Fixed presurgical orthopaedics for bilateral cleft lip and palate.

Abstract

BACKGROUND: Presurgical orthopaedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. It is accepted that presurgical orthopaedic plates facilitate lip repair and balanced orofacial growth. Aims: The aims of this retrospective study of newborns with bilateral cleft lip and palate were two-fold: to describe the use of a fixed appliance to reposition the displaced fragments, and to determine if the magnitude of the palatal changes was age-related. METHODS: Study models of 12 infants with bilateral cleft lip and palate were used. The models recorded the condition prior to expansion (2-3 weeks after birth) and at the end of retention (at the time of lip surgery). The intercanine width, intertuberosity width, palatal length, palatal depth and intercanine arch length were measured. RESULTS: As a result of the expansion the intercanine width and intertuberosity width increased, and the palatal length and intercanine arch length decreased. These changes were not age-related. CONCLUSIONS: Fixed presurgical orthopaedic expansion appliances can be used to expand the upper facial skeleton in newborns.