Comparison of Three Unilateral Cleft Lip and Palate Treatment Protocols in Infancy

Purpose: To evaluate the effects of the existing treatment protocols on the dental arches of children with unilateral cleft lip and palate treated with or without pre- and post-surgical orthopedics in the first year of life. Methods: Ninety-six dental models were divided into three groups: Group one-orthopedic intervention: Hotz plate; Group two-orthopedic intervention: nasoalveolar molding and Hotz plate; and Group three-without orthopedic intervention. The participants were evaluated before and after cheiloplasty (lip repair surgery), respectively, at time point one and time point two. The sample was analyzed using a 3D stereophotogrammetric imaging system. Linear measurements, segment and cleft areas, and angles were quantified. The Shapiro-Wilk test, Wilcoxon test, paired t-test, analysis of variance/Tukey's test, Kruskal-Wallis test, and Pearson's correlation were used (alpha equals five percent). Results: Intergroup analysis of the growth changes showed that children treated without pre- and post-surgical orthopedics (group three) had a smaller growth percentage of segment area (P=0.013), cleft area (P=0.012), and anterior angle of the greater palatal segment (P=0.002) than those treated with it. Group three had the worst asymmetry of the dental arches after lip repair surgery at time point two (P<0.001). Conclusions: Pre- and post-surgical orthopedics may help achieve a more optimal palatal shape. Participants treated with the Hotz plate alone and those treated with nasoalveolar molding and the Hotz plate had the greatest transverse reduction in the anterior part of the palate without experiencing a collapse of the palatal segments.