Maxillo-mandibular relationship in untreated and surgically treated patients with unilateral complete cleft lip and palate: A cephalometric evaluation

Background

Cleft lip and palate is the most frequently encountered birth defect resulting from an incomplete union of the lateral nasal process and maxillary process during development. A cephalometric assessment was carried out to compare the maxillo-mandibular relationship in untreated and surgically treated patients with unilateral complete cleft lip and palate (UCCLP).

Methods

This retrospective study included lateral and frontal cephalograms of 100 non-syndromic UCCLP patients of Indian origin within an age range of 12–20 years, divided in to two groups. Group I consisted of 50 untreated UCCLP patients. Group II consisted of 50 UCCLP patients who had undergone surgical intervention for cleft lip and palate repair before puberty.

Results

Maxilla in surgically treated patients was found to be significantly shorter in the anteroposterior and vertical direction along with retroposition and clockwise rotation with respect to the cranial base. The mandible was found shorter in length and posteriorly positioned with respect to the cranial base along with downward and backward rotation in group II patients. Class III skeletal pattern was observed in group II patients but was not as severe as anticipated though the maxilla is short and retropositioned because of some compensation being done by the shorter mandibular length and clockwise rotation of the mandible. Measurements on frontal cephalogram showed decreased maxillary width, nasal height and nasal width in surgically treated cases.

Conclusions

The findings of this study suggested that surgical intervention at early age has significant restraining effect on maxillary growth that results in class III skeletal relationship/tendency. Level of Evidence: Level IV, therapeutic study.