One- or Two-Stage Palate Closure in Patients with Unilateral Cleft Lip and Palate: Comparing Cephalometric and Occlusal Outcomes

Abstract

The transverse distances in the upper jaw developed initially more positively in the group with delayed hard palate closure, but it became apparent later that the transverse deficiency after one-stage palate closure could be compensated for. When considering surgical treatment in general, the advantages of the delayed hard palate closure must be weighed against criteria favoring the early one-stage closure of the hard and soft palate.

The effect of 1-stage versus 2-stage palate repair on facial growth in patients with cleft lip and palate: a review

“…All these articles were analysed according to the selection criteria, and nine studies 2,7,15,19,20,23,24,26,27 qualified for the review. Summarized data from the nine studies are given in Table 1.…”

“…SMAHEL et al 26 found no difference between repair in 1 stage at 3 years and 2 stages with hard palate closure at 6 years. ROHRICH et al 20 found no difference between repair in 1 stage at 11 months and in 2 stages with hard palate closure at 4 years; and STEIN et al 27 found no difference between 1-stage repair at 2 years and 2-stage repair with hard palate closure at 7 years. HOLLAND et al 7 found that 1-stage palate repair at 12 months provided better maxillary growth than did 2-stage palate repair with hard palate closure delayed until 7 years.…”

Lateral Cephalometric Evaluation in Cleft Palate Patients

“…Gaggl et al (12) found more severe impairment of the growth of maxilla in sagittal and frontal plane after two stage operation of the cleft palate. Stein et al (13) advocated early one stage repair of the cleft palate as there was no significant difference in the sagittal and vertical craniofacial dimensions whether the palate was closed in one or two stages.…”

Studies on the Craniofacial Morphology of Adult Cleft Patients Using Euclidean Distance Matrix Analysis (EDMA)

“…The morphology at the end of the growth period is determined by both hereditary factors and iatrogenic influences resulting from surgical and orthodontic interventions [6]. Surgical cleft lip and palate rehabilitation is believed to have a decisive effect on craniofacial growth [10,16,17,32].…”

“…So findet man am Ende des Wachstums eine Morphologie, die von hereditären wie auch iatrogenen Einflüssen durch chirurgische und kieferorthopädische Interventionen [6] geprägt ist. Entscheidenden Einfluss auf das Wachstum des Gesichtsschädels wird dem Konzept der operativen Versorgung der LKGSpalte [10,16,17,32] zugeschrieben.…”