Transversal dimension in dental cast of the unoperated BCLP patients

Operated patients with Bilateral Cleft Lip and Palate (BCLP) show a severe compression of the maxilla when they reached maturity, Levin (1963). It is not clear whether these growth disturbances may be attributed to the congenital malformation itself, to the cleft surgery, or to both. Objectives: The aims of this study to measure the transversal dimension of maxillary arch of the unoperated adult patients with BCLP compared with control group from the same population. Methods: 13 dental casts of BCLP, age between 13 to 40, compared with 24 dental casts from non cleft patient, age between 13 to 40 from the same population, were digitized three-dimensionally using an industrial coordinate measuring machine (Zeiss Numerex Carl Zeiss Stuttgart, Germany). Linear accuracy was up to 0.002 mm. Recorded point was given by Moyers et al (1976). The point 3 and 4 in BCLP were located in left and right side at the cleft margin and point 4 in control group coincide in the midline of the palate. Results: In BCLP maxillary arch width at the level of the canine significantly smaller was even 7.2 mm (SE 1.9) than the control group, while all others transversal dimension were not significantly different from the controls. The upper arch ratio showed only 51.8 % of the intermolar width compared to the control 64.2 % (p=0.00005). Conclusion: The presence of cleft as intrinsic factor in BCLP has influences on the final development of maxilla limited only to the canine region. These are important for our understanding of the iatrogenic effects of the surgical repair, which might lead to the new design of surgical techniques and better orthodontic management.