Craniofacial Growth at Age 6–11 Years after One-Stage Cleft Lip and Palate Repair: A Retrospective Comparative Study with Historical Controls

Background: Primary alveolar bone grafting inhibits craniofacial growth. However, its effect on craniofacial growth in one-stage cleft lip and palate protocols is unknown. This study investigated whether primary alveolar bone grafting performed during one-stage unilateral cleft lip and palate repair...

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Main Authors: Benito K. Benitez, Seraina K. Weibel, Florian S. Halbeisen, Yoriko Lill, Prasad Nalabothu, Ana Tache, Andreas A. Mueller
Format: Article
Language:English
Published: MDPI AG 2022-08-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/9/8/1228
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author Benito K. Benitez
Seraina K. Weibel
Florian S. Halbeisen
Yoriko Lill
Prasad Nalabothu
Ana Tache
Andreas A. Mueller
author_facet Benito K. Benitez
Seraina K. Weibel
Florian S. Halbeisen
Yoriko Lill
Prasad Nalabothu
Ana Tache
Andreas A. Mueller
author_sort Benito K. Benitez
collection DOAJ
description Background: Primary alveolar bone grafting inhibits craniofacial growth. However, its effect on craniofacial growth in one-stage cleft lip and palate protocols is unknown. This study investigated whether primary alveolar bone grafting performed during one-stage unilateral cleft lip and palate repair negatively affects growth up to 6–11 years old. Methods: The craniofacial growth, dental arch relationship and palatal morphology at 6–11 years old in children with unilateral cleft lip and palate were compared retrospectively. Two cohorts after a one-stage protocol without (Group A) and with (Group B) primary bone grafting at the same center were compared. Further, cephalometric measurements for growth were compared with an external cohort of a one-stage protocol and a heathy control. Results: Group A comprised 16 patients assessed at 6.8 years (SD 0.83), and Group B comprised 15 patients assessed at 9 years (SD 2.0). Cephalometric measurements indicated similar sagittal maxillary growth deficits and a significant deviation in maxillary inclination in both groups compared to the healthy group. Moderate to severe changes in palatal morphology were observed in 70% of the members in both groups. Conclusion: Omitting primary alveolar bone grafting under the one-stage protocol with two-flap palatoplasty studied did not improve growth at 6–11 years. The results implicate two-flap palatoplasty with secondary healing as having greater adverse effects on growth than primary alveolar bone grafting. Dental and palatal morphology was considerably compromised regardless of primary alveolar bone grafting.
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spelling doaj.art-1ca35a877fc94e4e9b80b1170ee6ccc42023-11-30T21:08:54ZengMDPI AGChildren2227-90672022-08-0198122810.3390/children9081228Craniofacial Growth at Age 6–11 Years after One-Stage Cleft Lip and Palate Repair: A Retrospective Comparative Study with Historical ControlsBenito K. Benitez0Seraina K. Weibel1Florian S. Halbeisen2Yoriko Lill3Prasad Nalabothu4Ana Tache5Andreas A. Mueller6Oral and Craniomaxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, SwitzerlandOral and Craniomaxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, SwitzerlandSurgical Outcome Research Center Basel, University Hospital and University of Basel, Spitalstrasse 12, 4031 Basel, SwitzerlandOral and Craniomaxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, SwitzerlandOral and Craniomaxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, SwitzerlandOral and Craniomaxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, SwitzerlandOral and Craniomaxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, SwitzerlandBackground: Primary alveolar bone grafting inhibits craniofacial growth. However, its effect on craniofacial growth in one-stage cleft lip and palate protocols is unknown. This study investigated whether primary alveolar bone grafting performed during one-stage unilateral cleft lip and palate repair negatively affects growth up to 6–11 years old. Methods: The craniofacial growth, dental arch relationship and palatal morphology at 6–11 years old in children with unilateral cleft lip and palate were compared retrospectively. Two cohorts after a one-stage protocol without (Group A) and with (Group B) primary bone grafting at the same center were compared. Further, cephalometric measurements for growth were compared with an external cohort of a one-stage protocol and a heathy control. Results: Group A comprised 16 patients assessed at 6.8 years (SD 0.83), and Group B comprised 15 patients assessed at 9 years (SD 2.0). Cephalometric measurements indicated similar sagittal maxillary growth deficits and a significant deviation in maxillary inclination in both groups compared to the healthy group. Moderate to severe changes in palatal morphology were observed in 70% of the members in both groups. Conclusion: Omitting primary alveolar bone grafting under the one-stage protocol with two-flap palatoplasty studied did not improve growth at 6–11 years. The results implicate two-flap palatoplasty with secondary healing as having greater adverse effects on growth than primary alveolar bone grafting. Dental and palatal morphology was considerably compromised regardless of primary alveolar bone grafting.https://www.mdpi.com/2227-9067/9/8/1228cleft lipcleft palategrowth and developmenttreatment outcomecephalometry
spellingShingle Benito K. Benitez
Seraina K. Weibel
Florian S. Halbeisen
Yoriko Lill
Prasad Nalabothu
Ana Tache
Andreas A. Mueller
Craniofacial Growth at Age 6–11 Years after One-Stage Cleft Lip and Palate Repair: A Retrospective Comparative Study with Historical Controls
Children
cleft lip
cleft palate
growth and development
treatment outcome
cephalometry
title Craniofacial Growth at Age 6–11 Years after One-Stage Cleft Lip and Palate Repair: A Retrospective Comparative Study with Historical Controls
title_full Craniofacial Growth at Age 6–11 Years after One-Stage Cleft Lip and Palate Repair: A Retrospective Comparative Study with Historical Controls
title_fullStr Craniofacial Growth at Age 6–11 Years after One-Stage Cleft Lip and Palate Repair: A Retrospective Comparative Study with Historical Controls
title_full_unstemmed Craniofacial Growth at Age 6–11 Years after One-Stage Cleft Lip and Palate Repair: A Retrospective Comparative Study with Historical Controls
title_short Craniofacial Growth at Age 6–11 Years after One-Stage Cleft Lip and Palate Repair: A Retrospective Comparative Study with Historical Controls
title_sort craniofacial growth at age 6 11 years after one stage cleft lip and palate repair a retrospective comparative study with historical controls
topic cleft lip
cleft palate
growth and development
treatment outcome
cephalometry
url https://www.mdpi.com/2227-9067/9/8/1228
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