Three-dimensional nasal septum and maxillary changes following rapid maxillary expansion in patients with cleft lip and palate: A case-series analysis

To determine the three-dimensional changes of the nasal septum (NS), alveolar width, alveolar cleft volume, and maxillary basal bone following rapid maxillary expansion (RME) in consecutive patients with unilateral cleft lip and palate (UCLP). A retrospective investigation was conducted based on the analysis of cone-beam computed tomography (CBCT) data of 40 consecutive patients with UCLP (mean age 11.1 ± 2.2 years). Scans were acquired prior to RME (T0) and after removal of the expander (T1) before graft surgery. A three-dimensional analysis of the effects of RME on the nasal septum, alveolar width, alveolar cleft volume, and maxillary basal bone was performed. No changes in the NS deviation were observed following RME ( > .05). Significant increases of the alveolar transverse dimension were found in the anterior (14.2%; < .001) and posterior (7.7%; < .001) regions as well as in the volume of the alveolar cleft (19.6%; < .001). No changes in the basal bone dimensions and morphology were observed ( > .05). Following RME, no changes were observed in the NS and maxillary basal bones of patients with UCLP despite the significant gain in the anterior and posterior alveolar width and the increase of the alveolar cleft defect. Clinicians should be aware that maxillary changes following RME in patients with UCLP are restricted to the dentoalveolar region.