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Delay A, Bellier A, Giot JP, Bettega G, Morand B. The influence of three different primary treatment protocols on 5-year-old maxillary growth in patients with complete unilateral cleft lip and palate. J Craniomaxillofac Surg 2024:S1010-5182(24)00169-0. [PMID: 38729845 DOI: 10.1016/j.jcms.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/13/2024] [Accepted: 04/27/2024] [Indexed: 05/12/2024] Open
Abstract
The study evaluated the effects of three different primary treatment protocols on maxillary growth in patients aged 5 years with complete unilateral cleft lip and palate (UCLP). The secondary objective was to assess the influence of initial cleft severity, family history of class III, and status of permanent lateral incisor on maxillary growth. In total, 54 patients with non-syndromic complete UCLP were included and grouped as follows: group An underwent lip adhesion, cheilorhinoplasty associated with tibial periosteal graft for hard palate repair, and finally veloplasty; group B underwent lip adhesion, then cheilorhinoplasty with intravelar veloplasty, and finally a hard-palate repair; group C underwent cheilorhinoplasty with intravelar veloplasty and then a hard-palate repair. Five-year maxillary growth was assessed on dental models, both clinically and digitally. No difference was found with GOSLON-Yardstick scoring. Five-year measurements showed that group C tended to have the best maxillary arch morphology (p = 0.012). Initial cleft severity did not impact maxillary growth, but status of permanent lateral incisor and family history of class III did (p = 0.019 and p = 0.004, respectively). In patients aged 5 years, the two-stage approach appeared to be the least detrimental to growth development. Predictive factors for growth retardation included the absence of lateral incisor and a family history of class III.
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Affiliation(s)
- Alexandra Delay
- Maxillo-facial and Plastic Surgery Department, Grenoble Alpes University Hospital, University Grenoble Alpes, F-38000, Grenoble, France.
| | - Alexandre Bellier
- Clinical Investigation Center, Grenoble Alpes University Hospital, University Grenoble Alpes, F-38000, Grenoble, France
| | - Jean-Philippe Giot
- Maxillo-facial and Plastic Surgery Department, Grenoble Alpes University Hospital, University Grenoble Alpes, F-38000, Grenoble, France
| | - Georges Bettega
- Maxillo-facial Surgery Department, Annecy Genevois Hospital, Annecy, France
| | - Beatrice Morand
- Maxillo-facial and Plastic Surgery Department, Grenoble Alpes University Hospital, University Grenoble Alpes, F-38000, Grenoble, France
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AMBROSIO ECP, PUCCIARELLI MGR, SFORZA C, SOARES S, MENEZES MD, CARRARA CFC, MACHADO MAAM, OLIVEIRA TM. Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study. Braz Oral Res 2023; 37:e021. [PMID: 37018803 DOI: 10.1590/1807-3107bor-2023.vol37.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/23/2022] [Indexed: 04/05/2023] Open
Abstract
This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.
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Lim J, Tanikawa C, Kogo M, Yamashiro T. Determination of prognostic factors for orthognathic surgery in children with cleft lip and/or palate. Orthod Craniofac Res 2021; 24 Suppl 2:153-162. [PMID: 33599070 DOI: 10.1111/ocr.12477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/26/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the prognostic factors for orthognathic surgery (OGS) in children with cleft lip and/or palate (CL/P) using artificial intelligence (AI) systems. DESIGN Retrospective cohort study. SETTING An orthodontic department at a university dental hospital. PARTICIPANTS This study included 126 patients with bilateral and unilateral CL/P for whom lateral cephalograms were obtained at three time points: 7 (T1), 10 (T2) and 15 (T3) years of age. MAIN OUTCOME MEASURES Cleft type, severity of lip separation at birth, number of missing teeth, sex, palatal repair methods and surgeons, cephalometric variables at T1 and T2, and the total duration of orthodontic treatment were examined as predictors. The need for OGS and skeletal and dental discrepancies at T3 was examined as outcomes. RESULTS A total of six models were developed, with a mean area under the receiver operating characteristic curve of 0.93. Multiple prognostic factors for OGS were identified. In particular, the number of clefts in the lip and alveolus showed relatively high odds ratios, as did anterior crossbite at T3. Achieving palatal closure with the push-back method, rather than Furlow's method, was also found to be a predictive factor for anterior crossbite at T3, with high odds ratios. CONCLUSIONS The prognostic factors for OGS determined by the AI systems were the number of clefts in the lip and alveolus, the palatal repair method, male sex, several cephalometric variables for the sagittal and vertical dimensions, growth patterns and the number of missing teeth.
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Affiliation(s)
- Jaeyeon Lim
- Graduate School of Dentistry, Osaka University, Suita, Japan
| | - Chihiro Tanikawa
- Graduate School of Dentistry, Osaka University, Suita, Japan.,Center for Advanced Medical Engineering and Informatics, Osaka University, Suita, Japan
| | - Mikihiko Kogo
- Graduate School of Dentistry, Osaka University, Suita, Japan
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Datusanantyo RA, Hutagalung MR, Rizaliyana S, Marzoeki D. Anthropometric Outcome of Primary Unilateral Cleft Lip Repair in Indonesia. Cleft Palate Craniofac J 2021; 58:1236-1241. [PMID: 33423535 DOI: 10.1177/1055665620982757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aimed to measure and analyze the outcome of primary unilateral cleft lip repair. DESIGN Observational cohort study. SETTING Surabaya Cleft Lip and Palate (CLP) Center, a major referral center for the Eastern part of Indonesia, affiliated with a tertiary center. PATIENTS, PARTICIPANTS From 69 patients who met the inclusion criteria, we excluded 31 patients who were more than 2 years of age and were operated on by junior residents under supervision. INTERVENTIONS We performed anthropometric measurements of the patients on photographs taken before, immediately after, and a year after the surgery. MAIN OUTCOME MEASURE(S) This study measured nasal width, vertical lip height, horizontal lip length, and philtral height ratios. RESULTS While nasal width and philtral height ratios decreased significantly (P = .000 and P = .000, respectively) reaching symmetry immediately after surgery, the horizontal lip length, and vertical lip height ratios remained unchanged (P = .862 and P = .981, respectively). A year after surgery, the nasal width and horizontal lip length ratios increased significantly (P = .017 and P = .006, respectively), while philtral height and vertical lip height ratios remained unchanged (P = .927 and P = .138, respectively). There was no difference in the ratios based on the initial size and completeness of the cleft. CONCLUSION In Surabaya CLP Center, the symmetry of nasal width, philtral height, horizontal lip length, and vertical lip height were achieved by the unilateral cleft lip repair despite the initial size and completeness of the cleft.
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Affiliation(s)
- Robertus Arian Datusanantyo
- Plastic Reconstructive & Aesthetic Surgery Department, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Magda Rosalina Hutagalung
- Plastic Reconstructive & Aesthetic Surgery Department, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Sitti Rizaliyana
- Plastic Reconstructive & Aesthetic Surgery Department, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Djohansjah Marzoeki
- Plastic Reconstructive & Aesthetic Surgery Department, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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Tache A, Mommaerts MY. The need for maxillary osteotomy after primary cleft surgery: A systematic review framing a retrospective study. J Craniomaxillofac Surg 2020; 48:919-927. [DOI: 10.1016/j.jcms.2020.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 06/26/2020] [Accepted: 07/12/2020] [Indexed: 11/29/2022] Open
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Baessa GCP, Ozawa TO, Garib D, Lauris RDCMC, Almeida AMD, Pegoraro‐Krook MI, Dutka JDCR, Gregorio LVL, Sathler R. Is the early mixed dentition dental arch relationship related to the anteroposterior alignment of the maxillary segments in infants with CUCLP? Orthod Craniofac Res 2020; 23:427-431. [DOI: 10.1111/ocr.12385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 04/20/2020] [Accepted: 04/23/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Terumi O. Ozawa
- Orthodontist of the Hospital for Rehabilitation of Craniofacial Anomalies University of São Paulo Bauru Brazil
| | - Daniela Garib
- Orthodontics Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies University of São Paulo Bauru Brazil
| | | | - Araci Malagodi de Almeida
- Orthodontist of the Hospital for Rehabilitation of Craniofacial Anomalies University of São Paulo Bauru Brazil
| | - Maria Inês Pegoraro‐Krook
- Speech Pathologist, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies University of São Paulo Bauru Brazil
| | - Jeniffer de Cassia Rillo Dutka
- Speech Pathologist, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies University of São Paulo Bauru Brazil
| | | | - Renata Sathler
- Orthodontist of the Hospital for Rehabilitation of Craniofacial Anomalies University of São Paulo Bauru Brazil
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Botticelli S, Küseler A, Marcusson A, Mølsted K, Nørholt SE, Cattaneo PM, Pedersen TK. Do Infant Cleft Dimensions Have an Influence on Occlusal Relations? A Subgroup Analysis Within an RCT of Primary Surgery in Patients With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2019; 57:378-388. [DOI: 10.1177/1055665619875320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim: To investigate whether infant cleft dimensions, in a surgical protocol with early or delayed hard palate closure, influence occlusion before orthodontics. Design: Subgroup analysis within a randomized trial of primary surgery (Scandcleft). Setting: Tertiary health care. One surgical centre. Patients and Methods: A total of 122 unilateral cleft lip and palate infants received primary cheilo-rhinoplasty and soft palate closure at age 4 months and were randomized for hard palate closure at age 12 versus 36 months. A novel 3D analysis of cleft size and morphology was performed on digitized presurgical models. Occlusion was scored on 8-year models using the modified Huddarth–Bodenham (MHB) Index and the Goslon Yardstick. Main Outcome Measurements: Differences in MHB and Goslon scores among the 2 surgical groups adjusted for cleft size. Results: The crude analysis showed no difference between the 2 surgical groups in Goslon scores but a better MHB ( P = .006) for the group who received delayed hard palate closure. When adjusting for the ratio between cleft surface and palatal surface (3D Infant Cleft Severity Ratio) and for posterior cleft dimensions at tuberosity level, the delayed hard palate closure group received 3.65 points better for MHB (confidence interval: 1.81; 5.48; P < .001) and showed a trend for reduced risk of receiving a Goslon of 4 or 5 ( P = .052). For posterior clefts larger than 9 mm, the Goslon score was better in the delayed hard palate closure group ( P = .033). Conclusions: Seen from an orthodontic perspective, when the soft palate is closed first, and the cleft is large, the timing of hard palate closure should be planned in relation to posterior cleft size.
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Affiliation(s)
- Susanna Botticelli
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
- Cleft Lip and Palate Center, IKH, Region Midt-Denmark
| | - Annelise Küseler
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
- Cleft Lip and Palate Center, IKH, Region Midt-Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital-Denmark
| | - Agneta Marcusson
- Maxillofacial Unit, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Kirsten Mølsted
- Copenhagen Cleft Palate Center-University Hospital of Copenhagen-Denmark
| | - Sven E. Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital-Denmark
- Section of Oral Surgery and Oral Pathology, Aarhus University-Denmark
| | | | - Thomas K. Pedersen
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital-Denmark
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Anthropometric Analysis of the Dental Arches of Five-Year-Old Children With Cleft Lip and Palate. J Craniofac Surg 2018; 29:1657-1660. [PMID: 30028406 DOI: 10.1097/scs.0000000000004806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aimed to analyze the dimensional alterations of the dental arches of 5-year-old children with cleft lip and palate and to compare these dimensions with children without oral clefts. One hundred twenty children were divided into the following groups: unilateral cleft lip (UCL), unilateral cleft lip and palate (UCLP), cleft palate (CP), and control (C). A specific software was used to digitize the dental casts and perform the anthropometric analyses through the measurement of transversal linear intercanine and intermolar distances on the maxilla and mandible. The intergroup comparisons of the maxillary dimensions exhibited that the intercanine distances of groups C and UCL were statistically greater than that of groups UCLP and CP. The intermolar distance was significantly smaller in group UCLP than in the other groups. No statistically significant difference occurred in the mandibular intercanine and intermolar distance among groups. The analysis of the superposition of the maxillary over the mandibular transversal distances showed statistically significant differences among groups. This study showed that at 5-year old, the children with cleft involving the palate had more maxillary dimensional alterations than those without cleft palate.
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Peterson P, Mars M, Gowans A, Larson O, Neovius E, Henningsson G, Andlin-Sobocki A, Pegelow M, Lemberger M, Raud-Westberg LM, Karsten ALA. Mean GOSLON Yardstick Scores After 3 Different Treatment Protocols—A Long-term Study of Patients With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2018; 56:236-247. [DOI: 10.1177/1055665618774010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: (1) To evaluate dental arch relationships, with the Great Ormond Street, London and Oslo (GOSLON) Yardstick, of participants with Unilateral cleft lip and palate (UCLP) and treated with 1-stage palatal closure with 3 different surgical protocols (2) to compare the mean GOSLON ratings with other CLP centers. Design: Retrospective study of medical charts and dental models. Setting: Karolinska University Hospital, Stockholm, Sweden. Participants: Eighty-seven patients with UCLP operated with 1-stage palatal repair. Thirty-five were operated with Veau-Wardill-Kilner (VWK) technique 1975 to 1986, 31 with minimal incision technique (MIT) from 1987 to 1997, and 21 according to MIT with muscle reconstruction (MITmr) 1998 to 2004. Interventions: Dental casts at ages 5 (n = 87), 7 to 8 (n = 27), 10 (n = 81), 16 (n = 61), and 19 (n = 35) years were rated by 10 assessors with the GOSLON Yardstick. Information of other interventions was retrieved from patients’ charts. Main outcome measures: Mean GOSLON ratings. Results: A total of 82% of the participants were rated as having excellent to satisfactory outcome. Weighted κ statistics for the 10 assessors was good for inter-rater agreement and good/very good for intra-rater agreement. Conclusions: The mean GOSLON score in the Stockholm overall material at age 10 was 2.67. The VWK technique resulted in a greater need of orthognathic surgery than the MIT ( P < .01). The MITmr did not produce better dental arch relationships than MIT at age 5 ( P < .05). The best dental arch relationships were found in the MIT group at 10 years, mean 2.58, which is not significantly different from other centers with excellent outcome except Gothenburg and Vienna.
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Affiliation(s)
- Petra Peterson
- Department of Reconstructive Plastic Surgery, Stockholm Cranofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - Michael Mars
- Department of Orthodontics, Great Ormond Street Hospital, London, United Kingdom
| | - Alan Gowans
- Department of Orthodontics, Leeds Dental Institute and Royal, College of Surgeons of Edinburgh, United Kingdom
| | - Ola Larson
- Department of Reconstructive Plastic Surgery, Stockholm Cranofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Neovius
- Department of Reconstructive Plastic Surgery, Stockholm Cranofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - Gunilla Henningsson
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karoliniska Insitutet, Stockholm, Sweden
| | | | - Marie Pegelow
- Division of Orthodontics and Jaw Orthopedics, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mathias Lemberger
- Division of Orthodontics and Jaw Orthopedics, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Liisi M. Raud-Westberg
- Department of Reconstructive Plastic Surgery, Stockholm Cranofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - Agneta L-A Karsten
- Department of Reconstructive Plastic Surgery, Stockholm Cranofacial Team, Karolinska University Hospital, Stockholm, Sweden
- Division of Orthodontics, Department of Dental Medicine, Karolinska University Hospital, Stockholm, Sweden
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Akarsu-Guven B, Arisan A, Ozgur F, Aksu M. Influence of nasoalveolar molding on skeletal development in patients with unilateral cleft lip and palate at 5 years of age. Am J Orthod Dentofacial Orthop 2018; 153:489-495. [PMID: 29602340 DOI: 10.1016/j.ajodo.2017.08.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 08/01/2017] [Accepted: 08/01/2017] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The aim of this retrospective study was to assess the influence of presurgical nasoalveolar molding (NAM) on skeletal development in patients with operated unilateral cleft lip and palate at 5 years of age. MATERIALS Lateral cephalometric radiographs of 26 unilateral cleft lip and palate patients who had undergone presurgical NAM (NAM group) and 20 unilateral cleft lip and palate patients who did not have any presurgical NAM (non-NAM group) were analyzed. The radiographs were digitally traced using Quick Ceph Studio software (version 3.5.1.r (1151); Quick Ceph Systems, San Diego, Calif). Independent samples t tests were performed for statistical analysis. RESULTS No significant differences were observed in sagittal and vertical skeletal measurements between the NAM and non-NAM groups. CONCLUSIONS NAM resulted in no significant difference in skeletal development in unilateral cleft lip and palate patients compared with those without NAM in early childhood.
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Affiliation(s)
- Bengisu Akarsu-Guven
- Department of Orthodontics, Faculty of Dentistry, Research and Application Center for the Treatment of Cleft Lip and Palate and Craniomaxillofacial Deformities, Hacettepe University, Ankara, Turkey
| | - Arda Arisan
- Department of Orthodontics, Faculty of Dentistry, Research and Application Center for the Treatment of Cleft Lip and Palate and Craniomaxillofacial Deformities, Hacettepe University, Ankara, Turkey
| | - Figen Ozgur
- Department of Plastic, Reconstructive and Esthetic Surgery, Faculty of Medicine, Research and Application Center for the Treatment of Cleft Lip and Palate and Craniomaxillofacial Deformities, Hacettepe University, Ankara, Turkey
| | - Muge Aksu
- Department of Orthodontics, Faculty of Dentistry, Research and Application Center for the Treatment of Cleft Lip and Palate and Craniomaxillofacial Deformities, Hacettepe University, Ankara, Turkey.
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Long-term craniofacial morphology in young adults treated for a non-syndromal UCLP: A systematic review. J Plast Reconstr Aesthet Surg 2018; 71:504-517. [DOI: 10.1016/j.bjps.2017.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 09/28/2017] [Accepted: 12/05/2017] [Indexed: 01/10/2023]
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Antonarakis GS, Tompson BD, Fisher DM. Preoperative Cleft Lip Measurements and Maxillary Growth in Patients with Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2016; 53:e198-e207. [DOI: 10.1597/14-274] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective Maxillary growth in patients with cleft lip and palate is highly variable. The authors' aim was to investigate associations between preoperative cleft lip measurements and maxillary growth determined cephalometrically in patients with complete unilateral cleft lip and palate (cUCLP). Design Retrospective cross-sectional study. Patients Children with cUCLP. Methods Preoperative cleft lip measurements were made at the time of primary cheiloplasty and available for each patient. Maxillary growth was evaluated on lateral cephalometric radiographs taken prior to any orthodontic treatment and alveolar bone grafting (8.5 ± 0.7 years). The presence of associations between preoperative cleft lip measurements and cephalometric measures of maxillary growth was determined using regression analyses. Results In the 58 patients included in the study, the cleft lateral lip element was deficient in height in 90% and in transverse width in 81% of patients. There was an inverse correlation between cleft lateral lip height and transverse width with a β coefficient of −0.382 ( P = .003). Patients with a more deficient cleft lateral lip height displayed a shorter maxillary length (β coefficient = 0.336; P = .010), a less protruded maxilla (β coefficient = .334; P =.008), and a shorter anterior maxillary height (β coefficient = 0.306; P = .020) than those with a less deficient cleft lateral lip height. Conclusions Patients with cUCLP present with varying degrees of lateral lip hypoplasia. Preoperative measures of lateral lip deficiency are related to later observed deficiencies of maxillary length, protrusion, and height.
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Affiliation(s)
| | - Bryan D. Tompson
- Division of Orthodontics, The Hospital for Sick Children, Department of Orthodontics, Faculty of Dentistry, University of Toronto, Toronto Ontario, Canada
| | - David M. Fisher
- Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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Jorge PK, Gnoinski W, Vaz Laskos K, Felício Carvalho Carrara C, Gamba Garib D, Okada Ozawa T, Andrade Moreira Machado MA, Pinelli Valarelli F, Oliveira TM. Comparison of two treatment protocols in children with unilateral complete cleft lip and palate: Tridimensional evaluation of the maxillary dental arch. J Craniomaxillofac Surg 2016; 44:1117-22. [DOI: 10.1016/j.jcms.2016.06.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/31/2016] [Accepted: 06/30/2016] [Indexed: 11/28/2022] Open
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Jabbari F, Reiser E, Thor A, Hakelius M, Nowinski D. Correlations between initial cleft size and dental anomalies in unilateral cleft lip and palate patients after alveolar bone grafting. Ups J Med Sci 2016; 121:33-7. [PMID: 26923345 PMCID: PMC4812055 DOI: 10.3109/03009734.2015.1134733] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective To determine in individuals with unilateral cleft lip and palate the correlation between initial cleft size and dental anomalies, and the outcome of alveolar bone grafting. Methods A total of 67 consecutive patients with non-syndromic unilateral complete cleft lip and palate (UCLP) were included from the cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. All patients were operated by the same surgeon and treated according to the Uppsala protocol entailing: lip plasty at 3 months, soft palate closure at 6 months, closure of the residual cleft in the hard palate at 2 years of age, and secondary alveolar bone grafting (SABG) prior to the eruption of the permanent canine. Cleft size was measured on dental casts obtained at the time of primary lip plasty. Dental anomalies were registered on radiographs and dental casts obtained before bone grafting. Alveolar bone height was evaluated with the Modified Bergland Index (mBI) at 1 and 10-year follow-up. Results Anterior cleft width correlated positively with enamel hypoplasia and rotation of the central incisor adjacent to the cleft. There was, however, no correlation between initial cleft width and alveolar bone height at either 1 or 10 years follow-up. Conclusions Wider clefts did not seem to have an impact on the success of secondary alveolar bone grafting but appeared to be associated with a higher degree of some dental anomalies. This finding may have implications for patient counseling and treatment planning.
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Affiliation(s)
- Fatima Jabbari
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
- CONTACT Fatima Jabbari DDS, senior consultant orthodontist Oral and Maxillofacial Surgery, Department of Surgical Sciences, Uppsala University, 751 85 Uppsala, Sweden
| | - Erika Reiser
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Andreas Thor
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Malin Hakelius
- Department of Surgical Sciences, Plastic Surgery, Uppsala University, Uppsala, Sweden
| | - Daniel Nowinski
- Department of Surgical Sciences, Plastic Surgery, Uppsala University, Uppsala, Sweden
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Antonarakis GS, Adibfar A, Tompson BD, Daskalogiannakis J, Fisher DM. Presurgical cleft lip anthropometrics and dental arch relationships in patients with complete unilateral cleft lip and palate. Cleft Palate Craniofac J 2014; 52:269-76. [PMID: 24805871 DOI: 10.1597/13-272] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate associations between anthropometric lip measurements and dental arch relationships in patients with complete unilateral cleft lip and palate (CUCLP). DESIGN Retrospective cross-sectional study. PATIENTS Children with CUCLP. METHODS Anthropometric lip measurements, made immediately prior to lip repair, were available for each patient. The dental arch relationships were evaluated on dental study casts (8.6 ± 0.9 years) taken prior to any orthodontic treatment and prior to alveolar bone graft, using the modified Huddart and Bodenham (MHB) scoring system. The presence of associations between anthropometric lip measurements and dental arch relationships was determined using linear regression analysis. RESULTS In the 63 patients included in the study, the cleft lateral lip element was deficient in height in 87% and in transverse width in 86% of patients. Patients with more deficient cleft-side lateral lip height were more likely to present with more negative MHB scores (r = .443; P < .001). Conversely, patients with more deficient cleft-side lateral lip transverse width more often presented with more positive MHB scores (r = .281; P = .025). CONCLUSIONS In patients with CUCLP, there is a wide variability in the degree of deficiency of the cleft-side lateral lip element, both in the vertical and in the transverse dimension. The extent of this deficiency may, in part, predict the resulting dental arch relationships.
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Maxillary reaction patterns identified by three-dimensional analysis of casts from infants with unilateral cleft lip and palate. J Orofac Orthop 2013; 74:275-86. [DOI: 10.1007/s00056-013-0153-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 12/07/2012] [Indexed: 11/26/2022]
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