Comparison of Facial Morphology in Two Populations with Complete Unilateral Cleft Lip and Palate from Two Different Centers

2006 ◽  
Vol 43 (4) ◽  
pp. 471-476 ◽  
Author(s):  
John Daskalogiannakis ◽  
Gabriëlle E. H. M. Dijkman ◽  
Anne Marie Kuijpers-Jagtman ◽  
R. Bruce Ross
Keyword(s):  
Repeated Measures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Craniofacial Morphology ◽  
Facial Morphology ◽  
History Of ◽  
Sick Children ◽  
Genetically Determined ◽  
Two Populations

Objective To identify differences in craniofacial morphology of two populations with a history of complete unilateral cleft lip and palate (UCLP) treated under different protocols. Design Retrospective longitudinal cohort study. Setting Cleft Center of the University of Nijmegen, The Netherlands, and the Cleft Lip and Palate Program, The Hospital for Sick Children, Toronto, Canada. Subjects Nineteen patients (16 male, 3 female) from Nijmegen and 19 patients (16 male, 3 female) from Toronto. Each patient was matched for sex and age with a patient from the other group. The mean ages at which lateral cephalometric radiographs were available for the Nijmegen group were 5.5, 9.9, and 18.3 years, while for the Toronto group these were available at mean ages of 5.3, 10.1, and 18.3 years, respectively. Eighteen patients from the Nijmegen group received an alveolar bone graft at a mean age of 9.5 years (range 8.2 to 13.5 years). None of the patients from Toronto received bone grafts. Main Outcome Measures Eighteen cephalometric variables per radiograph were calculated at each time registration, using Dentofacial Planner cephalometric software. Statistical evaluation was performed with repeated-measures analysis of variance. Results No differences were seen in the maxillary measurements. The patients in the Toronto group had significantly larger mandibles at all three time registrations. Conclusions The Nijmegen and Toronto protocols resulted in similar maxillary projections in patients with UCLP. Comparison of data from other studies supports the contention that the larger profile convexity of the Nijmegen group is a reflection of a genetically determined smaller mandibular size in the Dutch population.

scholarly journals Effects of Different Timing of Alveolar Bone Graft on Craniofacial Morphology in Unilateral Cleft Lip and Palate

2019 ◽  
Vol 57 (1) ◽  
pp. 105-113 ◽  
Author(s):  
Andrzej Brudnicki ◽  
Ewa Sawicka ◽  
Renata Brudnicka ◽  
Piotr Stanisław Fudalej
Keyword(s):  
Bone Graft ◽  
Regression Models ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Primary Repair ◽  
Craniofacial Morphology ◽  
Retrospective Assessment ◽  
Lateral Cephalograms ◽  
Negative Effect

Objective: To evaluate the effect of the timing of secondary alveolar bone graft (SABG) on craniofacial morphology in patients with complete unilateral cleft lip and palate (UCLP). Design: Single-center retrospective assessment of consecutively treated nonsyndromic patients with complete UCLP. Participants: One hundred sixty-seven patients (108 males, 59 females) with complete UCLP in whom the cleft was repaired with 1-stage method at approximately 8 months of age. The age of 128 patients at SABG varied from 1.4 to 11.5 years (SABG group), while 39 patients still awaited SABG at the moment of cephalometric evaluation (no-SABG group). Methods: Craniofacial morphology was assessed on lateral cephalograms taken at 10 years of age (standard deviation = 0.8; range: 7.5-12.3) using linear and angular measurements. T tests and regression models were made to analyze data. Results: Regression models demonstrated that the effect of SABG on the craniofacial morphology was limited—cephalometric variables which were statistically significantly different between SABG and no-SABG groups showed no association with the timing of SABG when (1) age of primary repair of the cleft, (2) age of cephalometric evaluation, (3) cleft side, (4) gender, and (5) operator were controlled for. Only the length of the maxilla (Condylion-point A) was affected—1-year delay of SABG corresponded with an increase in Co-point A distance by 0.52 mm. However, adjusted R 2 of the model was 0.11. Conclusions: Our findings cautiously indicate that SABG performed before 8 years of age can have limited negative effect on craniofacial morphology. Nevertheless, our results should be confirmed by cleft centers practicing alternative surgical repairs of the cleft.

Scandcleft trial of primary surgery for unilateral cleft lip and palate: Craniofacial cephalometrics at 8 years

2020 ◽  
Author(s):  
Annelise Küseler ◽  
Arja Heliövaara ◽  
Kirsten Mølsted ◽  
Agneta Marcusson ◽  
Agneta Karsten ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Controlled Trial ◽  
Craniofacial Morphology ◽  
Primary Surgery ◽  
Growth Studies ◽  
Alveolar Bone Grafting ◽  
Lateral Cephalograms

Summary Background The Scandcleft trial is a randomized controlled trial that includes children with unilateral cleft lip and palate where registrations are standardized and therefore provides the opportunity to describe craniofacial characteristics in a very large sample of patients. Objectives The aim of this study was to describe craniofacial growth and morphology in a large study sample of 8-year-old children with unilateral cleft lip and palate (UCLP); before orthodontic treatment and before secondary alveolar bone grafting; and to compare the cephalometric values with age-matched non-cleft children from previous growth studies to identify the differences between untreated cleft- and non-cleft children. Materials There are 429 eight-year-old UCLP patients in the Scandcleft study group. A total of 408 lateral cephalograms with a mean age of 8.1 years were analysed. Cephalometric analyses were performed digitally. The results from three previously published growth studies on non-cleft children were used for comparison. Results Cephalometric analyses showed a large variation in craniofacial morphology among the UCLP group. In general, they present with significant maxillary retrusion and reduced intermaxillary relationships compared to the age-matched non-cleft children. In addition, the vertical jaw relationship was decreased, mainly due to decreased maxillary inclination. The upper and lower incisors were retroclined. It can be expected that these differences will increase in significance as the children age. Conclusion Results from this study provide proposed norms for the young UCLP before any orthodontic treatment and can be valuable for the clinician in future treatment planning. Trial registration ISRCTN29932826.

P-A Cephalometric Analysis of Nonoperated Adult Cleft Lip and Palate

1994 ◽  
Vol 31 (3) ◽  
pp. 193-200 ◽  
Author(s):  
Nobuyoshi Motohashi ◽  
Takayuki Kuroda ◽  
Leopoldino Capelozza Filho ◽  
José Alberto De Souza Freitas
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Craniofacial Morphology ◽  
Cephalometric Analysis ◽  
Facial Morphology ◽  
Facial Deformity ◽  
Control Subjects ◽  
Significant Difference ◽  
Bilateral Cleft Lip ◽  
The Comparative Study

P-A cephalometric analysis was performed on the craniofacial morphology in 88 Brazilian men with nonoperated and operated cleft lip and palate. For the comparative study, these subjects were divided into the following four groups: (1) 31 nonoperated unilateral cleft lip and palate (UCLP), (2) 24 nonoperated bilateral cleft lip and palate (BCLP), (3) 16 operated UCLP, (4) 17 operated BCLP. Thirty Brazilian men without cleft lip and palate were used as control subjects. In comparison with the control subjects, nonoperated BCLP and UCLP showed remarkable facial deformity characterized by Increased width of various facial parts. Facial morphology of surgically treated BCLP and UCLP, however, was very similar to that of noncleft subjects, apart from the Immediate cleft region. There was no remarkable difference in the facial morphology between nonoperated BCLP and UCLP, except for the cleft width and the deviation of nasal septum base, while the only significant difference between operated BCLP and UCLP was in the cleft width.

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.

A Six-Center International Study of Treatment Outcome in Patients with Clefts of the Lip and Palate: Part 2. Craniofacial Form and Soft Tissue Profile

1992 ◽  
Vol 29 (5) ◽  
pp. 398-404 ◽  
Author(s):  
Kirsten Mølsted ◽  
Catherine Asher-Mcdade ◽  
Viveca Brattström ◽  
Erik Dahl ◽  
Michael Mars ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Soft Tissue ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Craniofacial Morphology ◽  
Facial Morphology ◽  
X Rays ◽  
Full Cohort ◽  
Soft Tissue Profile

The craniofacial morphology and the soft tissue profile were evaluated in this part of the intercenter study of the European Cleft Lip and Palate Research Group. The sample was comprised of cephalometric x-rays of the full cohort of 151 cases from the six European cleft palate centers. The facial morphology in complete unilateral cleft lip and patate patients was evaluated by means of roentgen cephalometry. Approximately 25 consecutive cases from each of six European cleft palate centers were compared. Only one center showed notable and consistent differences from the others. A contributing factor for these differences may be an inconsistent treatment regimen with many surgeons involved. Analysis of the soft tissue profile between the centers showed more pronounced differences than analysis of the skeletal profile. The treatment outcome in centers with more complex or expensive programs was no better than those centers using simpler management approaches.

Comparison of Facial Morphology in Two Populations With Complete Unilateral Cleft Lip and Palate From Two Different Centers

2006 ◽  
Vol 43 (4) ◽  
pp. 471 ◽  
Author(s):  
John Daskalogiannakis ◽  
Gabriëlle E.H.M. Dijkman ◽  
Anne Marie Kuijpers-Jagtman ◽  
R. Bruce Ross
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Facial Morphology ◽  
Two Populations

Comparison of Facial Form in Primary Alveolar Bone-Grafted and Nongrafted Unilateral Cleft Lip and Palate Patients: Intercenter Retrospective Study

1996 ◽  
Vol 33 (2) ◽  
pp. 91-95 ◽  
Author(s):  
Carroll-Ann Trotman ◽  
Ross E. Long ◽  
Sheldon W. Rosenstein ◽  
Carole Murphy ◽  
Lysle E. Johnston
Keyword(s):  
Cleft Palate ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Craniofacial Morphology ◽  
Long Term Effects ◽  
Treatment Protocols ◽  
Alveolar Bone Grafting ◽  
Matching Criteria

The purpose of this study was to describe and compare posttreatment craniofacial morphology in samples of complete unilateral cleft lip and palate (CUCLP) patients treated at two leading clinics: The Children's Memorial Hospital Cleft Palate Clinic, Chicago, Illinois, and the Lancaster Cleft Palate Clinic, Lancaster, Pennsylvania. These centers have well-defined treatment protocols that allow the long-term effects on craniofacial form of the following treatment regimes to be contrasted: (1) Chicago—primary alveolar bone grafting, with definitive lip repair at age 4 to 6 months and hard and soft palate repair at 6 to 12 months; and (2) Lancaster—definitive triangular-flap lip repair at 3 months of age, followed by staged surgeries of the hard and soft palates, both completed by 18 months of age, but without primary alveolar bone grafting. Although the Lancaster center now performs secondary alveolar bone grafting, the majority of the patients studied here were treated before this procedure became part of their protocol. Patients were eligible for inclusion if they had no other congenital anomalies and no previous orthodontic treatment. A sample of 43 (24 male, 19 female) CUCLP patients was obtained from the Chicago Center, each of which was then matched to a non-grafted Lancaster CUCLP patient. The matching criteria were age, sex, and sella-nasion distance (to control, at least in part, for size differences). Lateral cephalometric radiographs of these 86 CUCLP patients were traced, digitized, and analyzed. Additionally, all linear data were adjusted to a standard magnification of 8% because the cephalograms from each center featured different enlargements. The Chicago and Lancaster samples had mean posttreatment ages of 10.32 years (SD = 1.96) and 10.40 years (SD = 2.18), respectively. The grafted Chicago group had faces that were on average less maxillary protrusive compared with the nongrafted Lancaster sample; it appeared, however, that the mandible compensated for the maxillary position by downward and backward rotation. As a result, a similar maxillomandibular relationship was noted in both groups, although, in the Chicago group, the lower anterior facial height increased.

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.

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