; 39: 945–950.
