Sagittal growth of the facial skeleton of 6-year-old children with a complete unilateral cleft of lip, alveolus and palate treated with two different protocols

Wolfgang Zemann, Rudolf Mossböck, Hans Kärcher, Vesna Kozelj
Journal of Cranio-maxillo-facial Surgery 2007, 35 (8): 343-9

OBJECTIVE: The purpose of the study was to compare sagittal growth of the facial skeleton of 6-year-old children treated in two cleft centres with different surgical protocols.

MATERIAL AND METHODS: Each group consisted of 20 consecutive non-syndromic children with complete unilateral cleft lip, alveolus and palate. They all had presurgical orthopaedics with a passive plate and external strapping until lip repair. Centre 1 had lip repair at the age of 3 months and one stage palatal closure at the age of 1 year. Closure of the alveolar cleft was planned at 9 years with bone grafting. In centre 2 lip repair was performed at the age of 6 months, soft palate repair at 12 months and hard palate repair together with mucoperiosteal closure of the alveolar cleft at the age of 30 months. At the time of investigation, the children from both centres had not received any postoperative orthodontic treatment. Sagittal growth was evaluated on lateral cephalograms using the angles SNA, SNB, ANB and SNPg. For control, Droschl standards were used. The Mann-Whitney U test was used for statistical analysis.

RESULTS: There was no statistically significant difference in SNA, SNB, ANB and SNPg between the centres at the age of 6 years. There were no children with a class III jaw relationship. The sagittal dimensions were close to the values of non-cleft control persons (Droschl standards).

CONCLUSION: There was considerable similar sagittal growth of the facial skeleton in both centres which has not been affected by the different surgical protocols so far. A final evaluation should be delayed until the growth of the facial skeleton is complete.

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