Occlusion at 5 Years of Age Following Hard Palate Closure With Vestibular Flap

Abstract

Objective: This study aims to assess occlusal relationships and frequency of oronasal fistula at 5 years of age following 2 hard palate closure techniques and to compare results. Design: Retrospective longitudinal study. Setting: Institutional study. Patients: Study patients included 57 patients with nonsyndromic complete unilateral cleft lip and palate who were consecutively treated. All patients underwent our early 2-stage protocol for palatoplasty, which consisted of soft palate plasty at 1 year of age and hard palate closure at 1.5 years of age. Twenty-nine patients underwent hard palate closure using vestibular flap (VF group) technique (2009-2011) and 28 patients underwent conventional hard palate closure with local palatal flap (LPF group) technique (2006-2008). Main Outcome Measures: Occlusal relationships were assessed with 5-year-olds’ index, and frequency of oronasal fistula was investigated. Results: Average 5-year-olds’ index scores for VF and LPF groups were 3.11 and 3.57, respectively ( P < .001). Oronasal fistula occurred in approximately 7% of patients in the VF group and in 18% of patients in the LPF group. Conclusion: Hard palate closure with VF technique may provide better occlusal relationships at 5 years of age than does conventional local closure with the LPF.