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.

Dental Arch Relationship in Children with Complete Unilateral Cleft Lip and Palate following Warsaw (One-Stage Repair) and Oslo Protocols

2009 ◽  
Vol 46 (6) ◽  
pp. 648-653 ◽  
Author(s):  
Piotr Fudalej ◽  
Maria Hortis-Dzierzbicka ◽  
Zofia Dudkiewicz ◽  
Gunvor Semb
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Weighted Kappa ◽  
Dental Arch ◽  
Kappa Statistics ◽  
Consecutive Series ◽  
One Stage ◽  
Mother And Child ◽  
The Difference ◽  
Dental Arch Relationship

Objective: To compare the dental arch relationship following one-stage repair of unilateral cleft lip and palate (UCLP) in Warsaw with a matched sample of patients treated by the Oslo Cleft Team. Material: Study models of 61 children (mean age, 11.2; SD, 1.7) with a nonsyndromic complete UCLP consecutively treated with one-stage closure of the cleft at 9.2 months (range, 6.0 to 15.8 months; SD, 2.0) by the Warsaw Cleft Team at the Institute of Mother and Child, Poland, were compared with a sample drawn from a consecutive series of patients with UCLP treated by the Oslo Cleft Team and matched for age, gender, and soft tissue band. Methods: The study models were given random numbers to blind their origin. Four examiners rated the dental arch relationship using the GOSLON Yardstick. The strength of agreement of rating was assessed with weighted Kappa statistics. An independent t-test was carried out to compare the GOSLON scores between Warsaw and Oslo samples, and Fisher's exact tests were performed to evaluate the difference of distribution of the GOSLON scores. Results: The intrarater and interrater agreements were high (K ≥ .800). No difference in dental arch relationship between Warsaw and Oslo groups was found (mean GOSLON score  =  2.68 and 2.65 for Warsaw and Oslo samples, respectively). The distribution of the GOSLON grades was similar in both groups. Conclusions: The dental arch relationship following one-stage repair (Warsaw protocol) was comparable with the outcome of the Oslo Cleft Team's protocol.

Dental arch relationship in children with complete unilateral cleft lip and palate following Warsaw (one-stage repair) and Oslo protocols

2009 ◽  
pp. 091202121239062
Author(s):  
Piotr Fudalej ◽  
Maria Hortis-Dzierzbicka ◽  
Zofia Dudkiewicz ◽  
Gunvor Semb
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Arch ◽  
One Stage ◽  
Dental Arch Relationship

scholarly journals Speech in a consecutive series of children born with cleft lip and palate with and without syndromes and/or additional malformations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Klintö ◽  
Maria Sporre ◽  
Magnus Becker
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Consecutive Series ◽  
Total Group ◽  
One Stage ◽  
Audio Recordings ◽  
Bilateral Cleft Lip ◽  
Palatal Surgery ◽  
Group Comparisons

Abstract Background When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-). Methods One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed. Results In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group. Conclusions The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.

Assessment of Dental Arch Relationships in Japanese Patients with Unilateral Cleft Lip and Palate

2006 ◽  
Vol 43 (1) ◽  
pp. 96-102 ◽  
Author(s):  
Takafumi Susami ◽  
Yuji Ogihara ◽  
Masako Matsuzaki ◽  
Miyuki Sakiyama ◽  
Tsuyoshi Takato ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Good Practice ◽  
Weighted Kappa ◽  
Japanese Patients ◽  
Craniofacial Morphology ◽  
Dental Arch ◽  
Kappa Statistics ◽  
Consecutive Series ◽  
Alveolar Bone Grafting

Objective Evaluation of the dental arch relationships of Japanese patients with unilateral cleft lip and palate (UCLP) from the orthodontic clinic of the University of Tokyo Hospital (UTH) compared with patients treated by the Oslo Cleft Team, Norway. Design Retrospective study and comparison with previous reports. Materials Dental models of 24 patients with UCLP in UTH taken before orthodontic treatment and before alveolar bone grafting were included. Surgeons in many hospitals performed primary surgeries. These models were matched for age and gender with 24 models from a consecutive series of patients treated by the Oslo Cleft Team as part of the Eurocran Good Practice Archive. A total of 48 models were evaluated. Main Outcome Measure Dental arch relationship was rated with the Goslon Yardstick. The strength of agreement of rating was assessed with weighted kappa statistics. Results Intra- and interexaminer agreements evaluated by weighted kappa statistics were high, indicating good reproducibility. Almost 60% of the patients in UTH were classified into poor or very poor categories, and the mean Goslon score was 3.50. These results show a contrast to those in Oslo and were the poorest in comparison with previous reports. Conclusion Dental arch relationships in patients with UCLP in UTH were poor. This seemed to be attributable to surgical procedures, but a factor of racial difference in the craniofacial morphology was also considered. Further intercenter research is required to clarify this point.

Orthopedic Protraction of the Upper Jaw in Cleft Lip and Palate Patients during the Deciduous and Mixed Dentition Periods in Comparison with Normal Growth and Development

1993 ◽  
Vol 30 (2) ◽  
pp. 182-194 ◽  
Author(s):  
Rolf S. Tindlund ◽  
Per Rygh ◽  
Olav E. Bøe
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Normal Growth ◽  
Mixed Dentition ◽  
Deciduous Dentition ◽  
Lower Jaw ◽  
Lateral Cephalograms ◽  
Anterior Position ◽  
Upper Jaw ◽  
Posterior Position

Cleft lip and palate (CLP) patients often develop maxillary retrusion after cleft repair. Since 1977, a group of 98 cases with negative overjet (anterior crossbite) during the period of deciduous dentition has been treated by the Bergen CLP team. The purpose of treatment has been to achieve favorable occlusion with positive overjet and overbite by means of anterior orthopedic traction (protraction). The average age at start of treatment was 6 years 11 months, and mean treatment duration was 13 months. The protraction force was 700 g. The serial lateral cephalograms of the treated CLP group were compared with those of a noncleft group with normal growth. Normalization of the sagittal maxillomandibular relationship (ANB angle) was achieved. Significant changes were a more anterior position of the upper jaw, and a more posterior position of the lower jaw, due to mandibular clockwise rotation. The variation was considerable. This paper reports the overall changes in the whole CLP group (ALL-C group).

scholarly journals Comparative analysis of pubertal growth spurt predictors: Martins and Sakima method and Grave and Brown method

2005 ◽  
Vol 13 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Karina Emy Iguma ◽  
Orivaldo Tavano ◽  
Izabel Maria Marchi de Carvalho
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Female Gender ◽  
Male Gender ◽  
Growth Spurt ◽  
Pubertal Growth Spurt ◽  
Age And Gender ◽  
Pubertal Growth ◽  
And Gender ◽  
Initial Peak

The aim of this study was to evaluate whether Martins and Sakima and Grave and Brown methods are useful for the study of pubertal growth spurt in children with cleft lip and palate. A total of 132 hand-wrist radiographs of patients from HRAC/USP aged 7 to 17 years old were analyzed, including girls and boys. Six radiographs of each age and gender were employed. These methods were applied to evaluating the stages of the hand-wrist ossification and epiphyseal formation, by graphic representation. The Martins and Sakima and the Grave and Brown methods revealed that the initial, peak and final stages of pubertal growth spurt occurred between 9 to 10, 12 and 15 years old, respectively, in the female gender. Similarly, in the male gender, both Martins and Sakima and Grave and Brown methods showed similar mean ages: 12, 14 and 16 years old for initial, peak and final stages of pubertal growth spurt, respectively. The Pearson's correlation test showed high and significant correlation (r = 0.99 and p < 0.001) between the methods investigated. In conclusion, the methods appeared to be highly and significantly correlated as regards the analysis of children with cleft lip and palate. Moreover, based on the literature and present results, it is possible to suggest that the two methods have shown similar pattern and may be used with equal efficiency for assessment of the pubertal growth spurt in children with cleft lip and palate.

Can Occlusal Evaluation of Children with Unilateral Cleft Lip and Palate Help Determine Future Maxillofacial Morphology?

2014 ◽  
Vol 51 (6) ◽  
pp. 696-706 ◽  
Author(s):  
Akira Suzuki ◽  
Masaaki Sasaguri ◽  
Kenji Hiura ◽  
Atsushi Yasunaga ◽  
Takeshi Mitsuyasu ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rank Order ◽  
University Hospital ◽  
Dental Arch ◽  
Prospective Longitudinal Study ◽  
Lateral Cephalograms ◽  
Prospective Longitudinal ◽  
The Relationship ◽  
Dental Cast

Objective To investigate the change in occlusal evaluations from the 5-year-olds' index to the Goslon Yardstick and to compare the relationship between the evaluations and maxillofacial growth in patients with complete unilateral cleft lip and palate (UCLP). Design A prospective longitudinal study. Subjects The sample consisted of 85 patients with complete UCLP who underwent surgery from 1969 to 1994 and were treated at the Kyushu University Hospital in Fukuoka, Japan. Subjects had two serial dental casts performed at the ages of 5 and 10 years. Furthermore, each patient had lateral cephalographs taken at the age of 5 years, 76 of 85 subjects had films taken at the age of 10 years, and 54 subjects also had lateral cephalograms taken after the age of 15 years. Methods Every dental cast was evaluated by the 5-year-olds' index and the Goslon Yardstick, respectively. The lateral cephalographs were traced and digitized, and angular dimensions were calculated. Outcomes were compared using Spearman's rank-order correlation analysis and the Kruskal-Wallis analysis. Results and Conclusion Dental arch relationships were evaluated and rated as 2.96 in the 5-year-olds' index and 2.85 in the Goslon Yardstick, respectively. Both groupings showed a significant relationship, and they showed no change in 36 out of 85 subjects (42.3%), significant improvement in 30 (35.3%), and deterioration in 19 (22.3%). Two occlusal groupings and maxillofacial morphology on the cephalographs indicated that the grouping reflected the anteroposterior position of the mandible. Moreover, both groupings showed some relation to previous maxillofacial growth, but they did not show any relationship with future growth. The Goslon Yardstick may not predict maxillofacial morphology in adulthood.

Size and Form of the Cranial Base in Isolated Cleft Lip and Palate

1993 ◽  
Vol 30 (2) ◽  
pp. 170-174 ◽  
Author(s):  
Edward F. Harris
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Size Difference ◽  
Growth Disturbance ◽  
Age And Gender ◽  
Size And Shape ◽  
And Gender ◽  
Shape Controlling ◽  
Time Specific

Most cases with cleft lip and palate (CLP) have no other obvious malformation and are termed isolated CLP. The implication is that these individuals experienced a time-specific and anatomically-localized disturbance during palatogenesis but are otherwise normal. The cranial base was studied from cephalograms in subadults with isolated CLP (n = 43) to test for alterations in size and shape. Controlling for age and gender, analyses showed no size difference, but flexure of the cranial base was significantly greater in the CLP group. Taken in conjunction with increased risks of other conditions with prenatal onsets, it appears that “isolated CLP” is a misnomer and the cleft should be viewed as an overt manifestation of a more generalized growth disturbance.

Treatment Outcome after One-Stage Repair in Children with Complete Unilateral Cleft Lip and Palate Assessed with the Goslon Yardstick

2009 ◽  
Vol 46 (4) ◽  
pp. 374-380 ◽  
Author(s):  
Piotr Fudalej ◽  
Maria Hortis-Dzierzbicka ◽  
Barbara Obloj ◽  
Dorota Miller-Drabikowska ◽  
Zofia Dudkiewicz ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Interrater Agreement ◽  
Dental Arch ◽  
First Year ◽  
Kappa Statistics ◽  
One Stage ◽  
First Year Of Life ◽  
Plaster Models

Objective: To compare results of Golson Yardstick measurement of dental arch relationships in a sample of 10-year-old Polish children with results of the Golson measurement in published reports. Materials and Methods: Plaster models of 28 consecutively treated subjects with unilateral cleft lip and palate (UCLP) that was repaired with a one-stage simultaneous closure performed in the first year of life. All individuals were born between 1994 and 1995. The Goslon score (categories 1 to 5) was allocated. Intra- and interrater agreement was assessed with kappa statistics and Pearson correlation coefficient. Independent t tests were employed to detect difference between the score in the present and other published samples. Results: Mean Goslon score equaled 2.44; 57% of the patients were allocated Goslon category 1 or 2, 32% were rated Goslon 3, and 11% of the patients were assigned category 4 or 5. Intrarater agreement was between 0.75 and 0.77. Interrater agreement was 0.79. Conclusions: Dental arch relationship following one-stage repair was comparable with the results of the centers with the best outcome.

Relationship between Cleft Severity and Dentocraniofacial Morphology in Japanese Subjects with Isolated Cleft Palate and Complete Unilateral Cleft Lip and Palate

1993 ◽  
Vol 30 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Akira Suzuki ◽  
Yo Mukai ◽  
Masamichi Ohishi ◽  
Yasuko Miyanoshita ◽  
Hideo Tashiro
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Lateral Displacement ◽  
Craniofacial Morphology ◽  
Dental Arch ◽  
Arch Width ◽  
Lateral Cephalograms ◽  
Isolated Cleft Palate ◽  
Dental Arch Width

Relationships between the width of the palatal cleft measured at paIatopIasty and the craniofacial morphology or the occlusal conditions present at approximately 4 years of age were studied in 25 cleft palate (CP) and 39 complete unilateral cleft lip and palate (UCLP) subjects treated at the Dental Clinic of Kyushu University. Posteroanterior cephalograms and dental casts showed that the width of the palatal cleft was significantly correlated with wider upper facial width and posterior dental arch width in UCLP, but not in CP subjects. Cleft width was not significantly correlated with the buccolingual occlusal relationship in either subject type. The anterior occlusal relationship in UCLP was not as good as in CP subjects. On lateral cephalograms, the width of the palatal cleft was significantly correlated with vertical hypoplasia of the upper face in UCLP, but not in CP subjects. The cleft palate width appears to be related to the lateral displacement and the retardation of the downward and forward growth of the nasomaxillary complex in UCLP subjects.

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