"The influence of four different treatment protocols on maxillofacial growth in patients with unilateral complete cleft lip, palate, and alveolus".

BACKGROUND: To evaluate the effect of four different treatment protocols on maxillofacial growth in patients aged 7-8 years with UCCLPA.

METHODS: 61 patients with non-syndromic unilateral complete cleft lip, palate and alveolus were selected into this study. Patients with UCCLPA who had a repaired lip and unrepaired palate were placed in group 1. Patients with UCCLPA who received one-stage palatoplasty were placed in group 2. Patients with UCCLPA who received two-stage palatoplasty were placed in group 3. Patients with UCCLPA who received lip adhesion and two-stage palatoplasty were placed in group 4. The control group was composed of 16 patients with unilateral incomplete cleft lip. Kolmogorov-Smirnov test was used to test the nature of data distribution. Bonferroni test and Kruskal-Wallis H test were used for multiple comparisons.

RESULTS: Group 5 showed more protruding maxilla (Ba-N-A, Ba-N-ANS, S-N-ANS, p<0.05), longer maxillary sagittal length (ANS-PMP, p<0.05), maxillary basal sagittal length (A-PMP, p<0.05), and a better jaw relationship (ANB, p<0.05) than groups 2, 3, and 4. Group 2 had higher anterior facial height (ANS-N, ANS-Me, N-Me, p<0.05) and posterior facial height (R-PMP, p<0.05) than groups 3 and 4. Groups 2 and 3 had better maxillary position (S-Ptm, p<0.05) and deeper bony pharynx (Ba-PMP, p<0.05) than group 4.

CONCLUSIONS: In patients aged 7-8 years with UCCLPA, both one- and two-stage palatoplasty inhibited maxillary sagittal growth. Vomer flap repair with denuded bone inhibited maxillary vertical growth. Lip adhesion did adversely affect maxilla position.