Maxillary Development and Dental Arch Relationships Following Early Two-Stage Palatoplasty: A Comparative Study.

Objective: To examine skeletal morphology and dental arch relationships at 8 years of age following early 2-stage palatoplasty, which consists of soft palate plasty at 1 year of age and hard palate closure at 1.5 years of age, and to compare the results with those of conventional pushback palatoplasty.

Design: Retrospective.

Setting: Single institutional study.

Patients: Eighty-six patients with nonsyndromic complete unilateral cleft lip and palate (UCLP) were selected.

Intervention: The subjects were divided into 2 groups according to the palatoplasty protocols, as follows: 45 patients, who underwent early 2-stage palatoplasty (ETS group), and 41 patients, who underwent 1-stage pushback palatoplasty (PB group).

Main Outcome Measures: Skeletal morphology was assessed using lateral cephalometric analysis, and dental arch relationships were examined using the GOSLON yardstick.

Results: Cephalometric analysis revealed that the anterior-posterior length of the maxilla, measured by PTM-A and PTM-ANS, both projected to the nasal floor (NF) plane, was longer in the ETS group than in the PB group (PTM-A/NF,  = .04; PTM-ANS/NF,  = .03, unpaired -test), although no significant difference was observed in SNA ( = .09, unpaired -test). Upper posterior facial height was shorter in the ETS group than in the PB group ( = .02, unpaired ). Assessments with the GOSLON yardstick showed that the ETS group presented better dental arch relationships than the PB group ( = 0.04, Mann-Whitney's -test).

Conclusions: The present results suggested that the ETS protocol reduced the negative effects of palatal surgery on facial development and dental arch relationships in patients with complete UCLP at 8 years of age.