Association Between Cleft Size and Crossbite in Children With Cleft Palate and Unilateral Cleft Lip and Palate

Objective: To investigate the association between cleft size in infancy and crossbite at 5 years of age in children with cleft palate (CP) and unilateral cleft lip and palate (UCLP). Design: Retrospective study. Setting: University Hospital, Uppsala, Sweden. Patients: Dental study models of 80 consecutive children, 51 children with CP and 29 children with UCLP, born between 1990 and 1999 were analyzed. Interventions: Lip repair at 3 to 4 months in UCLP children. Primary soft palate repair at 6 to 10 months and secondary hard palate closure at 25 to 26 months of age. Main Outcome Measures: Maxillary arch dimensions and cleft size were measured on infancy dental casts. At follow-up at 5 years, crossbite scores were registered on dental study models. Results: The cleft dimensions in infancy showed large interindividual variation. Mean posterior cleft width was larger in UCLP children than in children with CP. The UCLP group also had significantly more crossbite at 5 years than the CP group. No significant association was noted between initial cleft size and crossbite scores at 5 years in the CP group. For the UCLP group, larger cleft widths at the level of the cuspid points were significantly associated with less anterior and posterior crossbite. Conclusions: The findings support the hypothesis that cleft size in infancy affects early outcome with respect to crossbite in children with UCLP, but not in children with CP.