Multifacility evaluation of presurgical infant orthodontics for Japanese children with cleft lip and palate

Purpose Children with cleft lip and palate (CLP) often suffer from morphological abnormalities, such as maxillary retrusion and underdevelopment, anterior crossbite, and narrow maxillary arch, as well as functional impairments in feeding, speech, and mastication. An increasing number of facilities have initiated presurgical infant orthopaedic (PIO) treatment to reshape the nose and maxilla, and improve feeding. However, studies from other countries have reported limited effectiveness of PIO treatment. Therefore, this multifacility study was conducted to evaluate treatment outcomes following PIO treatment in children with unilateral CLP treated at three Japanese facilities using different surgical protocols.Materials and methods Three facilities used different surgical protocols, but all performed PIO by orthodontists before the primary surgeries. Cast models of unilateral CLP at 5 years of age were analysed.Results The average maxillary arch width was no smaller than the norm for the Japanese non-cleft children at all three facilities, and molar crossbite was rarely seen in these cases. The average overjet was negative at all facilities, and the average maxillary arch length was slightly smaller than the norm for Japanese non-cleft children at one facility. But it was comparable to or greater than the norm at the other two facilities.Conclusion The direct effect of PIO treatment based on this study is obscure, because all subjects received PIO treatment and no comparison was performed with PIO-untreated subjects. However, analysis of children at 5 years of age with Japanese unilateral CLP indicated that the maxillary arch shape was overall comparable to the Japanese non-cleft children after PIO treatment. It is important to establish a sufficient number of Japanese facilities capable of providing PIO treatment throughout Japan.