الفهرس 
ACKNOWLEDGMENTOnly 14 pages are availabe for public view
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Abstract
Cleft lip and cleft palate are among the most common congenital defects in the cranio-facial region. They result from incomplete fusion of maxillary and intermaxillary processes during development of the fetus.The prevalence of cleft lip and palate worldwide is about one per 500–700 of all births.
In order to identify and implement the highest possible standards of care by the pediatric dentist for SR UCLP children, assessment of early treatment outcome after primary surgical repair of lip and palate regarding arch dimensions and occlusion is essential. The dental arch dimensions and occlusion among these children have been evaluated scarcely in Egypt. This presents a gap that impedes the delivery of proper dental care to these children. In attempt to meet the needs of these children, the present study aimed at determining the main characteristics of arch dimensions and occlusion following surgical repair of UCLP according to the Oslo protocol to further improve their standard of care.
In our current study, 31 non-syndromic children with repaired UCLP, with an age range 4-9 years, and fulfilling the selection criteria were recruited. Another group of 31 healthy, matched non-cleft children were also recruited to serve as a control group. The mean ages were (7.35 ± 1.52 years) in UCLP children and (7.13 ± 1.52 years) in non-cleft children. The controls were companions of the SR UCLP children.
For each subject, presence of palatal fistula and dental arch dimensions were determined from the dental study casts. The measured parameters were maxillary and mandibular arch depth, inter-canine arch width and inter-molar arch width. In addition, sagittal molar and canine relations were determined for each subject. The incisor over-jet, overbite and open bite as well as midline deviation were also measured. The dental arch relationship and total arch constriction score were determined using the modified Huddart’s scoring system.
Palatal fistulas were observed in eight children with SR UCLP requiring revision surgery. Mean maxillary arch depth and inter-canine width were significantly narrower in SR UCLP children than non-cleft children throughout the age period of 6-9 years. The mean maxillary inter-molar width and all mandibular arch dimensions in SR UCLP group were not significantly different from those of non-cleft group.
With respect to occlusion, there were significant differences between groups regarding sagittal molar and canine relations. There was predominance of mesial step terminal plane in SR UCLP children while straight terminal plane was more predominant in non-cleft children in the age group 4 to <6 years. Class III permanent molar and cuspid relations were clearly seen in SR UCLP group, whereas class I permanent molar and cuspid relations were significantly higher in non-cleft group in the age groups 6 to <8 years and 8 to <10 years.
There was higher tendency for anterior cross-bite (negative over-jet) especially in the age group 6 to <8 years and anterior open bite in SR UCLP group than in non-cleft group. Finally, there was a significant tendency to midline deviation towards non-cleft side in SR UCLP group.
As regards the dental arch relationships, the modified Huddart/Bodenham scores were significantly more negative in SR UCLP group among all age periods especially for central incisors and canines cross-bite scores. Total arch constriction scores were significantly more negative in SR UCLP group than non-cleft group in the age groups 6 to <8 years and 8 to <10 years.