A Two-center Study on Facial Morphology in Patients With Complete Bilateral Cleft Lip, Alveolus, and Palate at the End of Growth: A Cross-sectional Cephalometric Study.

OBJECTIVE

To compare the dentofacial morphology of patients with complete bilateral cleft lip, alveolus, and palate (CBCLAP) treated at 2 European centers participating in the ERN CRANIO Network, employing different protocols for alveolar cleft closure. The Milano Cleft Center (Center M) utilizes early secondary gingivo-periosteo-plasty (esGPP) at the time of hard palate closure, while the Nijmegen Cleft Center (Center N) employs early secondary alveolar bone grafting with or without premaxillary osteotomy at 9 to 11 years of age.

MATERIALS AND

METHODS

This retrospective long-term outcome study included 95 patients (44 from Center M; 51 from Center N), treated consecutively from birth on in the same center, and evaluated at the end of growth (mean age 18 y). Lateral cephalograms were used to analyze skeletal and dentoalveolar variables. Measurements were conducted by an independent hospital to ensure objectivity. Statistical analyses included t tests and multiple linear regression to assess the effects of center, protocol, age, and sex.

RESULTS

The skeletal variable SN-ML (mandibular plane angle) indicated a more hyperdivergent pattern in Center N (mean 37.65 degrees, SD=6.62) compared with Center M (mean 34.55°, SD 7.52; P =0.037). Among dentoalveolar variables, only the upper incisor inclination (ILs-NL) was significantly larger in Center M (4.06 degrees, P =0.05). Regression analysis revealed minimal effects of center, protocol, age, or sex on skeletal and dentoalveolar variables.

CONCLUSION

Patients from both centers achieved acceptable maxillofacial outcomes independent of the type of alveolar cleft closure. Further research should consider patient-reported outcomes to align clinical evaluations with patient perceptions.