Risk of Malocclusion Among Patients Undergoing Single-Stage Versus Two-Stage Cleft Palate Repair

Area of Science:

• Craniofacial surgery
• Pediatric dentistry
• Orthodontics

Background:

• Cleft palate (CP) repair aims to optimize facial growth and dental arch development.
• Malocclusion, particularly Class III, is a common complication following CP repair.
• The impact of single-stage versus staged palate repair on malocclusion risk requires further investigation.

Purpose of the Study:

• To evaluate the impact of single-stage versus staged palate repair on the risk of developing malocclusion in patients with cleft palate.
• To identify factors associated with malocclusion development after palate repair.

Main Methods:

• Retrospective cohort study of 967 patients undergoing CP repair between 1999 and 2015 at a tertiary children's hospital.
• CP repair was categorized as single-stage or staged.
• Time to development of Class III malocclusion was the primary outcome measure, analyzed using Cox proportional hazards models.

Main Results:

• Malocclusion was diagnosed in 28.2% of patients.
• Staged palate repair showed no protective effect against developing malocclusion in both ≤5 years (HR 0.98) and >5 years (HR 0.86) age groups.
• Increased risk of malocclusion was associated with non-white ethnicity (HR 2.46) and higher Veau classification.

Conclusions:

• Staged cleft palate repair is not protective against the development of Class III malocclusion.
• Non-white ethnicity and higher Veau classification are risk factors for malocclusion.
• Age at hard palate closure in staged repair may influence malocclusion risk.