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.

Craniofacial Morphology in Adult Patients with Unoperated Complete Bilateral Cleft Lip and Palate

1998 ◽  
Vol 35 (2) ◽  
pp. 111-119 ◽  
Author(s):  
Omar Gabriel Da Silva Filho ◽  
Rita De Cássia Moura Carvalho Lauris ◽  
Leopoldino Capelozza Filho ◽  
Gunvor Semb
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Craniofacial Morphology ◽  
Striking Difference ◽  
Control Group ◽  
Gonial Angle ◽  
Face Height ◽  
Lateral Cephalograms ◽  
And Gender

Objective This report is a retrospective study that compares the craniofacial morphology of adult subjects with unoperated bilateral complete cleft lip and palate (BCLP) with that of a noncleft group. Methods The study was performed on standardized lateral cephalograms obtained at the Hospital for Research and Rehabilitation of Cleft Lip and Palate, University of São Paulo, Brazil. The research group consisted of 28 subjects (20 males, 8 females) with unoperated BCLP, ranging in age from 15 to 41 years. The control group was matched to the cleft group with regard to gender and age. The findings were analyzed on the basis of the two-way analysis of variance (ANOVA) for cleft and gender. Results The most striking difference between the groups was the extremely prominent premaxilla in the cleft group that gave the BCLP face a very convex profile. The mandible exhibited a vertical growth pattern that resulted in a steep mandibular plane, an obtuse gonial angle and a long lower face height. The posterior face height was reduced. The cranial base dimensions were smaller, but there was no difference in cranial base angulation. Conclusions These findings confirm that in subjects with unoperated BCLP, the initial characteristics of the cleft malformation persist during growth.

Examination of Craniofacial Morphology in Children with Unilateral Cleft Lip and Palate

1996 ◽  
Vol 33 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Yildiz Öztürk ◽  
Nil Cura
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Turkish Children ◽  
Gonial Angle ◽  
Facial Height ◽  
Mandibular Plane

Craniofacial morphology of children with and without clefts has been reported to differ because of a combination of factors including, morphogenetic pattern, adaptive changes, and lip and palate management. The purpose of this study was to make a cephalometric evaluation of possible differences in craniofacial morphology of Turkish children with and without unilateral cleft lip and palate (UCLP). Twenty UCLP children (7 girls, 13 boys) with a mean age of 10.75 years (SD = 2.58 years) were compared with a control group of children without UCLP, who were matched for age (mean = 10.64 years, SD = 2.58 years) and sex. No patient had received orthodontic treatment. Linear and angular variables were measured from tracings of lateral cephalometric radiographs and the resulting data were evaluated statistically. Compared with children in the control group, the children in the cleft palate group demonstrated a greater flattening of the cranial base, a more retrognathic and posteriorly inclined maxilla with decreased length, a larger mandibular plane and gonial angle, larger anterior facial height, and decreased posterior and upper-posterior facial heights.

Effects of Lip Repair on Maxillofacial Morphology in Patients with Unilateral Cleft Lip with or without Cleft Palate

2014 ◽  
Vol 51 (6) ◽  
pp. 658-664 ◽  
Author(s):  
Qinghua Shao ◽  
Zhengxi Chen ◽  
Yang Yang ◽  
Zhenqi Chen
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Negative Impact ◽  
Growth Stages ◽  
Mandibular Growth ◽  
Gonial Angle ◽  
Maxillofacial Development ◽  
Lateral Cephalograms ◽  
Maxillary Incisors

Objective To evaluate the effects of lip repair on maxillofacial development of patients with unilateral cleft lip with or without cleft palate. Design Retrospective. Patients A total of 75 patients were recruited, including 38 surgical patients with complete unilateral cleft lip and alveolus and 37 patients with complete unilateral cleft lip and palate who had lip but not palate repair. As controls, 38 patients with no cleft were selected. All subjects were divided according to two growth stages: before the pubertal peak (GS1) and after the pubertal peak (GS2) Interventions Lateral cephalograms of all subjects were obtained. Main Outcome Measures Cephalograms were analyzed and compared in the study and control groups. Results The patients with unilateral cleft lip and palate in both GS1 and GS2 demonstrated an almost normal maxillary and mandibular growth with retroclined maxillary incisors. The patients with unilateral cleft lip and palate showed a shorter length of maxilla, a more clockwise-rotated mandible, and retroclined maxillary incisors. Conclusions There was an almost normal maxillary and mandibular growth but retroclined maxillary incisors in patients with cleft lip with or without cleft palate who had received lip repair only, indicating that lip repair may not have a negative impact on the maxillofacial development and influences only the inclination of the maxillary incisors. The shorter anterior-posterior maxillary length and larger gonial angle in patients with unilateral cleft lip and palate compared with those in patients with unilateral cleft lip and alveolus suggest that these variations in maxillary and mandibular growth may be a consequence of the cleft itself.

Cranial Base in Newborns with Complete Cleft Lip and Palate: Radiographic Study

1995 ◽  
Vol 32 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Kirsten Mølsted ◽  
Inger Kjær ◽  
Erik Dahl
Keyword(s):  
Temporal Bone ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Test Group ◽  
Cranial Base ◽  
Sphenoid Bone ◽  
Control Group ◽  
Petrous Portion ◽  
A Minor ◽  
Base Width

In a 1993 study, Mølsted and colleagues found an increased width of the sphenooccipital synchondrosis in newborns with complete clefts of the lip, alveolus, and palate compared with newborns with incomplete clefts. As the spheno-occipital synchondrosis represents remnants of the early chondrocranium that later ossifies and incorporates in the cranial base, it is possible that an inborn alteration, such as a deviant growth of cartilage, or a delayed maturation in the early development of the cartilaginous cranial base, can affect not only the length and the width of the cranial base, but also the petrous portion of the temporal bone and the nasal septum, as these structures also have a cartilaginous origin. The purpose of the present study was to measure the cranial base width, including the width of the maxilla, and to measure the bilateral angulation of the petrous portion of the temporal bone and the sphenoid bone in 3-month-old children with complete clefts and in 3-month-old children with an incomplete cleft of the lip, and to compare the two groups. Fifty-two children with complete clefts (CLP) without associated malformations comprised the test group. Forty-eight children with a minor, incomplete cleft lip (CL) constituted the control group. The results of the comparison showed marked differences between the CLP and CL groups. In the CLP children, the cranial base width and the bilateral angulation of the sphenoid bone increased. An increased angulation was also seen between left and right sides of the pars petrosa. Furthermore, increased maxillary width was found. This confirms that cleft lip and palate is not an isolated malformation localized to the jaws but a malformation, which also involves the cartilaginous cranial base.

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.

Midfacial Growth in a Consecutive Series of Preadolescent Children with Complete Unilateral Cleft Lip and Palate following a One-Stage Simultaneous Repair

2008 ◽  
Vol 45 (6) ◽  
pp. 667-673 ◽  
Author(s):  
Piotr Fudalej ◽  
Barbara Obloj ◽  
Dorota Miller-Drabikowska ◽  
Anna Samarcew-Krawczak ◽  
Zofia Dudkiewicz
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Arch ◽  
Consecutive Series ◽  
Age And Gender ◽  
Prepubertal Children ◽  
One Stage ◽  
Lateral Cephalograms ◽  
And Gender ◽  
Posterior Position

Objective: To evaluate midfacial growth in prepubertal children with complete unilateral cleft lip and palate following one-stage simultaneous repair. Subjects: A series of 28 consecutively treated subjects with complete unilateral cleft lip and palate were compared with age- and gender-matched controls with normal midfacial structure. Methods: On the lateral cephalograms taken at the age of approximately 10 years, size and position of the maxilla and upper dental arch were evaluated in vertical and horizontal planes. Statistical analysis included independent t tests and nonparametric Mann-Whitney tests. Results: The maxilla was found to be retruded (sella-nasion-point A angle decreased by 4.5° and nasion to point A distance increased by 4.2 mm) and rotated posteriorly (sella-nasion/palatal plane angle decreased by 4.5°) in the cleft group. Maxillary length (pterygomaxillare-point A distance) was diminished by approximately 2 mm. Upper incisors were found retroclined in comparison to controls (both upper incisor axis/sella-nasion and upper incisor axis/palatal plane angles were decreased by 10.7° and 6.1°, respectively). Conclusion: Maxillary prominence, as measured with the sella-nasion-point A angle and the condylion-point A and articulare-point A distances, was decreased. Shortened length and posterior position of the maxillary body were responsible at a ratio of 60% to 40% for a decreased prominence of the maxillary complex. The palatal plane demonstrated a larger inclination to the sella-nasion plane by 4.5° due to a decreased sella-posterior nasal spine distance.

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.

Predisposing Factors to Formation of Cleft Lip and Palate: Inherited Craniofacial Skeletal Morphology

2004 ◽  
Vol 41 (6) ◽  
pp. 613-621 ◽  
Author(s):  
Evangelia Chatzistavrou ◽  
R. Bruce Ross ◽  
Bryan D. Tompson ◽  
Malcom C. Johnston
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Monozygotic Twins ◽  
Cranial Base ◽  
Length Ratio ◽  
Control Individual ◽  
Skeletal Morphology ◽  
Lateral Cephalograms ◽  
Student’S T

Objective To identify inherited craniofacial morphologic features in individuals at high risk for cleft of the lip, cleft palate, or both. Subjects Twins without cleft from 33 pairs of monozygotic twins discordant for cleft lip, cleft palate, or both were studied. There were 17 males and 16 females of Caucasian origin, ranging from 3 to 18 years (15 with cleft lip and palate [CLP], 10 with cleft lip [CL], and 8 with cleft palate [CP]), collected from five craniofacial centers (United States and Canada). Design The twin without cleft (noncleft) from each set was compared with an age- and sex-matched control individual from the Burlington Growth Centre, Toronto, Ontario. Posteroanterior and lateral cephalograms were traced and digitized using a computer custom analysis. Descriptive statistics, Student's t tests, and analysis of variance were used to test 40 variables in a pilot study comparing the noncleft twin groups with the controls. Preliminary analysis permitted pooling of the CLP and CL groups (n = 25). To minimize false-positive significance, only 14 variables (from the maxillofacial area) were tested. Results Using the raw probabilities, eight variables showed significant differences between the pooled noncleft CLP and CL (CL[P]) twin group and the controls. However, when the level of significance was adjusted, only four (nasal width [p < .01], cranial base length [p < .05], cranial base width/length ratio [p < .001], and maxillary width/length ratio [p < .05]) were significantly different. No significant differences were confirmed between the noncleft CP twin group and the controls. Conclusions The noncleft member of a discordant monozygotic pair has a number of facial characteristics that differ from the general population. These may predispose to the formation of a cleft lip or palate and may result from a deficiency or distortion of the mesenchyme that forms the craniofacial structures.

Mandibular Morphology in Complete Unilateral Cleft Lip and Palate

2004 ◽  
Vol 41 (4) ◽  
pp. 403-409 ◽  
Author(s):  
Gwen Swennen ◽  
Johannes-Ludwig Berten ◽  
Franz-Josef Kramer ◽  
Chantal Malevez ◽  
Albert De Mey ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Spatial Position ◽  
Control Group ◽  
Mandibular Ramus ◽  
Treatment Protocols ◽  
Palate Repair ◽  
Mandibular Morphology ◽  
Post Hoc ◽  
Comparison Data

Objective The purpose of this study was to evaluate and compare mandibular morphology and spatial position in children with complete unilateral cleft lip and palate (UCLP) treated at two different cleft centers (Hannover and Brussels) following different surgical treatment protocols. Patients A total of 62 Caucasian children (40 boys, 22 girls) with nonsyndromic complete unilateral cleft lip and palate (UCLP) were evaluated by means of conventional cephalometric analysis at approximately the age of 10 years. Data of both cleft groups were compared with a control, noncleft group (n = 40) matched according to age and sex. Interventions The Hannover children with cleft (n = 36) underwent lip repair at a mean age of 5.83 ± 1.16 months. The hard and soft palates were closed at a mean age of 29.08 ± 4.68 and 32.25 ± 4.29 months, respectively. The Brussels children with cleft (n = 26) were treated according to the Malek surgical protocol with soft palate repair at a mean age of 3.04 ± 0.20 months and simultaneous lip and hard palate repair at a mean age of 6.15 ± 0.68 months. Results Statistical analysis (analysis of variance with post hoc Tukey's test) showed a significant (p = .001) smaller mandibular ramus length (Co-Go) in the Brussels cleft group, compared with the control group. The Hannover-Brussels comparison data revealed that the S-N-B angle was significantly (p = .047) less in the Brussels cleft group. Conclusions The influence of surgical procedures in patients with UCLP might not be restricted to the maxilla but could influence mandibular spatial position to the cranial base. Because of these positional changes of the mandible, both cleft groups showed facial balance.

Craniofacial Morphology in Twins with Cleft Lip and Palate

1996 ◽  
Vol 33 (2) ◽  
pp. 96-103 ◽  
Author(s):  
Tuula Laatikainen ◽  
Reijo Ranta ◽  
Rolf Nordström
Keyword(s):  
Cleft Palate ◽  
Normative Data ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Craniofacial Morphology ◽  
Mandibular Angle ◽  
Gonial Angle ◽  
Maxilla And Mandible ◽  
Single Birth

The craniofacial morphology of 11 pairs of monozygotic (MZ) and 28 pairs of dizygotic (DZ) Finnish twins, discordant or concordant for cleft of the lip (CL), unilateral cleft lip and palate (UCLP), or cleft palate only (CP) were investigated by means of lateral cephalometric radiographs. The results were compared to those of age-, sex-, and cleft-type matched single-birth cleft subjects, and also with normative data from the Nordic population. The co-twins with no cleft lip or palate (NONC) showed only slightly more obtuse gonial and steeper mandibular angles compared to normative data. Twins with CL, UCLP or CP had a more retrusive mandible, a wider cranial base and mandibular angle, and a wider angle between the maxilla and mandible than did the single-birth cleft subjects. Comparison of the noncleft twin group with the CL, UCLP, and CP twin groups for the CL twins showed no significant differences. For the UCLP twins, a more retrusive and down- and backward rotation of both jaws, a wider gonial angle, and a wider cranial base angle was seen. The CP twins had their maxillae slightly retrusive, the down- and backward rotation of both jaws was apparent, and the gonial angle was more obtuse. A comparison between the noncleft MZ and noncleft CDZ twins showed no significant differences. The MZ CP twins had a more retrusive mandible and more down- and backward rotation of both jaws than did DZ CP twins. It thus can be suggested that twinning itself does not seem to have an effect on maxillofacial morphology, but the features of the mandibular structure, the cranial base angulation, and the inclination of the jaws are at least partly genetically induced.

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