Objective: The objective of this study is to examine the operative and immediate postoperative effects of the use of a dentomaxillary appliance (DMA).
Design: Retrospective chart review of 40 treated patients with unilateral complete cleft lip and palate who had a comprehensive set of pre-, peri-, and postoperative records.
Setting: Boston Children's Hospital.
Patients: Forty treated patients with unilateral complete cleft lip and palate.
Interventions: Use of DMA.
Main outcome measures: Outcome variables of interest included cleft lip width reduction following use of DMA and odds of having primary gingivoperiostetoplasty (GPP).
Results: The study sample included 40 subjects (31 boys and 9 girls). The average age at the time of DMA insertion was 11 weeks. The average width of the alveolar cleft prior to DMA insertion was 10.77 mm. The mean cleft width reduction was 8.66 mm. Each 1-mm increase in pre-DMA cleft width was associated with a 0.631-mm reduction in cleft width (P < .001). Thirty-three patients (82.5%) had a GPP procedure. Each 1-mm increase in post-DMA width was associated with a lower odds of having a GPP (odds ratio = 0.32, 95% confidence interval = 0.14-0.77, P = .01).
Conclusions: Post-DMA width was the significant factor associated with the performance of GPP. The use of DMA is associated with a significant reduction in the width of the cleft, and outcomes are predictable without any major adverse events or complications.
Keywords: Latham appliance; cleft lip and palate; infant orthopedics.