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. 2022 Jul 29:30:e20220120.
doi: 10.1590/1678-7757-2022-0120. eCollection 2022.

Six-year post-surgical evaluation in the treatment protocols in the dental arches of children with oral cleft: longitudinal study

Affiliations

Six-year post-surgical evaluation in the treatment protocols in the dental arches of children with oral cleft: longitudinal study

Eloá Cristina Passucci Ambrosio et al. J Appl Oral Sci. .

Abstract

Objective: Oral cleft surgical repairs are performed using different techniques worldwide. To evaluate and compare the development of the dental arches of children with unilateral cleft lip and palate before and after the primary surgeries performed with different techniques at the first months and six years of life.

Methodology: This is a retrospective longitudinal study. The sample comprised 56 dental casts divided int the following groups: Group 1 (G1) - cheiloplasty (Millard technique) at three months and one-step palatoplasty (von Langenbeck technique) at 12 months; and Group 2 (G2) - cheiloplasty (Millard technique) and two-step palatoplasty: anterior hard palate closure (Hans Pichler technique) at three months and posterior soft palate closure (Sommerlad technique) at 12 months. The digitized dental casts were evaluated at three months - pre-surgical (T1) and six years of life- post-surgical (T2). The following linear measurements were analyzed: intercanine (C-C'), intertuberosity (T-T') distances; anterior dental arch (I-CC'), anterior intersegment (I-C'), and total arch (I-TT') lengths. The palate area was also measured. Parametric and non-parametric tests were applied (p<0.05).

Results: In G1, the intragroup comparison showed statistically significant smaller I-CC' and I-C' at T2 (p=0.001 and p<0.001, respectively), while T-T', I-TT', and area comparisons were significantly greater (p<0.001, p=0.002, and p<0.001, respectively). In G2, the intragroup comparison exhibited statistically significant smaller C-C' and I-C' at T2 (p=0.004, for both), whereas T-T', I-TT' and area comparisons were significantly greater (p<0.001, p=0.004, and p<0.001, respectively). At T2, the intergroup analysis revealed that G1 had a statistically significant smaller I-CC' (p=0.014). The analysis of the intergroup differences (∆=T2-T1) showed that G1 had a statistically smaller I-CC' (p=0.043).

Conclusion: The two-step palatoplasty showed a more favorable prognosis for the maxillary growth than one-step palatoplasty in children with oral clefts.

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Conflict of interest statement

Conflict of interest

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1. Study flowchart
Figure 2
Figure 2. Dental arch of T1. A) Anatomical points and linear measurements. B) Contour of the greater and smaller segments to calculate the area
Figure 3
Figure 3. Dental arch of T2. A) Anatomical points and linear measurements. B) Contour of the palate to calculate the area

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