A Cephalometric Evaluation of Lower Lip in Patients with Unilateral Cleft Lip and Palate

2004 ◽  
Vol 41 (5) ◽  
pp. 485-489 ◽  
Author(s):  
T. Ufuk Toygar ◽  
M. Okan Akçam ◽  
Ayça Arman
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Normal Subjects ◽  
Middle Part ◽  
Class I ◽  
Control Group ◽  
Upper Lip ◽  
Lower Lip ◽  
Normal Individuals ◽  
Lateral Cephalograms

Objective The aim of this study was to evaluate cephalometrically the lower lip position and area of patients with unilateral cleft lip and palate (UCLP) comparatively with Class I skeletodental normal subjects. Patients Lateral cephalometric and hand-wrist radiographs obtained from 24 patients with UCLP (mean age 12.86 years), along with 20 normal individuals (mean age 12.33 years) used as a control group, were examined. Design In addition to standard cephalometric dentofacial variables, lower lip area (superior, middle, inferior) was also measured using a digital planimeter on the lateral cephalograms. Results The superior and middle part of the lower lip areas were significantly smaller (p < .05) in the UCLP group, compared to the control group. The inferior and total lower lip areas of patients with UCLP were found to be significantly smaller than controls. The labiomental angle was also smaller (38.79 degrees). Conclusions The results suggest that the lower lip of patients with UCLP is smaller, retruded, and curved, with a deep labiomental sulcus, compared with normal individuals during puberty. Therefore, practitioners should focus not only on the upper lip of patients with UCLP but also should consider the lower lip as it was found distinct from normal individuals during puberty.

Soft-Tissue Profile Changes during Widening and Protraction of the Maxilla in Patients with Cleft Lip and Palate Compared with Normal Growth and Development

1993 ◽  
Vol 30 (5) ◽  
pp. 454-468 ◽  
Author(s):  
Rolf S. Tindlund ◽  
Per Rygh
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Lower Lip ◽  
Maxillary Protraction ◽  
Transverse Expansion ◽  
Short Period ◽  
Soft Tissue Profile ◽  
Lateral Cephalograms ◽  
Maxillary Deficiency

During the last 15 years, cleft lip and palate (CLP) patients with maxillary deficiency in the care of the Bergen CLP team have undergone an interceptive orthopedic treatment phase during the deciduous and mixed dentition period. The present study includes 68 patients who received maxillary transverse expansion by use of a modified quad-helix appliance and 98 cases given maxillary protraction by a facial mask. All cases were treated until an acceptable normal occlusion was attained. Lateral cephalograms were taken immediately before and after the active treatment periods. Sagittal changes of the soft-tissue profile during transverse expansion and protraction were analyzed separately for unilateral complete cleft lip and palate (UCLP) patients and bilateral complete cleft lip and palate (BCLP) patients. The soft-tissue profiles of the groups were compared to growth changes of noncleft age-matched children (NORM group). During the short period of maxillary transverse expansion (mean period, 3.5 months) no significant change of the soft-tissue profile was found, except in the protrusion of the lower lip in the BCLP group. During the period of maxillary protraction (mean periods, 12 months in the UCLP group and 15 months in the BCLP group) the soft-tissue profile improved significantly by reducing the characteristic tendency towards a concave profile in CLP patients with maxillary deficiency. Significant Increases of the sagittal maxillomandlbular lip relation (angle SS-N-SM: mean Increase, 2.5 degrees) and the Holdaway-angle (H-angle: mean increase, 3.0 degrees) were found to be similar in the UCLP and BCLP groups. However, the use of different reference lines for evaluation of treatment effects upon the soft-tissue profile resulted in conflicting findings suggesting that anteriorly situated reference lines are more suitable for the evaluation of CLP patients. Thus, the esthetic line (E.line) indicated a favorable position of the lips after treatment; the subspinale-pogonlon line (ss.pg) revealed an Improved soft-tissue profile; the soft-tissue-facial line (N.PG) showed a retruded nose and upper lip; whereas basal references such as the nasion-sella line (NSL) and the occlusal-line perpendicular (OLP) mainly showed major differences between the CLP groups and the NORM groups.

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.

scholarly journals Functional Outcomes of Cleft Lip Surgery. Part II: Quantification of Nasolabial Movement

2007 ◽  
Vol 44 (6) ◽  
pp. 607-616 ◽  
Author(s):  
Carroll-Ann Trotman ◽  
Julian J. Faraway ◽  
H. Wolfgang Losken ◽  
John A. van Aalst
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Mouth Opening ◽  
Upper Lip ◽  
Vertical Movements ◽  
Lower Lip ◽  
Lower Jaw ◽  
Lip Movement ◽  
The Asymmetry

Objective: To explore nasolabial movements in participants with repaired cleft lip and palate. Design: A parallel, three-group, nonrandomized clinical trial. Subjects: Group 1 = 31 participants with a cleft lip slated for revision surgery (revision), group 2 = 32 participants with a cleft lip who did not have surgery (nonrevision), and group 3 = 37 noncleft control participants. Methods: Three-dimensional movements were assessed using a video-based tracking system that captured movement of 38 landmarks placed at specific sites on the face during instructed maximum smile, cheek puff, lip purse, mouth opening, and natural smile. Measurements were made at two time points at least 1 week and no greater than 3 months apart. Summary measurements were generated for the magnitude of upper lip, lower lip, and lower jaw movements and the asymmetry of upper lip movement. Separate regression models were fitted to each of the summary measurements. Results: Lateral movements of the upper lip were greater than vertical movements. Relative to the noncleft group, the revision and nonrevision groups demonstrated 6% to 28% less upper lip movements, with the smiles having the most restriction in movement and greater asymmetry of upper lip movement. Having an alveolar bone graft further increased the asymmetry, while a bilateral cleft lip decreased the asymmetry. Lower jaw movement caused a small increase in upper lip movement. Conclusions: The objective measurement of movement may be used as an outcome measure for cleft lip surgery.

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.

scholarly journals Comparison of three-dimensional soft-tissue evaluations between skeletal and pseudo-class III malocclusions

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Burak Kale ◽  
Muhammed Hilmi Buyukcavus
Keyword(s):  
Soft Tissue ◽  
Demographic Data ◽  
Three Dimensional ◽  
Middle Part ◽  
Class I ◽  
Control Group ◽  
Class Iii ◽  
Upper Lip ◽  
Linear Measurements ◽  
Skeletal Class

Abstract The aim of our study was to compare soft tissue measurements with 3D imaging methods in individuals with untreated skeletal and pseudo-Class III malocclusions. The study sample consisted of 75 patients (38 males, 37 females, mean age 12.41 ± 2.35 years) with pseudo- and true skeletal Class III malocclusions and skeletal Class I malocclusions. Soft tissue evaluations of all patients were performed using 3D stereophotogrammetric facial images. In our study, 26 landmarks, 17 linear measurements, 13 angular measurements, and 5 volume measurements were made using the 3dMD Vultus software. The significance was determined to be p < 0.05 in ANOVA, Tukey tests. No significant differences were found among the groups in terms of demographic data (p > 0.05). The skeletal Class I control group had a significantly more extended upper lip and vermillion length as compared to the Class III groups. The soft tissue convexity angle and upper nasal angle were found to be wider in the Class III malocclusion group compared to those in the Class I control group. While the pseudo-Class III group had a significantly lower midface volume, chin volume was significantly higher in the skeletal class group. Upper lip volume was significantly higher in the Class I group. Using 3dMD for guiding clinicians in the differential soft and hard tissue diagnosis of pseudo-Class III malocclusions, differences were revealed in Class I patients in the middle part of the face. In the differential diagnosis of true Class III malocclusions, chin volume was found to be different from that of Class I patients.

scholarly journals Base of the skull morphology and Class III malocclusion in patients with unilateral cleft lip and palate

2015 ◽  
Vol 20 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Mariana Maciel Tinano ◽  
Milene Aparecida Torres Saar Martins ◽  
Cristiane Baccin Bendo ◽  
Ênio Mazzieiro
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Care Center ◽  
Class I ◽  
Control Group ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Skull Morphology ◽  
Cleft Lip Palate ◽  
Base Of The Skull

OBJECTIVE: The aim of the present study was to determine the morphological differences in the base of the skull of individuals with cleft lip and palate and Class III malocclusion in comparison to control groups with Class I and Class III malocclusion. METHODS: A total of 89 individuals (males and females) aged between 5 and 27 years old (Class I, n = 32; Class III, n = 29; and Class III individuals with unilateral cleft lip and palate, n = 28) attending PUC-MG Dental Center and Cleft Lip/Palate Care Center of Baleia Hospital and PUC-MG (CENTRARE) were selected. Linear and angular measurements of the base of the skull, maxilla and mandible were performed and assessed by a single calibrated examiner by means of cephalometric radiographs. Statistical analysis involved ANCOVA and Bonferroni correction. RESULTS: No significant differences with regard to the base of the skull were found between the control group (Class I) and individuals with cleft lip and palate (P > 0.017). The cleft lip/palate group differed from the Class III group only with regard to CI.Sp.Ba (P = 0.015). Individuals with cleft lip and palate had a significantly shorter maxillary length (Co-A) in comparison to the control group (P < 0.001). No significant differences were found in the mandible (Co-Gn) of the control group and individuals with cleft lip and palate (P = 1.000). CONCLUSION: The present findings suggest that there are no significant differences in the base of the skull of individuals Class I or Class III and individuals with cleft lip and palate and Class III malocclusion.

Functional Analysis of Cleft Lip and Palate Patients with Modified Rakosi Method

2002 ◽  
Vol 39 (1) ◽  
pp. 101-104
Author(s):  
M. Okan Akcam ◽  
Tunç Altiok ◽  
F. Erhan Özdiler
Keyword(s):  
Functional Analysis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mouth Opening ◽  
Class I ◽  
Control Group ◽  
Angle Class ◽  
Significant Difference ◽  
Joint Disorder ◽  
Orthodontic Patients

Objective The aim of this study was to investigate the mandibular functions of patients with cleft lip and palate (CLP) by means of modified Rakosi Functional Analysis and to test whether there was a risk of tendency to temporo-mandibular joint disorder when compared with Angle Class I non-CLP patients. Design Fifteen patients with unilateral CLP with a mean age of 12.2 ± 1.91 years and randomly selected 15 Angle Class I orthodontic patients with a mean age of 10.5 ± 2.01 years as a control group. None of the subjects had complaint of symptoms of temporomandibular joint disorder in their histories. All subjects were evaluated using modified Rakosi Functional Analysis method in accordance with a scoring system of the findings. Main outcome Measures Intra- and extracapsular clinical functional surveys were taken. A Mann-Whitney U test was used to evaluate the differences between the CLP and non-CLP groups. Results and Conclusion There was a significant difference (p < .01) between the distributions of the total scores of the two groups. A significant difference (p < .05) in right lateral movement was also observed between the two groups. However, there were no significant but borderline differences in clicking, crepitus, and maximum mouth opening findings between the two groups. Because these results do not explain the reason for the aforementioned differences, further studies seem essential.

Cephalometric Comparison of Craniofacial Morphology between Primary Bone Grafted and Nongrafted Complete Unilateral Cleft Lip and Palate Adults

1996 ◽  
Vol 33 (5) ◽  
pp. 429-435 ◽  
Author(s):  
Akira Suzuki ◽  
Keiya Goto ◽  
Norifumi Nakamura ◽  
Yasuo Honda ◽  
Masamichi Ohishi ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Bone Grafts ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Craniofacial Growth ◽  
Anterior Maxilla ◽  
Lateral Cephalograms ◽  
Primary Bone

The effect of primary bone grafts on craniofacial growth was evaluated in adult patients with complete unilateral cleft lip and palate (UCLP).The subjects were 18 UCLP patients with primary bone grafts and a control group of 36 UCLP patients without bone grafts. The former received primary transplantation of autogenous rib bone simultaneously with primary cheiloplasty by the same surgeon between 1963 and 1969. Frontal and lateral cephalograms taken after 16 years of age were traced. Skeletal landmarks were Identified on them, and their x,y-coordinates were digitized. The effects of gender and/or primary bone graft on the craniofacial morphology were tested by ANOVA using 21 angles, 8 breadths, 13 distances, and 2 ratios. Nasal cavity breadth was wider in the primary bone grafted group. However, the anterior maxilla in that group was more upward and retruded than that in the nongrafted group. The primary bone grafted group was divided into two subgroups based on the overjet of the incisors: group N = normal overjet; group C = anterior cross-bite. There was no difference in the maxilla between groups N and C. However, the mandible in group C was more anterior and superior than in group N. In conclusion, primary bone graft may impede maxillary horizontal and vertical growth to a certain degree, and severe anterior cross-bite in primary bone grafted subjects may be brought about by mandibular closure.

Mandibular Morphology and Spatial Position following One-Stage Simultaneous Repair of Complete Unilateral Cleft Lip and Palate

2008 ◽  
Vol 45 (3) ◽  
pp. 272-277 ◽  
Author(s):  
Piotr Fudalej ◽  
Barbara Obloj ◽  
Zofia Dudkiewicz ◽  
Maria Hortis-Dzierzbicka
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Spatial Position ◽  
Control Group ◽  
Gonial Angle ◽  
One Stage ◽  
Irregularity Index ◽  
Lateral Cephalograms ◽  
Mandibular Body

Objective: To assess mandibular structure and spatial position following one-stage simultaneous repair of the unilateral cleft lip and palate. Design: Forty boys and 17 girls with complete unilateral cleft lip and palate who underwent one-stage simultaneous repair of the cleft by the same surgeon at the age of 9.23 months (standard deviation  =  1.74) were selected. Lateral cephalograms taken at the age of approximately 10 years were analyzed and were compared with a sex- and age-matched control group that consisted of individuals with Angle Class I, no crossbite, positive overbite <5 mm, mild crowding (Incisor Irregularity Index <3.5 mm), and harmonious facial build. Results: No intergroup differences were demonstrated regarding structure of the cranial base. The mandible was found to be retruded and at a larger inclination to the cranial base as compared with controls. Both total mandibular length (ArGn) and length of the mandibular body were larger in the control group, at <2 mm. Height of the ramus and gonial angle were similar in both groups. Intergender comparison showed few significant differences in control subjects only (SN, SGo, and NMe variables). Conclusions: The mandible, following a one-stage simultaneous repair of cleft, was found to be retrusive, and the length of mandibular body was <2 mm shorter than that of the controls.

scholarly journals Evaluation of Lip Morphology and Nasolabial Angle in Non-Syndromic Cleft Lip and/Palate and Non-Cleft Individuals

2021 ◽  
Vol 12 (1) ◽  
pp. 357
Author(s):  
Mohammad Khursheed Alam ◽  
Ahmed Ali Alfawzan ◽  
Fatema Akhter ◽  
Haytham Jamil Alswairki ◽  
Prabhat Kumar Chaudhari
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Upper Lip ◽  
Lateral Cephalogram ◽  
Lower Lip ◽  
Nasolabial Angle ◽  
Bilateral Cleft Lip ◽  
Different Types ◽  
The Mean ◽  
Two Parameters

Objective: To investigate the variation between the non-syndromic cleft lip and/or palate (NSCLP) and non-cleft (NC) subjects in relation to the lip morphology (LM) and nasolabial angle (NLA). Materials and Methods: Lateral cephalogram (Late. Ceph.) of 123 individuals (92 NSCLP [29 = bilateral cleft lip and palate (BCLP), 41 = unilateral cleft lip and palate (UCLP), 9 = unilateral cleft lip and alveolus (UCLA), 13 = unilateral cleft lip (UCL)], and 31 NC) who did not undergo any orthodontic treatment were investigated. By WebCeph, an artificial intelligence- (A.I.) driven software, 2 (two) parameters of LM, namely upper lip to E line (LM-1) and lower lip to E line (LM-2), and NLA analysis was carried out for each individual. Multiple tests were carried out for statistical analysis. Results: The mean ± SD observed for LM-1, LM-2, and NLA for NC individuals were 1.56 ± 2.98, 0.49 ± 3.51, and 97.20 ± 16.10, respectively. On the other hand, the mean ± SD of LM-1, LM-2, and NLA for NSCLP individuals were 4.55 ± 4.23, 1.68 ± 2.82, and 82.02 ± 14.66, respectively. No significant variation was observed with respect to gender and side. NSCLP (different types) and NC individuals showed significant disparities in LM-1 and NLA. Conclusion: It can be concluded that parameters of lip morphology such as LM-1, LM-2, and NLA vary among NSCLP and NC individuals.

Sign in / Sign up

Export Citation Format

Share Document