Alveolar Cleft Severity in UCLP Infants Affects Subsequent Maxillofacial Growth

Objectives: To investigate the association between the severity of alveolar cleft in infants and the subsequent maxillofacial growth in patients affected by complete unilateral cleft lip and palate (UCLP). Methods: The subjects were 35 nonsyndromic patients affected by UCLP (n = 27) or bilateral cleft lip and palate (BCLP, n = 8), who visited Department of Orthodontics and Dentofacial Orthopedics at the Tokushima University Hospital. Plaster models and lateral cephalograms taken at 6 year-old were analyzed and compared to those of the Japanese norm. In UCLP patients, the relationship between the width of alveolar cleft before palatoplasty (WAC) and the skeletal characteristics were also explored. Results: Vertical deficiency of the posterior maxilla and a steep palatal angle were significantly demonstrated in both BCLP and UCLP patients. However, they were not clearly observed in the UCLP patients with the mild WAC, and were correlated with the severity of alveolar cleft. Neither cleft types nor the alveolar cleft severity affected the maxillary arch form in childhood, but the growth of the alveolar height on the affected side was less in the UCLP patients with large WAC. Conclusions: Severity of alveolar cleft before palatoplasty affects the succeeding vertical maxillofacial growth in patients with complete UCLP, which suggests the necessity of different diagnosis and treatment in patients affected by UCLP according to the severity of alveolar cleft at infant.