Laura Linkevièienë, Juozas Olekas, L . Z aleckas, G. Kapuðinskas 54 Relation between the severity of palatal cleft and maxillary dental arch size Laura Linkevièienë, Juozas Olekas, Linas Zaleckas, Gintautas Kapuðinskas Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania Address for correspondence: Laura Linkevièienë, Institute of Odontology, Faculty of Medicine, Vilnius University, Þalgirio 117, Vilnius, Lithuania. E-mail: linklauros@one.lt The disorder of maxilla growth is one of the principal problems in treatment of cleft palate patients. For a long time the main cause for disturbance of maxillary growth has been thought to be surgical inter- vention – palatoplasty, the closure of palatal cleft. We analysed the influence of palatal cleft width on the development of upper jaw. Eva- luation of treatment results requires the records of primary anatomical data on cleft size and maxillary dimensions. The aim of the study was to define the primary anatomical data of isolated palatal clefts and to find a correlation between cleft width and maxillary dental arch size. We analysed the influence of palatal cleft width on the development of the upper jaw. Materials and methods . We analysed casts of 34 cases of isolated cleft palate patients at the age of 18 months before palatal surgery. The casts were moulded from A type silicone (Panasil, Keten- bach, german) impressions made under general anaesthesia. The mea- surements were perfomed with a Dentaurum sliding calliper of Mun- chen design and a three-direction Dentaurum Korkhaus meter. The ac- curacy of measurements was 0.1 mm. Repeated landmark identification reproducibility test of the measurements was done on 10 randomly se- lected study casts after at least 1 month by the same investigator. Pa- tiens were treated at Vilnius University Hospital Þalgiris Clinic. Results . The results showed that the width of the palatal cleft statistically signi- ficantly influenced the size of the maxilla. The largest maxillary dental arch circumference was found in the group of narrow clefts. Conclusion. Our results confirm the hypothesis that the width of the cleft influences the dental arch size. Key words : model analysis, isolated palatal cleft, cast measurements, cleft width, maxillary dental arch width ACTA MEDICA LITUANICA. 2005. VOLUME 12 No. 1. P. 54–57 © Lietuvos mokslø akademija, 2005 © Lietuvos mokslø akademijos leidykla, 2005 INTRODUCTION Every year about 30–40 newborns with some cra- niofacial malformations are born in Lithuania. Con- genital clefts of lip, alveolar process and palate ma- ke the major part among them. Maxillofacial surge- ons, orthodontists, ENT, speech therapists, paediat- ricians and restorative dentists provide rehabilita- tion for patients with maxillofacial clefts (1, 2). The treatment protocol at Vilnius University Institute of Odontology is complex and developed according to the Eurocleft recommendations (2). In spite of the fact that during the last two decades a significant improvement of treatment techniques and quality has been achieved, there is a lot of discussion left on the treatment time, tactics and methods. This is so because the final results of the treatment can be seen when the patient reaches 18 years of age. There are only a few prospective studies in the literature over- viewing the results of 18 years of treatment (2, 3). On the other hand, the primary anatomical data of clefts are of utmost importance, if we start to evaluate the final treatment results and analyse postoperative photos, dental casts, spe- ech fluency. The research projects are limited by a small number of samples, the variety of patho- logy, different treatment methods, and different case documentation methods (2, 3). Despite the general opinion that the deficiency of tissue, probably seen as the width of the alveolar cleft, and the position of maxillary segments are es- sential variables affecting the growth of the maxilla following lip, palate and nose repair, there are only a few studies aimed at examining this possible asso- ciation. More often the effect of treatment, particu- larly surgical technique and timing of operation, ha- ve been studied and considered to have a great im- pact on the growth and development of craniofacial complex in children with cleft (4–7).