The aim of this retrospective study was a three-dimensional evaluation of the orthopaedic effect of the drink plate from birth to surgical palatal closure, taking into account individual maxillary growth in patients with unilateral non-syndromic cleft lip and palate (UCLP).
Methods: Out of the patient population of infants with unilateral non-syndromic unilateral cleft lip and palate treated in the Department of Orthodontics, Medical Faculty Carl Gustav Carus, TU Dresden, in the period in of 1991-2016, model casts taken immediately after birth (t0), before surgical lip closure (t1) and/or closure of the soft palate (t2) were evaluated, of which n=27 patients (n=70 model casts) fulfilled the inclusion criteria, which were then digitised using a 3D scanner (OrthoxScan, Dentaurum, Ispringen, Germany) and measured three-dimensionally (CleftDynamic, S.K.M. Informatik GmbH, Schwerin, Germany). In addition to the morphological changes of the maxilla and cleft dimension during drink plate therapy, a possible correlation of these to the cleft expression at birth was also analysed. For this purpose, an individual growth area was also determined for each patient/ model cast in order to be able to make corresponding statements. Statistical analysis was performed using Microsoft Excel 2018 (Microsoft Corporation, Redmond, USA), paired and unpaired t-test, Pearson and Spearman correlation coefficient analysis, respectively, and regression analysis (p = 0.05). Ethical approval had been registered under the following number in before all examinations and measurements: EK 154042017.
Results: During the observation period t0-t2, the cleft expression at birth decreased significantly by a total of 56%, and taking into account the individual maxillary growth, a significant decrease of 31% and 25% for the time interval: t0-t1 and t1-t2, respectively, as well as a significant linear correlation between the cleft expression at birth and the decrease of the cleft area during pre-surgical orthopaedics (PSO) was observed for both investigation periods.
Conclusions: Even if surgical lip closure increased the convergence of the cleft segments (t1-t2), considering individual maxillary growth, a significant decrease of the cleft area could be found during drink plate therapy until lip closure (t0-t1), suggesting an orthopaedic effect of this treatment with convergence of the cleft segments.