Orthodontic and bone grafting procedures in a cleft lip and palate series: an interim cephalometric evaluation.
An attempt is being made to observe the facial and dental development of a cleft lip and palate sample. The study is continuing and, hopefully, offers insight into what happens to these children who have undergone the placement of a dentofacial maxillary orthopedic appliance early at the time of lip closure and an additional surgical procedure and autogenous osteoplasty. Though the final answers to the two previously posed questions are not yet available, we are able to make some value judgments by observing the lateral cephalometric films of these children, and observing their occusion intraorally. Thus far, we are able to state that in our sample, using our treatment procedures in the sequence advocated, we have seen no growth attenuation in the posterior/anterior dimension. The maxilla, at least to the ages observed, does not appear to have been attenuated by our procedures. Further, it would seem that after a limited first phase of orthodontic treatment to align dental units, the degree of crossbite is considerably smaller from that reported in the literature by those using more conventional approaches; thus it is possible that we are doing some good. We are still using these procedures on our newborn and continue to feel that we have a real opportunity to be able to do more orthodontically for these children when they possess a full, permanent dentition and are ready for comprehensive treatment.