Long-Term Effects of Lip Repair on Dentofacial Morphology in Patients with Unilateral Cleft Lip and Palate

2005 ◽  
Vol 42 (5) ◽  
pp. 526-532 ◽  
Author(s):  
Yu-Fang Liao ◽  
Michael Mars
Keyword(s):  
Bone Remodeling ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Adult Patients ◽  
Sri Lankan ◽  
Statistical Control ◽  
Long Term Effects ◽  
Exact Matching ◽  
Lateral Cephalograms

Objective Lateral cephalograms from the growth archive of the Sri Lankan Cleft Lip and Palate Project were analyzed in a cohort design to study the long-term effects of lip repair on dentofacial morphology in patients with unilateral cleft lip and palate. Methods A total of 71 patients were recruited, including 23 adult patients with nonsyndromic unilateral cleft lip and palate without surgical repair and 48 adult patients with nonsyndromic unilateral cleft lip and palate who had lip repair, but without management of alveolus or anterior vomer. The design utilized exact matching on ethnicity and statistical control for gender and age. Results and Conclusions The data support the hypothesis that lip repair primarily produces a bone-bending effect on the anterior maxillary alveolus (alveolar molding), accompanied by controlled uprighting of maxillary incisors, and secondarily produces a bone-remodeling effect (bone resorption) in the base of the anterior maxillary alveolus. When analyzed by the age at lip repair and the surgeon who performed lip repair, early lip repair produced a greater bone-remodeling effect than did late lip repair, and variation in the surgeon who performed lip repair had an insignificant impact on dentofacial morphology after adjusting for covariates.

Long-Term Effects of Clefts on Craniofacial Morphology in Patients with Unilateral Cleft Lip and Palate

2005 ◽  
Vol 42 (6) ◽  
pp. 601-609 ◽  
Author(s):  
Yu-Fang Liao ◽  
Michael Mars
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Craniofacial Morphology ◽  
Sri Lankan ◽  
Long Term Effects ◽  
Retrospective Case ◽  
Alveolar Cleft ◽  
Dental Cast ◽  
Posterior Height

Objective To identify the long-term effects of clefts (intrinsic and functional) on craniofacial growth and to evaluate the possible association between the sizes of the cleft maxillary segment (intrinsic) and alveolar cleft (functional) and the craniofacial morphology in patients with unilateral cleft lip and palate (UCLP). Design Retrospective case-control study. Setting Sri Lankan Cleft Lip and Palate Project. Subjects Thirty unoperated adult patients with UCLP and 52 normal controls. Main Outcome Measures Maxillary dental cast was used to measure the sizes of the cleft maxillary segment and alveolar cleft. Cephalometry was used to determine craniofacial morphology. Results Patients with UCLP had shorter height of the basal maxilla, shorter posterior length of the basal maxilla, and less protruded basal maxilla at the zygomatic level than did control subjects. In patients with UCLP, the posterior height of the basal maxilla was related to the size of the cleft maxillary segment, and there was a tendency toward significant association between the anterior height of the basal maxilla and the size of the alveolar cleft. Conclusion The adverse effects of clefts on the growth of the maxilla in patients with UCLP are restricted to the basal maxilla in size. This growth inhibition is major in height and minor in length. The reduced posterior height of the basal maxilla in unoperated patients with UCLP might be primarily attributed to intrinsic effects, whereas the reduced anterior height of the basal maxilla might be attributed to functional effects.

Repair of Protruding Bilateral Cleft Lip and Palate With Staged Premaxilla Setback Osteotomy, Cheiloplasty, and Palatoplasty in Trisomy 17p Patient: A Review of Syndromic Clinical Characteristic

2021 ◽  
pp. 105566562110698
Author(s):  
Kristaninta Bangun ◽  
Jessica Halim ◽  
Vika Tania
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Techniques ◽  
Chromosome 17 ◽  
Long Term Effects ◽  
Surgical Strategies ◽  
Increased Risk ◽  
The Cost

Chromosome 17 duplication is correlated with an increased risk of developmental delay, birth defects, and intellectual disability. Here, we reported a female patient with trisomy 17 on the whole short arm with bilateral complete cleft lip and palate (BCLP). This study will review the surgical strategies to reconstruct the protruding premaxillary segment, cleft lip, and palate in trisomy 17p patient. The patient had heterozygous pathogenic duplication of chromosomal region chr17:526-18777088 on almost the entire short arm of chromosome 17. Beside the commonly found features of trisomy 17p, the patient also presented with BCLP with a prominent premaxillary portion. Premaxillary setback surgery was first performed concomitantly with cheiloplasty. The ostectomy was performed posterior to the vomero-premaxillary suture (VPS). The premaxilla was firmly adhered to the lateral segment and the viability of philtral flap was not compromised. Two-flap palatoplasty with modified intravelar veloplasty (IVV) was performed 4 months after. Successful positioning of the premaxilla segment, satisfactory lip aesthetics, and vital palatal flap was obtained from premaxillary setback, primary cheiloplasty, and subsequent palatoplasty in our trisomy 17p patient presenting with BLCP. Postoperative premaxillary stability and patency of the philtral and palatal flap were achieved. Longer follow-up is needed to evaluate the long-term effects of our surgical techniques on inhibition of midfacial growth. However, the benefits that the patient received from the surgery in improving feeding capacity and facial appearance early in life outweigh the cost of possible maxillary retrusion.

Long-Term Effects of Palate Repair on Craniofacial Morphology in Patients with Unilateral Cleft Lip and Palate

2005 ◽  
Vol 42 (6) ◽  
pp. 594-600 ◽  
Author(s):  
Yu-Fang Liao ◽  
Michael Mars
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Craniofacial Morphology ◽  
Effective Length ◽  
Long Term Effects ◽  
Cross Sectional ◽  
Alveolar Level ◽  
Palate Repair

Objective To identify the long-term effects of palate repair on craniofacial growth in patients with unilateral cleft lip and palate (UCLP). Design Retrospective cross-sectional study. Setting Sri Lankan Cleft Lip and Palate Project. Subjects Forty-eight adults with nonsyndromic unilateral cleft lip and palate, 29 men and 19 women, had lip repair only (LRO group). Fifty-eight adults with nonsyndromic unilateral cleft lip and palate, 35 men and 23 women, had lip and palate repairs by the age of 9 (LPR group). Main Outcome Measures Clinical notes were used to record surgical treatment histories. Cephalometry was used to determine craniofacial morphology. Results In the lip and palate repair group, the depth of the bony pharynx (Ba-PMP), the maxillary length at the alveolar level (PMP-A), the effective length of the maxilla (Ar-IZ, Ar-ANS, Ar-A), the maxillary protrusion (S-N-ANS, SNA), the anteroposterior jaw relation (ANS-N-Pog, ANB), and the overjet were smaller than in the lip repair only group. There were no significant differences in the maxillary length at the basal level (PMP-IZ, PMP-ANS) and the anterior and posterior maxillary heights (N-ANS and R-PMP, respectively) in the two groups. Conclusion Palate repair inhibits the forward displacement of the basal maxilla and anteroposterior development of the maxillary dentoalveolus in patients with unilateral cleft lip and palate. Palate repair has no detrimental effects on the downward displacement of the basal maxilla or on palatal remodeling in patients with unilateral cleft lip and palate.

Long-Term Outcomes for Adult Patients With Cleft Lip and Palate

2019 ◽  
Vol 30 (7) ◽  
pp. 2048-2051
Author(s):  
Katharine A. Connolly ◽  
Nicole M. Kurnik ◽  
Tuan A. Truong ◽  
Cristiane Muller ◽  
Patricia H. Beals ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Adult Patients ◽  
Long Term Outcomes

Isolated Influences of Lip and Palate Surgery on Facial Growth: Comparison of Operated and Unoperated Male Adults with UCLP

1996 ◽  
Vol 33 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Leopoldino Capelozza Filho ◽  
Antonio David Correa Normando ◽  
Omar Gabriel Da Silva Filho
Keyword(s):  
Surgical Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
White Male ◽  
Adult Patients ◽  
Facial Growth ◽  
Male Adult ◽  
Lateral Cephalograms ◽  
Cephalometric Measurements ◽  
Nonoperated Group

Our aim was to evaluate the isolated effects of cheiloplasty and palatoplasty on dentofacial morphology. Ninety-three lateral cephalograms of white male adult patients with complete unilateral cleft lip and palate were analyzed in this study. The sample was divided into three groups according to the surgical treatment received: (1) nonoperated group (NO) — 35 patients without surgical treatment; (2) operated lip group (OL) — 23 subjects with lip closure only, (3) operated lip and palate group (OLP) — 35 individuals with both lip and palatal closure. No statistically significant differences in the cephalometric measurements between the OL and OLP groups were found. There were, however, several significant differences between these two groups (OL and OLP) and the nonoperated group (NO). Thus, the differences in dentofacial morphology in patients with unilateral cleft lip and palate, seem to be influenced principally by the surgically repaired lip. Influences of the palatal repair appeared to be minimal and statistically insignificant.

scholarly journals Systematic Review of the Long-Term Effects of Presurgical Orthopedic Devices on Patient Outcomes

2021 ◽  
pp. 105566562199817
Author(s):  
Katie Garland ◽  
Brendan McNeely ◽  
Luc Dubois ◽  
Damir Matic
Keyword(s):  
Systematic Review ◽  
Patient Outcomes ◽  
English Language ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Case Reports ◽  
Confounding Factors ◽  
Long Term Effects ◽  
Device Use

Objective: To perform a systematic review of the literature to identify the long-term effects of presurgical orthopedic (PSO) device use on patient outcomes. Design: A comprehensive literature review of Embase and Ovid databases was performed to identify all English-language publications related to unilateral cleft lip and palate, presurgical devices, and patient outcomes. Studies were excluded if they did not report patient outcomes beyond 2 years of age, did not describe the use of a PSO device, were case reports (n < 10), or were purely descriptive studies. Main Outcome Measures: Reported patient outcomes following the use of PSO devices. Results: Following a review of all articles by 2 independent reviews, 30 articles were selected for inclusion. Overall, there was no reported consensus as to the long-term effects of PSO devices. Furthermore, this study identified that only 10% of published research controlled for confounding factors that could influence the reported results. Confounding factors that were identified included different operating surgeon, different surgical protocols, and different rates of revision surgeries. Conclusions: Overall, this systematic review identified 2 important conclusions. Firstly, there is no consensus in the literature about the long-term effects of PSO devices on long-term patient outcomes. Secondly, research in this domain is limited by confounding factors that influence the applicability of the reported results.

A Cephalometric Intercenter Comparison of Patients with Unilateral Cleft Lip and Palate: Analysis at 5 and 10 Years of Age and Long Term

2008 ◽  
Vol 45 (6) ◽  
pp. 654-660 ◽  
Author(s):  
Maria Costanza Meazzini ◽  
Greta Giussani ◽  
Alberto Morabito ◽  
Gunvor Semb ◽  
Giovanna Garattini ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
T Test ◽  
Lateral Cephalograms ◽  
Significant Difference ◽  
Short And Long Term ◽  
Jaw Surgery ◽  
Cephalometric Measurements

Objective: To compare the short- and long-term craniofacial growth of patients operated with the Milan protocol to those operated with the Oslo protocol. Design: The Milan sample included 88 patients with unilateral cleft lip and palate (UCLP) at 5 years, 26 at 10 years, and 23 at the end of growth. The Oslo samples included 48 UCLP patients at 5 years, 29 at 10, and 23 at growth completion. Lateral cephalograms were used for comparison. An unpaired t test was run for the 5- and 10-year-old samples. The samples long term were matched for age and sex, and a paired t test was run. Results: There was no significant cephalometric difference in the maxillary prominence at 5 years, a mild but significant difference at 10 years, and again no difference at the end of growth. Nevertheless, at an older age, the need for orthognathic surgery was larger in the Milan sample (26%) than in the Oslo sample (13%). Conclusion: Although no statistically significant differences in the cephalometric measurements were found long term, the need for orthognathic surgery was clinically judged to be larger in the Milan sample. On the other hand, although the Milan protocol seemed to require more final jaw surgery, only the cases that needed an additional orthognathic procedure in the Milan group will undertake a third surgical step, while the Oslo protocol included three surgical steps for all the patients.

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