Cleft Skeletal Asymmetry

2017 ◽  
Vol 55 (3) ◽  
pp. 348-355 ◽  
Author(s):  
Delnaz S. Patel ◽  
Rachel Jacobson ◽  
Yao Duan ◽  
Linping Zhao ◽  
David Morris ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Quantitative Measure ◽  
Facial Asymmetry ◽  
Asymmetry Index ◽  
Control Group ◽  
Facial Skeleton ◽  
Midsagittal Plane ◽  
The Asymmetry ◽  
Skeletal Asymmetry

Objective: To quantitatively measure the extent of 3D asymmetry of the facial skeleton in patients with unilateral cleft lip and palate (UCLP) using an asymmetry index (AI) approach, and to illustrate the applicability of the index in guiding and measuring treatment outcome. Method: Two groups of subjects between the ages of 15 and 20 who had archived CBCT scan were included in this study. Twenty-five patients with complete UCLP were compared with 50 age-matched noncleft subjects. The CBCT scans were segmented and landmarked for 3D anthropometric analysis. An AI was calculated as a quantitative measure of the extent of facial skeletal asymmetry. Results: For the control group, the AI ranged from 0.72 ± 0.47 at A point to 4.77 ± 1.59 at Gonion. The degree of asymmetry increased with the increasing laterality of the landmark from the midsagittal plane. In the UCLP group, the values of AI significantly increased compared to the control group at nearly all measured landmarks. The extent of the asymmetry to involve the upper, middle, and lower facial skeleton varied widely with the individual patient with UCLP. Conclusion: The asymmetry index is capable of capturing the 3D facial asymmetry of subjects with UCLP and as a basis for classification of the extent of the asymmetry. We found the index to be applicable in surgical planning and in measuring the outcome in improving the symmetry in patients who have undergone orthognathic surgery.

Mandibular Asymmetry in Noncleft and Unilateral Cleft Lip and Palate Individuals

1997 ◽  
Vol 34 (5) ◽  
pp. 410-416 ◽  
Author(s):  
Christodoulos P. Laspos ◽  
Stephanos Kyrkanides ◽  
Ross H. Tallents ◽  
Mark E. Moss ◽  
J. Daniel Subtelny
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Age Groups ◽  
Facial Asymmetry ◽  
Cranial Base ◽  
Temporal Region ◽  
Facial Skeleton ◽  
Mandibular Asymmetry ◽  
The Asymmetry

Objective: The purpose of this study was to retrospectively investigate mandibular asymmetry in unilateral cleft lip and palate individuals (UCLP) in relation to chronologic age and in relation to lower facial asymmetry. Design: The longitudinal records of 34 UCLP individuals and 142 controls treated in the Department of Orthodontics, Eastman Dental Center, Rochester, NY, were included in the study. Posteroanterior and oblique cephalometric radiographs were analyzed for lower facial asymmetry and mandibular asymmetry, respectively. Mandibular asymmetry in UCLP was analyzed relative to three age groups (6–10, 11–14, and 15 or greater) and compared to controls. Moreover, mandibular asymmetry was analyzed relative to lower facial asymmetry. Results: UCLP individuals showed no significant differences in mandibular asymmetry compared to controls. In addition, no significant correlation was found between mandibular asymmetry and lower facial asymmetry in UCLP. Conclusions: The degree of mandibular asymmetry in UCLP appears not to be the major contributing factor to the lower facial asymmetry noted on these individuals. Possible cranial-base/temporal-region anomalies may be involved in unilateral cleft lip and palate and be responsible of the asymmetry noted in the lower facial skeleton.

Three-Dimensional Evaluation of Facial Asymmetry in Cleft Lip and Palate

1994 ◽  
Vol 31 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Frank Ras ◽  
Luc L.M.H. Habets ◽  
Floris C. Van Ginkel ◽  
Birte Prahl-Andersen
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Vertical Direction ◽  
Facial Asymmetry ◽  
Three Dimensions ◽  
Control Group ◽  
Craniofacial Anomalies ◽  
Facial Landmarks ◽  
Three Components

The purpose of the present study was to describe facial asymmetry in three dimensions in individuals with an operated complete unilateral cleft lip and palate (UCLP) and in individuals without craniofacial anomalies (controls). Three-dimensional coordinates for 16 bilateral and 10 midsagittal facial landmarks were determined for the UCLP group (N=49) and the control group (N=80) by means of stereophotogrammetry. The total asymmetry was measured and resolved for transverse, vertical, and sagittal components. It can be concluded that all three components are Important in studies on facial asymmetry. Individuals with UCLP show more facial asymmetry in the vertical direction than controls. They demonstrate more facial asymmetry in the region related to the cleft than controls. And, males in general demonstrate more asymmetry of the nose than females.

Mesiodistal Angulation of Each Whole Tooth in Patients With Nonsyndromic Unilateral Cleft Lip and Palate: Is it Symmetrical?

2020 ◽  
pp. 105566562096753
Author(s):  
Yağmur Lena Sezici ◽  
Furkan Dindaroğlu ◽  
Abdülkadir Işık ◽  
Servet Doğan
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Asymmetry Index ◽  
T Test ◽  
Class I ◽  
Control Group ◽  
Second Molar ◽  
Skeletal Class ◽  
Significant Difference ◽  
Mandibular Teeth

Objective: To assess the symmetry of the mesiodistal angulations of maxillary and mandibular teeth in patients with unilateral cleft lip and palate (UCLP) and compare with the class I control group without cleft lip and palate (CLP). Design: A retrospective study. Setting: University department. Patients, Participants: The panoramic radiographs of 45 orthodontically untreated individuals with nonsyndromic UCLP (mean age 14.13 ± 0.75 years) and 45 skeletal class I individuals without CLP (mean age 14.01 ± 0.74 years). Interventions: The line passing through the most superior points of the condyles was taken as the reference. The angle between the long axes of the maxillary and mandibular teeth and reference line was measured digitally. With the purpose of determining condylar symmetry, mandibular asymmetry index measurements were utilized. Independent samples t test and paired samples t test were used for the statistical analyses. Main Outcome Measure(s): The mesiodistal angulation of the maxillary and mandibular teeth in patients with UCLP was measured. The differences between the contralateral sides were determined and compared to class I individuals without CLP. Results: No statistically significant difference was found among the condylar asymmetry in both groups ( P > .05).The significant differences between the cleft and noncleft sides in the UCLP group was observed in the maxillary central, canine, first premolar and second molar teeth ( P < .001, P = .002, P = .013, P = .012, respectively). The mean differences were found to be higher in the central and lateral incisors, canines and first premolars in the UCLP group ( P < .001, P = .006, P = .001, respectively). Conclusions: Although the cleft-side maxillary central incisors tipped in a distal direction in patients with UCLP, the canine and first premolar showed more inclinations toward the mesial direction.

Dermatoglyphic Analysis in Parents with Nonfamilial Bilateral Cleft Lip and Palate Children

2010 ◽  
Vol 47 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Arezoo Jahanbin ◽  
Naser Mahdavishahri ◽  
Mohammad Mahdi Naseri ◽  
Yasaman Sardari ◽  
Sareh Rezaian
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Normal Population ◽  
Control Group ◽  
Ridge Count ◽  
Chi Square ◽  
Bilateral Cleft Lip ◽  
History Of ◽  
The Asymmetry ◽  
The Difference

Objectives To test the hypothesis that unaffected parents with nonsyndromic bilateral cleft lip and palate children possess greater levels of dermatoglyphic asymmetry than the normal population and to test for the difference in the distribution of pattern types. Design Case-control study. Setting Mashhad University of Medical Sciences, Mashhad, Iran. Participants Forty-five unaffected parents (45 men and 45 women) of children with nonfamilial bilateral cleft lip and palate anomaly were enlisted. A control group of 45 unaffected parents with at least two unaffected children and no prior family history of clefting were also simultaneously selected. Main Outcome Measures Palm prints and fingerprints were taken from each participant, and total ridge counts, atd angles, and pattern types were determined. For each of the three dermatoglyphic measures, asymmetry scores between right and left hands were defined, and then asymmetry scores of unaffected parents and pattern types were compared statistically with the controls, using Mann-Whitney and chi-square tests. Results In contrast to total ridge count asymmetry, the asymmetry of atd angles in unaffected parents and the asymmetry of patterns (in unaffected mothers) were significantly higher in comparison with the controls. Furthermore, unaffected fathers had significantly more arches than the controls, but there were no significant differences in dermatoglyphic patterns of unaffected mothers and the controls. Conclusion The findings suggest that an increase in the asymmetry of atd angles and pattern types in parents of sporadically affected children may reflect more the genetic base of this congenital malformation.

Dynamic Analysis of the Effects of Upper Lip Pressure on the Asymmetry of the Facial Skeleton in Patients with Unilateral Complete Cleft Lip and Palate

2009 ◽  
Vol 46 (2) ◽  
pp. 154-160 ◽  
Author(s):  
Tomohisa Nagasao ◽  
Junpei Miyamoto ◽  
Eri Konno ◽  
Hisao Ogata ◽  
Tatsuo Nakajima ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Computer Aided Design ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Nasal Bone ◽  
Facial Asymmetry ◽  
Upper Lip ◽  
Facial Skeleton ◽  
Alveolar Bone Grafting

Objective: Our purpose was to assess quantitatively the effect of increased upper-lip pressure on asymmetry of the facial bones in patients with unilateral complete lip-alveolar-palatal clefts. Methods: We collected computed tomographic images from 16 patients with unilateral complete lip-alveolar-palatal clefts and classified them into two groups based on absence/presence of alveolar bone grafting. We categorized eight patients (9.6 ± 2.0 years old) who had not been treated with alveolar bone grafting as the ABG(−) group and the other eight patients (9.3 ± 1.6 years old) who had received alveolar bone grafting as the ABG(+) group. After producing a computer-aided design model for each patient, we applied a uniform load on the anterior aspects of the maxilla, alveolus, and teeth of the model to simulate the upper-lip pressure. Then we calculated the degree of distortion each model presented using the finite element method. We compared the distortion pattern between the ABG(−) and ABG(+) groups. Results: In the ABG(−) patients, asymmetry of distortion between the cleft and noncleft sides was present in wide areas involving the orbit, nasal bone, piriform margin, and anterior wall of the maxillary sinus. In the ABG(+) patients, asymmetry of distortion was limited to rather small areas. Conclusions: In unilateral complete lip-alveolar-palatal clefts patients, the upper-lip pressure works to dislocate the cleft-side segment to a more posterior position than the noncleft-side segment. This finding implies that the increased lip pressure exacerbates facial asymmetry of these patients. The exacerbating effect on facial asymmetry is alleviated by alveolar bone grafting.

Longitudinal Study on Three-Dimensional Changes of Facial Asymmetry in Children between 4 to 12 Years of Age with Unilateral Cleft Lip and Palate

1995 ◽  
Vol 32 (6) ◽  
pp. 463-468 ◽  
Author(s):  
Frank Ras ◽  
Luc L.M.H. Habets ◽  
Floris C. Van Glnkel ◽  
Birte Prahl-Andersen
Keyword(s):  
Longitudinal Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Facial Asymmetry ◽  
Control Group ◽  
Basal Region ◽  
Craniofacial Anomalies ◽  
Dimensional Changes ◽  
Growth Changes

The purpose of the present study was to describe three-dimensional developmental changes of facial asymmetry in children with an operated complete unilateral cleft lip and palate (UCLP) and in children without craniofacial anomalies (controls). Using stereophotogrammetry, three-dimensional coordinates for 16 bilateral and 10 midsagittal facial landmarks were determined for the UCLP group (n = 33) and the control group (n = 63) on two occasions. In this mixed-longitudinal study, the children were 4 to 12 years of age. Facial asymmetry and left-right dominance was measured and resolved for transverse, vertical, and sagittal components. Significant effects were analyzed with multivariate analyses of variance (MANOVA). We concluded that individuals with complete unilateral cleft lip and palate, as well as individuals without craniofacial anomalies, show an increase, during growth, in the amount of facial asymmetry in the basal region of the nose. In the region that is related to the cleft, children with complete unilateral cleft lip and palate do not show changes in the amount of facial asymmetry between the occasions. Regarding facial left-right dominance and variation in dominance, no demonstrable growth changes take place in individuals with complete cleft lip and palate, nor in individuals without craniofacial anomalies.

scholarly journals An Innovative Assessment of the Dynamics of Facial Movements in Surgically Managed Unilateral Cleft Lip and Palate Using 4D Imaging

2020 ◽  
Vol 57 (9) ◽  
pp. 1125-1133
Author(s):  
Shyam Gattani ◽  
Xiangyang Ju ◽  
Toby Gillgrass ◽  
Aileen Bell ◽  
Ashraf Ayoub
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Facial Asymmetry ◽  
Control Group ◽  
Dimensional System ◽  
3 Dimensional ◽  
Facial Movements ◽  
4D Imaging ◽  
Anatomical Basis ◽  
Facial Images

Objective: Assess facial asymmetry during maximum smile in patients with surgically managed unilateral cleft lip and palate (UCLP), using a dynamic 3-dimensional (3D) imaging (4-dimensional) system. Design: Prospective 2 cohort comparative study. Methods: Twenty-five surgically managed UCLP cases and 75 controls at 8 to 10 years of age were recruited. Facial movements during maximum smile were recorded using video stereophotogrammetry at a rate of 60 3D facial images per second. Maximum smile took approximately 3 seconds and generated 180 3D facial images for the analysis. A generic facial mesh which consists of more than 7000 quasi landmarks was used for the assessment of facial asymmetry at 5 key 3D frames representing the pattern of maximum smile. Results: Statistically significant differences were seen regarding the magnitude of facial asymmetry between the UCLP group and the noncleft controls. Higher average asymmetry in the UCLP group was seen in the 3D frame midway between maximum smile and rest (frame 4) followed by the frame at peak expression of maximum smile (frame 3). The average magnitude of nasolabial asymmetry of the control group was within 0.5 mm in comparison with the UCLP cases which was about 1.8 mm. Conclusion: This study provided for the first time, an objective tool for analysis of the dynamics of muscle movements which provided an unprecedented insight into the anatomical basis of the residual dysmorphology. The research demonstrates the limitations of the primary lip repair in achieving symmetrical results and underpins the required refinements to improve the quality of surgical repair of cleft lip.

Electromyographic Investigation of Masticatory Muscles in Unilateral Cleft Lip and Palate Patients with Anterior Crossbite

1998 ◽  
Vol 35 (5) ◽  
pp. 415-418 ◽  
Author(s):  
Weiran Li ◽  
Jiuxiang Lin ◽  
Minkui Fu
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Masticatory Muscles ◽  
Asymmetry Index ◽  
Chinese Patients ◽  
Control Group ◽  
Electromyographic Activity ◽  
Normal Individuals ◽  
Masseter Muscles ◽  
Electromyographic Investigation

Objective To evaluate the characteristics of masticatory muscle activity in operated unilateral cleft lip and palate (UCLP) patients with anterior crossbite compared with normal individuals. Subjects Sixteen male and 13 female Chinese patients with UCLP and anterior crossbite. Fifteen male and 13 female Chinese individuals without cleft abnormalities served as a control group. Design Electromyographic activity of the masseter muscles and anterior temporalis muscles was recorded bilaterally in different mandibular positions using bipolar surface electrodes. Results Compared to noncleft controls, patients with UCLP demonstrated (1) higher activation levels of masseter and temporalis muscles in the rest position, (2) lower potential function of masseter and temporalis, (3) inharmonious activity of the masticatory muscles during mandibular border movement, (4) a higher asymmetry index of the masseter and temporalis muscles, and (5) longer silent periods of the two muscles. Conclusions The function of masticatory muscles is different in patients with UCLP with anterior crossbite. Muscle function should be considered when evaluating cleft patients for orthodontic treatment and orthognathic surgery.

Vertical Facial Skeletal Asymmetry and Occlusal Cant Relationship in Patients With Unilateral Cleft Lip and Palate

2020 ◽  
pp. 105566562097457
Author(s):  
Bengisu Akarsu-Guven ◽  
Ezgi Atik ◽  
Hande Gorucu-Coskuner ◽  
Muge Aksu
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Facial Asymmetry ◽  
Cranial Base ◽  
Control Group ◽  
Lower Face ◽  
Significant Difference ◽  
Angular Measurements ◽  
Cleft Lip Palate

Objective: To evaluate the maxillary and mandibular vertical skeletal asymmetries, and the correlation between these asymmetries and occlusal cant in patients with unilateral cleft lip–palate (UCLP). Methods: Anteroposterior radiographs of 25 patients with UCLP (UCLP group, mean age: 20.98 ± 4.88 years) and 25 subjects without cleft (control group, mean age: 19 ± 2.86 years) were included. Independent samples t test, Mann-Whitney U test and Pearson correlation analysis were performed based on linear and angular measurements. Results: Lower facial horizontal asymmetry did not show statistically significant difference between the UCLP and control groups. However, vertical asymmetry of (a) the lateral cranial base ( P = .014), (b) the nasomaxillary region ( P < .001), (c) the maxillary dentoalveolus ( P = .001), and (d) the lower face ( P = .038) were all found to be significantly greater in UCLP group. The occlusal cant angle was also significantly greater in patients with UCLP compared to the controls ( P = .016). While the occlusal cant angle was found to be correlated with the vertical asymmetry of the occlusal cant ( r = 0.931, P < .001), maxillary cant angle was found to be correlated with the vertical asymmetry of the maxillary dentoalveolus ( r = 0.655, P < .001). Conclusions: There was no correlation between the occlusal cant and the vertical and horizontal skeletal asymmetries. Vertical asymmetries of the lower face and the medial cranial base were negatively correlated with the horizontal lower facial asymmetry.

Sri Lankan Cleft Lip and Palate Study Model Analysis: Clefts of the Secondary Palate

1993 ◽  
Vol 30 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Andrew Mccance ◽  
David Roberts-Harry ◽  
Martyn Sherriff ◽  
Michael Mars ◽  
William J.B. Houston
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Model Analysis ◽  
Control Group ◽  
Tooth Size ◽  
Sri Lankan ◽  
Control Groups ◽  
Secondary Palate ◽  
Comparable Control ◽  
And Control

The study models of a group of adult Sri Lankan patients with clefts of the secondary palate were investigated. Tooth-size and arch-dimension comparisons were made with a comparable control group. Significant differences were found between the cleft and control groups in tooth sizes, chord lengths, and arch widths. The cleft group dimensions were generally smaller than those of the control group. Overjets were larger in the cleft group.

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