An electromyogram study on mandibular movement in unilateral cleft lip and palate patients before and after...

The purpose of this study is to investigate masticatory muscle function in subjects with unilateral cleft lip and palate compared with normal occlusion and the extents of improvement before and after orthodontic treatment. Subjects were twenty pretreatment patients, thirty posttreatment patients and ten controls. Electromyograms were recorded from their masticatory muscles during masticatory movement and tapping movement. Reduction of duration/stroke ratio (D/S) was observed in electromyograms obtained during masticatory movement after orthodontic treatment. The reduction was especially notable in the masseter muscle. In spite of a significant reduction in coefficient of variation (CV) values, a significant difference between the posttreatment group and the control group indicated some persisting irregularity in masticatory movement. Electromyograms taken during tapping movement showed no change in latency in the posttreatment group, but duration of the silent period (SP) was shortened and SP appearance increased. The findings outlined above reveal electromyographically clear improvements in masticatory muscle functions and jaw reflex mechanisms after orthodontic treatment. Nevertheless, parameters for subjects with cleft lip and palate still differed from those for controls with normal occlusion. The influence of plastic surgery in subjects with the defects discussed here causes maxillary retrusion, which in turn results in skeletal malocclusion. Orthodontic treatment should be designed to compensate this dentally and alveolarly. This design and the need to improve masticatory functions would contribute to eliminate the extreme difficulty of the therapeutic process.