Early bone grafting in complete cleft lip and palate cases following maxillofacial orthopedics. II. The soft tissue development from seven to thirteen years of age

The subsequent effect of preoperative maxillofacial orthopedics and early bone grafting on the development of the soft tissue profile of the face was studied with roentgencephalometric analysis on cleft patients between 7 and 13 years of age. They were divided into two unilateral and one bilateral complete-cleft group, all having been bone grafted early with the "four-flap" technique. The two unilateral groups were one group of 39 children operated on between 1960 and 1965 without preoperative orthopedics and one group of 46 children operated on between 1965 and 1972 after preoperative orthopedics ("T-traction"). The bilateral group comprised 19 children operated on between 1960 and 1972 after premaxillary retropositioning pressure, combined when necessary, with outward rotation of the lateral maxillary segments. Comparisons of facial growth were made with U.S. non-grafted clefts and with nonclefts. The effect of the preoperative orthopedic management facilitated the subsequent surgical procedure by a narrowing of the cleft and replacement of the deviated maxillary and nasal structures. The results were within limits of the non-grafted cases, with the exception of the soft tissue overlying the subnasal region. The reduced prominence of that region was explained by the primary surgical procedure, which made the lip adherent to the alveolar crest. In comparison with nonclefts, all parameters indicated a reduced growth capacity.

Need for preventive and interceptive intervention for malocclusion in 3--5-year-old Finnish children

The need for preventive and interceptive intervention for malocclusion was studied in a sample of 931 Finnish children aged 3--5 years. Orthodontic intervention was estimated to be needed for 14.4% of the children due to crossbite or functional crossbite of the anterior or lateral segments, or to the early loss of primary molars with an observed tendency to space closure. Education was needed for 2.7% of the children in cases of finger-sucking, and restorative caries therapy for 12.2% of the children in cases with carious primary molars. The need for further inspection in order to follow up development was noted in 21.2% of the children. The indications occasioning this consideration were the numerical variation of primary teeth (1.4%), joined primary teeth (0.8%), the early loss of primary molars without observed risk of space closure (0.2%), luxated and exarticulated primary incisors (5.5%), true Class III (Angle) malocclusion (0.4%), and the dummy-sucking habit (13.1%).