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Occlusal relationship in patients with bilateral cleft lip and palate during the mixed dentition stage: does neonatal maxillary arch configuration predetermine outcome?
Cleft Palate Craniofac J. 2002 May; 39(3):317-21.CP

Abstract

OBJECTIVE

To determine whether there is any correlation between initial maxillary arch dysmorphology patterns in complete bilateral cleft lip/palate (BCLP) and the subsequent occlusal relationship in early mixed dentition.

DESIGN

This retrospective study evaluated 41 consecutive patients with complete BCLP who were managed by a single tertiary cleft team between 1983 and 1992. All patients had bilateral synchronous lip adhesions with placement of a passive alveolar molding appliance at 4 to 8 weeks of age; definitive modified Manchester lip repair at 6 to 8 months of age; and a one-stage "two-flap" palatoplasty at 14 months of age. Neither gingivoperiosteoplasty nor early alveolar bone grafting was performed. Four patients required early surgical premaxillary setback because of adverse social reactions to a very protrusive premaxilla. All patients (7 to 9 years) were assessed prior to initiation of first-phase orthodontics (maxillary expansion) in anticipation of alveolar bone grafting. Cleft team records were reviewed to determine initial maxillary arch dysmorphology, treatment, and occlusal relationships in early mixed dentition stage. The initial maxillary dysmorphology was classified using a new grouping based on orientation of the vomer, the intercanine distance, and its symmetry. Patterns of mixed dentition occlusion were then compared with group type, and predication tables were generated. Because midface retrusion is the major dentoskeletal morbidity in cleft patients, angle Class I and II occlusions were designated as "favorable" and Class III as "unfavorable."

RESULTS

In early mixed dentition, approximately three-fourths of patients with complete BCLP had favorable occlusion and one-fourth unfavorable occlusion. The occlusal status seemed unrelated to the initial maxillary arch dysmorphology, the use of early passive alveolar molding appliance, or surgical premaxillary setback.

CONCLUSION

Patterns of variation within the initial dysmorphology of the maxillary arch in infants with complete BCLP cannot be used to predetermine subsequent molar occlusal relationships in the mixed dentition.

Authors+Show Affiliations

, Cleft Palate and Craniofacial Deformities Institute, St. Louis Children's Hospital, St. Louis, Missouri 63110, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12019008

Citation

Perlyn, Chad A., et al. "Occlusal Relationship in Patients With Bilateral Cleft Lip and Palate During the Mixed Dentition Stage: Does Neonatal Maxillary Arch Configuration Predetermine Outcome?" The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, vol. 39, no. 3, 2002, pp. 317-21.
Perlyn CA, Brownstein JN, Huebener DV, et al. Occlusal relationship in patients with bilateral cleft lip and palate during the mixed dentition stage: does neonatal maxillary arch configuration predetermine outcome? Cleft Palate Craniofac J. 2002;39(3):317-21.
Perlyn, C. A., Brownstein, J. N., Huebener, D. V., Marsh, J. L., Nissen, R. J., & Pilgram, T. (2002). Occlusal relationship in patients with bilateral cleft lip and palate during the mixed dentition stage: does neonatal maxillary arch configuration predetermine outcome? The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, 39(3), 317-21.
Perlyn CA, et al. Occlusal Relationship in Patients With Bilateral Cleft Lip and Palate During the Mixed Dentition Stage: Does Neonatal Maxillary Arch Configuration Predetermine Outcome. Cleft Palate Craniofac J. 2002;39(3):317-21. PubMed PMID: 12019008.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Occlusal relationship in patients with bilateral cleft lip and palate during the mixed dentition stage: does neonatal maxillary arch configuration predetermine outcome? AU - Perlyn,Chad A, AU - Brownstein,Jeffrey N, AU - Huebener,Donald V, AU - Marsh,Jeffrey L, AU - Nissen,Richard J, AU - Pilgram,Thomas, PY - 2002/5/23/pubmed PY - 2002/8/10/medline PY - 2002/5/23/entrez SP - 317 EP - 21 JF - The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association JO - Cleft Palate Craniofac. J. VL - 39 IS - 3 N2 - OBJECTIVE: To determine whether there is any correlation between initial maxillary arch dysmorphology patterns in complete bilateral cleft lip/palate (BCLP) and the subsequent occlusal relationship in early mixed dentition. DESIGN: This retrospective study evaluated 41 consecutive patients with complete BCLP who were managed by a single tertiary cleft team between 1983 and 1992. All patients had bilateral synchronous lip adhesions with placement of a passive alveolar molding appliance at 4 to 8 weeks of age; definitive modified Manchester lip repair at 6 to 8 months of age; and a one-stage "two-flap" palatoplasty at 14 months of age. Neither gingivoperiosteoplasty nor early alveolar bone grafting was performed. Four patients required early surgical premaxillary setback because of adverse social reactions to a very protrusive premaxilla. All patients (7 to 9 years) were assessed prior to initiation of first-phase orthodontics (maxillary expansion) in anticipation of alveolar bone grafting. Cleft team records were reviewed to determine initial maxillary arch dysmorphology, treatment, and occlusal relationships in early mixed dentition stage. The initial maxillary dysmorphology was classified using a new grouping based on orientation of the vomer, the intercanine distance, and its symmetry. Patterns of mixed dentition occlusion were then compared with group type, and predication tables were generated. Because midface retrusion is the major dentoskeletal morbidity in cleft patients, angle Class I and II occlusions were designated as "favorable" and Class III as "unfavorable." RESULTS: In early mixed dentition, approximately three-fourths of patients with complete BCLP had favorable occlusion and one-fourth unfavorable occlusion. The occlusal status seemed unrelated to the initial maxillary arch dysmorphology, the use of early passive alveolar molding appliance, or surgical premaxillary setback. CONCLUSION: Patterns of variation within the initial dysmorphology of the maxillary arch in infants with complete BCLP cannot be used to predetermine subsequent molar occlusal relationships in the mixed dentition. SN - 1055-6656 UR - https://www.unboundmedicine.com/medline/citation/12019008/Occlusal_relationship_in_patients_with_bilateral_cleft_lip_and_palate_during_the_mixed_dentition_stage:_does_neonatal_maxillary_arch_configuration_predetermine_outcome L2 - http://journals.sagepub.com/doi/full/10.1597/1545-1569_2002_039_0317_oripwb_2.0.co_2?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -