Effects of Two-Stage Palatoplasty Combined with Hotz's Plate on Maxillary Growth in Unilateral Cleft Lip and Palate

-Comparison of Permanent Dentition of Patients Treated by One-Stage Palatoplasty and Noncleft Normal Subjects-

Abstract

The purpose of this study was to investigate the effects of two-stage palatoplasty combined with Hotz's plate on maxillary growth in patients with complete unilateral cleft lip and palate. The subjects selected for this study were 32 Japanese males who were divided into three different groups: The two-stage group consisted of 12 UCLP patients whose cleft palates were closed with two-stage palatoplasty (soft palate closure at 1 year and 6 months, followed by hard palate closure at 5 years and 11 months on an average); the one-stage group consisted of 10 UCLP patients whose cleft palates were closed with one-stage palatoplasty at 1 year and 1 month of age; and control group consisted of 10 noncleft subjects who had Class I normal occlusion. Plaster dental casts of each group (mean age: 12.5,12.8, and 12.3 years for two-stage, one-stage, and control groups, respectively) were examined. Nine measurements of dental arch width and 7 measurements of dental arch length were obtained, and the data from the three groups were compared by Student's t-test. Upper dental arches were significantly larger in the two-stage and control groups than in the one-stage group, and there were no significant differences between the two-stage and control groups except in the inter-canine distance. Only 3 of 12 subjects in the two-stage group had crossbite, while in the one-stage group, all 10 subjects had severe crossbite. The results in this study showed that maxillary growth up to permanent dentition in UCLP patients with two-stage palatoplasty combined with Hotz's plate was better than that in UCLP patients with one-stage palatoplasty, and was similar to that of subjects with normal occlusion, indicating that this procedure for palatal closure could be advantageous for maxillary growth.