Oral Health Assessment in Cleft Lip & Palate Patients During Orthodontic Treatment for Maxillary Protraction: A Periodontal & Microbiological Study

Objective To assess the oral health status and microbiota of subgingival plaque in patients with surgically repaired cleft lip and palate (CLP) during orthodontic treatment for maxillary protraction with two different orthodontic appliances. Design Randomized controlled trial Setting Institutional. Participants A total of 90 patients with surgically repaired Unilateral Cleft Lip and Palate, out of initially enrolled 120 patients, were divided into 3 groups: experimental group I, experimental group II and control group, with 30 subjects each. Patients with a history of oral prophylaxis in last 6 months or antibiotic therapy within 3 months were excluded from the study. Interventions Bone Anchored Maxillary Protraction was done in experimental group I, while facemask with acrylic occlusal splint was used for maxillary protraction in experimental group II and no orthodontic intervention in control group. Mean Outcome Measures Plaque Index (PI), Gingival Index (GI), Gingival Bleeding Index (GBI), Probing Depth (PD), and microbiota of subgingival plaque (P. gingivalis, P. intermedia, Veillonella and Capnocytophaga) were compared at baseline (T-0) and after 8 months (T-1). Results The PI, GI, GBI and PD were observed to be significantly higher in experimental group II followed by experimental group I as compared to control group at 8 months interval (P < .001). The microbiota counts increased significantly in experimental group II and experimental group I (P < .001), as compared to control group. Conclusion Maxillary protraction with facemask and bone plates was found to be a better alternative than facemask with occlusal splint, considering the overall oral health of patients with CLP.