Complete cleft lip and palate without bone grafting and its effect on craniofacial morphology in three planes

The aim of the study was to analyze the morphology of the viscerocranium in patients with unilatertal or bilateral cleft lip and palate (CLP) who had undergone no surgical intervention of the alveolous meaning that no bone grafting was conducted. In this cross-sectional study 47 patients with complete unilateral (UCLP) or bilateral clefts (BCLP) were examined, and compared to a group of 42 patients without facial clefts. Each group was subdivided into two age groups (ca. 8 and ca. 15 years) approximately before and after the pubertal growth maximum. All patients with CLP received a complete palate closure by means of velopharyngoplasty at age of three, without any alveolar ridge osteoplasty. The craniofacial morphology of all patients was analysed in three planes (sagittal, coronal, horizontal) with help of model analysis and cephalometric analysis. The craniofacial morphology of all groups of CLP patients differed from that of the control groups. On average, more markedly impaired growth was observed in the older age group. Moderate retrognathic maxilla and slight mandible, a coronal skeletal excess, and a remarkable retrusion of the upper and lower anterior teeth were characteristic. Horizontal restriction of width could only be identified in the region of maxillary canines. CLP patients who had no bone grafting showed that the craniofacial developmental impairment was reasonably slight compared to patients without CLP, although it became more pronounced in the older age groups.