Cleft Lip/Palate Treatment Outcomes

A study published in the European Journal of Orthodontics assessed wheth­er the initial cleft width in patients born with complete unilateral cleft lip and palate (UCLP) is correlated to final treatment outcome regarding maxillary growth. The retrospective longitudinal cohort study, conducted by Katarina Wiggman et al of Stock­holm, Sweden, involved 45 consecutive nonsyndromic individuals with UCLP—19 from the Stockholm Cleft Team and 26 from the Oslo Cleft Team. The treatment protocols in the 2 teams differed. The initial transversal width in infants was measured at 3 levels on study casts. The width was correlated to variables obtained from lateral cephalograms at 17 years of age, from rating of dental arch relationship and to treatment variables obtained from the medical records: existence of Simonart’s band, missing maxillary teeth, duration of ortho­paedic/orthodontic treatment, and the need for orthognathic surgery. The initial width of the middle part of the cleft and final maxillary inclination (nasion-sella line—nasal line) showed a weak correlation (P < .05); the wider the cleft, the less the inclination. No further correlations were found between the initial width and final outcome measurements studied. In the Oslo group, where a Simonart’s band was present, the anterior and middle widths of the cleft were significantly smaller (P < .001). Addition­ally, the existence of a Simonart’s band had a significant effect on final maxillary inclination (P < .05), ie, the maxillary inclination increased. The study concluded that treatment outcome seems mainly to depend on the treatment protocol performed rather than the severity of the cleft. The width of the middle part of cleft may be associated with the final maxillary inclination.
(Source: European Journal of Ortho­dontics; doi: 10.1093/ejo/cjr144; first published online on January 20, 2012, ejo.oxfordjournals.org)