Morphological alveolar changes with pre-surgical orthopedic treatment of the unilateral cleft lip and palate

抄録

We report the morphological alveolar changes in 10 patients with unilateral cleft lip and palate after pre-surgical orthopedic treatment. Plaster casts of the maxilla made at the initial examination and just before cheiloplasty were measured and analyzed using a VIVID-910 three-dimensional laser scanner (Minolta Co., Tokyo, Japan). The pre-surgical orthopedic treatment was based on the method of Hirakawa et al. whereby a palatal plate is used prior to cheiloplasty. The palatal plates were placed for an average of 99 days.
Use of the palatal plate reduced the alveolar cleft in all 10 cases. The major segment and minor segment cleft side stumps were moved toward the alveolar cleft, reducing the distance between the stumps (B-B') significantly. In addition, because the distance between the medial surfaces of both segments (C-C'1) was significantly reduced, it appeared that bone apposition was occurring toward the cleft palate site in the anterior region of the alveolar arch. The fact that the distance between the bilateral maxillary tuberosities (T-T') and the distance between the regions corresponding to the deciduous molar eruption (D-D') increased significantly suggests that the palatal plate did not inhibit growth in the maxillary alveolus.
.The above suggests that pre-surgical orthopedic treatment using a palatal plate does not inhibit lateral growth in either segment. It also suggests that narrowing of the alveolar cleft width occurs by medially induced growth and that narrowing of the cleft alveolar site and cleft palate site are caused by medial bone apposition in the alveolar site.