Background and objectives: In the treatment of cleft lip and palate, it is important to evaluate its treatment results after all the treatments have been completed. Above all, acquirement of good dental occlusion by natural teeth without maxillary osteotomy is of paramount importance. The objective of this study is to evaluate final treatment results of unilateral cleft lip and palate (CLP) treated by palatoplasty using mucosal grafts and flaps (MG method) with a focus on completion of occlusion by natural teeth alone.
Methods: The cases included in this study are the patients with complete unilateral cleft lip and palate who underwent palatoplasty by MG method between February, 1984 and February, 1990 and visited our hospital periodically till at least 16 years old (male; 18 cases, female 12 cases). Six cases are excluded from this study because of the lack of periodical follow-up. From clinical record, photos, dental cast and panoramic and cephalometric radiograms, we investigate the accomplishment rate of completing dental occlusion by natural teeth alone in addition to speech results and maxillary growth by cephalometric analysis.
Results: All the patients (24/24) acquired good dental occlusion by their natural teeth alone with good speech and without marked maxillary growth impairment. There was one case, in which maxillary osteotomy was required, but there is no case where the speech aid appliance or secondary operation such as re-pushback palatoplasty, pharyngoplasty or pharyngeal flap were required.
Conclusions: The highest standard of CLP treatment is whether dental occlusion is completed with natural teeth alone without orthognathic surgery. We conclude our MG method almost lives up to the standard.
Key words: cleft lip and palate; palatoplasty; dental occlusion; natural teeth