Malocclusion due to early surgical management of newborn cleft lip and palate

Abstract

The early surgically repaired cleft L/P patients specially bilateral most of them will complain at future from malocclusion, velopharyngeal incompetence and speech problems due to displacement and deficiency of premaxilla and maxillary segments, while the early treatment by the use of orthodontic prosthesis and continuous separation of oral and nasal cavities to restore the anatomical and function is necessary for each cleft palate patients to create normal pattern of feeding, speech, hearing and facial growth. In this study, we focus on the problems resulting from early surgical treatment which lead to different premaxilla and maxillary segment movements which lead to different type of malocclusion and classified them according to these types of movements. 60 Iraqi patients were surgically repaired their cleft L/P during the first year of life was chosen randomly as a study group and a set of study casts were taken for each patient and classified them into four groups according to the development and direction of the segment. Group I: The collapse of maxillary segments bilaterally, medially with protrusion of premaxilla. Group II: The collapse only one lateral segment medially. Group III: Bilateral maxillary segments separated laterally with Regression of premaxilla backwards. Group IV: Normal lateral segments and very little protruded premaxilla. The percentage of each group was 32% G4, 30% G1, 25% G2 and the least was group3, ITS' percentage 13%. It was concluded from this study that the coop- erative intervention between the orthodontist and maxillofacial surgeon and the early treatment of Cleft L/P infant by orthodontic prosthesis is the most versatile treatment, and the severity of collapse during early surgical treatment depends on the size and site of the cleft L/P.