3D Assessment of Nasolabial Appearance in Patients With Complete Unilateral Cleft Lip and Palate

2017 ◽  
Vol 55 (2) ◽  
pp. 220-225 ◽  
Author(s):  
Ieva Bagante ◽  
Inta Zepa ◽  
Ilze Akota

Objective: Rhinoplasty in patients with complete unilateral cleft lip and palate (UCLP) is challenging, and the surgical outcome of the nose is complicated to evaluate. The aim of this study was to assess the nasolabial appearance of patients with UCLP compared with a control group. Design: Cross-sectional study. Setting: Riga Cleft Lip and Palate Centre, Latvia. Participants: All consecutive 35 patients born between 1994 and 2004 with nonsyndromic complete UCLP were included. Of 35 patients, 29 came for checkup; the mean age was 14.7 years (range 10-18). In the control group, 35 noncleft participants at 10 years of age were included. Interventions: Nasolabial appearance was evaluated from 3-dimensional images using a 3-dimensional stereo-photogrammetric camera setup (3dMDface System), the results being analysed statistically. Results: In UCLP group, a statistically significant difference between cleft and noncleft side was found only in alar wing length ( P < .05). The difference of nasolabial anthropometric distances in the control group between the left and right side was not significant. The difference between the UCLP group and the control group was significant in all anthropometric distances except the lateral lip length to cupid’s bow. Conclusions: The nasolabial appearance with acceptable symmetry after cleft lip and reconstructive surgery of the nose was achieved. Symmetry of the nasolabial appearance in patients with UCLP differed from those in the control group. The 3D photographs with a proposed set of anthropometric landmarks for evaluation of nasolabial appearance seems to be a convenient, accurate, and noninvasive way to follow and evaluate patients after surgery.

Author(s):  
Manoel Itaguacy Leite NOVAIS JUNIOR ◽  
Manuella Santos Carneiro ALMEIDA ◽  
Camila Helena Machado da COSTA ◽  
Tassia Cristina de Almeida Pinto SARMENTO ◽  
Luis Ferreira de SOUSA FILHO ◽  
...  

ABSTRACT Objective: Evaluating the development of the permanent cuspids in children from Paraíba with cleft lip and palate applying the Nolla and the Demirjian methods. Methods: A cross-sectional study using an inductive approach and applying a comparative statistical procedure and direct documentation research technique. The universe of the study consisted of children assisted at the orthodontic practice of the Brazilian Association of Dentistry - Paraíba Section. The sample comprised 72 pairs of panoramic radiographs of children with and without cleft lip and palate from the same gender and, age difference of up to 30 days, ranging from 5 to 13 years of age. The study has evaluated the development of 576 cuspids. The images were evaluated by three duly calibrated examiners concomitantly, and the calcification stages were determined by a consensus. The stages of the cuspids calcification were evaluated in the panoramic radiographs according to Nolla and Demirjian classifications. Results: The average of the calcification stage of teeth was correspondingly higher in the control group than in the case group, showing a development delay of the cuspid teeth in the cleft lip and palate patients. The lower cuspids were significantly more developed than the upper cuspids (p <0.001). There were no significant differences between the sides. There was early tooth development in females but without significant difference. Conclusion: It was possible to note that patients with cleft lip and palate presented a delay in the development of the permanent cuspids when compared to non-cleft lip and palate patients, thus, reinforcing the importance of the individualization of the orthodontic planning.


2017 ◽  
Vol 2 (2) ◽  
pp. 110
Author(s):  
Ayu Wahyuni ◽  
Muliaty Yunus ◽  
Muhammad Ruslin

Objective: Gnathoschisis is the most common congenital craniofacial abnormality in patients with cleft lip and/or palate (CL and/or P). The panoramic radiograph is one means to establish a diagnosis and treatment plan with two-dimension photograph. The cone-beam computed tomography (CBCT) is one means of supporting the maxillofacial to get a three-dimension photograph. The aim of this study was to determine the difference in the results of the use of panoramic photos and CBCT in evaluation before and after gnathoplasty surgery.Material and Methods: This is an observational descriptive research with cross-sectional study method. All samples that meet the suitable criteria are put in this research. The data gained by collecting status card at medical record installation about photo panoramic application in gnathoschisis patients was then compare to the examination with CBCT.Results: The result performed shows that there is a significant difference between panoramic and CBCT picture. The CBCT provide better evaluation about teeth age and segment position of jaw curve from the cleft size. While the panoramic photo provides a widely covered area to observe facial and teeth bone.Conclusion: The CBCT results are more accurate in evaluating gnathoplasty surgery than panoramic photo; however, exposure to the radiation should be considered.


2021 ◽  
Vol 58 (5) ◽  
pp. 612-618
Author(s):  
Evgenija Markovic ◽  
Nemanja Marinkovic ◽  
Ksenija Zelic ◽  
Petar Milovanovic ◽  
Marija Djuric ◽  
...  

Objective: To assess dental age and deviations of dental from chronological age according to the Willems and Cameriere methods (European formula) in patients with cleft lip and/or cleft palate (CL/P) and compare it with control group. Design: Retrospective cross-sectional study. Setting: Clinic of Orthodontics. Participants: Sixty-nine patients with CL/P between 6 and 15 years of age (55 with unilateral and 14 with bilateral CL/P) with 148 panoramic radiographs. The same number of radiographs was examined in the age-matched control group. Main Outcome Measures: Estimation and comparison of dental age and differences of dental from chronological age in relation to the type of cleft, sex, and age in the group of patients with and without CL/P according to Willems and Cameriere method. Results: No significant intersex and intergroup differences were found in deviations of dental from chronological age according to Cameriere method ( P > .05). Significant difference in deviation of dental from chronological age was found between the patients with and without CL/P according to Willems method ( P < .001). Conclusion: Cameriere European formula for dental age estimation, which is not influenced by sex and tooth morphology, showed similar dental development of children with and without CL/P. However, Willems method detected that deviation of dental from chronological age significantly differed between children with and without clefts.


2005 ◽  
Vol 42 (4) ◽  
pp. 417-422 ◽  
Author(s):  
Bo Werner Nielsen ◽  
Kirsten Mølsted ◽  
Lene Theil Skovgaard ◽  
Inger KjæR

Objective The purpose of this study was to analyze the human nasal bone length in newborns and male adults with cleft lip (CL), cleft palate (CP), and unilateral cleft lip and palate (UCLP) and to compare the results to previous findings in prenatal material. Design This study was a radiographic profile cephalometric cross-sectional analysis. Subjects and Methods Profile radiographs from 60 newborns with a male-to-female ratio of 1:1 in each group (20 CL, 20 CP, and 20 UCLP) and 60 male adults (20 CL, 20 CP, and 20 UCLP) were randomly selected among radiographs, taken for optimizing the treatment planning. The nasal bone lengths (n-na) were measured with a digital caliper on the profile radiographs. To compare the nasal bone lengths in the different cleft groups, Student's t tests at a significant level at 5% were performed. Results Nasal bone length was significantly shorter in male adult patients with CL compared with patients with CP. Furthermore, the nasal bone length was significantly shorter in newborns with CL (2 months) compared to newborns with UCLP (2 months). A borderline significance was seen in the comparison of patients with CL and UCLP in male adults. There was no significant difference in the nasal bone length between the patients with CP and UCLP, in either the newborns or the male adults. Conclusions Nasal bone length was significantly shorter in subjects with CL compared with subjects in whom the palate was clefted. The results show that the clefted lip in CL is associated with a subjacent skeletal deviation in the upper midface.


2008 ◽  
Vol 45 (6) ◽  
pp. 661-666 ◽  
Author(s):  
Geer M. van den Dungen ◽  
Edwin M. Ongkosuwito ◽  
Irene H. A. Aartman ◽  
Birte Prahl-Andersen

Objective: Comparison of craniofacial morphology in bilateral cleft lip and palate patients to that of a noncleft control group at the age of 15 years. Design: A cross-sectional study of cephalometric data. Subjects and Methods: Cephalometric records of 41 consecutive patients (32 boys and 9 girls) with nonsyndromic complete bilateral cleft lip and palate born between 1973 and 1987. The patients were treated by the cleft teams of the Erasmus Medical Centre in Rotterdam and the VU University Amsterdam. The control group of normal Dutch subjects was followed in the Nijmegen Growth Study. From this population, mean cephalometric data were used. Differences in cephalometric measurements and other variables were calculated between the bilateral cleft lip and palate group and the control group. Results: Independent-sample t tests indicated that there was a statistically significant difference between the mean of the cephalometric values of the bilateral cleft lip and palate patients and the control group with respect to all cephalometric variables. Pearson correlation coefficients calculated between angle ANB and the number of operators, number of surgical procedures before 15 years of age, and the year of birth were not significant. Conclusions: Bilateral cleft lip and palate patients treated in the Amsterdam and Rotterdam cleft centers differed significantly from the control group in all measurements. A Class III development due to a less forward positioned maxilla was observed. The vertical measurements indicated a more divergent growth pattern in bilateral cleft lip and palate patients (Ans-Me/N-Me, GoGn-SN, and SN-FFH).


2007 ◽  
Vol 44 (3) ◽  
pp. 292-303 ◽  
Author(s):  
Siti Noor Fazliah Mohd Noor ◽  
Sabri Musa

Objectives: Determination of the psychosocial status and assessment of the level of satisfaction in Malaysian cleft palate patients and their parents. Design: Cross-sectional study. Participants and Methods: Sixty cleft lip and palate patients (12 to 17 years of age) from Hospital Universiti Sains Malaysia and their parents were selected. The questionnaires used were the Child Interview Schedule, the Parents Interview Schedule, and the Cleft Evaluation Profile (CEP), administered via individual interviews. Results: Patients were teased because of their clefts and felt their self-confidence was affected by the cleft condition. They were frequently teased about cleft-related features such as speech, teeth, and lip appearance. Parents also reported that their children were being teased because of their clefts and that their children's self-confidence was affected by the clefts. Both showed a significant level of satisfaction with the treatment provided by the cleft team. There was no significant difference between the responses of the patients and their parents. The features that were found to be most important for the patients and their parents, in decreasing order of priority, were teeth, nose, lips, and speech. Conclusions: Cleft lip and/or palate patients were teased because of their clefts, and it affected their self-confidence. The Cleft Evaluation Profile is a reliable and useful tool to assess patients’ level of satisfaction with treatment received for cleft lip and/or palate and can identify the types of cleft-related features that are most important for the patients.


2020 ◽  
pp. 105566562096957
Author(s):  
Ikenna Gerald Isiekwe ◽  
Taofeek Olalekan Ligali ◽  
Mohammed Adam Sheikh Abdullahi ◽  
Wasiu Lanre Adeyemo

Background and Aim: Children with cleft lip and palate present with a wide range of dental and occlusal anomalies as a result of the cleft defect. These patients also present with oral habits which may affect their quality of life. The aim of this study was to compare the prevalence of oral habits in these children, with children without orofacial clefts. Methodology: This was a cross-sectional comparative study comparing children with repaired cleft lip and/or palate aged 3 to 12 years, with children without orofacial clefts. Ethical approval for the study was obtained from the institutional review boards of both centers. Data collection was via interviewer administered questionnaires given to the parents/guardians of the children in each group. Data analysis was carried out using SPSS version 23. The level of significance was set at P < .05. Results: A total of 107 respondents participated in the study, comprising 53 children with repaired cleft lip and/or palate 54 children without orofacial clefts. The mean age for the children with Cleft lip and/or palate/ was 6.81 (standard deviation [SD] 1.898) years, while that for the control group was 7.78 (SD 1.68) years. Two oral habits recorded a significantly higher prevalence ( P < .05) in the children with repaired clefts as compared to controls and these were lip sucking and bruxism. No significant difference in prevalence was recorded for all the other oral habits surveyed. Conclusion: A significantly higher prevalence ( P < .05) was observed in lip sucking and bruxism among children with cleft lip and palate, as compared to the children without orofacial clefts.


2018 ◽  
Vol 55 (8) ◽  
pp. 1103-1114
Author(s):  
Staffan Morén ◽  
Per Åke Lindestad ◽  
Mats Holmström ◽  
Maria Mani

Objectives: The aim of the current study was to assess voice quality among adults treated for unilateral cleft lip and palate (UCLP), after one- or two-stage palate closure, and compare it to a noncleft control group. Study Design: Cross-sectional study of patients with UCLP with long-term follow-up and noncleft controls. Participants: Patients with UCLP born between 1960 and 1987, treated at Uppsala University Hospital, Sweden, were examined (n = 73) at a mean of 35 years after primary surgery. Forty-seven (64%) patients had been treated with 1-stage palate closure and 26 with 2-stage closure (36%). The noncleft control group consisted of 63 age-matched volunteers. Main Outcome Measures: Ratings of perceptual voice characteristics from blinded voice recordings with Swedish Voice Evaluation Approach method. Acoustic voice analysis including pitch and spectral measures. Results: Among the patients, the mean values for the 12 evaluated variables on a visual analog scale (0 = no abnormality, 100 = maximal abnormality) ranged between 0.1 and 17, and the mean for all was 6 mm. Voice variables were similar between patients and controls, except the total mean of all the perceptual voice variables, as well as “vocal fry”; both slightly lower among patients ( P = .018 and P = .009). There was no difference in any variable between patients treated with 1-stage and 2-stage palate closure. No clear relationship was found between velopharyngeal insufficiency and dysphonia. Conclusions: The voice characteristics among adults treated for UCLP in childhood are not different from those of individuals without cleft.


2018 ◽  
Vol 56 (2) ◽  
pp. 177-186 ◽  
Author(s):  
Rosaline S. Zhang ◽  
Lawrence O. Lin ◽  
Ian C. Hoppe ◽  
Oksana A. Jackson ◽  
David W. Low ◽  
...  

Objective: To characterize the epidemiology and risk factors for nasal obstruction among subjects with cleft lip and/or cleft palate (CL/P) utilizing the well-validated Nasal Obstruction Symptom Evaluation (NOSE) survey. Design: Retrospective cross-sectional study. Setting: Cleft Lip and Palate Program, Children’s Hospital of Philadelphia. Patients, Subjects: One thousand twenty-eight surveys obtained from 456 subjects (mean age: 10.10 (4.48) years) with CL/P evaluated between January 2015 and August 2017 with at least 1 completed NOSE survey. Interventions: Nasal Obstruction Symptom Evaluation surveys completed at each annual visit. Main Outcome Measures: Composite NOSE and individual symptom scores. Results: Sixty-seven percent of subjects had nasal obstruction at some point during the study period, with 49% reporting nasal obstruction at latest follow-up. subjects aged 14 years and older reported the most severe symptoms ( P = .002). Subjects with cleft lip and alveolus (CL+A) and unilateral cleft lip and palate (CLP) reported more severe nasal blockage than other phenotypes ( P = .021). subjects with a history of either posterior pharyngeal flap (PPF) or sphincter pharyngoplasty (SP) had significantly higher NOSE scores than subjects with no history of speech surgery ( P = .006). There was no significant difference ( P > .050) in NOSE scores with regard to history of primary tip rhinoplasty, nasal stent use, or nasoalveolar molding. Conclusions: There are more severe nasal obstructive symptoms among subjects older than 14 years of age, with CL+A or unilateral CLP, and with a history of PPF or SP. Future studies utilizing the NOSE are needed to evaluate and address this prevalent morbidity in the CLP population.


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