Evaluation of dental arch characteristics in early and late mixed dentition of cleft lip and palate individuals treated by infant orthopedics

Aim: The aim of this study is to investigate the effects of infant orthopedics (IO) and gingivoperiosteoplasty (GPP) on dental arch dimensions and dental arch relationships in early and late mixed dentition children with cleft lip and palate (CLP) by comparing them with non-cleft children. Materials and Methods: 95 children with CLP between the ages of 7-13 were first divided into groups according to cleft type. There are 52 children with CLP in the unilateral total CLP (TTDDY) group, 22 children in the unilateral cleft lip and alveolar group (TDAY), and 21 children in the çift taraflı total CLP (ÇTDDY) group. After that, the groups were divided into subgroups according to who had IO and GPP. Arch width, length and depth, cleft width and level difference in all directions between segments were measured on three-dimensional digital models of children with CLP and compared with 75 children without cleft in the control group. Fistula types were evaluated based on digital intraoral photographs of children with CLP. MHB Index scoring was performed in children with CLP and the relationship between index scores and dental arch dimensions was evaluated. ANOVA, Tukey Test, Pearson Chi-square Test, Kruskal-Wallis H Test and Spearman Correlation Test were used in statistical analyses. Results: The upper intercanine distance measurements of the TTDDY, ÇTDDY and TDAY groups were found to be statistically significantly smaller than the control group (p<0.05). Upper total arch length and upper posterior palatal depth measurements of TTDDY and ÇTDDY groups were found to be statistically significantly smaller than the control group (p<0.05). In the TTDDY group, level difference measurements in all directions between segments were found to be statistically significantly higher in children who had no IO than in children with who had GPP after IO (p<0.05). The incidence of Type VI and Type VII fistula in all cleft types was found to be statistically significantly lower in children who had GPP after IO than in children who had no GPP after IO and those who had no IO (p<0.05). MHB Index scores were found to be similar between children who had and had no IO and GPP in all cleft types. Conclusion: The upper intercanine distance in children with CLP was found to be smaller than in children without cleft. GPP has been shown to reduce the incidence of Type VI and VII fistulas in all cleft types. GPP is effective in preserving the dental arch form created by IO and reducing the narrowing of the maxillary arch. In children with CLP, the decrease in dental arch dimensions may be related to the presence of clefts and related tissue deficiencies or palatoplasty applications, independent of IO and GPP.