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Surgery for patients with unilateral (UCLP) and bilateral (BCLP) complete cleft lip, alveolus and palate has a considerable influence upon craniofacial growth. With respect to this, the cleft team at Hannover Medical School has attempted to reduce necessary surgical interventions to labioplasty, palatoplasty and veloplasty. Still, the effects of these operations influence maxillary growth to an extent which requires orthodontic treatment in all patients. This study focuses upon the transverse alterations of the alveolar arch and the deciduous dentition after lip and palate surgery. Dental casts prior to any surgical intervention and after labioplasty and complete palaotoplasty of the hard and soft palate were measured for transverse changes by using anatomical landmarks. The results indicate a significant occurrence of anterior relative to posterior arch width loss for both UCLP and BCLP patients. Orthodontic treatment should be planned and performed with respect to these findings in order to support craniofacial growth and prevent maxillary dental arch deficiency.

It was concluded that a vertical growth impairment of the maxilla is found in patients with cleft lip and palate. The maxilla of cleft patients shows a significant clockwise rotation, whereas the inclination of the mandible shows little difference. Consequently, there is a skeletal superposition of the jaws. The posterior height of the maxilla is significantly shorter in patients both with UCLP and BCLP at T(0) and T(1). An increase of the anterior height of the mandible is found in the cleft groups.

A significant reduction in overjet (p < 0.001) and overbite (p < 0.01) occurred during the course of treatment. A significant reduction in the SNA-angle (p < 0.001) and increase in the SNB-angle (p < 0.001) led to a reduced ANB-angle (p < 0.001). The treatment effect on the maxilla was greater than on the mandible. A slight posterior rotation of the maxilla (p < 0.05) occurred whereas the other vertical relations did not change significantly. The upper incisors were significantly retruded (p < 0.001) while the lower incisors were increasingly protruded (p < 0.001). The interincisal angle was not markedly altered.