Three-dimensional evaluation of the maxillary arch and palate in unilateral cleft lip and palate subjects using digital dental casts

The palatal forms in 20 infants with a complete unilateral cleft lip, and palate (12 with a Hotz plate and 8 without, selected at random) were studied from birth until 18 months of age. Using techniques developed previously, the degree of curvature In the palate and the magnitude of migration of the maxillary segments were measured three-dimensionally. Furthermore, using a newly developed method to approximate a set of the points on the alveolar ridge to a circle in a plane, the form of the alveolar arch was evaluated. Results from the group with a Hotz plate revealed that the plate possesses four effects not seen in the group without a Hotz plate. The size of the palate was larger, and the sagittal gap between the two segments of the maxilla was smaller. These results suggest that the appliance could stimulate the growth of the segments and could prevent collapse of the maxillary arch from the force of lip closure. Third, the steepness of the segments toward the nasal cavity was smaller, possibly occurring because the appliance prevents tongue intrusion into the cleft. Fourth, the magnitude of migration of the lesser segment toward the cleft edge of the major segment was larger. This result suggests that the appliance could guide the growth of the maxillary segments to narrow the cleft width until 18 months of age.

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Three-Dimensional Morphology of the Palate in Patients with Bilateral Complete Cleft Lip and Palate at the Stage of Permanent Dentition

The Cleft Palate-Craniofacial Journal ◽

10.1597/07-199.1 ◽

2009 ◽

Vol 46 (4) ◽

pp. 399-408 ◽

Cited By ~ 12

Author(s):

Zbyněk Šmahel ◽

Jana Velemínská ◽

Pavel Trefný ◽

Živa Müllerová

Keyword(s):

Laser Scanning ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Substantial Reduction ◽

Three Dimensional ◽

Permanent Dentition ◽

Cross Sectional ◽

Size And Shape ◽

Control Study ◽

Dental Casts

Objective: Three-dimensional analysis of palate size and shape in 30 patients with complete bilateral cleft lip and palate (BCLPc) at the stage of permanent dentition. Design: Cross-sectional study based on laser scanning. Subjects: Thirty dental casts of boys approximately 15 years old with BCLPc and 28 dental casts of healthy boys of the same age. Interventions: Arched-lip suture with periosteoplasty and push-back of the palate with pharyngeal-flap surgery. Main Outcome Measures: Data on palate height in the 210 defined locations and on palate widths and profile area in 10 transverse sections. Results: The palate in patients with BCLPc was conical and narrower than in control study subjects, much more anteriorly than posteriorly. From the canines posteriorly, the palate was of almost constant height of 10 mm in the midline, being higher than in control study subjects at this location and lower more posteriorly (by 24% to 29% between molars). The area of transverse sections was reduced as compared with control study subjects from the first premolars posteriorly and reached more than 40% between molars. The length of the palate up to the first molars was not changed. Conclusion: BCLPc subjects exhibited narrow, low, and flat palate. Palate size and shape differences indicate a substantial reduction of the space for the tongue.

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Changes in the Transverse Dimension of the Maxillary Arch of 5-Year-Olds Born With UCLP Since the Introduction of Nationwide Guidance

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211028511 ◽

2021 ◽

pp. 105566562110285

Author(s):

Charlotte Molyneaux ◽

Martyn Sherriff ◽

Yvonne Wren ◽

Anthony Ireland ◽

Jonathan Sandy

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Transverse Dimension ◽

Advisory Group ◽

Second Primary ◽

Primary Molar ◽

Cross Sectional ◽

Significant Difference ◽

Maxillary Arch ◽

Dental Casts

Objective: To determine whether the transverse dimensions of the maxillary arch of 5-year-old children with unilateral cleft lip and palate (UCLP) have changed following centralization of cleft services in the United Kingdom. Design: Retrospective cross-sectional study. Setting: Digital analysis of UCLP maxillary dental casts. Participants: All available maxillary dental casts from 5-year-old participants of the Clinical Standards Advisory Group (CSAG, N = 114) and Cleft Care UK (CCUK, N = 175) studies. Interventions: Quantitative measurements of the intercanine width (ICW), intermolar width (IMW), and the distance from the midline to the greater and lesser side canine (GC/LC) and greater side and lesser side second primary molar (GE/LE). Degree measurements of the greater and lesser arch form angles, arch length, anterior palatal depth (APD), and posterior palatal depth were also measured. Main outcome: Differences between the transverse dimensions of the maxillary arch for the CSAG and CCUK cohorts. Results: In 5 (ICW, IMW, LC, LE, and APD) of the 11 measurements, there was a statistically significant difference between the CSAG and CCUK cohorts. In all of these, the CCUK values were greater than CSAG. Conclusions: There have been small but positive improvements for the transverse maxillary dimensions since centralization of the UK cleft service.

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Three-Dimensional Morphology of the Palate in Subjects with Unilateral Complete Cleft Lip and Palate at the Stage of Permanent Dentition

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-053.1 ◽

2004 ◽

Vol 41 (4) ◽

pp. 416-423 ◽

Cited By ~ 17

Author(s):

Zbynek Šmahel ◽

Pavel Trefný ◽

Pavel Formánek ◽

Živa Müllerová ◽

Miroslav Peterka

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Permanent Dentition ◽

Maximum Height ◽

Anterior Portion ◽

Posterior Direction ◽

The Difference ◽

Reduced Space ◽

Dental Casts

Objective Three-dimensional analysis of palate size and shape in patients with complete unilateral cleft lip and palate (UCLP) at the stage of permanent dentition. Subjects Thirty randomly selected dental casts of boys approximately 15 years old with complete UCLP and 28 dental casts of normal boys of the same age. Interventions All patients underwent lip repair according to Tennison with primary periosteoplasty (mean age 8.5 months) and palate repair by pushback and pharyngeal flap surgery (mean age 4.9 years). Main Outcome Measures Data on the palate height in 210 defined locations. Results The palate in patients with UCLP was narrower throughout its whole extent, more anteriorly than posteriorly. From the canines posteriorly, it was also lower, and the difference as compared with controls increased in a posterior direction up to the level of second premolars (up to 30%) and then slightly diminished (to 21% between the first molars). The reduction of area of transverse sections reached 45% between premolars and 39% between first molars. The palate in the anterior portion was highest on the cleft side and in a posterior direction the maximum height of the palate shifted toward the midline and even beyond that line toward the noncleft side. Palatal height did not depend on dentoalveolar arch width. Conclusion The smaller width and height of the palate confirm the substantially reduced space for the tongue in patients with UCLP. The reduction is only slightly larger than in previously examined patients with isolated cleft palate. Palatal vault is asymmetrical, highest anteriorly on the cleft side and posteriorly on the noncleft side.

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Effects of Multiple Factors on Treatment Outcome in the Three-Dimensional Maxillary Arch Morphometry of Children With Unilateral Cleft Lip and Palate

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000006464 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Cited By ~ 1

Author(s):

Sanjida Haque ◽

Mohd Fadhli Khamis ◽

Mohammad Khursheed Alam ◽

Wan Muhamad Amir Wan Ahmad

Keyword(s):

Treatment Outcome ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Multiple Factors ◽

Maxillary Arch

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Three-dimensional Digital Evaluation of Dental Arches in Infants with Cleft Lip and/or Palate

Brazilian Dental Journal ◽

10.1590/0103-6440201300161 ◽

2015 ◽

Vol 26 (3) ◽

pp. 297-302 ◽

Cited By ~ 10

Author(s):

Viviane Mendes Fernandes ◽

Paula Karine Jorge ◽

Cleide Felício Carvalho Carrara ◽

Márcia Ribeiro Gomide ◽

Maria Aparecida Andrade Moreira Machado ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

3D Scanner ◽

Primary Surgery ◽

Digital Evaluation ◽

Bilateral Cleft Lip ◽

Scanned Images ◽

Intercanine Distance ◽

Dental Casts

The aim of this study was to measure and compare the dimensions of the dental arches on three-dimensional digital study models in children with and without cleft lip and palate before the primary surgery. The sample consisted of 223 digital models of children aged 3-9 months, divided into 5 groups: without craniofacial deformities, unilateral and bilateral incomplete cleft lip and alveolus, unilateral and bilateral complete cleft lip and alveolus, unilateral cleft lip and palate, and bilateral cleft lip and palate. Dental casts of the maxillary dental arches of the children were used. The dental casts underwent a process of scanning through 3D scanner and the measurements used for the correlation among groups were made on the scanned images. Statistical analysis was performed by t test and ANOVA followed by Tukey test. The results showed that the intercanine distance and anterior cleft width was wider in children with unilateral cleft lip and palate. The intertuberosity distances and posterior cleft width was wider in children with bilateral cleft lip and palate among the groups. Children with cleft lip and palate before the primary surgery had wider maxillary arch dimensions than the children without cleft lip and palate.

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