Growth and development of the face in complete unilateral cleft lip and palate during prepubertal and pubertal...

Roentgencephalometry was used for the assessment of the growth and development of the face during prepubertal and pubertal periods in children with complete unilateral cleft lip and palate treated with the same methods. The first series included 16 boys and 15 girls, the second series consisted of 15 boys and 15 girls examined repeatedly at the beginning and at the end of the follow-up period. There were no definite differences in the growth rate of the face between the two periods of age. Therefore, the deterioration of overjet during puberty could be due to the depletion of the compensation and adaptation mechanisms after the previous orthodontic treatment rather than to the enhanced growth rate. As compared to other facial dimensions a lower growth rate showed during both periods the length of the anterior base, the depth of the maxilla and in particular the height of the upper lip. Developmental changes of variables of shape and position proceeded similarly during both periods of age. An exception represented the rotation of the mandible and the inclination of upper incisors. During the prepubertal period the lower jaw showed a very slight posterior rotation, while during puberty an anterior growth rotation was present. A rapid improvement of the proclination of upper incisors was attained only during the prepubertal period. It was accompanied by an improvement of overjet. However, during the period of puberty there was a renewed deterioration of overjet. A marked retrusion of the maxilla developed already in the prepubertal period. During both periods occurred an identical impairment of sagittal jaw relations and of the upper lip prominence, accompanied by a flattening of the facial profile and reduction of the nasolabial angle. The prominence of the nose increased, the angle of the cranial base remained unchanged. Intersexual differences were not demonstrated in any studied characteristics.