Postpubertal growth and development of the face in unilateral cleft lip and palate as compared to the pubertal period: a longitudinal study.
X-ray cephalometry was used for the assessment of 22 boys and 23 girls with complete unilateral cleft lip and palate who were treated with the same surgical method. They were examined at the age of 10 years and in adulthood. In the group of 13 boys and 15 girls, examined also at the age of 15 years, were analysed intersexual differences of facial growth and development during the postpubertal period and the results were compared with those obtained during the pubertal period. The data showed that in boys facial growth persists after the age of 15 years and in the region of the upper face attains about half the values recorded in the period of puberty, while mandibular growth attains almost the same values as during puberty. In girls the growth is almost terminated but for the lower jaw, where it is still significant though several times slighter than during puberty. In both sexes there is only a minimum growth of maxillary depth and of upper lip height during the postpubertal period, as well as during the pubertal period. The highest growth rate shows the depth of the nose. Because of the intersexual differences in the amount of postpubertal growth, developmental changes in facial configuration do not occur in girls during this period, while in boys a further deterioration of maxillary protrusion, of sagittal jaw relations, and of the upper lip prominence continues, as well as an increase of the flattening of the face. In contrast to the pubertal period in both sexes, a proclination of upper incisors and an improvement of overjet was not attained. Contrary to the pubertal period, in the postpubertal period, intersexual differences in the amount of growth and of the developmental changes in the shape and position of facial characteristics were recorded. Therefore during studies of the growth and development of the face, it is not possible to pool both sexes without some reservations. This holds true in particular in the postpubertal period.