| Summary: | Indiana University-Purdue University Indianapolis (IUPUI) === Obturator therapy has been proposed for many years as an aid
in maxillary orthopedics for the complete unilateral cleft lip and
palate infant. The obturator appliance had the added benefit of providing
a false palate against which the infant can suckle. This has
aided in the feeding of these infants to assure adequate nutrition
with the least effort for parent and child. The current study
assessed three aspects of obturator therapy at James Whitcomb Riley
Hospital for Children, Indianapolis, Indiana.
Parental evaluations of the obturator proved to be very positive.
Almost all parents (96%) rated it as beneficial and would recommend
its use to other parents with cleft lip and palate infants. Weight
gain analysis over the first nine months of life demonstrated that
these infants were only slightly below the average for birth weight.
At three and nine months of age, a number (69% and 56% respectively)
had maintained their original weight percentile rankings or had just
dropped into the next lower category. Thus, many of the infants were
able to achieve adequate nutrition, a problem noted by many authors
when obturator therapy was not used. It should be emphasized that
each infant underwent either one or two major surgical procedures
during this time period.
Arch symmetry assessments at one, four and ten months showed
a gradual reduction in lateral posterior crossbite, canine crossbite,
and anterior crossbite tendency. Although the arches still showed
some collapse at the end of ten months of age, the pattern was much
better than at initial presentation with values much closer to normal.
Improvements in arch symmetry was expected as the maxilla grew.
From the results of this study, obturator therapy appears to be beneficial
in maxillary orthopedics by helping to maintain adequate weight
gain and gain parental acceptance.
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