Facial Growth and Dentition in the Unoperated Cleft Palate

¹ Medical College of South Carolina, Charleston, South Carolina

Ninety-nine cases of cleft palate were studied with conventional and soft-tissue cephalometric roentgenograms. The Type III cases (clefts of the entire palate, alveolar ridge, and lip) were studied in detail and statistically evaluated. No gross differences were seen in bony growth of the postoperative and unoperated cases of cleft palate of this group. In the postoperative cases of cleft palate, where the lips had been repaired at an average age of three months, there was a significant lingual version of the incisor teeth, posterior displacement of the upper lip, and exaggerated fulness of the lower lip. This was not seen in the unoperated cases of cleft palate, where the lips were closed at an average age of two years. These contoural abnormalities are believed to be related to tight, early, lip closure and not to the effects of palatal surgery. Further support of this theory was obtained in the quantitative studies of dental-arch collapse, which revealed an almost identical degree of collapse in the anterior quadrants on the cleft side in both the unoperated and the postoperative cleft-palate cases. Conventional palatal surgery can be carried out before the end of the second year of life without detriment to the facial contour and with maximal opportunity for the development of good speech. It is most important to effect a loose lip closure to obtain a more normal facial contour.