scholarly journals Longitudinal 3D Assessment of Facial Asymmetry in Unilateral Cleft Lip and Palate

2018 ◽  
Vol 56 (4) ◽  
pp. 495-501 ◽  
Author(s):  
Dhelal Al-Rudainy ◽  
Xiangyang Ju ◽  
Felicity V. Mehendale ◽  
Ashraf Ayoub
2002 ◽  
Vol 39 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Stephanos Kyrkanides ◽  
Liubov Richter

Objective To determine whether asymmetric antigonial notching is associated with the development of mandibular and lower facial asymmetry in individuals with unilateral cleft lip and palate (UCLP). Design Retrospective mixed-longitudinal investigation including UCLP and nonaffected orthodontic patients. Participants All (24) available patients with UCLP treated in our clinic with complete longitudinal records, and 72 skeletal maturation matched noncleft orthodontic patients that served as controls. Subject records included hand-wrist, panoramic, frontal, and 45° oblique cephalometric radiographs. Main outcome Measures The development of mandibular asymmetry, measured on oblique cephalometric radiographs, as well as lower facial asymmetry, measured on frontal cephalometric radiographs, was monitored in individuals with UCLP in relation to antigonial notching asymmetry, assessed on panoramic and oblique cephalometric radiographs. Results First, no statistical differences were found in antigonial notching asymmetry between patients with UCLP and noncleft controls. Second, antigonial notching asymmetry, observed on panoramic and oblique cephalometric radiographs, significantly correlated with the attendant development of mandibular and lower facial asymmetry in individuals with UCLP. Third, the development of mandibular and lower facial asymmetry at pubertal and post-pubertal growth spurt stages significantly correlated with antigonial notching asymmetry, measured on panoramic radiographs, at prepubertal and pubertal growth spurt stages, respectively. Conclusions The degree of antigonial notching noted on panoramic radiographs can be used as an early indicator of developing mandibular and lower facial asymmetry in individuals with UCLP.


1994 ◽  
Vol 31 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Frank Ras ◽  
Luc L. M. H. Habets ◽  
Floris C. Van Ginkel ◽  
Birte Prahl-Andersen

RSBO ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 05-10
Author(s):  
Tuanny Carvalho de Lima do Nascimento ◽  
Fernando Luiz Zanferrari ◽  
Juliana Lucena Schussel ◽  
José Luís Dissenha ◽  
Laurindo Moacir Sassi ◽  
...  

This study aimed to analyze the effectiveness of the closure of oronasal communication, to report the importance of secondary alveolar bone graft repositioning of the premaxilla in patients with bilateral complete cleft lip and palate. Material and methods: This retrospective study analyzed the medical records obtained from the Cleft Lip and Palate Integral Care Center/ Association of Rehabilitation and Social Development of Cleft Lip and Palate Patients (CAIF/AFISSUR), Curitiba – Paraná – Brazil, to obtain statistical data involving 26 records of patients who underwent this surgery in the period between January/2010 – January/2014. Results and Conclusion: The benefits observed were: premaxilla stability, aided by the union of pre-maxillary segments; integrity of oronasal structure; aesthetic improvement; better bone support for the teeth adjacent to the cleft; support for the bridge of the nose reducing facial asymmetry and facilitating future rhinoplasty; orthodontic treatment without the limitation of the bone defect; closure of oronasal communication in 88% of patients.


2017 ◽  
Vol 55 (3) ◽  
pp. 348-355 ◽  
Author(s):  
Delnaz S. Patel ◽  
Rachel Jacobson ◽  
Yao Duan ◽  
Linping Zhao ◽  
David Morris ◽  
...  

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.


1994 ◽  
Vol 31 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Frank Ras ◽  
Luc L.M.H. Habets ◽  
Floris C. Van Ginkel ◽  
Birte Prahl-Andersen

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.


Author(s):  
Sachiko Nishina ◽  
Katsuhiro Hosono ◽  
Shizuka Ishitani ◽  
Kenjiro Kosaki ◽  
Tadashi Yokoi ◽  
...  

AbstractCDK9 has been considered a candidate gene involved in the CHARGE-like syndrome in a pair of cousins. We report an 8-year-old boy with a strikingly similar phenotype including facial asymmetry, microtia with preauricular tags and bilateral hearing loss, cleft lip and palate, cardiac dysrhythmia, and undescended testes. Joint contracture, no finger flexion creases, and large halluces were the same as those of a previously reported patient with homozygous CDK9 variants. The ocular phenotype included blepharophimosis, lacrimal duct obstruction, eyelid dermoids, Duane syndrome-like abduction deficit, and congenital cataracts. Optical coherence tomography and electroretinography evaluations revealed severe retinal dystrophy had developed at an early age. Trio-based whole-exome sequencing identified compound heterozygous variants in CDK9 [p.(A288T) of maternal origin and p.(R303C) of paternal origin] in the patient. Variants’ kinase activities were reduced compared with wild type. We concluded that CDK9 biallelic variants cause a CHARGE-like malformation syndrome with retinal dystrophy as a distinguishing feature.


1997 ◽  
Vol 34 (5) ◽  
pp. 410-416 ◽  
Author(s):  
Christodoulos P. Laspos ◽  
Stephanos Kyrkanides ◽  
Ross H. Tallents ◽  
Mark E. Moss ◽  
J. Daniel Subtelny

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.


2009 ◽  
Vol 46 (2) ◽  
pp. 154-160 ◽  
Author(s):  
Tomohisa Nagasao ◽  
Junpei Miyamoto ◽  
Eri Konno ◽  
Hisao Ogata ◽  
Tatsuo Nakajima ◽  
...  

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.


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