Soft Tissue Profile Changes Following Orthodontic Treatment in Patients With Unilateral Cleft Lip and Palate

Background: Anterior crossbite is a frequent malocclusion in patients with Unilateral Cleft Lip and Palate (UCLP). Several studies have investigated the effects of orthognathic surgery or orthopedic treatment on correction of this malocclusion. Only few studies evaluated the effect of conventional orthodontic treatment on growing patients Objective: The present study investigated significant changes of facial profile as well as the underlying hard tissue following conventional orthodontic treatment in growing subjects with UCLP. Methods: Lateral cephalograms of ۳۲ non-syndromic children with UCLP (۱۵ boys, ۱۷ girls) with the Mean±SD age of ۱۰.۹۱±۲.۰۰ years were retrospectively collected. All patients had complete orthodontic records before and after treatments, indicating the acceptable treatment results, in respect of the degree of overbite, overjet, maximum intercuspation occlusion and facial profile. Cephalometric measurements represented dentoskeletal and soft tissue profile before and after treatments were evaluated, and significant changes were assessed by paired t test. One-sample t test was used to analyze significant differences between these measurements and the clinical norm.  Results: The initial characteristics of the UCLP patients were skeletal class III maxillary retrusion with relative mandibular prognathism, retroclination of the incisors, negative overjet, and increased overbite and concave facial profile. After conventional orthodontic treatment, maxillary arch expansion and class III elastic traction, the acceptable overbite and overjet were achieved by proclination of the upper incisors. Significant changes of the soft tissue profile due to facial growth and treatment included increase in facial convexity, nose length, nose depth, columellar length, soft tissue face height ratio, upper and lower lip lengths and upper lip protrusion. The soft tissue profile was acceptable after the treatment, compared to the clinical norm.  Conclusions: The early correction of the anterior crossbite with maxillary arch expansion and class III traction could improve the soft tissue facial profile of patients with UCLP.