3D morphometric evaluation of the dental arches in children with cleft lip and palate submitted to different surgical techniques

• Published in: Clinical oral investigations Vol. 26; no. 2; pp. 1975 - 1983
• Main Authors: Falzoni, Maiara Miyuki Matsui, Ambrosio, Eloá Cristina Passucci, Jorge, Paula Karine, Sforza, Chiarella, de Menezes, Márcio, de Carvalho Carrara, Cleide Felício, Valarelli, Fabricio Pinelli, Soares, Simone, Machado, Maria Aparecida Andrade Moreira, Oliveira, Thais Marchini
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2022; Springer Nature B.V
• Subjects: Age; Child; Children; Cleft Lip - surgery; Cleft lip/palate; Cleft Palate - surgery; Dental Arch - surgery; Dentistry; Digitization; Hospitals; Humans; Infant; Maxilla; Medicine; Mouth; Original Article; Orthodontics; Pediatrics; Plastic surgery; Public health; Rehabilitation; Surgery; Surgical techniques; Growth and development; Cleft palate; Cleft lip; Dental models
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-021-04177-z

Objectives
This study aimed to compare dimensional alterations of dental arches in children with unilateral complete cleft lip and palate before and after different techniques of primary plastic surgeries.
Materials and methods
The sample was divided into two groups: group 1—cheiloplasty by Millard’s technique and one-stage palatoplasty by von Langenbeck’s technique; group 2—cheiloplasty by Millard’s technique and two-stage palatoplasty: anterior palatoplasty by Hans Pichler’s technique and posterior palatoplasty by Sommerlad’s technique. Dental arches were evaluated before (T1), after the first phase (T2), and 1 year after the second phase (T3) of primary surgeries. Linear measurements and palatal area were assessed. To analyze the method’s error, interclass correlation coefficient was applied. ANOVA (followed by Tukey test), dependent, and independent t-test were used (
p
 < 0.05).
Results
At T1, the intertuberosity distance was statistically greater in G2 (
p
 = 0.004). At T2, the anterior length of the dental arch was statistically greater in G2 (
p
 = 0.025), while the area of the smaller palatal segment (
p
 = 0.001), cleft area (
p
 = 0.014), and total area (
p
 = 0.002) were statistically smaller in G2. At T3, the intertuberosity distance was statistically greater in G2 (
p
 = 0.017).
Conclusion
This study suggests that cheiloplasty and one-stage palatoplasty resulted in smaller growth of maxilla than cheiloplasty and two-stage palatoplasty in the linear measurements (T-T’ and I-CC’) and total area of the dental arches.
Clinical relevance.
Surgical protocols need to be evaluated to verify their effects aiming at improving the clinical practice of the interdisciplinary team, determining new parameters for the rehabilitation of individuals with cleft lip and palate.