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Evaluation of craniofacial growth in patients with cleft lip and palate undergoing one-stage palate repair

BACKGROUND: Primary surgeries such as cheiloplasty and palatoplasty interfere with the morphology and physiology of the maxillofacial complex, causing alterations in its growth and development in unilateral cleft lip and palate (UCLP) patients. The aim of the present study was to perform a preliminary analysis of the effects of surgery on maxillofacial growth through an examination of dental arch relationships. METHODS: Forty-five patients with UCLP who underwent primary surgery for the repair of cleft lip and palate were evaluated. Comparative analysis of plaster models of dental arches was performed by two orthodontists using the Atack index. RESULTS: Some patients (44.4%) analyzed showed scores of 1 and 2, representing the most favorable maxillofacial growth conditions. The intermediate score (score 3) was found in 40% of patients, while 15.6% showed unfavorable maxillary growth tendencies (scores 4 and 5). The mean score at 4 years of age was 2.62 + 0.98. A correlation between scores 1 and 2 in the present study with those of previous studies resulted in a significant difference (P = 0.23) in comparison to Bongaarts' series, which obtained the best results. Our results for scores 3, 4, and 5 were similar to those of 3 related studies in terms of the percentages obtained, which were better than those of the first study that used the Atack index for the evaluation of primary surgeries. CONCLUSIONS: The Atack index enabled the analysis of the effects of primary surgery on maxillofacial growth and a comparison with the results obtained by other centers for the treatment of UCLP.

Cleft lip; Cleft palate; Maxillofacial development


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