Infant orthopedics has no effect on maxillary arch dimensions in the deciduous dentition of children with complete unilateral cleft lip and palate (Dutchcleft)

Catharina A M Bongaarts, Martin A van 't Hof, Birte Prahl-Andersen, Iris V Dirks, Anne M Kuijpers-Jagtman
Cleft Palate-craniofacial Journal 2006, 43 (6): 665-72

OBJECTIVE: Evaluation of the effect of infant orthopedics on maxillary arch dimensions in the deciduous dentition in patients with unilateral cleft lip and palate.

DESIGN: Prospective two-arm randomized controlled clinical trial with three participating cleft palate centers.

SETTING: Cleft palate centers of the Radboud University Nijmegen Medical Center, Academic Center of Dentistry Amsterdam, and University Medical Center Rotterdam, the Netherlands.

PATIENTS: Children with complete unilateral cleft lip and palate (n = 54) were included.

INTERVENTIONS: Patients were randomly divided into two groups. Half of the patients (IO+) had a presurgical orthopedic plate until surgical closure of the soft palate at the age of 52 weeks; the other half (IO-) did not undergo presurgical orthopedics.

MEAN OUTCOME MEASURES: Maxillary arch dimensions were assessed on dental casts at 4 and 6 years of age with measurements for arch width, arch depth, arch length, arch form, and the vertical position of the lesser segment. Contact and collapse were assessed also.

RESULTS: There were no clinically significant differences found between IO+ and IO- for any of the variables.

CONCLUSIONS: Infant orthopedics had no observable effect on the maxillary arch dimensions or on the contact and collapse scores in the deciduous dentition at the ages of 4 and 6 years. Considering the Dutchcleft results to date, there is no need to perform infant orthopedics for unilateral cleft lip and palate patients.

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