Three-dimensional analysis of the deciduous dentition of patients with bilateral cleft lip and palate and delayed cleft closure.

Objective: The objective of this study was to describe the three-dimensional morphology of the maxilla of patients with bilateral cleft lip and palate treated by a delayed cleft closure in the deciduous dentition. They were compared to a eugnathic control group.

Patients And Methods: Thirty-two study casts of complete bilateral cleft lip and palate from the archive of the former Wolfgang-Rosenthal Clinic Thallwitz were scanned in three-dimensions and compared to an equally large eugnathic control group. The mean age of the study group was 4.92 years, and that of the control group 5.02 years. Dimensions were recorded using a reflex microscope according to specific landmarks.

Results: The study group exhibited transversal anterior compression and posterior over-development of the dental arch. We observed conspicuously more frequent, marked inward rotation of the left lateral segment together with broadly-scattered data. We were unable to establish a correlation between the anterior and posterior dental arch widths. In the sagittal dimension, the mean position of the premaxilla was in no way different than that of the control group. Vertically we noted a difference in the level between the premaxilla and lateral segments. The premaxilla was situated significantly more caudally than the lateral segments.

Conclusions: Even when cleft palate closure is delayed, the result is maxillary constriction and vertical deviation of the cleft segments. The large individual scatter of deviations demands a greatly individualized, differentiated concept for later maxillary development.