Four-year follow-up on maxillary arch outcomes with presurgical infant orthopedics in unilateral cleft lip, alveolus, and palate: a retrospective cohort study.

OBJECTIVE: To compare the effects of different presurgical infant orthopedic (PSIO) modalities on maxillary arch morphology in children with complete unilateral cleft lip and palate (UCLP) at 4 years following cheiloplasty. MATERIALS AND METHODS: In this retrospective cohort study, 48 children with UCLP were included in four groups (n = 12 each): Modified Grayson's NAM, Dynacleft nasal elevator, aligner-based NAM with Dynacleft nasal elevator, and no-PSIO control. Digital maxillary models obtained at 4 years of age were analyzed for arch width, depth, length, arch form, vertical segment position, and segmental contact/collapse. Inter- and intraexaminer reliability were assessed using intraclass correlation coefficients (ICC). Intergroup comparisons were performed using one-way ANOVA and chi-square tests (α = 0.05). RESULTS: Intraclass correlation coefficients demonstrated good to excellent reliability, with ICC values ranging from 0.73 to 0.96. No statistically significant differences were found among the four groups for arch width, arch depth, arch length, arch form, vertical position of the lesser segment, or segmental contact/collapse (p > 0.05). Mean values across all transverse, sagittal, and vertical parameters were comparable, with no consistent pattern favoring any PSIO modality. CONCLUSION: At 4 years of age following primary cheiloplasty, no statistically significant differences in maxillary arch morphology were detected among the PSIO modalities and the no-PSIO group. Within the limitations of this retrospective cohort and its sample size, these findings do not demonstrate a detectable difference in the evaluated maxillary arch parameters among the four groups at 4 years of age. CLINICAL RELEVANCE: PSIO may provide early presurgical benefits, but no detectable differences in the evaluated maxillary arch parameters were observed among the four groups at 4 years of age in this cohort.