Development of the palate in patients with complete unilateral cleft lip and palate following cheiloplasty with primary periosteoplasty: 3D geometric morphometric study
Abstract
The aim: (1) to analyze the growth of cleft palate in patients with complete unilateral cleft of the lip and palate (cUCLP) after cheiloplasty with primary periosteoplasty, and (2) to compare the results with published data of younger cUCLP patients after neonatal cheiloplasty. Materials and methods: The study deals with the longitudinal growth changes of the palate, including alveolar segments and its variability within the analysed group of 14 patients with cUCLP.
Twenty eight dental plaster casts obtained from each patient in the two examinations (before cheiloplasty and before palatoplasty) were used for the analysis. The first dental plaster cast was taken from patients with an average age of 8.5 months, while the average age for second continuous casting was 4.5 years.
Dental casts were scanned using a 3D laser scanner and then analysed, using methods of geometric morphometrics. Results: Palatal morphology did not differ significantly between the sexes, but a statistically significant growth of palate was detected.
A detailed colour-coded map identified the most marked growth at the anterior and posterior ends of both segments. Growth insufficiency of the smaller upper jaw segment after cheiloplasty with periosteoplasty was detected.
Conclusion: The reconstructed lip of both compared groups (neonatal and later cheiloplasty) exerts a natural formative effect on the actively growing anterior parts of split segments, which grow towards each other. But on top of that, neonatal cheiloplasty has many other benefits (wound healing, feeding facilitation, socialization), and so it is the most common surgical approach in the Czech Republic now.