Growth and changes in maxillary arch form in complete unilateral cleft lip and cleft palate children

This study aims at the comparison of growth changes of the maxillary arch of 62 normals and 87 complete unilateral cleft lip and cleft palate subjects. This is achieved by measuring their maxillo-facial models, which will aid in clarifying such questions as: when and where the maxillary growth inhibition will occur, and the several aspects of growth-change. Patients with complete unilateral cleft lip and cleft palate were classified into four stages: 1) six month old infants before lip and palatal closure; 2) two year old children, lip repair at six months of age; 3) three year old children, lip repair at six months and palatal closure at two years; 4) four year old children, with repairs as in stage 3. Normal subjects were also classified into four stages, to match the cleft group by age and body weight. Impressions were taken for each patient's upper jaw and upper face simultaneously under general anesthesia, and the maxillo-facial model was made. Results obtained were as follows: (1) In the normal group, the forward and downward growth of the anterior alveolar region increased considerably between stages 1 and 2 and stages 3 and 4. The growth of the anterior alveolar arch was slight during all four stages. The depth and width of the retromolar point increased gradually through all four stages, and measured the growth of the posterior alveolar region. (2) In the cleft group: at stage 1 the anterior end of the larger segment was protruded and both the larger and smaller segments, especially in the anterior region, were laterally dislocated. The height of the anterior alveolar region was found to be noticeably less than that of the normal group. At stage 2 the growth inhibition in depth and height was noted in all the alveolar points of the cleft group, especially in the anterior alveolar region, in comparison to the normal group. At stage 3 the depths in all alveolar points decreased, but no significant difference was found when compared to stage 2. However, the increase in heights was marked. At stage 4 the depths and heights of alveolar points in the cleft group were found to be smaller than those of the normal group.