A Comparison of Mixed Dentition Dental Development in Cleft Patients Treated With and Without the Latham-type Appliance.

PURPOSE: The purpose of this study was to retrospectively evaluate the Latham-type appliance's effect on the development and eruption of posterior teeth during the mixed dentition stage before palatal expansion and secondary alveolar bone graft(s). METHODS: The charts of complete cleft lip and palate (CLP) patients treated with and without the Latham-type appliance were screened using the following inclusion criteria: nonsyndromic; CLP; and available panoramic radiographs and clinical photographs in the mixed dentition prior to palatal expansion and secondary alveolar bone grafts. Surgical repair for Latham-type appliance patients followed the Latham-Millard protocol. The differences in outcomes were analyzed using Fisher's exact tests. RESULTS: The sample consisted of 65 patients treated with the appliance (Latham group) and 36 subjects who were not (non-Latham group). Similar incidences were found between the non-Latham group and the Latham group for maxillary second premolar agenesis (11 percent versus 10 percent) and enamel defects in the maxillary arch (17 percent versus 14 percent). The incidence of ectopic permanent maxillary first molars was higher in the Latham group than in the non-Latham group (28 percent versus one percent, P=0.01). CONCLUSIONS: A higher incidence of ectopic permanent maxillary first molars was found in patients treated with the Latham-type appliance.