Periodontal conditions in adolescents with cleft lip, alveolus and palate following treatment in a co-ordinated team approach

Abstract

The aim of the present investigation was to evaluate the oral hygiene habits and the periodontal conditions of a group of cleft lip, alveolus and palate patients at the end of a longitudinal multidisciplinary treatment. From a total of 120 patients who had been supervised at the University of Berne, Clinic for Pediatric Surgery for at least 18 years in a co-ordinated team approach, 80 were selected on the basis of availability. Plaque control record (PCR), calculus index (CI), gingival bleeding index (GBI), pocket probing depth (PD), loss of attachment (LA) and furcation involvement were recorded. Using the technique and the ruler described by Schei et al., the radiographic height of the alveolar crest from the cemento-enamel junction was determined. Between the different groups of deformities, no statistically significant differences were found for all the clinical parameters with the exception of the mean PD orally and the mean PD bucally which were shallower in the isolated cleft lip group. These differences were attributed to the long-term orthodontic therapy with fixed appliances. When the PD and the LA at the sites adjacent to the cleft region were compared to two 'unaffected' control sites, no statistically significant differences were found, whereas the comparison with the radiographic bone loss showed a statistically significant bone height. These results may indicate the presence of a long connective tissue attachment without bony support in the cleft region. As a result of inadequate oral hygiene, the patients with cleft lip, alveolus and palate showed beginning periodontitis with loss of attachment and beginning furcation involvement in most of the cases. Since these patients need long-term orthodontic therapy with fixed appliances, they should be incorporated in intensive prophylaxis programs as early in age as possible.