Evaluation of the Effects of Cheiloplasty on Maxillary Arch in UCLP Infants Using Three-Dimensional Digital Models

2019 ◽  
Vol 56 (8) ◽  
pp. 1013-1019 ◽  
Author(s):  
Thanawut Kongprasert ◽  
Kengkart Winaikosol ◽  
Araya Pisek ◽  
Aggasit Manosudprasit ◽  
Amornrut Manosudprasit ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
High Reliability ◽  
Anterior Part ◽  
Intraclass Correlation ◽  
Dental Arch ◽  
Posterior Arch ◽  
Anterior Arch ◽  
Arch Width ◽  
Significant Difference

Objective: To analyze and identify changes in the maxillary dental arch before and after cheiloplasty in a group of unilateral complete cleft lip and palate (UCLP) infants. Design: This is a cohort study. Material and Method: Study models from 16 infants with nonsyndromic UCLP, who were treated at Khon Kaen University, were taken before (T1) and after cheiloplasty (T2). The dental models underwent a process of scanning through a 3D scanner, from which 9 linear and 2 angular landmarks were evaluated. Paired t test was used to compare the measurement statistically between T1 and T2. Results: Alveolar cleft gap (G-L), anterior basal angle (∠GC-CC′), and anterior arch curvature angle on greater segment (∠GIC) were significantly decreased ( P < .05). Contrarily, anterior ridge length of greater segment (C-I), anterior ridge length of lesser segment (L-C′), and posterior arch width (T-T′) were significantly increased ( P < .05) after cheiloplasty. While, anterior portion of greater segment (I-G), anterior arch width (C-C′), anterior arch depth (I⊥CC′), arch length (G⊥TT′), and arch circumference (T-C-I-G-L-C′-T′) showed no significant difference. The measurements were tested using the Intraclass correlation coefficient. The coefficients indicated high reliability. Conclusion: Cleft gap significantly decreased after lip repair, and the anterior part of maxillary dental arch was also bent palatally after cheiloplasty without any other intervention except cheiloplasty. More studies are needed to assess the amount of lip pressure. If any convincing force is presented, an appliance to prevent undesirable pressure is indicated.

Comparison between the Palatal Configurations in Complete and Incomplete Unilateral Cleft Lip and Palate Infants under 18 Months of Age

2001 ◽  
Vol 38 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Katsuaki Mishima ◽  
Yoshihide Mori ◽  
Toshio Sugahara ◽  
Masayoshi Sakuda
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Measuring System ◽  
Posterior Arch ◽  
Orthopedic Treatment ◽  
Arch Width ◽  
Significant Difference ◽  
The Difference ◽  
Arch Forms

Objective The purpose of this study was to examine the three-dimensional characteristics of the palatal configurations in incomplete unilateral cleft lip and palate (UCLP) patients and to determine whether there are differences in the effect of early orthopedic treatment between complete and incomplete UCLP patients. Design Eight infants with incomplete UCLP and 12 infants with complete UCLP, selected at random, wore Hotz plates, and 8 other infants with complete UCLP did not. Palatal impressions were taken of these patients immediately after birth and at 1, 2, 3, 4 (just before cheiloplasty), 6, and 18 months of age (just before palatoplasty). Using our measuring system, the palatal casts were measured and compared three-dimensionally. Results and Conclusions The palate of the incomplete UCLP patients measured immediately after birth, compared with complete UCLP, showed: (1) smaller posterior arch width; (2) sagittal arch length did not differ; (3) incisal point was located more mesially; (4) the gap between the alveolar arch forms of the major and minor segments was smaller; and (5) the curvature of the palatal surface forward the nasal cavity in the minor segment was less. At 18 months of age, the following characteristics could be observed: (1) the difference observed at birth in the posterior arch width between the incomplete and complete UCLP infants vanished; (2) a significant difference in the location of the incisal point was observed only between the incomplete UCLP infants and the complete UCLP infants with a Hotz plate; and (3) the curvature was less in the incomplete UCLP infants than in the complete UCLP infants. Furthermore, the morphological change of the palatal surface was less in the incomplete UCLP infants than in the complete UCLP infants. This suggested that any influence of the Hotz appliance might be less in incomplete UCLP than in complete UCLP.

Maxillary Arch Dimensions in Bilateral Cleft Lip and Palate from Birth until Four Years of Age in Boys

1998 ◽  
Vol 35 (3) ◽  
pp. 233-239 ◽  
Author(s):  
Kiki L.W.M. Heidbuchel ◽  
Anne M. Kuijpers-Jagtman ◽  
Gem J.C. Kramer ◽  
Birte Prahl-Andersen
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Hospital ◽  
Control Group ◽  
Posterior Arch ◽  
Anterior Arch ◽  
Arch Width ◽  
Bilateral Cleft Lip ◽  
The University ◽  
Maxillary Arch

Objective To describe the development of maxillary arch dimensions in children with bilateral cleft lip and palate (BCLP) during the first 4 years of life and to compare it with that in noncleft children. Design This was a retrospective, mixed-longitudinal study. Setting The study was conducted at the Cleft Palate Center of the University Hospital of Nijmegen. Subjects The sample consisted of 26 boys with BCLP who were born between 1976 and 1990 and treated at the University Hospital of Nijmegen. Data for a control group of 34 noncleft boys were collected at the University Hospital of Amsterdam. Method Palatal arch dimensions were digitized on dental casts. A comparison between BCLP and noncleft dimensions was made at fixed time intervals. Results At birth, anterior and posterior arch widths as well as arch depths were significantly larger in children with BCLP. After 7 months (lip closure), anterior arch width and arch depth diminished considerably in the cleft group. After 12 months (palatoplasty), a slight decrease in posterior arch width was observed, and arch depths showed slight catch-up growth. At 4 years of age, anterior arch width was significantly narrower and anterior arch depth was shorter in children with BCLP than in control subjects. Posterior arch width was significantly wider. Conclusions During the first 4 years of life, maxillary arch dimensions in children with BCLP show a unique development that is significantly different from that in noncleft children.

scholarly journals Facial profile and maxillary arch dimensions in unilateral cleft lip and palate children in the mixed dentition stage

2017 ◽  
Vol 11 (01) ◽  
pp. 076-082 ◽  
Author(s):  
Vellore Kannan Gopinath ◽  
Ab Rani Samsudin ◽  
Siti Noor Fazliah Mohd Noor ◽  
Hady Youssef Mohamed Sharab
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Mixed Dentition ◽  
Dental Arch ◽  
Base Length ◽  
Facial Profile ◽  
Arch Width ◽  
Significant Difference ◽  
Maxillary Arch

ABSTRACT Objectives: The aim of this study was to evaluate the vertical and sagittal facial profile and maxillary arch width, depth, and length of patients with unilateral cleft lip and palate (UCLP) and to compare them with healthy noncleft children in the mixed dentition stage (7–13 years). Materials and Methods: This study is conducted at Hospital Universiti Sains Malaysia. UCLP group comprised 48 patients with nonsyndromic UCLP who have had the lip and palate repaired, whereas the control group comprised 48 healthy noncleft cases. The lateral cephalometrics measurements were used to determine the vertical height, sagittal depth of the face, and cranial base length and angle. Maxillary arch dimensions were measured on the study cast including arch width, depth, and length. Results: Vertical facial height and sagittal depth measurements showed a significant decrease (P < 0.05) in the mean growth pattern in UCLP group. The anterior cranial base length (S-N) was shorter in UCLP children (P < 0.001), while Ba-N length had no significant difference (P = 0.639). Nasion-Sella Tursica-Basion angle was significantly higher in the UCLP group (P = 0.016). Dental arch width with reference to canine-to-canine and first premolar-to- first premolar distance was significantly larger in control (P = 0.001). Conclusion: Mean vertical and sagittal facial dimensions in the UCLP children who do not undergo orthodontic treatment are significantly lesser in all directions of growth than healthy noncleft children. The maxillary dental arch had a normal depth but constricted in width and arch length.

Intraoral Photographs for Rating Dental Arch Relationships in Unilateral Cleft Lip and Palate

2009 ◽  
Vol 46 (4) ◽  
pp. 415-419 ◽  
Author(s):  
Yu-Fang Liao ◽  
Chiung-Shing Huang ◽  
I-Feng Lin
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The Other ◽  
Viable Alternative ◽  
Dental Arch ◽  
Significant Difference ◽  
Intraexaminer Reliability ◽  
Experienced Examiner ◽  
Dental Casts

Background and Purpose: The Goslon Yardstick is one of the most commonly used methods to assess dental arch relationships of patients with unilateral cleft lip and palate. This system was originally applied to dental casts. For reasons of economy and convenience, we aimed to determine whether intraoral photographs could substitute for dental casts for rating dental arch relationships. Methods: Records of 58 patients with nonsyndromic complete unilateral cleft lip and palate from the Chang Gung Craniofacial Center, Taipei, Taiwan, were used in this study. A set of dental casts and digital intraoral photographs taken at around 9 years of age were available for all patients. An experienced examiner rated the dental casts using the Goslon Yardstick to provide the reference scores. The other three examiners rated the intraoral photographs and repeated the rating 1 week later to calculate inter- and intraexaminer reliability. The photographic scores for each examiner were then compared with the reference scores to determine the validity of the photographs. Results: The results showed no significant difference between the rating of dental casts and photographs using the Goslon Yardstick. Reliability was also high for rating on photographs. Conclusions: Intraoral photographs appear to be a viable alternative to the application of the Goslon Yardstick on dental casts.

Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: impact of maxillary dental agenesis on craniofacial growth and dental arch relationship in 8 year olds

2021 ◽  
Author(s):  
Sara Rizell ◽  
Annelise Küseler ◽  
Arja Heliövaara ◽  
Pål Skaare ◽  
Eli Brinck ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Randomized Trials ◽  
Cleft Lip And Palate ◽  
Dental Arch ◽  
Craniofacial Growth ◽  
Primary Surgery ◽  
Maxillary Tooth ◽  
Significant Difference ◽  
The Impact ◽  
Dental Arch Relationship

Summary Background It is suggested that dental agenesis affects maxillary protrusion and dental arch relationship in children with unilateral cleft lip and palate (UCLP). In addition, an association between the need for orthognathic surgery and dental agenesis is reported. Aim The aim was to study the impact of maxillary dental agenesis on craniofacial growth and dental arch relationship in 8-year-old children with UCLP. Subjects and methods The sample consisted of individuals with UCLP from Scandcleft randomized trials. The participants had available data from diagnosis of maxillary dental agenesis as well as cephalometric measurements (n = 399) and GOSLON assessment (n = 408) at 8 years of age. Results A statistically significant difference was found for ANB between individuals with agenesis of two or more maxillary teeth (mean 1.52°) in comparison with those with no or only one missing maxillary tooth (mean 3.30° and 2.70°, respectively). Mean NSL/NL was lower among individuals with agenesis of two or more maxillary teeth (mean 9.90°), in comparison with individuals with no or one missing maxillary tooth (mean 11.46° and 11.45°, respectively). The number of individuals with GOSLON score 4–5 was 47.2% in the group with two or more missing maxillary teeth and 26.1% respectively 26.3% in the groups with no or one missing maxillary tooth. No statistically significant difference was found in the comparison between individuals with no agenesis or with agenesis solely of the cleft-side lateral. Conclusion Maxillary dental agenesis impacts on craniofacial growth as well as dental arch relationship and should be considered in orthodontic treatment planning.

Early Palatal Changes after Initial Palatal Surgery in Children with Cleft Lip and Palate

1996 ◽  
Vol 33 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Gem J.C. Kramer ◽  
Jan B. Hoeksma ◽  
Birte Prahl-Andersen
Keyword(s):  
Soft Palate ◽  
Growth And Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Timing Of Surgery ◽  
Normal Children ◽  
Anterior Arch ◽  
Arch Width ◽  
Different Types ◽  
Palatal Surgery

Early palatal growth and development after primary palatal closure was studied in children with different types of cleft lip and palate (CLP). Palatal dimensions were measured on dental casts taken at fixed ages, from 9 months to 4 years of age. The results showed that soft and hard palatal closure in one stage had a significant impeding influence on posterior sagittal palatal growth compared to closure of the soft palate only. Timing of surgery possibly had a small temporary restrictive effect on posterior transverse palatal growth and development. Type and severity of the oral cleft had a significant effect on transverse palatal development and anterior sagittal dimensions. Anterior arch width was reduced in children with a complete unilateral (U) CLP or bilateral (B) CLP. The palates of the latter children had consistently larger anterior arch depths. Compared to normal children, palates of cleft children changed anteriorly from wider at 9 months of age to narrower at 4 years of age. Arch depths were smaller in cleft children except for anterior arch depths in children with complete BCLP.

Maxillary Dental Arch Affected by Different Sleep Positions in Unilateral Complete Cleft Lip and Palate Infants

1994 ◽  
Vol 31 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Chiung-Shing Huang ◽  
Hsin-Chung Cheng ◽  
Yu-Ray Chen ◽  
M. Samuel Noordhoff
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Longitudinal Change ◽  
Sleep Position ◽  
Dental Arch ◽  
Initial Visit ◽  
Arch Width ◽  
Supine Sleep ◽  
The Relationship ◽  
Maxillary Arch

The development of the dental arch is well designed for adaptive and compensatory growth. In this study, the relationship between the sleep position and dental arch development was Investigated. A group of 42 infants with unilateral complete cleft lip and palate with either prone (16) or supine (26) sleep position were seen in the craniofacial center. All infants were less than 1 month of age at the initial visit. Dental impressions of the maxillary arch were taken at the initial visit and just before cheiloplasty. Ten arch dimensions were measured in each dental cast and the longitudinal change in each dimension was compared between the prone sleep group and the supine sleep group. Statistically significant changes were detected in the growth rate of the following dimensions: intercanine width, intertuberosity width, alveolar cleft width, anterior cleft width, and posterior cleft width. This study indicated that sleep position affected maxillary arch development. Infants sleeping in the prone sleep position tended to have narrower arch width and cleft width.

Relationship between Cleft Severity and Dentocraniofacial Morphology in Japanese Subjects with Isolated Cleft Palate and Complete Unilateral Cleft Lip and Palate

1993 ◽  
Vol 30 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Akira Suzuki ◽  
Yo Mukai ◽  
Masamichi Ohishi ◽  
Yasuko Miyanoshita ◽  
Hideo Tashiro
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Lateral Displacement ◽  
Craniofacial Morphology ◽  
Dental Arch ◽  
Arch Width ◽  
Lateral Cephalograms ◽  
Isolated Cleft Palate ◽  
Dental Arch Width

Relationships between the width of the palatal cleft measured at paIatopIasty and the craniofacial morphology or the occlusal conditions present at approximately 4 years of age were studied in 25 cleft palate (CP) and 39 complete unilateral cleft lip and palate (UCLP) subjects treated at the Dental Clinic of Kyushu University. Posteroanterior cephalograms and dental casts showed that the width of the palatal cleft was significantly correlated with wider upper facial width and posterior dental arch width in UCLP, but not in CP subjects. Cleft width was not significantly correlated with the buccolingual occlusal relationship in either subject type. The anterior occlusal relationship in UCLP was not as good as in CP subjects. On lateral cephalograms, the width of the palatal cleft was significantly correlated with vertical hypoplasia of the upper face in UCLP, but not in CP subjects. The cleft palate width appears to be related to the lateral displacement and the retardation of the downward and forward growth of the nasomaxillary complex in UCLP subjects.

Influence of Early Hard Palate Closure in Unilateral and Bilateral Cleft Lip and Palate on Maxillary Transverse Growth during the First Four Years of Age

2003 ◽  
Vol 40 (2) ◽  
pp. 126-130 ◽  
Author(s):  
Bernhard Lehner ◽  
Joerg Wiltfang ◽  
Karin Strobel-Schwarthoff ◽  
Michaela Benz ◽  
Ursula Hirschfelder ◽  
...  
Keyword(s):  
Hard Palate ◽  
Primary Closure ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Arch Width ◽  
Significant Difference ◽  
Early Primary ◽  
Delayed Closure ◽  
The University

Objective To evaluate and compare the effects of early primary closure of the hard palate on the anterior and posterior width of the maxillary arch in children with bilateral (BCLP) and unilateral (UCLP) cleft lip and palate during the first 4 years of life. Design A retrospective, mixed-longitudinal study. Setting Cleft Palate Center of the University of Erlangen-Nuremberg. Subjects and Methods The present investigation analyzes longitudinally 42 children with UCLP and 8 children with BCLP between 1996 and 2000 with early simultaneous primary closure of lip and hard palate (4 to 5 months). Palatal arch width was measured on dental casts with a computer-controlled three-dimensional digitizing system, and their growth velocities were calculated from consecutive periods (mean follow-up 39 months). Differences in growth velocities were compared with those of 25 children with UCLP and 15 children with BCLP with delayed closure of hard palate (12 to 14 months). Results and Conclusions There was no significant difference in terms of anterior and posterior maxillary width between early and delayed closure of hard palate within the first 4 years of life.

The Influence of Orthodontic Treatment on the Goslon Score of Unilateral Cleft Lip and Palate Patients

2012 ◽  
Vol 49 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Peter Southall ◽  
Mark Walters ◽  
Steven Singer
Keyword(s):  
Retrospective Study ◽  
Treatment Group ◽  
Surgical Outcome ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Favorable Outcome ◽  
Dental Arch ◽  
Significant Difference ◽  
The Mean

Objective To assess the effect of orthodontic treatment on Goslon Yardstick outcome. Design Retrospective study. Patients A series of 66 consecutive patients born with a complete unilateral left lip and palate. Patients were sorted into a nontreatment group (n = 47) and a treatment group (n = 19). Method Three assessors trained in the use of the Goslon Yardstick ranked the dental arch relationships of study casts taken at 6 and 9 years. Results There was only a fair agreement (κ = .33) between 6- and 9-year Goslon Yardstick scores for the cohort of 66 patients, with a significant (p < .05) difference in the mean score at 6 years (3.17 ± 0.8) and at 9 years (2.88 ± 1.0). Removal of 19 subjects who had orthodontic inventions prior to taking of the 9-year-old study cast improved the agreement to moderate (κ = .52). There was no significant difference (p > .05) in mean scores at 6 and 9 years (3.13 ± 0.9 and 3.17 ± 1.03, respectively). The treatment group exhibited significant differences (p < .001) with mean Goslon Yardstick scores of 3.0 ± 0.9 at 6 and 2.25 ± 0.45 at 9 years. Conclusions The inclusion of patients who had received orthodontic treatment prior to taking of study casts being used for Goslon Yardstick scoring can result in a more favorable outcome. Patients who have received active orthodontic treatment prior to taking of dental casts should be excluded or accounted for in audits to assess primary cleft surgical outcome in patients with a unilateral cleft lip and palate.

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