Dentoalveolar effects of early orthodontic treatment in patients with cleft lip and palate

No agreement exists on the most appropriate timing of orthodontic treatment in patients with cleft lip and palate. The aim of this study is to investigate the effect of early orthodontic treatment on development of the dental arches and alveolar bone. A dental casts analysis was performed on 28 children with cleft lip and palate before orthodontic treatment (T0; mean age, 6.5±1.7) and at the end of active treatment (T1; mean age, 9.2±2.1 years). The considered variables were: intercanine and intermolar distances; dental arch relationships, evaluated according to the modified Huddart/Bodenham system. The study group was divided into 2 samples according to the age at T0: Group A (age < 6 years) and Group B (age ≥ 6 years). A statistical comparison of the treatment effects between the 2 samples was performed. Patients in Group A exhibited a greater increase of intercanine distance (8mm versus 2.7 mm; P<0.001), intermolar distance (7.2mm versus 5 mm; P=0.06), and Huddart/Bodenham score (7.1 versus 3; P<0.05) when compared with patients in Group B. Early orthodontic treatment strongly improved the dental arch relationship, since subjects starting the therapy before the age of 6 had a better response in terms of anterior maxillary expansion.