Spontaneous Growth of the Palatal Plates in the Cleft Lip and Palate

Area of Science:

• Craniofacial Surgery
• Pediatric Dentistry
• Orthodontics

Background:

• Unilateral cleft lip and palate (UCLP) presents significant challenges in infant oral and facial development.
• Presurgical orthopedics are often used to manage cleft width, but their necessity is debated.
• Understanding spontaneous changes in the palate is crucial for optimizing treatment strategies.

Purpose of the Study:

• To prospectively evaluate spontaneous changes in the palatal cleft dimensions in infants with UCLP.
• To assess the impact of cheiloplasty on palatal arch dimensions without presurgical orthopedics.
• To provide data for refining surgical timing and techniques in UCLP management.

Main Methods:

• Prospective study of 12 infants with UCLP, aged less than one month.
• Plaster models of the upper arch were taken at three time points: before cheiloplasty, before palatoplasty, and at one month of life.
• 3D analysis of anthropometric measurements, with statistical analysis using two-way ANOVA and Tukey test.

Main Results:

• A statistically significant reduction in the cleft gap was observed from the first month to before palatoplasty (T1 to T3).
• Intercanine width significantly decreased between T2 and T3, and T1 and T3.
• Posterior arch width significantly increased between T2 and T3, and T1 and T3, with palatal plate width increasing throughout.

Conclusions:

• The palatal cleft demonstrates spontaneous narrowing in both midpoint and posterior regions within the first six months.
• Cheiloplasty appears to enhance palatal cleft reduction, potentially exerting a greater influence on anterior arch width.
• These findings suggest that spontaneous changes and cheiloplasty play significant roles in palatal development prior to definitive repair.