Early Craniofacial Morphology and Growth in Children with Bilateral Complete Cleft Lip and Palate

2004 ◽  
Vol 41 (4) ◽  
pp. 424-438 ◽  
Author(s):  
N. V. Hermann ◽  
T. A. Darvann ◽  
B. L. Jensen ◽  
E. Dahl ◽  
S. Bolund ◽  
...  
Keyword(s):  
Growth Pattern ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Displacement Vector ◽  
Craniofacial Morphology ◽  
Individual Growth ◽  
Control Group ◽  
Facial Growth ◽  
X Ray ◽  
Pharyngeal Airway

Purpose Analysis of craniofacial morphology and growth in children with bilateral complete cleft lip and palate (BCCLP), compared with a control group with unilateral incomplete cleft lip (UICL), before any treatment as well as 20 months after lip closure. Material The children were drawn from a group representing all Danish children with cleft born 1976 to 1981. Sixty-four children were included in the study (19 BCCLP and 45 UICL). The ages were 2 and 22 months at examinations 1 and 2, respectively. Method The method of investigation was infant cephalometry in three projections. The craniofacial morphology was analyzed using linear, angular, and area variables. Growth was defined as the displacement vector from the coordinate of the corresponding landmark in the x-ray at examination 1 to its coordinate at examination 2, corrected for x-ray magnification. The growth of an anatomical region in a patient was assessed by investigating the growth pattern formed by a collection of individual growth vectors in that region. Results The BCCLP group differed significantly from the UICL group. The most striking findings in BCCLP were an extremely protruding premaxilla; markedly increased posterior maxillary width; increased width of the nasal cavity; short maxilla with reduced posterior height; short mandible; bimaxillary retrognathia; severe reduction in the size of the pharyngeal airway; and a more vertical facial growth pattern. Conclusion Our findings indicate that a facial type including a wide and posterior short maxilla, short mandible, and bimaxillary retrognathia might be a liability factor that increases the probability of developing cleft lip and palate.

Early Craniofacial Morphology and Growth in Children with Nonsyndromic Robin Sequence

2003 ◽  
Vol 40 (2) ◽  
pp. 131-143 ◽  
Author(s):  
N. V. Hermann ◽  
S. Kreiborg ◽  
T. A. Darvann ◽  
B. L. Jensen ◽  
E. Dahl ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Displacement Vector ◽  
Growth Direction ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Anatomical Location ◽  
Facial Morphology ◽  
Facial Growth ◽  
Pharyngeal Airway ◽  
Robin Sequence

Purpose Craniofacial morphology and growth comparisons in children with untreated nonsyndromic Robin Sequence (RS) and a control group with unilateral incomplete cleft lip (UICL) in which the lip was surgically closed at 2 months of age. Material The 52 children (7 RS and 45 UICL) included in the study were drawn from a group representing all Danish cleft children born 1976 through 1981. The ages of the children were 2 and 22 months at the time of examination 1 and 2, respectively. Method The method of investigation was three-projection cephalometry. Craniofacial morphology was analyzed by means of linear, angular, and area variables. Growth at a specific anatomical location in a patient was defined as the displacement vector from the coordinate of the corresponding landmark at examination 1 to its coordinate at examination 2. Results The most striking findings in the RS group were markedly increased posterior maxillary width, increased width of the nasal cavity, short maxilla with reduced posterior height, short mandible, bimaxillary retrognathia, and severe reduction in size of the pharyngeal airway. The amount of facial growth was similar in the two groups; however, a tendency toward a more vertical growth direction was observed in the RS group. Conclusion Facial morphology in children with RS differed significantly from that of children with UICL at both 2 and 22 months of age. The magnitude of facial growth was similar in the two groups, whereas a tendency toward a more vertical facial growth direction was observed in the RS group.

Craniofacial Morphology and Growth Comparisons in Children with Robin Sequence, Isolated Cleft Palate, and Unilateral Complete Cleft Lip and Palate

2003 ◽  
Vol 40 (4) ◽  
pp. 373-396 ◽  
Author(s):  
N. V. Hermann ◽  
S. Kreiborg ◽  
T. A. Darvann ◽  
B. L. Jensen ◽  
E. Dahl ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Nasal Cavity ◽  
Growth Pattern ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Craniofacial Morphology ◽  
Facial Morphology ◽  
Facial Growth ◽  
Pharyngeal Airway ◽  
Isolated Cleft Palate

Objective Comparison of early craniofacial morphology and growth in children with nonsyndromic Robin Sequence (RS), isolated cleft palate (ICP), and unilateral complete cleft lip and palate (UCCLP). Subjects One hundred eight children with cleft: 7 with RS, 53 with ICP, and 48 with UCCLP were included in the study. The children were drawn from the group of all Danish children with cleft born 1976 through 1981. Method Three-projection infant cephalometry. Results The craniofacial morphology in the RS, ICP, and UCCLP groups had some common characteristics: a wide maxilla with decreased length and posterior height, wide nasal cavity, short mandible, bimaxillary retrognathia, and reduced pharyngeal airway. The shortest mandible was found in RS followed by ICP and UCCLP; the pharyngeal airway was reduced in RS and ICP, compared with UCCLP; and the maxillary complex and nasal cavity were wider in UCCLP than in the other groups. The amount of facial growth in all three groups was similar; however, the direction was more vertical in UCCLP than in RS and ICP. Conclusion Except for a shorter RS mandible, the facial morphology of infants with RS and ICP was similar, as was the amount of facial growth and the growth pattern. The differences in facial morphology can be ascribed to the difference in the primary anomaly. The amount of facial growth was similar in the three groups; however, the growth pattern showed a more vertical direction in UCCLP than in RS and ICP. It is hypothesized that the mandibular retrognathia in RS represents the outer end of that of the ICP distribution.

Early Craniofacial Morphology and Growth in Children with Unoperated Isolated Cleft Palate

2002 ◽  
Vol 39 (6) ◽  
pp. 604-622 ◽  
Author(s):  
N.V. Hermann ◽  
S. Kreiborg ◽  
T.A. Darvann ◽  
B.L. Jensen ◽  
E. Dahl ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Growth Pattern ◽  
Cleft Lip ◽  
Growth Direction ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Facial Morphology ◽  
Facial Growth ◽  
Vertical Growth ◽  
Isolated Cleft Palate

Objective Analysis of craniofacial morphology and growth in children with untreated isolated cleft palate (ICP) (cleft of the secondary palate only) at 2 and 22 months of age and comparison of the morphology and growth to that of a control group with unilateral incomplete cleft lip (UICL). Material and Methods A total of 98 cleft children (53 with ICP and 45 with UICL) drawn from a larger group representing all Danish children with cleft born in the period 1976 to 1981 were included in the study. Craniofacial morphology and growth were analyzed using three-projection infant cephalometry. Results The ICP group differed significantly from the UICL group. The most striking findings in the ICP group were: short maxilla; reduced posterior maxillary height; increased posterior maxillary width (in the 2-month-old); short mandible; reduced posterior height of the mandible; bimaxillary retrognathia; and reduced pharyngeal depth, height, and area. The facial growth pattern was fairly similar in the two groups except for a somewhat more vertical growth direction in the ICP group. Conclusion The facial morphology in ICP children differs significantly from that of children with UICL of the same age. The differences in facial morphology can be ascribed to the difference in the primary anomaly in the ICP group. The facial growth pattern was fairly similar in the ICP and UICL group; however, a somewhat more vertical growth direction was observed in the ICP group.

scholarly journals Three-dimensional Evaluation of Mandibular Volume in Patients with Cleft Lip and Palate During the Deciduous Dentition Period

2019 ◽  
Vol 90 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Abhishekhi Shrestha ◽  
Masahiro Takahashi ◽  
Tetsutaro Yamaguchi ◽  
Mohamed Adel ◽  
Mayu Furuhata ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Pairwise Comparison ◽  
Craniofacial Morphology ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Deciduous Dentition ◽  
Post Hoc ◽  
And Control

ABSTRACT Objectives To examine the relationship between mandibular volume and craniofacial morphology in patients with cleft lip and palate using cone beam computed tomography (CBCT) and to compare these findings with control (noncleft) patients undergoing CBCT for other purposes during the deciduous dentition period. Materials and Methods Eighty-four patients were categorized into the unilateral cleft lip and alveolus (UCLA) group (n = 25; mean age, 4.60 ± 0.40 years), unilateral cleft lip and palate (UCLP) group (n = 23; mean age, 4.52 ± 0.39 years), bilateral cleft lip and palate (BCLP) group (n = 22; mean age, 4.54 ± 0.37 years), and control group without cleft (n = 14; mean age, 5.19 ± 0.52 years). Mandibular volume and craniofacial cephalometric measurements were obtained using CBCT. All measurements were assessed by analysis of covariance (ANCOVA) using Bonferroni post hoc pairwise comparison tests. Results ANCOVA revealed no statistically significant differences in mandibular volume among the groups. SNA° and ANB° were significantly larger in the UCLA and BCLP groups than in the control group. SN-MP° was smallest in the UCLA group. Co-A in the UCLP group was shorter than in the UCLA and BCLP groups. Go-Gn was shortest in the UCLP and BCLP groups compared with the control group. Conclusions Three-dimensional evaluation of craniofacial morphology using CBCT can provide valuable information on malocclusion and other dentoskeletal problems among patients with CLP.

Three-Dimensional Analysis of the Pharyngeal Airway Volume and Craniofacial Morphology in Patients With Bilateral Cleft Lip and Palate

2020 ◽  
pp. 105566562094698
Author(s):  
Wenying Kuang ◽  
Jie Zheng ◽  
Shaolin Li ◽  
Shiyu Yuan ◽  
Hong He ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Tertiary Hospital ◽  
Craniofacial Morphology ◽  
Class I ◽  
Oropharyngeal Airway ◽  
Pharyngeal Airway ◽  
Bilateral Cleft Lip ◽  
Maxilla And Mandible

Objective: This study aimed to determine the correlations between the craniofacial morphology and pharyngeal airway volume in patients with complete bilateral cleft lip and palate (BCLP). Design: Retrospective study. Setting: Tertiary hospital. Participants: Twenty-seven patients with complete BCLP and 27 class I control patients, aged 10 to 14 years. Main Outcome Measure: The pharyngeal airway volume and craniofacial morphology were evaluated using cone-beam computed tomography. Measurements were compared between groups and any correlations were identified. Results: A significantly smaller total pharyngeal airway volume (TPV), oropharyngeal airway volume, and upper (UOPV) and lower (LOPV) oropharyngeal airway volume were found in patients with BCLP than in class I control patients, with no difference in the nasopharyngeal volume between groups. Furthermore, the craniofacial morphology measurements of N-Me, S-Go, Or-C, Ptm-C, Me-C, Co-Go, Go-Me, Ptm-Or, N-S-Ar, and Ar-Go-Me significantly differed between the BCLP and control groups (all P < .05). Multiple regression analysis indicated that Ptm-C and Me-C; Ptm-C, Or-C, and Me-C; and Me-C explained 20.3%, 38.9%, and 17.1% of the variations in TPV ( P = .025), UOPV ( P = .002), and LOPV ( P = .018), respectively. Conclusions: Total pharyngeal airway volume, TPV, OPV, UOPV, and LOPV were significantly smaller in patients with BCLP than in class I controls. In patients with BCLP, the maxilla showed inhibited sagittal development and a retrograde position; moreover, the pharyngeal airway volume was weakly associated with the position of the maxilla and mandible relative to the coronal plane.

scholarly journals Timing of Spheno-Occipital Synchondrosis Ossification in Children and Adolescents with Cleft Lip and Palate: A Retrospective Case-Control Study

2020 ◽  
Vol 17 (23) ◽  
pp. 8889
Author(s):  
Francisco Vale ◽  
Inês Francisco ◽  
António Lucas ◽  
Ana Roseiro ◽  
Francisco Caramelo ◽  
...  
Keyword(s):  
Median Time ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Complete Fusion ◽  
Facial Growth ◽  
Retrospective Case ◽  
Chi Square ◽  
Males And Females ◽  
Experimental Group

Background: Cleft lip and palate (CLP) can affect the development of the maxilla; which may create a midfacial deficiency as well as an interference of the facial growth pattern and dentofacial esthetics. Objective: This study aimed to estimate the chronological age of complete fusion of the spheno-occipital synchondrosis (SOS) in cleft lip and palate patients and a control group; using cone beam computed tomography (CBCT) images. Methods: In this retrospective study; 125 patients were enrolled (cleft lip and palate group (n = 91); control group (n = 34)). Age comparison was made with a chi-square test; and a Kaplan–Meier analysis determined the median time to reach complete fusion of the spheno-occipital synchondrosis (p < 0.05). Results: The experimental group showed statistically significant differences in the median time for complete ossification between males and females (p = 0.019). The median time for complete ossification of the spheno-occipital synchondrosis was; for males; 15.0 years in both groups; for females; it was 14.0 years and 13.0 years in the experimental group and in the control group; respectively. Both for males and females; there were no statistically significant differences between experimental and control groups (p = 0.104). Conclusions: The present study showed no differences in the ossification of the spheno-occipital synchondrosis between individuals with and without cleft lip and/or palate.

Position of the Hyoid Bone in Cleft Lip, Alveolus, and Palate: Variation of Normal Anatomy or Sign Accompanying the Malformation?

2003 ◽  
Vol 40 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Wolfram M.H. Kaduk ◽  
Rosemarie Grabowski ◽  
Karsten K.H. Gundlach
Keyword(s):  
Growth Pattern ◽  
Hyoid Bone ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Long Term Study ◽  
Lateral Cephalograms ◽  
Skull Growth ◽  
Class 1 ◽  
Orthodontic Patients

Objective To compare the hyoid bone position in patients with clefts of lip, alveolus, and palate with orthodontic patients with no cleft. Design Retrospective cephalometric long-term study. Patients Lateral cephalograms of 23 patients with a complete unilateral cleft were compared with those of 24 orthodontic patients with no cleft with an Angle class 1 occlusion. Twenty-five of the patients were girls, and 22 were boys. The age of the patients with cleft at the beginning of the study was 8.1 ± 0.7 years and at the end 14.8 ± 0.6 years. The patients without cleft were 8.4 ± 0.8 years old at the beginning and 14.4 ± 0.6 years at the end of the study. Main Outcome Measures Cephalometric analysis was used to determine the skull growth pattern as well as the positions of the head and hyoid bone twice in all 47 persons. Results With increasing age of the patients, the skull growth pattern changed from vertical to horizontal growth, but no significant differences were found between patients with and without cleft. Head position did not differ significantly between patients with and without cleft. However, hyoid bone position differed significantly. The hyoid in patients with cleft was located more caudally and more anteriorly than in patients without cleft. Conclusion The hyoid bone in a subset of north German adolescents with complete unilateral cleft lip and palate was found to be caudal and anterior, compared with a control group.

Facial Growth and Development in Unilateral Cleft Lip and Palate during the Period of Puberty: Comparison of the Development after Periosteoplasty and after Primary Bone Grafting

1994 ◽  
Vol 31 (2) ◽  
pp. 106-115 ◽  
Author(s):  
Zbyněk Šmahel ◽  
Živa Müllerová
Keyword(s):  
Growth And Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Bone Grafts ◽  
Facial Growth ◽  
X Ray ◽  
Stage Of Development ◽  
Lower Jaw ◽  
The Face ◽  
Primary Bone

X-ray cephalometry was used in studies of facial growth and development carried out in 32 males with complete unilateral cleft lip and palate. They underwent primary periosteoplasty and were examined at the ages of 10 and 15 years. The results were compared with the development of the face In a longitudinal study of 20 males with the same type of cleft who were operated with a primary bone graft. The series with periosteoplasty showed a more marked proclination of the upper dentoalveolar component with the restoration of a positive overjet, as compared to a persistent anterior crossbite in the males with bone grafts. The lower jaw showed a larger protrusion, while individuals with bone grafts were characterized at the ages of 10 and 15 years by a larger posterior rotation of the mandible. The growth of the maxilla did not differ between series. In both series, there was a marked reduction In the growth of maxillary depth and of upper lip height, while the highest growth rate showed parameters of nasal prominence. An increasing mandibular protrusion and maxillary retrusion resulted in an impairment of sagittal jaw relations and in the flattening of the face, both of which occurred in almost all patients. The rotation of the lower jaw was not correlated with either the convexity of the face, sagittal jaw relations, or an overjet. The independence of developmental changes of selected characteristics at their initial state documented the impossibility of predicting the development of the face on the basis of a single x-ray examination at a given stage of development. Fixed appliances promoted a more marked proclination of upper incisors and the alveolar process than removable appliances, but they exerted no direct action on the other facial parameters studied.

Craniofacial Morphology of Dutch Patients with Bilateral Cleft Lip and Palate and Noncleft Controls at the Age of 15 Years

2008 ◽  
Vol 45 (6) ◽  
pp. 661-666 ◽  
Author(s):  
Geer M. van den Dungen ◽  
Edwin M. Ongkosuwito ◽  
Irene H. A. Aartman ◽  
Birte Prahl-Andersen
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Class Iii ◽  
Cross Sectional ◽  
Significant Difference ◽  
Bilateral Cleft Lip

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).

Craniofacial Comparisons in 22-Month-Old Lip-Operated Children with Unilateral Complete Cleft Lip and Palate and Unilateral Incomplete Cleft Lip

2000 ◽  
Vol 37 (3) ◽  
pp. 303-317 ◽  
Author(s):  
N.V. Hermann ◽  
B.L. Jensen ◽  
E. Dahl ◽  
S. Bolund ◽  
S. Kreiborg
Keyword(s):  
Statistical Analysis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Anterior Part ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Facial Morphology ◽  
Surgical Methods ◽  
Student’S T ◽  
Student’S T Test

Objective The objective of the study was to analyze the craniofacial morphology in infants with unilateral complete cleft lip and palate (UCCLP) in which the lip and the anterior part of the palate had been surgically closed at 2 months of age and to compare the morphology with that of a control group with unilateral incomplete cleft lip (UICL) in which the lip had also been surgically closed at 2 months of age. Design The sample consisted of a total of 108 cleft children all fulfilling the entry criteria, besides diagnosis, as follows: The child was of Danish origin; the age of the child was between 650 and 750 days (approximately 22 months) at the time of examination; the child was healthy except for its single cleft malformation; the surgical procedure in each group had been performed at about 2 months of age by the same surgeon. The surgical methods used were a Tennison procedure (UICL group) and a Tennison procedure supplemented by palatovomer plasty (UCCLP group). Methods The method of investigation was infant cephalometry in the lateral, frontal, and axial projections. Linear, angular, and area variables describing the craniofacial morphology were calculated and supplemented by mean plots from the cephalometric projections in the two groups. Results and Conclusions Statistical analysis based on Student's t test showed that the facial morphology in the 22-month-old UCCLP group differed significantly from that of the UICL group. The most pronounced differences were found in the maxillary complex and the mandible. The deviations observed in the UCCLP group at 22 months of age were similar to those previously observed at 2 months of age. However, several of the dysmorphic traits had become less pronounced; some had remained the same; and a few had become worse with time.

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