Craniofacial Growth in Patients With Cleft Before and After Puberty: A Longitudinal Case–Control Study

OBJECTIVES: To compare craniofacial morphology between individuals with isolated cleft lip (CL), cleft lip and palate (CLP), and a matched control group before and after the pubertal growth spurt. MATERIALS AND METHODS: Cephalometric data from before and after the growth spurt were collected from 71 anonymized patients, of whom 29 (40.8%) had CLP, 13 (18.3%) had CL and 29 (40.8%) non-cleft control patients presenting Angle Class I malocclusion. Data analysis included raw and standardized mean values along with comparisons using ANOVA and Kruskal-Wallis tests. The significance level was set at 0.05. RESULTS: At baseline, mean ages were comparable across groups: 8.24 ± 0.94 years (control), 8.24 ± 0.94 years (CL), and 8.33 ± 2.44 years (CLP). The cleft groups included a higher proportion of male individuals (CL: 76.9%, CLP: 62.1% vs. 48.3% for control), although not statistically significant. Patients with CL had significantly higher A-Nasion-B angle when compared with CLP and control groups. Individuals with CLP presented significantly lower values of Sella-Nasion-A and Sella-Nasion-B angles and significantly higher values of mandibular plane to Sella-Nasion and gonial angles when compared to the control group. Changes in the maxillo-mandibular relationship were observed in the CLP and CL groups, reaching Class III and Class I relationships after the growth spurt, respectively. CONCLUSION: Although normal prepubertal maxillary prominence was observed in children with CL, impaired sagittal maxillary growth was recorded in this group during puberty. Individuals with CLP or CL present significant differences in maxillary and mandibular morphology and growth, which should be considered in orthodontic planning and treatment.