Transverse development of premaxilla depending on the cleft type - a clinical study over 16 years in 217 patients

Functional and aesthetic problems in children with cleft lip (CL), cleft lip/alveolus (CLA) and cleft lip/alveolus/palate (CLP) arise due to the affected transversal maxillary growth. This cross-sectional, retrospective, anonymized, descriptive study aims to demonstrate the influence of the cleft form on maxillary transverse development. Metric standardized parameters were collected annually for 234 patients over an observation period of 14 years. The transverse growth of the primary (premaxilla) was analyzed as a function of the cleft form (IBM SPSS Statistics Version 26). Patients with isolated CL served as controls. Despite different stages of development, there was no difference in the transverse development of the premaxilla in unilateral CL- and CLA-patients at the age of 16, while CLP-patients ultimately have a significantly smaller transversal premaxilla width. Bilateral cleft patients showed the same significantly reduced transversal development of the premaxilla, when the hard palate (CLP) was involved. The bilateral cleft forms showed significantly less width development overall. Due to the determined transversal growth inhibition in cleft patients with involvement of the hard palate and bilateral manifestation, continuous conservative growth-adapted treatment is necessary to maintain the compromised transversal growth of the maxilla.