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Association between cleft size and crossbite in children with cleft palate and unilateral cleft lip and palate
Erika Reiser1, Valdemar Skoog, Bengt Gerdin
1Department of Maxillofacial Surgery and Orthodontics, Uppsala University Hospital, Uppsala, Sweden. erika.reiser@surgsci.uu.se
Insights
Cleft size in infancy impacts crossbite development in children with unilateral cleft lip and palate (UCLP), but not those with cleft palate (CP). Larger clefts in UCLP patients correlated with less crossbite.
Area of Science:
- Craniofacial development
- Pediatric dentistry
- Oral and maxillofacial surgery
Background:
- Crossbite is a common complication in children with cleft palate (CP) and unilateral cleft lip and palate (UCLP).
- The relationship between initial cleft dimensions and the development of malocclusion requires further investigation.
Purpose of the Study:
- To examine the association between infant cleft size and the occurrence of crossbite at age five in children with CP and UCLP.
- To determine if cleft dimensions predict early crossbite development.
Main Methods:
- Retrospective analysis of dental models from 80 children (51 CP, 29 UCLP) born between 1990-1999.
- Measurements of maxillary arch dimensions and cleft size from infancy casts.
- Assessment of crossbite severity at five years of age using dental study models.
Main Results:
- Infant cleft dimensions exhibited significant variability.
- Unilateral cleft lip and palate (UCLP) patients presented with larger posterior cleft widths and more crossbite at age five compared to cleft palate (CP) patients.
- In the UCLP group, larger cleft widths were associated with reduced anterior and posterior crossbite; no such association was found in the CP group.
Conclusions:
- Cleft size in infancy is a significant factor influencing early crossbite outcomes in children with UCLP.
- The impact of infant cleft size on crossbite development appears to differ between CP and UCLP patient groups.
Objective:
To investigate the association between cleft size in infancy and crossbite at 5 years of age in children with cleft palate (CP) and unilateral cleft lip and palate (UCLP).
Design:
Retrospective study.
Setting:
University Hospital, Uppsala, Sweden.
Patients:
Dental study models of 80 consecutive children, 51 children with CP and 29 children with UCLP, born between 1990 and 1999 were analyzed.
Interventions:
Lip repair at 3 to 4 months in UCLP children. Primary soft palate repair at 6 to 10 months and secondary hard palate closure at 25 to 26 months of age.
Main Outcome Measures:
Maxillary arch dimensions and cleft size were measured on infancy dental casts. At follow-up at 5 years, crossbite scores were registered on dental study models.
Results:
The cleft dimensions in infancy showed large interindividual variation. Mean posterior cleft width was larger in UCLP children than in children with CP. The UCLP group also had significantly more crossbite at 5 years than the CP group. No significant association was noted between initial cleft size and crossbite scores at 5 years in the CP group. For the UCLP group, larger cleft widths at the level of the cuspid points were significantly associated with less anterior and posterior crossbite.
Conclusions:
The findings support the hypothesis that cleft size in infancy affects early outcome with respect to crossbite in children with UCLP, but not in children with CP.
