ABSENCE OR PRESENCE OF MID-PALATAL SUTURE IN PATIENTS WITH COMPLETE UNILATERAL CLEFT LIP AND PALATE, (A RETROSPECTIVE STUDY)

Background: The absence/presence of the mid-palatal suture in patients with cleft lip and palate has never been well investigated, although this is essential for the rapid palatal expansion and maxillary growth modification. The aim of this study was to test the hypothesis that the mid-palatal suture is present in patients with unilateral complete cleft lip and palate (UCLP).
Methods: Twenty-three consecutive growing patients with UCLP who received cone beam computed tomography (CBCT) and maxillary growth modification at the bone age of cervical vertebral maturation stage 2 (CVS2) from 2007-2013 were included. For each patient, the CBCT axial sections right before the treatment were examined for the prevalence of presence, extent of suture in maxilla, and maturation of mid-palatal suture at the basal and alveolar bone levels. The data were analysed statistically.
Results: The prevalence of presence of mid-palatal suture was 100.00% at the basal-bone levels but decreased significantly (p<0.001) to 60.87% at the alveolar levels. The incidence of late stage suture maturation was 86.96% at the basal-bone levels and decreased significantly (p<0.001) to 14.29% at the alveolar levels when the mid-palatal suture is present. The extent of suture in the maxilla was 72.00±20.52% at the basal-bone levels and decreased significantly (p<0.001) to 28.54±27.00% at the alveolar levels.
Conclusions: Although the mid-palatal suture in patients with UCLP is present, it fades away sharply and matures gradually from the basal bone down to the alveolar bone level of maxilla at the bone age of CVS2.