Infant Orthopedics Has No Effect on Maxillary Arch Dimensions in the Deciduous Dentition of Children With Complete Unilateral Cleft Lip and Palate (Dutchcleft)

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doi: 10.1597/05-129
The Cleft Palate-Craniofacial Journal: Vol. 43, No. 6, pp. 665–672.

Infant Orthopedics Has No Effect on Maxillary Arch Dimensions in the Deciduous Dentition of Children With Complete Unilateral Cleft Lip and Palate (Dutchcleft)

Catharina A.M. Bongaarts, D.D.S.
Martin A. van 't Hof, Ph.D.
Birte Prahl-Andersen, D.D.S., Ph.D.
Iris V. Dirks, D.D.S.
Anne M. Kuijpers-Jagtman, D.D.S., Ph.D.

C.A.M. Bongaarts is Orthodontist, Department of Orthodontics and Oral Biology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands. Dr. van 't Hof is Professor in Biostatistics, Department of Preventive and Curative Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands. Dr. Prahl-Andersen is Emeritus Professor in the Department of Orthodontics, Academic Center of Dentistry Amsterdam, Amsterdam, the Netherlands, and Head of the Department of Orthodontics, University Medical Center Rotterdam, Rotterdam, the Netherlands. I.V. Dirks is a Dentist and is affiliated with the Department of Orthodontics and Oral Biology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands. Dr. Kuijpers-Jagtman is Professor and Chairperson of the Department of Orthodontics and Oral Biology, and Head of the Cleft Palate Craniofacial Unit, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands

Submitted July 2005; Accepted January 2006.

Objective: Evaluation of the effect of infant orthopedics on maxillary arch dimensions in the deciduous dentition in patients with unilateral cleft lip and palate.
Design: Prospective two-arm randomized controlled clinical trial with three participating cleft palate centers.
Setting: Cleft palate centers of the Radboud University Nijmegen Medical Center, Academic Center of Dentistry Amsterdam, and University Medical Center Rotterdam, the Netherlands.
Patients: Children with complete unilateral cleft lip and palate (n = 54) were included.
Interventions: Patients were randomly divided into two groups. Half of the patients (IO+) had a presurgical orthopedic plate until surgical closure of the soft palate at the age of 52 weeks; the other half (IO−) did not undergo presurgical orthopedics.
Mean outcome measures: Maxillary arch dimensions were assessed on dental casts at 4 and 6 years of age with measurements for arch width, arch depth, arch length, arch form, and the vertical position of the lesser segment. Contact and collapse were assessed also.
Results: There were no clinically significant differences found between IO+ and IO− for any of the variables.
Conclusions: Infant orthopedics had no observable effect on the maxillary arch dimensions or on the contact and collapse scores in the deciduous dentition at the ages of 4 and 6 years. Considering the Dutchcleft results to date, there is no need to perform infant orthopedics for unilateral cleft lip and palate patients.

KEY WORDS: arch dimension, cleft palate, collapse, deciduous dentition, infant orthopedics, multicenter, randomized clinical trial, treatment outcome