Catch-Up Growth Pattern in Cleft Palate: A Longitudinal Study from Infancy to Adolescence.

OBJECTIVE: To characterize the patterns of somatic catch-up growth from infancy to adolescence in patients with cleft palate (CP). STUDY DESIGN: We assessed 474 nonsyndromic patients with isolated cleft palate (n = 69) and unilateral and bilateral cleft lip and palate (n = 271; n = 134) who underwent palatoplasty between 1988 and 2017 and had longitudinal physical growth data at birth (T0), cheiloplasty (T1), palatoplasty (T2), childhood (T3), and adolescence (T4). The z scores of weight (ZWT), height (ZHT), and body mass index (ZBMI) were compared among the CP types (isolated cleft palate, unilateral cleft lip and palate, and bilateral cleft lip and palate) and time points (T1, T2, T3, and T4). Subgroup analyses were performed to investigate the growth of patients with malnourishment (z score < -1) at T1 or T2. A generalized linear model was used to investigate the effects of gestational age and cardiac anomalies on the longitudinal changes in ZHT and ZBMI. RESULTS: Regardless of the time point, the overall ZHT, ZWT, and ZBMI approximated 0 in all CP types, indicating few differences from the mean values of noncleft children. Significant catch-up growth occurred in ZHT and ZWT from T1 to T4 for all CP types (all P < .05). Despite the recovery of ZHT and ZBMI in most patients with malnourishment, these values remain relatively low until adolescence. Patients who were born at preterm stage or had surgically repaired cardiac anomalies grew well. CONCLUSIONS: Even in infants with CP and malnutrition, preterm birth, or cardiac anomalies, rapid catch-up growth can occur prior to palatoplasty with the help of comprehensive cleft care.

Long-term effects of lateral nasal wall anchored facemasks compared with tooth-borne facemasks.

INTRODUCTION: This study investigated the long-term effect and stability of skeletally anchored facemasks (SAFMs) with lateral nasal wall anchorage compared with conventional tooth-borne facemasks (TBFMs) in growing patients with a Class III relationship. METHODS: A total of 180 subjects treated with SAFMs (n = 66) and TBFMs (n = 114) were screened. Thirty-four subjects were qualified and grouped into the SAFM group (n = 17) and TBFM group (n = 17). Lateral cephalograms were taken at the initial observation, after the protraction, and at the final observation. RESULTS: Greater advancement of the maxilla was attained with SAFM than with TBFM after protraction (initial observation - after the protraction) (P <0.05). In particular, advancement of the midfacial area (SN-Or) was prominent and maintained after the postpubertal stage (P <0.05). The intermaxillary relationship was also improved (ANB, AB-MP) (P <0.05), and greater counterclockwise rotation of the palatal plane (FH-PP) was observed in the SAFM group compared with the TBFM group (P <0.05). CONCLUSIONS: Compared with TBFM, the orthopedic effects of SAFM were greater in the midfacial area. The palatal plane had a greater counterclockwise rotation in the SAFM group than in the TBFM group. Maxilla (SN-Or), intermaxillary relationship (APDI), and palatal plane angle (FH-PP) demonstrated a significant difference between the 2 groups after the postpubertal stage.