Effect of Presurgical Orthopedics and Lip Adhesion on Maxillary Alveolar Arch in Complete Unilateral Cleft of Primary and Secondary Palate

ABSTRACT

The ultimate goal of the treatment of cleft lip and palate is the obliteration of the entire cleft early without disturbing facial bone growth. Presurgical orthopedics attempts to correct the characteristic skeletal deformities that occur in cleft lip and palate, and lip adhesion reduces the tension of the definite lip repair and allows gentle molding until the solidification of the arch occurs. Additionally lip adhesion gives a psychologic benefit to the patient's parents because of the improvement in appearance. The authors performed presurgical orthopedics and lip adhesion for 26 cases of complete unilateral cleft of primary and secondary palate between 1997 and 2001. Postoperatively, the patients are evaluated by the analysis using preoperative and postoperative dental casts. Dental cast analyses evaluate width, length, height of maxillary alveolar cleft, alveolar gap, palatal gap, and angle of arch. Results include improvement of alignment of maxillary alveolar arch and reducement of cleft gap. Also, this study of serial dental cast is the objective method to explain the corrective effect on maxillary alveolar arch in cleft lip and palate. In conclusion, presurgical orthodontics and lip adhesion achieve the main goal of moving the palate into a normal position and stabilizing the arch with a bony bridge that attracts teeth. It avoids the difficult anterior fistulae and presents a more symmetrical platform upon which the lip can be united and the nose can be corrected early. Additionally, there is a psychologic benefit to the patient's parents because of the improvement in appearance