Assessment of the facial skeleton in patients with secondary cleft palate operated on in early childhood

The most common congenital craniofacial deformities, accounting for about 14–17% of all developmental anomalies, are clefts of the lip, alveolar process and palate. There are only few publications concerning the analysis of changes in the bones of the facial skeleton in patients with isolated cleft palate in the available literature.

Aim
To assess the facial skeleton and dental abnormalities in patients with secondary cleft palate.

Material and methods
The study material consisted of standard medical records of 64 patients with secondary cleft palate aged 7 to 14 years, surgically treated in early childhood. The control group consisted of 56 children without congenital anomalies in the facial skeleton and with normal skeletal relationships. Each group was divided into subgroups based on the dental age. Selected angular and linear parameters were included in the cephalometric analysis. Orthopantomographic images were used to evaluate dental abnormalities (hypodontia or hyperdontia) in the study and control groups.

Results
The cephalometric analysis results indicated that both subgroups of patients with clefts had statistically significant maxillary shortening and retraction, mandibular posterorotation, deterioration of vertical parameters, and inclination of the lower incisors compared to the control group. Moreover, orthopantomographic images demonstrated that hypodontia was more common in patients with secondary cleft palate than in thecontrol group and affected mainly the maxillary and mandibular premolars.

Conclusions
The results presented here suggest that secondary cleft palate has an adverse effect on the facial skeleton's growth and development.