Effects of soft tissue and osseous bridge on facial configuration in adults with unilateral cleft lip and palate.

Roentgencephalometric study was used for the assessment of 16 adult males with unilateral cleft lip and palate and an osseous bridge and of 10 males with a soft tissue bridge. They were compared with 32 individuals with a complete cleft and with a control group of 50 normal males. All patients were operated upon and subsequently treated with the same methods. In contrast to the soft bridge, an osseous bridge prevents the reduction of upper face height, and an increased width of the nasal cavity. Both an osseous and a soft tissue bridge exert a favorable effect on the shortening and retrusion of the maxilla and thus also on the maxillo-mandibular relations and on facial configuration. The thickness of the upper lip is related to the presence of a soft bridge, while deviations of the lower jaw and the posterior position of the maxilla are not related to the presence of either type of bridge. Alveolar retroinclination was insignificantly smaller in the presence of both types of bridges. These differences disclosed that clefts with soft bridges cannot be pooled with complete clefts (or with clefts with osseous bridges), when there is not definite evidence of the same proportion of both forms of clefts in the series used for comparison.