Early maxillary arch changes in complete bilateral cleft lip and palate: a report of four cases.

OBJECTIVE To evaluate early maxillary arch changes in infants with complete bilateral cleft lip and palate (BCLP), using a simple measurement technique. MATERIAL AND METHOD A measurement model technique simplified from previously reported methods was used to analyze early maxillary changes of four non-syndromic complete BCLP. Study models of these cases were evaluated before presurgical orthopedic treatment and lip reconstruction (T1) and prior to palatal closure (T2). Comparisons of maxillary arch changes were performed. RESULTS At T1, protrusion with or without deviation of the primary palate and different amounts of cleft width were found. Anterior alveolar arch width was larger than the posterior At T2, the primary palate was retracted and initial lateral displacement was corrected. Cleft widths were narrowed at all levels with the narrowest part located anteriorly, corresponding with the increasing of primary palate arch width. Posterior alveolar arch width was wider than the anterior region. Although the posterior alveolar arch was lengthened, total alveolar arch length was decreased which could be attributable to a large retraction of the primary palate. CONCLUSION Early morphological and positional changes to the three segments of maxillary arch could be visualized and clarified with this technique, using study models and arch form superimposition methods.