Orthodontic needs of patients with cleft lip and palate in Enugu, five years post repair

Abstract

Background: Orthodontists play an integral role in the management of cleft lip and palate anomaly. This study looks at the frequency of  anomalies amenable to orthodontics in patients who have had surgery and the effect of early or late surgical intervention.
Methodology: Patients aged 0-5 years with cleft of the lip and/or palate who were operated on by the plastic surgeon at the Good  Shepherd Specialist Hospital, Enugu between 1st July 2011 and 30th June 2014, were recalled after a minimum of five years post-surgery and examined to determine the absence or presence of dental anomalies, amenable to orthodontic treatment, which have arisen since surgical repair. Descriptive statistics and t-test were used for data analysis and significance was at 0.05.
Results: Thirty-one children were operated upon in the period under review. Seventeen had timely (three months or less) lip repair. Seven had timely palate repair (18 months or less). Thirteen patients were successfully recalled, 12 had cleft lip repair while one had cleft palate repair. Repair was timely in 10 (83.3%) of the 12 that had lip repair with a mean frequency of four dental anomalies, while the two (16.7%) that had late repair had a mean frequency of five dental anomalies and this was not statistically significant (P value=0.711). The only isolated cleft palate patient successfully recalled had a late repair. All 13 patients had at least four dental anomalies amenable to orthodontics. Hypoplastic maxilla were the most commonly occurring (eight patients, 61.54%) dental anomaly amenable to orthodontic treatment. None of the patients had a clinically visible supernumerary tooth. Out of 13 patients reviewed, sis were males with a mean frequency of four dental anomalies while seven were females, also with a mean frequency of four dental anomalies. This was not  significant (P-value=0.553).
Conclusion: There is need for the long term Orthodontic follow up of cleft lip and palate patients. The orthodontic management of dental anomaly should, therefore, be central in the planning and treatment of patients with cleft lip and palate.