Assessment of craniofacial maturation in preadolescents with cleft lip and/or palate using the cervical vertebral maturation method.

OBJECTIVES

Aberrant growth of the maxillomandibular complex in patients with cleft lip and/or palate (CL/P) can be managed with dentofacial orthopaedics. However, no consensus has been reached regarding timing and evolution of the maturational stages. Therefore, the aim of this study is to determine if patients with CL/P have an increased risk for delayed craniofacial maturation.

MATERIALS AND METHODS

A sample of 246 cleft patients and 210 non-affected individuals was retrospectively compiled. Cephalometric radiographs taken between the ages of 10 and 14 years (girls) and 12 and 16 years (boys) were collected and assessed with the cervical vertebral maturation (CVM) method.

RESULTS

In boys, no significant association between the presence of CL/P and a CVM score of CS3 or higher was observed in any age subsample. This was similar for a CVM score of CS5 or higher. Girls in the CL/P group had a significant lower probability of having a CVM score of at least CS3 in the subsample with age 11 to 12 (p = 0.001) and a borderline non-significant lower probability of having a CVM score of at least CS5 in the subsample with age 12 to 13 (p = 0.055).

CONCLUSIONS

The current study demonstrated a discrete delay in skeletal maturation before the pubertal growth spurt of (pre)adolescents with CL/P, especially girls. This delay was less apparent at the end of the pubertal growth spurt.

CLINICAL RELEVANCE

This research suggests that the craniofacial maturational stages relevant for dentofacial orthopaedic treatment in cleft patients, especially girls, occur at higher chronological age. Further research must quantify this delay, investigate its clinical significance, and determine its effect on the timing of dentofacial orthopaedic treatment.