Orthopaedic growth guidance and stimulation for patients with cleft lip and palate.

The growth potential of the craniofacial complex of a child with a congenital cleft is not at variance with that of the normal craniofacial complex. Early surgery including mucoperiosteal undermining and the formation of scar tissue generally results in considerable growth retardation. Primary bone grafting seriously inhibits maxillary growth. 15 years' experience with the treatment of cleft patients applying "growth stimulators" combined with postponing surgical corrections is reported, and the results of this treatment method are compared with those found in literature. As a criterion an accurately measurable and reliable parameter, namely the crossbite relation, was opted for. The frequency of crossbite occurrence is now only 16% for deciduous dentitions and 21% for mixed dentitions. In comparison with the most favourable treatment results found in the literature this constitutes a reduction of more than 50%. This implies that the development of maxillary morphology is normalised, leading to an improvement of the oro-nasal functions including speech development.