Correction of jaw deformities in patients with cleft lip and palate

Larry M. Wolford, DMD, and Eber L. L. Stevao, DDS, PhD

From the Department of Oral and Maxillofacial Surgery, Baylor University Medical Center, Dallas, Texas.

Corresponding author: Larry M. Wolford, DMD, 3409 Worth Street, Suite 400, Dallas, Texas 75246 (e-mail: lwolford@swbell.net).

A cleft lip/palate deformity occurs in approximately one in every 700 live births in the USA. Jaw growth in the population of patients with unrepaired cleft lip and palate is generally favorable. No significant difference exists between patients with and those without such deformities in the distribution of vertical or anteroposterior skeletal jaw relationships, except that posterior crossbites (deficiency in the width of the upper jaw, with the upper teeth biting inside the lower teeth) may be more common in patients with a cleft deformity. However, significant disturbances of growth of the jaws, particularly the maxilla (upper jaw), can occur in patients with cleft deformities as a result of surgical repairs of the cleft lip and palate or other factors. The maxilla can become underdeveloped, affecting the alveolus (bone supporting the teeth), dentition (teeth), and associated soft-tissue structures. The following surgical procedures, commonly performed during childhood, can have an unfavorable effect on facial growth: cleft lip repair, cleft palate repair, alveolar cleft repair, and pharyngeal flap. (BUMC Proceedings 2002;15:250-254)