Prevention Methods of Tooth-Jaw Deformities in Children with Uranoplasty
Keywords:
Cleft lip and palate, uranoplasty, palatoplasty, maxillary growth, dental arch, malocclusion, alveolar bone grafting, orthodontic preventionAbstract
Cleft lip and palate is one of the most common congenital malformations of the maxillofacial region and causes not only aesthetic but also functional disorders of speech, swallowing and mastication. Uranoplasty eliminates the communication between the oral and nasal cavities, but the scar tissue formed after surgery can restrict the growth of the upper jaw and lead to dentoalveolar deformities. The aim of this study was to summarize current evidence on the influence of palatoplasty protocols on the development of the dental arches, on the frequency of dental and occlusal anomalies in children with cleft lip and palate, and to substantiate methods for preventing tooth-jaw deformities after uranoplasty. A narrative review of 17 publications from 1986 to 2025 was carried out, covering clinical studies with digitized dental models, cephalometric and epidemiological studies, systematic reviews and classic works on orthodontic treatment and alveolar bone grafting. The analysis showed that both one-stage and two-stage palatoplasty reduce the anterior dimensions of the maxillary arch compared with children without clefts, while two-stage palatoplasty is associated with a more favorable prognosis for maxillary growth. Malocclusion, crowding, hypodontia and microdontia of the lateral incisors are common, and an unfavorable sagittal intermaxillary relationship is significantly associated with reduced oral-health-related quality of life in adolescents. Secondary alveolar bone grafting is most effective when one-half to two-thirds of the root of the permanent canine has formed. Prevention of tooth-jaw deformities therefore requires a growth-friendly surgical protocol, regular orthodontic monitoring from early childhood, timely orthodontic and orthopedic treatment, and alveolar bone grafting within a multidisciplinary team.
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