Three-dimensional development of the upper dental arch in unilateral cleft lip and palate patients after early neonatal cheiloplasty
Abstrakt
Objectives: This prospective morphometric study evaluated the growth of the upper dental arch in UCLP patients after early neonatal cheiloplasty and compared the selected dimensions with published data on non-cleft controls and on later operation protocol patients. Methods: The sample comprised 36 Czech children with nonsyndromic complete UCLP (cUCLP) and 20 Czech children with nonsyndromic incomplete UCLP (UCLP + b). 2-D and 3-D analyses of palatal casts were made at two time points: before neonatal cheiloplasty at the mean age of 3 days (+-1 day), and 10 months after surgery at the mean age of 10 months (+-1 month).
Results: The upper dental arch of cUCLP and UCLP + b patients showed similar developmental changes, but the cleft type influenced growth significantly. The initial high shape variability in cUCLP patients diminished after 10 months, and approached the variability in UCLP + b patients.
Both the width and length dimensions increased after surgery. Important growth concerned the anterior ends of both segments.
The width and length dimensions illustrated similar growth trends with non-cleft controls and UCLP patients who underwent later cheiloplasty. Conclusion: Early neonatal cheiloplasty caused no reduction in the length or width dimensions during the first year of life.
Our data suggest a reconstructed lip has a natural formative effect on the actively growing anterior parts of upper dental arch segments, which cause narrowing of the alveolar cleft.