Changes in occlusion and maxillary dental arch dimensions in adults with treated unilateral complete cleft lip and palate: a follow-up study.

The purpose of this study was to evaluate the occlusion and maxillary dental arch dimensions in adults with repaired complete unilateral cleft lip and palate (UCLP) and to investigate the patterns of change in early adulthood. Study models from 39 patients (25 men, 14 women; mean age 24.7 years, range 20.2-29.3 years) with a diagnosis of complete UCLP taken at a follow-up examination were analysed and compared with the study models taken at baseline examination (mean age 19.1 years, range 16.0-20.6 years). Lip closure was carried out according to the Millard technique and palatal closure according to the Wardill-Kilner technique. All patients had received orthodontic treatment with fixed appliances. The patients were divided into three groups according to the type of retention in the upper arch: no retention (n = 15), retention with a bonded twisted retainer (n = 13), an onlay or fixed bridge (n = 11). Occlusion was evaluated according to a scoring system. The maxillary dental arch dimensions were measured with a video imaging system. There was a significant deterioration in the total occlusal score during the follow-up period and this was larger on the cleft than on the non-cleft side. There were no significant differences in the anterior scores. A comparison of the transversal and sagittal maxillary arch dimensions revealed significant differences in all measurements during the follow-up interval. The reduction was largest for the maxillary second premolar width, followed by the first molar width. The overjet differed significantly between the registrations. The occlusal score and the maxillary arch dimensions were reduced in all of the three subgroups, but there were no differences between the groups.