Dental Cast Study of Adult Patients with Untreated Unilateral Cleft Lip or Cleft Lip and Palate in Indonesia Compared with Surgically Treated Patients in the Netherlands

Abstract

To determine differences in maxillary and dentoalveolar relationships between untreated and treated patients having unilateral clefts of the lip and alveolus (UCLA) or lip and palate (UCLP), dental cast assessments were done on 70 untreated adult indonesian patients (UCLA-I, UCLP-I) and 67 Dutch patients, surgically treated in infancy (UCLA-D, UCLP-D). The indonesian group consisted of 44 UCLA-I and 26 UCLP-I patients, and the Dutch group of 24 UCLA-D and 43 UCLP-D patients. In the UCLA-I patients, deformities occurred in that part of the dentoalveolar complex that surrounds the cleft. Lip repair in the UCLA-D group more frequently caused deformities in the incisor and buccal areas on the cleft side. In the UCLP-I patients, deformities were present in the incisor and cuspid areas on the cleft side. The buccal segments showed collapse both on the cleft and noncIeft sides. Lip and palate repair in the UCLP-D group caused significantly more deformities in the incisor, cuspid, and buccal areas up to the level of the first molars, both on the cleft and noncleft sides. Surgical treatment seems to cause maxillary and dentoalveolar deformities up to the first molars more frequently, but these are not as pronounced as one would expect: following the practiced surgical regimen, the deformities were usually mild. Negative effects of surgical intervention seem to be antagonized by the restored integrity of the lip and palate leading to orientation of maxillary parts and correction of tongue position, which in turn has a molding effect on the maxilla and mandible.

Dental Arch Width Stability after Quadhelix and Edgewise Treatment in Complete Unilateral Cleft Lip and Palate

“…[15][16][17][18][19][20][21] The reduction of arch width in the repaired cleft patients was more severe than that of the unrepaired patients. 12 Buccal crossbites occurred in 75.6% of the repaired unilateral cleft lip and palate patients, 18 which was more frequent than that of the unoperated UCLP patients. Palatal surgery and the LI, LIN Angle Orthodontist, Vol 77, No 6, 2007 constriction of scar tissue caused more severe collapse of the buccal segment in the repaired cleft lip and palate patients.…”

“…In acteristic feature of the upper dental arch is constriction anterior to the molars, but posterior crossbites are less of a problem. [11][12][13][14] McCance et al 14 studied unoperated cleft patients and reported that the width of upper dental arch was reduced compared to normal controls. Anterior crossbites occurred in 19.5% of the sample, whereas posterior crossbites were not considered significant.…”

Examination of dental casts in newborns with bilateral complete cleft lip and palate

“…The measurements between certain landmarks are more precise than others; it may be possible to use the more precise points for a longitudinal study from birth to 18 years. Postnatal development and growth in patients with cleft lip and palate depends on intrinsic 5,11,20 and extrinsic factors 21,22 that have not been fully elucidated. Treatment of cleft lip and palate is a difficult process, to which different medical and dental specialities contribute 10 .…”