Development of the facial profile between age 5 and the end of pubertal growth in patients with complete bilateral cleft lip and palate was studied by means of cephalometric x-rays taken at the age of 5, 10 and 15 years as well as at the end of the growth period. All 29 patients had been treated according to the same plan and operated upon by the same surgeon. Values for the ANB angle are typically very high in 5 year old children, and then decrease to values corresponding to those of the general population by the end of the pubertal growth period. Vertical development maintains the initial pattern; no compensatory vertical excess was observed. Due to the wide range in all measurements, the value of age-related mean values in a patient sample is of little consequence for individuals but can point out tendencies.
The multidisciplinary concept of maintaining the initially protrusive position of the premaxilla by means of a passive plate at the newborn and infant stage, as well as using surgical procedures with limited retrusive effect proved to be correct in the long run: At the young adult stage the angle ANB remained positive for almost all patients except for those with multiple tooth agenesis in the upper arch. A potential benefit of two-stage palate repair is seen
in the neutral vertical development of the patients examined. This hypothesis is supported by comparison with other studies from the literature.