The influence of the initial width of the cleft in patients with unilateral cleft lip and palate related to final treatment outcome in the maxilla at 17 years of age

The aim of this study was to assess whether the initial cleft width in patients born with complete unilateral cleft lip and palate (UCLP), is correlated to final treatment outcome regarding maxillary growth. This report is a retrospective longitudinal cohort study of 45 consecutive non-syndromic individuals with UCLP, 19 from the Stockholm Cleft Team, and 26 from the Oslo Cleft Team. The treatment protocols in the two teams differed. The initial transversal width in infants was measured at three levels on study casts. The width was correlated to variables obtained from lateral cephalograms at 17 years of age, from rating of dental arch relationship and to treatment variables obtained from the medical records: existence of Simonart's band, missing maxillary teeth, duration of orthopaedic/orthodontic treatment, and the need for orthognathic surgery. The initial width of the middle part of the cleft and final maxillary inclination (NSL/NL) showed a weak correlation (P < 0.05); the wider the cleft, the less the inclination. No further correlations were found between the initial width and final outcome measurements studied. In the Oslo group where Simonart's band was present, the anterior and middle widths of the cleft were significantly smaller (P < 0.001). Additionally, the existence of Simonart's band had a significant effect on final maxillary inclination (P < 0.05), i.e. the maxillary inclination increased. Treatment outcome seems mainly to depend on the treatment protocol performed rather than the severity of the cleft. The width of the middle part of cleft may be associated with the final maxillary inclination.