Occlusal Outcomes in Non-Robin Sequence Patients with Isolated Cleft Palate

Cleft Palate Craniofac J. 2024 Feb 22:10556656241236078. doi: 10.1177/10556656241236078. Online ahead of print.

Abstract

Objectives: 1. To assess the skeletal class occlusion and lateral cephalometry in children with isolated cleft palates (non-Robin sequence) and 2. to identify associations between these findings and pre-palatoplasty cleft palate measurements.

Study design: Retrospective cohort study.

Setting: North American Institutional Tertiary Paediatric Center.

Patients: Our cleft database was reviewed, and patients were included if they had an isolated cleft palate without a Robin Sequence diagnosis, had a Furlow palatoplasty and had available per operative cleft palate measurements and available lateral cephalogram between 6 and 8 years old. Thirty-two patients matched to inclusion criteria.

Intervention: Furlow's Palatoplasty.

Main outcome and measures: Cleft size at palatoplasty, cephalometric measurements and skeletal occlusal classes were analysed. ANOVA was used to test the association between cephalometric measurements and occlusal classes. Results are presented as means with a 95% confidence interval. The association between cleft measurements and cephalometric parameters was tested with Spearman Correlation (rs).

Results: The skeletal occlusal outcome at 7 years old for this series of patients was: Class I: 19%; Class II: 59% and Class III: 22%. No single cleft measurement at palatoplasty was predictive of the skeletal occlusal outcome. A larger hard palate cleft was associated with a shorter antero-posterior maxilla.

Conclusions: The skeletal occlusal class outcomes were similar to those found in a previous study in the literature. The occlusal prognosis appears to be better than in patients with Robin Sequence or with an associated cleft lip. No preoperative measurement was found to be associated with the occlusal outcome.

Keywords: cephalometry; cleft palate; malocclusion; pierre robin sequence; retrospective study.