Abstract

NAVAS-APARICIO, M.C.. Maxillary growth according to the severity of unilateral cleft lip and palate. Cir. plást. iberolatinoam. [online]. 2012, vol.38, n.4, pp.349-357. ISSN 1989-2055.  https://dx.doi.org/10.4321/S0376-78922012000400006.

The inhibition of the growth and development resulting of a surgical treatment in patients with cleft lip and palate is a widely discussed topic in the world. According to literature, tissue deficiency, probably due to the cleft width and position of the alveolar segments, is a considerable variable that affects the growth of the maxilla, which is also influenced by the surgical correction of the lip, the nose and the palate by scarring, types of surgical treatment, time of the surgery, surgeon skills and pre-surgical orthopedics. The purpose of this study was to determine the possible associations between the severity of cleft and maxillary growth in patients with non-syndromic unilateral cleft lip and palate, who were born in 2001 and treated at the Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social, San José, Costa Rica. The study was retrospective and descriptive, based on data obtained from medical records, initial maxillary study casts of the newborn child, cephalometric radiograph and the present study casts of the child at the age of 5 years. The study sample comprised of 13 patients. The maxillary transverse arch of 12 cases was asymmetric, indicating an alteration of growth in this direction. There is a statistically significant positive correlation between the length of the arch and the SNA angle, indicating that a bigger length of the arch is related to a bigger SNA angle. The ANB mean value has a important deviation bigger than 2. There is no relationship between the position and length of the maxillary arch (SNA, BaNA and ANS-PNS) and the severity of the cleft. This means that the scar tissue, types of surgical treatment, time of the surgery, surgeon skills and pre-surgical orthopedics do not influence the anterior maxillary growth direction. In conclusion, the maxillary transverse asymmetry of the arch was the most important finding in this study. A new research study must be made in regards to the maxillary transversal dimension in children with cleft lip and palate, since this condition was affected. The anterior maxillary position and maxillary length were not influenced by the severity of clefting. It is important to consider, that the maxillary growth can be affected by individual factors, such as genetic facial pattern. A new evaluation should be delayed until the growth of the facial skeleton is complete.

Keywords : Cleft lip and palate; Maxillary growth.

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