Dentoalveolar Growth of Patients with Complete Unilateral Cleft Lip and Palate by Early Two-Stage Furlow and Push-Back Method: Preliminary Results

2004 ◽  
Vol 41 (5) ◽  
pp. 519-525 ◽  
Author(s):  
Taiji Kitagawa ◽  
Hiroshi Kohara ◽  
Taiji Sohmura ◽  
Junzo Takahashi ◽  
Takashi Tachimura ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Laser Scanner ◽  
Japanese Patients ◽  
Horizontal Direction ◽  
Two Stage ◽  
Cross Sectional ◽  
Growth Changes ◽  
Deciduous Molar

Objective This study examined dentoalveolar growth changes prior to the time of palatoplasty up to 3 years of age by the early two-stage Furlow and push-back methods. Subjects Thirty-four Japanese patients with complete unilateral cleft lip and palate (UCLP) treated with either a two-stage Furlow procedure (Furlow group: seven boys, eight girls) from 1998 to 2002 or a push-back procedure (push-back group; 12 boys, 7 girls) from 1993 to 1997. Method Consecutive plaster models were measured by three-dimensional laser scanner, before primary palatoplasty, before hard palate closure (Furlow group only), and at 3 years of age. Bite measures were taken at 3 years of age. Results In the Furlow group, arch length, canine width, first and second deciduous molar width and cross-sectional area, and depth and volume at midpoint showed greater growth than in the push-back group. In the Furlow group, the crossbite score was also better than in the push-back group at 3 years of age. In comparison with the push-back group, inhibition of growth impediment in the anterior region was observed in the horizontal direction in the Furlow group. In the midregion, it was observed in the horizontal and vertical directions, and in the posterior region it was observed in the horizontal direction. Conclusion The results demonstrate that the early two-stage Furlow method showed progressive alveolar growth. Therefore, the early two-stage Furlow method is a more beneficial procedure than the push-back method.

Patterns of Maxillary Alveolar Arch Growth Changes of Infants with Unilateral Cleft Lip and Palate: Preliminary Findings

2003 ◽  
Vol 40 (4) ◽  
pp. 363-372 ◽  
Author(s):  
Bert Braumann ◽  
Ludger Keilig ◽  
Angelika Stellzig-Eisenhauer ◽  
Christoph Bourauel ◽  
Stefaan Bergé ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Laser Scanner ◽  
First Year ◽  
Osteoplastic Surgery ◽  
Growth Changes ◽  
Crest Length ◽  
First Year Of Life

Objective Because of significant differences in pathomorphology at birth, it may be that a better treatment outcome prognosis exists for patients with incomplete versus complete cleft forms. Can reaction patterns be extracted from changes in maxillary dimensions of different cleft forms within the first year of life to support this hypothesis? Subjects Chronologically consecutive casts of the maxilla (1 week and 3, 6, and 12 months of life) of 15 patients with complete unilateral cleft lip and palate (cUCLP) and 13 patients with incomplete unilateral cleft lip and palate (iUCLP). All patients were treated with passive palatal plates. Cheiloplasty was performed at 6 months of age. No primary osteoplastic surgery was carried out. Interventions Following digitizing with a three-dimensional laser scanner, all cast surfaces were computer reconstructed, aligned, and superimposed. Distances between the surfaces were determined and expressed graphically. Computer-aided determination of defined maxillary dimensions was performed. The volumes of segmented surfaces were determined and compared. Results Within the first year of life, decreased sagittal but increased transverse alveolar growth for patients with iUCLP was found. The increase in alveolar crest length in patients with iUCLP was 50% less within the first year of life than in patients with cUCLP. In the same patients, the volumes of the molar segments were, on average, larger at each registration stage and the increase in these volumes larger within the first year of life. Conclusion Conclusions regarding the direction and extent of growth cannot be drawn from the visible level of severity of the malformation.

The Hyoid Bone in Malay Infants with Cleft Lip and Palate

2006 ◽  
Vol 43 (5) ◽  
pp. 532-538 ◽  
Author(s):  
Zainul A. Rajion ◽  
Grant C. Townsend ◽  
David J. Netherway ◽  
Peter J. Anderson ◽  
Toby Hughes ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Software Package ◽  
Hyoid Bone ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Cross Sectional ◽  
Computed Tomography Scans ◽  
Age Range

Objective: To compare morphological and positional variations of the hyoid bone in unoperated infants with cleft lip and palate (CL/P) with those in noncleft infants. Design: Retrospective, cross sectional. Patients and Methods: Three-dimensional computed tomography scans were obtained from 29 unoperated CL/P infants of Malay origin aged between 0 and 12 months and from 12 noncleft infants in the same age range. Observations were made and measurements were obtained with a software package developed at the Australian Craniofacial Unit. The sizes of the hyoid bones and the position of the hyoid body and epiglottis in relation to the cervical spine were measured. Anatomical anomalies of the hyoid and prevalence of aspiration pneumonia were also documented. Results: The hyoid bones and epiglottis were found to be located more inferiorly in CL/P infants compared with the noncleft infants. Also, 17% (5/29) of the CL/P infants had nonossified hyoid bodies. Conclusion: The results suggest that there are differences in the location and genesis of the hyoid bone in infants with CL/P that warrant further investigation.

scholarly journals Relationship between Orthodontic Treatment Plan and Goslon Yardstick Assessment in Japanese Patients with Unilateral Cleft Lip and Palate: One-stage vs. Two-stage Palatoplasty

2016 ◽  
Vol 57 (3) ◽  
pp. 159-168
Author(s):  
Takenobu Ishii ◽  
Teruo Sakamoto ◽  
Munetada Ishikawa ◽  
Toshihiko Yasumura ◽  
Haruyo Miyazaki ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Plan ◽  
Japanese Patients ◽  
Two Stage ◽  
One Stage

Three-Dimensional Analysis of Morphological Changes in the Maxilla of Patients with Cleft Lip and Palate

2002 ◽  
Vol 39 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Bert Braumann ◽  
Ludger Keilig ◽  
Christoph Bourauel ◽  
Andreas Jäger
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Morphological Changes ◽  
Three Dimensional ◽  
Laser Scanner ◽  
Computer Software ◽  
Reference Points ◽  
Starting Point ◽  
Ideal Tool ◽  
Infant Orthopedics

Objective Three-dimensional (3-D) morphological changes in the maxilla of patients with cleft lip and palate (CLP) have been recorded, mainly using two-dimensional cast analyses. Although these seem to be insufficient, no standardized 3-D method has been developed until now. In this study, accuracy, precision, and validity of a newly developed 3-D digital computer-aided procedure to visualize and metrically analyze the growth of the edentulous maxilla of infants with CLP have been evaluated. Patients The method was applied to 10 infants with complete unilateral CLP. Interventions Consecutive casts of the maxilla (1 week and 3, 6, and 12 months) of each patient were optically measured with a 3-D laser scanner. Following digitizing, the casts were computer reconstructed, aligned, and superimposed using specialized computer software. The distances between the surfaces were measured. Additionally, the surfaces were segmented perpendicular to the alveolar crest, the reference points being C1, C1′, C2, C2′, and I. The volumes of the resulting segments were determined and compared with one another. Results The newly developed analysis enables a visualization of the extent and direction of morphological changes in the maxilla of infants with CLP. With this method it is possible to quantify these changes of the volume of defined alveolar segments. Conclusions The 3-D analysis developed is an ideal tool for the examination of 3-D morphological changes in the edentulous maxilla of patients with CLP. The results will serve as the starting point for a longitudinal study on the efficacy of different methods, not only of presurgical infant orthopedics but also of surgical procedures.

A Three-Dimensional Computed Tomographic Analysis of the Cervical Spine in Unoperated Infants with Cleft Lip and Palate

2006 ◽  
Vol 43 (5) ◽  
pp. 513-518 ◽  
Author(s):  
Zainul A. Rajion ◽  
Grant C. Townsend ◽  
David J. Netherway ◽  
Peter J. Anderson ◽  
Asilah Yusof ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Abnormal Development ◽  
Posterior Arch ◽  
Cross Sectional ◽  
Computed Tomography Scans ◽  
Vertebral Bodies

Objective: To investigate anatomical variations and abnormalities of cervical spine morphology in unoperated infants with cleft lip and palate. Design: Retrospective cross-sectional investigation of infants born with nonsyndromic cleft lip and palate using computed tomography scans acquired for investigation of a spectrum of clinical conditions. Setting: Computed tomography scan data were obtained from 29 unoperated cleft lip and palate infants and 12 noncleft infants of Malay origin, ages 0 to 12 months. Methods: Observational study of cervical spine computed tomography scans. Heights of cervical vertebral bodies (C2-C7) and intervertebral spaces were measured from landmarks identified from computed tomography reformats and three-dimensional computed tomography reconstructions. Linear modeling of heights and spaces, with age as a covariate, was undertaken to identify differences between the samples. Results: Anomalous features observed in the cleft lip and palate sample included short posterior arch of C1 (2/29), abnormal development of the anterior arch of C1 (2/29), and fusions of the posterior arch of C2 and C3 (2/29). No anomalies of the cervical spine were observed in the noncleft sample. Although the heights of three cervical vertebral bodies were significantly smaller and two intervertebral spaces were significantly larger in infants with cleft lip and palate compared with noncleft infants (p < .05), overall length of the cervical spine did not differ significantly between the samples. Conclusion: There was evidence for subtle upper spinal anomalies in the infant cleft lip and palate population. Our finding of reduced size of some cervical vertebral bodies may reflect delayed upper spinal development in infants with cleft lip and palate.

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

2009 ◽  
Vol 46 (4) ◽  
pp. 399-408 ◽  
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.

A Longitudinal Study on Influence of Primary Facial Deformities on Maxillofacial Growth in Patients with Cleft Lip and Palate

2005 ◽  
Vol 42 (6) ◽  
pp. 633-640 ◽  
Author(s):  
Norifumi Nakamura ◽  
Akira Suzuki ◽  
Hideki Takahashi ◽  
Yasuo Honda ◽  
Masaaki Sasaguri ◽  
...  
Keyword(s):  
Surface Area ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Laser Scanner ◽  
Total Surface Area ◽  
3D Analysis ◽  
Alar Base ◽  
Angular Measurements ◽  
Ocular Hypertelorism

Objective The goal of this study was to use three-dimensional (3D) analysis to characterize the primary facial deformities in children with unilateral cleft lip and palate (UCLP) and then serially analyze the relationships between facial deformities and maxillofacial growth from infancy to adolescence. Participants Twenty-one Japanese subjects with unilateral cleft lip and alveolus (UCLA) and 20 with UCLP who had been operated on and then followed up for more than 15 years were enrolled in this study. Main Outcome Measures Facial cast models taken at cheiloplasty were scanned with a 3D laser scanner. Lateral cephalographs taken when subjects were 15 years of age or older were traced, and linear and angular measurements were calculated. The correlation between primary facial forms and maxillofacial morphology in adolescence was analyzed. Results Three-dimensional analysis showed larger ocular hypertelorism, wider cleft, greater deviation of the columella base, and more severe retruded position of the affected nasal alar base in subjects with UCLP than those with UCLA. Total surface area of the upper lips in subjects with UCLP was significantly smaller than those with UCLA. Correlation analyses revealed that the width of cleft lip, deviation of the columella base, difference of the nose base width, and surface area of the upper lip were statistically correlated with the maxillary length, the anterior position of the maxillary alveolar base, the posterior facial height, and the high angle of the mandible. Conclusion The subjects who had less severe facial deformities and more tissue volume of the upper lips at cheiloplasty showed better maxillofacial growth.

Precision of Landmark Positioning on Digitized Models from Patients with Cleft Lip and Palate

2006 ◽  
Vol 43 (2) ◽  
pp. 168-173 ◽  
Author(s):  
Jakob Brief ◽  
Jan H. Behle ◽  
Angelika Stellzig-Eisenhauer ◽  
Stefan Hassfeld
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Laser Scanner ◽  
Plaster Cast ◽  
Anatomical Landmarks ◽  
Positioning Error ◽  
The University ◽  
Plaster Models ◽  
The Ideal

Objective To quantify the precision of landmark positioning on digitized casts of patients with unilateral cleft lip and palate. Patients Forty plaster models of newborns up to 8 months of age were selected from the archive of the Department of Orthodontics of the University of Heidelberg. Material and Method The plaster-cast models were digitized with a Micromeasure 70 three-dimensional laser scanner (Micromeasure, Bischoffen, Germany). The laser scanner used in this study operates with a precision of 0.15 mm on the x- and y-axes and 0.06 mm on the z-axis. In the intraobserver study, a single observer placed anatomical landmarks in four rounds, with at least 4 weeks between each round. In the interobserver study, four different observers each placed the same landmarks once. For the two different studies, an ideal location for each landmark was calculated by averaging the landmark positions of the four rounds or observers. The distance between each of the four landmark positions and the ideal landmark was measured. Results A 95% confidence interval for the landmark positioning error was calculated. For the intraobserver investigation, this error was 0.34 to 1.30 mm, and for the interobserver investigation it was 0.7 to 2.00 mm. Conclusion Because both investigations displayed comparable error intervals, it was concluded that different observers could perform landmark positioning for the same studies.

Three-Dimensional Analysis of Bilateral Cleft Lip and Palate Nasal Deformity

2020 ◽  
Vol 58 (1) ◽  
pp. 105-113
Author(s):  
Lucas M. Harrison ◽  
Rami R. Hallac ◽  
Christopher A. Derderian
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Time Points ◽  
Alar Base ◽  
Nasolabial Angle ◽  
Base Width ◽  
Nasal Length

Objective: This cross-sectional study utilizes 3-dimensional analysis to assess nasal morphology in patients with bilateral cleft lip and palate (BCLP) compared to controls across the timeline of cleft care. Design: Retrospective comparative cross-sectional study. Setting: Tertiary pediatric academic institution. Patients and Participants: One hundred and twelve patients with BCLP and an equal number of age and sex-matched control participants. Main Outcome Measure(s): Nasolabial angle, nasal length, nasal protrusion, columella length, columella width, nasal tip width, alar width, and alar base width were collected at each time point. The measurements were collected pre-nasoalveolar molding (NAM) therapy, post-NAM therapy, post-primary cleft rhinoplasty, 1 year, 5 years, 10 years, and 15 years of age. Results: Nasolabial angle and nasal tip width were significantly different from controls from pre-NAM through 15 years of age time points. Nasal length was not significantly different at any time point. Alar width and alar base width were significantly different from pre-NAM through 10 years of age time points. Nasal protrusion, columella length, and columella width were significantly different from pre-NAM through 5 years of age time points. Conclusions: This study demonstrates that three-dimensional photogrammetry is effective in assessing the changes in nasal morphology that occur throughout the course of care in patients with BCLP from before cleft lip repair to the completion of nasal growth.

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