Three-dimensional morphology of the palate in subjects with isolated cleft palate at the stage of permanent dentition

Objective: Three-dimensional analysis of palate size and shape in patients with isolated cleft palate at the stage of permanent dentition. Design: Cross-sectional study using Fourier transform profilometry. Subjects: Twenty-nine randomly selected dental casts of approximately 15-year-old boys with isolated cleft palate and 28 dental casts of normal boys of the same age. Interventions: All patients were operated on by the same method (pushback and pharyngeal flap surgery) at a mean age of 4.5 years. Main Outcome Measures: Data on the palate height in 210 defined locations (pixels). Results: The palate in isolated clefts is narrower throughout its whole extent and lower from the level of the first premolars. The difference, as compared with controls, increases in a posterior direction. At the level of the first molars, palatal height is reduced by one-quarter, the area of the transversal section by more than one-third. The shaping of the palate vault is, on average, symmetrical with a marked interindividual variability. Palatal height does not depend on the width of the dentoalveolar arch, and the height of the primary palate is not reduced. Conclusion: The smaller width and reduced height from the level of the first premolars posteriorly confirm the substantially reduced space available for the tongue in patients with isolated cleft palate. Deviations are on the average symmetrical, and the anterior part of the palate is not shallower.