Comparison of the dental arches of children with oral clefts operated by different primary surgeries at first months and 5 years of life

• Ano de defesa: 2021
• Autor(a) principal: Sartori, Isabela de Castro
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: eng
• Instituição de defesa: Biblioteca Digitais de Teses e Dissertações da USP
• Palavras-chave em Português: Cleft lip; Cleft palate; Dental molds; Fenda labial; Fenda palatina; Imagem tridimensional; Modelos dentários; Three-dimensional image
• Link de acesso: https://www.teses.usp.br/teses/disponiveis/61/61132/tde-18022022-124747/

This study aimed to evaluate and compare the development of the dental arches of children with unilateral cleft lip and palate before and after the primary surgeries performed with different techniques at the first months and five years of life. The sample comprised 56 dental casts divided int the following groups: Group 1 (G1) cheiloplasty (Millard technique) at 3 months and one-step palatoplasty (Von Langenback technique) at 12 months; and Group 2 (G2) cheiloplasty (Millard technique) and two-step palatoplasty: hard palate closure (Hans Pichler technique) at 3 months and soft palate closure (Sommerlad technique) at 12 months. The dental casts were digitized through 3D scanner and evaluated at 3 months of life presurgical (T1) and 5 years post-surgical (T2). The following linear measurements were analyzed: intercanine (CC), intertuberosity (TT), and intermolar distances (MM); anterior dental arche length (ICC), anterior intersegment (IC), and total arch (ITT). The dental arch area was also measured. Paired t test and Wilcoxon test compared the intragroup analyses, while independent t test and Mann-Whitney test the intergroup analyses (p<0.05). In G1, the intragroup comparison showed statistically significant smaller ICC and IC means at T2 (p=0.001 and p<0.001, respectively), while TT, ITT, and area comparisons were significantly greater between times (p<0.001, p=0.002, and p<0.001, respectively). In G2, the intragroup comparison exhibited statistically significant smaller CC and IC means at T2 (p=0.004, for both), while T T, ITT and area comparisons were significantly greater between times (p<0.001, p=0.004, and p<0.001, respectively). At T2, the intergroup analysis revealed that G1 had a statistically significant smaller ICC mean (p=0.014). The analysis of the intergroup differences ( = T2 T1) showed that G1 had a statistically smaller ICC mean (p=0.043). In conclusion, two-step palatoplasty showed a more favorable prognosis for the maxillary growth than one-step palatoplasty in children with oral clefts.