A longitudinal cephalometric study from age 5 to 18 years on individuals with complete bilateral cleft lip and palate.

Development of the facial profile between the age of 5 years and the end of pubertal growth in patients with complete bilateral cleft lip and palate was studied by means of cephalometric radiographs obtained at the age of 5, 10, and 15 years as well as at the end of the growth period. All 29 patients had been treated according to the same plan and operated on by the same surgeon.Values for the ANB angle are typically very high in 5-year-old children and then decrease to values corresponding to those of the general population by the end of the pubertal growth period. Vertical development maintains the initial pattern; no compensatory vertical excess was observed. Owing to the wide range in all measurements, age-related mean values in a patient sample are of little consequence for individuals but can point out tendencies.The multidisciplinary concept of maintaining the initially protrusive position of the premaxilla by means of a passive plate at the newborn and infant stage, as well as using surgical procedures with limited retrusive effect, proved to be correct in the long run: At the young adult stage, the ANB angle remained positive for almost all patients except for those with multiple-tooth agenesis in the upper arch. A potential benefit of 2-stage palate repair is seen in the neutral vertical development of the patients examined. This hypothesis is supported by comparing with other studies from the literature.