Initial growth pattern of children with cleft before alveolar bone graft stage according to cleft type Unilateral cleft lip and alveolus, unilateral cleft lip and palate, and cleft palate

Abstract

Objective: To test the null hypothesis that there is no significant difference in the initial growth pattern among three cleft types before alveolar bone graft (ABG) according to cleft type (unilateral cleft lip and alveolus [UCLA], unilateral cleft lip and palate [UCLP], and cleft palate [CP]). Materials and Methods: Samples consisted of the UCLA group, the UCLP group, and the CP group. Individuals were treated with the identical surgical technique by the same surgeon and had no history of orthodontic/orthopedic treatment. Lateral cephalograms taken 1 month before ABG were analyzed using 29 variables. One-way analysis of variance (ANOVA) testing and bivariate and logistic regression analyses were performed. Results: An increasing tendency for Class III relationships in the order of UCLA, UCLP, and CP was noted (ANB, AB-to-facial plane angle, AB-to-mandibular plane angle; P < .001, respectively). UCLP and CP groups demonstrated more posterior positioning of the maxilla (SNA, A-to-N-perp; P < .001, respectively) and a hyperdivergent pattern (gonial angle, SN-GoMe angle, FMA; P < .001, respectively) compared with the UCLA group. Because no differences in palatal plane angle and SN-to-occlusal plane angle were noted among the three groups, the hyperdivergent pattern in the UCLP and CP groups might be due to an innate growth pattern and eventual adaptation of the mandible to maxillary growth. UCLP and CP groups showed more Class III relationships (ANB: P < .05, P < .001, respectively) and a more hyperdivergent pattern (FMA: P < .05, P < .01, respectively) than the UCLA group. Conclusion: When the degree of cleft involvement increases from the primary palate to the secondary palate, the predominance of the Class III relationship and the hyperdivergent pattern increases also. (c) 2011 by The EH Angle Education and Research Foundation, Inc.