Orthopedic Protraction of the Upper Jaw in Cleft Lip and Palate Patients during the Deciduous and Mixed Dentition Periods in Comparison with Normal Growth and Development

Cleft lip and palate (CLP) patients often develop maxillary retrusion after cleft repair. Since 1977, a group of 98 cases with negative overjet (anterior crossbite) during the period of deciduous dentition has been treated by the Bergen CLP team. The purpose of treatment has been to achieve favorable occlusion with positive overjet and overbite by means of anterior orthopedic traction (protraction). The average age at start of treatment was 6 years 11 months, and mean treatment duration was 13 months. The protraction force was 700 g. The serial lateral cephalograms of the treated CLP group were compared with those of a noncleft group with normal growth. Normalization of the sagittal maxillomandibular relationship (ANB angle) was achieved. Significant changes were a more anterior position of the upper jaw, and a more posterior position of the lower jaw, due to mandibular clockwise rotation. The variation was considerable. This paper reports the overall changes in the whole CLP group (ALL-C group).