The Slav-cleft: A three-center study of the outcome of treatment of cleft lip and palate. Part 1: Craniofacial morphology

Objective: This study examined the factors related to the morphogenesis of the craniofacial complex of the CL/Fr mouse fetus affected with CLP based on the findings of a lateral cephalogram. Design: Embryo transfer experiments were performed to determine the effect of the fetus weight, dam strain, dam weight, and litter size on the intra-uterine craniofacial morphogenesis of CL/Fr mouse fetuses. On the 18th gestational day, each pregnant dam that had received CL/Fr mouse embryos was laparotomized to remove the transferred fetuses that had developed in the uteri of the cleft lip and palate (CLP)-susceptible CL/Fr strain dam and the CLP-resistant C57BL strain dam. A cephalometric observation of the craniofacial morphology of each fetus was subsequently performed. Results: Based on a multiple regression analysis, the standardized partial regression coefficients of the affected fetus weight, the dam weight, and the litter size on the maxillary size of the affected CL/Fr fetus were 0.71 (p < .01), 0.03, and −0.07. According to a least-squares analysis of variance, the dam strain effect in addition to the effect of the affected fetus weight on the maxillary size and the cranial size of the affected fetuses was significant (p < .01 for cranial size, p < .05 for maxillary size) and close to a significant level (p = .09) for the mandibular size of the affected fetuses. The adjusted maxillary size and cranial size after statistically eliminating the effects of the affected fetus weight, dam weight, and lifter size on each original craniofacial size of the affected fetuses that had developed in the CL/Er dam strain were also significantly smaller than those of the affected fetuses that had developed in the C57BL dam strain. Conclusions: The present results indicate that the craniofacial growth of the CL/Fr mouse fetus affected with CLP increased in proportion to the fetus weight. The dam strain effect, in addition to the effect of the affected fetus weight, could thus not be ignored when the etiology of the spontaneous CLP was examined, while the uterine environment, provided by the CL/Fr strain dam, retarded the intra-uterine craniofacial growth of the affected fetuses. It was therefore concluded that the dam strain effect, as well as the effect of the affected fetus weight, both play an important role on the craniofacial morphogenesis of the CL/Fr strain of the affected fetuses that developed in both strain dams.

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Craniofacial Morphology in Children with Complete Bilateral Cleft Lip and Palate: Does Infantile Size of the Premaxilla Predetermine Outcome?

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-021.1 ◽

2004 ◽

Vol 41 (4) ◽

pp. 410-415 ◽

Cited By ~ 6

Author(s):

Yu-Fang Liao ◽

Chiung-Shing Huang ◽

Ya-Yu Tsai ◽

M. Samuel Noordhoff

Keyword(s):

Retrospective Study ◽

Outcome Measures ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Craniofacial Morphology ◽

University Hospital ◽

Cephalometric Analysis ◽

Bilateral Cleft Lip ◽

Dental Cast ◽

Craniofacial Characteristics

Objective To evaluate the possible association between the size of the premaxilla in infants and craniofacial morphology in children with complete bilateral cleft lip and palate (CBCLP) and identify the characteristics of craniofacial morphology in children with CBCLP with median facial dysplasia (MFD). Design Retrospective study. Setting A university hospital craniofacial center. Subjects Thirty-four patients with nonsyndromic CBCLP, 24 boys and 10 girls, had large premaxilla (LP group). Thirty-six patients with nonsyndromic CBCLP, 16 boys and 20 girls, had small premaxilla (SP group). Thirteen CBCLP patients with MFD, five boys and eight girls (MFD group). Main Outcome Measures Infant maxillary dental cast at the age of 1 year was used to measure the size of the premaxilla. Cephalometric analysis was used to determine craniofacial morphology in children at the age of 5 years. Results The size of the premaxilla in infants with CBCLP varied greatly. The LP group tended to have a longer maxilla and a more protruded maxilla, producing a better interjaw relation. The opposite phenomena were observed in the MFD group; the SP group yielded results between those of the LP and the MFD groups. Conclusion The size of the premaxilla in infants with CBCLP can be used to predetermine subsequent craniofacial morphology at the age of 5 years. Children with nonsyndromic CBCLP had craniofacial characteristics that differed significantly from those of children with CBCLP with median facial dysplasia.

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Three-dimensional craniofacial morphology in unilateral cleft lip and palate

Journal of Oral Science ◽

10.2334/josnusd.56.165 ◽

2014 ◽

Vol 56 (2) ◽

pp. 165-172 ◽

Cited By ~ 13

Author(s):

Eyas Abuhijleh ◽

Halise Aydemir ◽

Ufuk Toygar-Memikoğlu

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Craniofacial Morphology

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A Longitudinal Three-Center Study of Dental Arch Relationship in Patients With Bilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/08-249.1 ◽

2010 ◽

Vol 47 (2) ◽

pp. 167-174 ◽

Cited By ~ 13

Author(s):

Theodosia Bartzela ◽

Christos Katsaros ◽

William C. Shaw ◽

Elisabeth Rønning ◽

Sara Rizell ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Dental Arch ◽

Bilateral Cleft Lip ◽

Dental Arch Relationship ◽

Center Study

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A Roentgenocephalometric Study of Dento-craniofacial Morphology of Repaired Complete Unilateral Cleft Lip and Palate Individuals after Adolescent Growth Spurt

THE JOURNAL OF THE STOMATOLOGICAL SOCIETY JAPAN ◽

10.5357/koubyou.40.476 ◽

1973 ◽

Vol 40 (4) ◽

pp. 476-497 ◽

Cited By ~ 4

Author(s):

Yoshinobu Shibasaki

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Craniofacial Morphology ◽

Growth Spurt ◽

Adolescent Growth Spurt

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Changes in Craniofacial Development Due to Modifications of the Treatment of Unilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1998_035_0240_cicddt_2.3.co_2 ◽

1998 ◽

Vol 35 (3) ◽

pp. 240-247 ◽

Cited By ~ 10

Author(s):

Zbyněk Šmahel ◽

Živa Müllerova ◽

Aleš Nejedly ◽

Ivan Horak

Keyword(s):

Bone Grafting ◽

Orthodontic Treatment ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Craniofacial Morphology ◽

Consecutive Series ◽

Posterior Displacement ◽

Surgical Methods ◽

Primary Bone ◽

Fixed Appliances

Objective The objective of this study was to evaluate the craniofacial morphology of children with unilateral cleft lip and palate (UCLP) resulting from differing management protocols practiced in Prague from 1945 to 1976. Design The craniofacial morphologies of four groups of patients were compared. Two groups were assessed retrospectively (individuals born from 1945 to 1963), and two groups were followed on a longitudinal basis (individuals born from 1966 to 1976). Setting The study was conducted at the Cleft Lip and Palate Center at the Department of Plastic Surgery, Prague, which has a catchment area population of 6 million. Patients The subjects were a consecutive series of adult males (n = 84) who had complete UCLP without associated malformations. Interventions Patients born from 1945 to 1955 did not receive centralized orthodontic therapy. From 1945 to 1965, the alveolar process in the area of the cleft was not surgically repaired. Primary bone grafting was used for the group born from 1965 to 1972, and primary periosteoplasty was used in the subsequent period. Throughout the period covered by the study, the palate was operated on by pushback and pharyngeal flap surgery. From 1945 to 1965, the lip was repaired initially according to Veau, and later according to Tennison and Randall, and during this time, fixed appliances were used for orthodontic treatment. Results The results for the period from 1945 to 1955 are characterized by mandibular overclosure with anterior crossbite. Centralized orthodontic treatment in the later period improved sagittal jaw relations due to the posterior displacement of the mandible and an edge-to-edge bite was attained, but maxillary retrusion was unchanged. Primary bone grafting increased retrusion of the maxilla, which was compensated by further posterior displacement of the mandible. An edge-to-edge bite was also obtained. Primary periosteoplasty reduced maxillary retrusion, and the marked proclination of the upper dentoalveolar component with fixed appliances resulted in a positive overjet. It was no longer necessary to push the mandible back to the extent required in bone grafting. Conclusion Effective orthodontic treatment made the greatest contribution to improved facial development. It allowed compensation of maxillary retrusion by changes in the position of the mandible or by proclination of the upper dentoal-veolar component with fixed appliances. The applied surgical methods using primary bone grafting caused deterioration of the anterior growth of the maxilla.

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Craniofacial Morphology in Patients with Kallmann's Syndrome with and without Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1997_034_0417_cmipwk_2.3.co_2 ◽

1997 ◽

Vol 34 (5) ◽

pp. 417-424 ◽

Cited By ~ 9

Author(s):

Kirsten Mølsted ◽

Inger Kjær ◽

Aleksander Giwercman ◽

Søren Vesterhauge ◽

Niels Erik Skakkebæk

Keyword(s):

Luteinizing Hormone ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Hypogonadotropic Hypogonadism ◽

Craniofacial Morphology ◽

Endocrine Treatment ◽

Anterior Cranial Base ◽

Kallmann's Syndrome ◽

Maxilla And Mandible ◽

Kallmann’S Syndrome

Objective: Kallmann's syndrome is characterized by the association of hypogonadotropic hypogonadism and anosmia or hyposmia. The principal endocrine defect of hypogonadotropic hypogonadism is a failure to secrete luteinizing hormone-releasing hormone (LHRH), resulting in underdevelopment of the pituitary gonadotropes and an inability to synthesize and release luteinizing hormone and follicle-stimulating hormone. The purpose of the present investigation was to describe the dentition and the craniofacial morphology in patients diagnosed with Kallmann's syndrome. Design: The sample consisted of 11 patients, 2 of whom also had bilateral cleft lip and palate. Radiographic investigations, including cephalometry, were performed. Comparisons were made to normal individuals and to cleft lip individuals without Kallmann's syndrome. Results: Dentition: tooth agenesis occurred more frequently in patients with Kallmann's syndrome. Craniofacial morphology: Increased mandibular inclination and mandibular angulation were seen in Kallmann patients. When clefting also occurred, extreme retrognathism of both maxilla and mandible was seen, a deviation which seemingly worsened during growth. The anterior cranial base and the sphenoid bone showed an altered morphology in one of the patients with Kallman's syndrome. Conclusions: An early diagnosis of Kallmann's syndrome is very important because the prognosis for endocrine treatment thereby improves, and therefore, it is recommended that the sense of smell be evaluated in patients with the craniofacial morphology described.

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Three-dimensional Evaluation of Mandibular Volume in Patients with Cleft Lip and Palate During the Deciduous Dentition Period

The Angle Orthodontist ◽

10.2319/112618-831.1 ◽

2019 ◽

Vol 90 (1) ◽

pp. 85-91 ◽

Cited By ~ 1

Author(s):

Abhishekhi Shrestha ◽

Masahiro Takahashi ◽

Tetsutaro Yamaguchi ◽

Mohamed Adel ◽

Mayu Furuhata ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Pairwise Comparison ◽

Craniofacial Morphology ◽

Analysis Of Covariance ◽

Control Group ◽

Deciduous Dentition ◽

Post Hoc ◽

And Control

ABSTRACT Objectives To examine the relationship between mandibular volume and craniofacial morphology in patients with cleft lip and palate using cone beam computed tomography (CBCT) and to compare these findings with control (noncleft) patients undergoing CBCT for other purposes during the deciduous dentition period. Materials and Methods Eighty-four patients were categorized into the unilateral cleft lip and alveolus (UCLA) group (n = 25; mean age, 4.60 ± 0.40 years), unilateral cleft lip and palate (UCLP) group (n = 23; mean age, 4.52 ± 0.39 years), bilateral cleft lip and palate (BCLP) group (n = 22; mean age, 4.54 ± 0.37 years), and control group without cleft (n = 14; mean age, 5.19 ± 0.52 years). Mandibular volume and craniofacial cephalometric measurements were obtained using CBCT. All measurements were assessed by analysis of covariance (ANCOVA) using Bonferroni post hoc pairwise comparison tests. Results ANCOVA revealed no statistically significant differences in mandibular volume among the groups. SNA° and ANB° were significantly larger in the UCLA and BCLP groups than in the control group. SN-MP° was smallest in the UCLA group. Co-A in the UCLP group was shorter than in the UCLA and BCLP groups. Go-Gn was shortest in the UCLP and BCLP groups compared with the control group. Conclusions Three-dimensional evaluation of craniofacial morphology using CBCT can provide valuable information on malocclusion and other dentoskeletal problems among patients with CLP.

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