Growth and Development Analysis of Unilateral Cleft Palate Patients at One, Five, and Ten Years
Abstract
Active and passive pre-surgical orthopedic (PSO) devices are a controversial part of cleft palate management. There is no consensus as to the effects of these PSO devices on long-term outcomes and there is limited research comparing different PSO devices. The first objective of this research was to perform a systematic review of the literature surrounding the long-term effects of PSO device use. The second was to analyze and compare 10-year nasolabial aesthetic outcomes between patients treated with an active PSO device, passive PSO device, or no device. The final objective was to analyze and compare 10-year dental occlusion and facial growth in patients who received treatment with an active versus a passive PSO device. All patient data was assessed at 1, 5, and 10 years. Nasolabial aesthetics were assessed using patient photographs, dental occlusion was assessed using dental molds, and facial growth was assessed through cephalometric analysis. Systematic review identified 41 articles pertaining to long-term effects of PSO device use. This systematic review didn’t identify a consensus as to the effects of these devices but did identify that all 41 articles had methodologic flaws that limit the applicability of their results. Comparison of nasolabial aesthetics showed that patients treated with a PSO device have comparable aesthetics at the 10-year mark to patients treated with no device who have less severe alveolar gaps. Patients treated with active and passive devices have similar dental occlusion/arch development and facial growth up to 10 years.