The Dentomaxillofacial Morphology of Patients with Unilateral Cleft Lip and Palate for Which Surgical Orthodontic Treatment Was Selected

Purpose: As a characteristic of the maxillofacial morphology of patients with cleft lip and palate, anterior crossbite is often observed due to the lack of maxillary growth caused by postoperative scar tissues. This study investigated the maxillofacial morphologies of patients with skeletal mandibular prognathism accompanied by unilateral cleft lip and palate, where surgical orthodontic treatment was applicable. <br>Methods: Subjects included patients with unilateral cleft lip and palate treated at the Orthodontics Department of Tokyo Dental University Chiba Dental Medical Center. Twenty patients who underwent surgical orthodontic treatment were selected as the surgery group, and 27 patients who underwent orthodontic treatment alone as the orthodontic group. Cephalometric analysis was performed using lateral roentgenographic cephalograms. A comparison between the two groups at the first visit and the time of re-diagnosis was performed, and also changes between the first and re-diagnosis visits were compared. <br>Results: At the first visit, there was no significant difference in the maxillary anteroposterior relationship between the two groups. Compared to the orthodontic group, the surgery group had a shorter anterior cranial base, more anterior positioning of the mental region, and a higher gonial angle. At the time of re-diagnosis, the mandibular ramus and body of the mandible in the surgery group were significantly longer and larger. Significant differences were observed in the Wits appraisal, ANB angle, and angle of convexity items. The surgery group had a more significant anteroposterior positional discrepancy of the maxilla and mandible than the orthodontic group. Significant differences were observed in the amount of growth for the SNB angle and N-perpendicular to Pog, and the mandible was positioned more anteriorly. Incisor overjet showed a significant difference at the time of the first visit, the time of re-diagnosis, and between the first and re-diagnosis visits. <br>Conclusion: For patients with unilateral cleft lip and palate, the maxillofacial characteristics for which surgical orthodontic treatment was selected included subjects who were not affected by the anteroposterior position of the maxilla, had high gonial angles and short anterior cranial base. Surgery was indicated in patients where the mandible, which was in an anterior position at the initial examination, developed over time, causing an anteroposterior positional discrepancy between the maxilla, making the incisor overjet significantly negative. This study suggested the necessity of observing mandibular growth.