A comparison of craniofacial cephalometric morphology and the later need for orthognathic surgery in 6-year-old cleft children

ObjectivesTo compare 6-year-old children with unilateral cleft lip and palate (UCLP) and children with unilateral cleft lip and a separate cleft palate (CL + CP), cephalometrically and to evaluate the need for orthognathic surgery of these children in later life.Materials and methodsOne hundred and seven cleft children (67 UCLP, 40 CL + CP) were compared retrospectively using lateral cephalograms taken at a mean age of 6.2 years (range 5.7–7.3). The need for maxillary or bimaxillary osteotomies in these patients was evaluated from the hospital records at the mean age of 18.1 years (range 15.6–20.5).ResultsThe craniofacial morphology of children with UCLP and CL + CP was similar except for a more retrusive maxilla in children with UCLP. The frequency of orthognathic surgery was 40% (27/67) in the UCLP group and 18% (7/40) in the CL + CP group. The patients who needed orthognathic surgery (UCLP and CL + CP combined) had smaller mean values of ANB angle at the age of 6 years when compared to those who did not (1.8 versus 3.9°). None of the children whose ANB angle was greater than 4.5 needed orthognathic surgery whereas all the children whose ANB angle was less than −1 needed osteotomies.ConclusionSix-year-old children with UCLP have more retruded maxillae and require orthognathic surgery later in life more often than the children with CL + CP.