Morphological evoliution of development of maxillary in children with unilateral and bilateral cleft lip and palat

Abstract

Summary Introduction. Cleft lip and palate are the most common congenital malformations in children. Although surgical methodologies have evolved over the years, morphofunctional deficiencies in child development remain to be adressed. Objective The impact of Congenital Cleft and Palate (CL/P) Malformations on the Development of the Dentoalveolar And Dentomaxillary System. Materials and Methods. A total of 15 children with congenital malformations in the oromaxillofacial region including unilateral and bilateral cleft lip and palate, were analyzed. All patients underwent staged surgical treatment, initiated at the ages of 3, 5 and 6 months and completed by 32 months. The surgical protocol included primary repair of the upper lip and soft palate at 12 months, followed by primary repair of the hard palate at 24 months. Additionally, all children received speech therapy and orthopedic treatment. A morphometric study was conducted on models of patiens with complete unilateral and bilateral clefts in three planes and compared to models of healhy children. Differences in maxillary growth were analyzed by examining occlusal contacts, canine-level distances, molar level distances, and transverse measurements from the canine to the proximal surface on the molar teeth. Results. In children with unilateral clefts, occlusal contacts were 75% efficient compared to 95% in healthy children.The maxillary growth difference was reduced by 1-2cm compared to healthy individuals. In casses of bilateral clefts, occlusal contact efficiency was 65% versus 95% children in healthy children, while growth restrictions resulted in a maxillary reduction of 2-3cm. Conclusion In conclusion, maxillary development is reduced in children with unilateral clefts compared to healthy individuals, while those with bilateral clefts, exhibit a severe growth restriction, both in comparison to healthy children and those with unilateral clefts. These findings highlight the necessityof an interdisciplinary management approach.