Movement of maxillary segments after expansion and/or secondary bone grafting in cleft lip and palate: a roentgen stereophotogrammetric study with the aid of metallic implants.

The study was undertaken to examine the effects of expansion treatment and secondary bone grafting in cleft lip and palate. Movement of the lateral maxillary segments in four patients with complete bilateral cleft lip and palate (BCLP) was complicated and asymmetric, and a greater relative widening of the dental arch was observed. The least expansion was found in the oldest patient. Bone grafting did not bring about a stable relationship between the segments. The width of the dental arch was mostly maintained despite segmental movement. In one patient with unilateral cleft of the lip and primary palate (UCL) growth in the midpalatal suture followed the pattern observed in noncleft patients but was less extensive. Accurate and comprehensive recording of the relatively small maxillary movements requires that implant stability is checked and that a reference is established outside the maxilla.