Clinical and Basic Study on Palatal Growth in Cleft Lip and Palate

Abstract

In pediatric dentistry, it is important to investigate and utilize the infants' latent abilities for craniofacial growth and development. Cleft lip with cleft palate is one of the serious types of congenital anomaly with the highest frequencies in the craniofacial region, and need a long period of dental management during growth and development. However, how secondary palate formation is affected in cleft lip remains poorly understood. To examine the effects of presurgical nasoalveolar molding (PNAM) on palatal growth with cleft lip under some conditional differences, four patients with unilateral cleft lip and palate were selected. PNAM treatment resulted in a positive effect depending on the length of the treatment. The study suggests that an earlier start of PNAM treatment in the neonatal period could possibly provide more effective results for the growth promotion of craniofacial growth including palatal growth with cleft lip. In model mice with cleft lip and palate (CL/Fr strain), cleft palate follows reduced cell proliferation of secondary palatal mesenchyme, however, the palates successfully fused in palatal organ culture. These palatal latent abilities indicated by our research might be useful not only for clarifying the mechanism of craniofacial growth and development but also for counseling and informed consent about early treatment for infants with cleft lip and palate.