The Effects of Presurgical Infant Orthopedic Treatment on the Maxillary Arch, Craniofacial Form, and Lip Morphology of Patients with Unilateral Cleft Lip and Palate, Aged up to 5 Years.

Presurgical infant orthopedics (PSIO) has been used worldwide to improve orofacial deformations due to cleft lip and palate before primary surgeries. However, their effectiveness remains controversial. This retrospective study examined the effect of PSIO treatment on the orofacial morphology of patients with non-syndromic unilateral cleft lip and palate (UCLP) up to 5 years of age. The study included 22 patients with UCLP who were treated and followed up from birth to 5 years of age. The patients were divided into two groups. The PSIO group consisted of 11 patients, while the control group consisted of 11 patients who were not treated with PSIO. Maxillary dental casts obtained from birth to 5 years of age were analyzed three-dimensionally. Furthermore, 5-Year-Olds' Index evaluation was performed, along with cephalometric and facial morphometric analyses. The analyses were performed on dental casts, lateral cephalograms, and frontal facial photographs at 5 years of age, respectively. The PSIO group showed significantly superior alveolar cleft width, anterior palatal depth, and posterior palatal depth, as well as less lateral deviation of the incisor point before cheiloplasty than the control group. However, no significant differences were observed between the two groups in terms of occlusion, craniofacial form, or lip morphology at 5 years of age. The present results suggest that PSIO treatment may improve deformations of the maxillary alveolus and palate before cheiloplasty, thereby simplifying surgery. In contrast, PSIO had no long-term effects on the orofacial morphology of patients with UCLP, aged up to 5 years.