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

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.

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Longitudinal Study of Effect of Hotz's Plate and Lip Adhesion on Maxillary Growth in Bilateral Cleft Lip and Palate Patients

The Cleft Palate-Craniofacial Journal ◽

10.1597/10-042 ◽

2012 ◽

Vol 49 (2) ◽

pp. 230-236 ◽

Cited By ~ 5

Author(s):

Muhammad Syafrudin Hak ◽

Masaaki Sasaguri ◽

Farida Kamil Sulaiman ◽

Enny Tyasandarwati Hardono ◽

Akira Suzuki ◽

...

Keyword(s):

Longitudinal Study ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Maxillofacial Surgery ◽

University Hospital ◽

Dental Arch ◽

Prospective Longitudinal Study ◽

Bilateral Cleft Lip ◽

Maxillary Growth ◽

Prospective Longitudinal

Objective To investigate the effects of infant orthopedic treatment and lip adhesion on maxillary growth of patients with bilateral cleft lip and palate (BCLP). Design Prospective longitudinal study. Setting The present study was conducted at the Cleft Lip and Palate Center, Harapan Kita Children and Maternity Hospital, Indonesia, and the Department of Oral and Maxillofacial Surgery, Kyushu University Hospital, Japan. Subjects The study sample consisted of 53 patients with complete BCLP and 10 noncleft patients with other diseases. Patients with BCLP were divided into three groups: H (-), 11 patients treated without Hotz's plate; H (+), 24 treated with Hotz's plate; and LA-H, 18 treated with lip adhesion and Hotz's plate. Methods Serial dental casts were obtained from each BCLP child at the following four time points: first visit, labioplasty, palatoplasty, and 5 years of age. Each maxillary dental cast was scanned, and the linear and angular dimensions were measured. Results and Conclusion Lip adhesion showed a temporary negative effect. In all patients with BCLP, the surgeries affected the growth of the anterior arch width until the age of 5 years. Collapse of the premaxilla following labioplasty in the H (-) group affected the growth of dental arch length until the age of 5 years. Treatment using Hotz's plate prevented collapse of the premaxilla, and the growth of the arch length was comparable to that observed in the noncleft group.

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Effects of Cheiloplasty on Maxillary Dental Arch Development in Infants with Unilateral Complete Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2002_039_0513_eocomd_2.0.co_2 ◽

2002 ◽

Vol 39 (5) ◽

pp. 513-516 ◽

Cited By ~ 18

Author(s):

Chiung-Shing Huang ◽

Wein-I Wang ◽

Eric Jein-Wein Liou ◽

Yu-Ray Chen ◽

Philip Kao-Ting Chen ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

University Hospital ◽

Dental Arch ◽

Anterior Portion ◽

Prospective Longitudinal Study ◽

Anterior Arch ◽

Before And After ◽

Prospective Longitudinal ◽

Rotation Advancement

Objective: To identify and analyze quantitatively the development of the maxillary dental arch before and after cheiloplasty. Design: Prospective, longitudinal study of maxillary dental arch development at age of 1, 3, 6, and 12 months. Setting: All patients were treated at a university hospital craniofacial center. Patients: Twenty-seven infants with nonsyndromic, unilateral complete cleft lip and palate. Intervention: Millard's rotation-advancement cheiloplasty was performed between the ages of 3 and 4 months. Results: The anterior portion of the nonclefted segment (I-G), anterior ridge length of the nonclefted segment (I-C), and anterior ridge length of the clefted segment (L-C′) continuously increased from 1 to 12 months of age. The anterior cleft width (G-L), anterior arch depth (I⊥CC), anterior basal angle (∠GC-CC′), and anterior arch curature angle (∠GIC) continuously decreased after the cheiloplasty. Conclusions: Cheiloplasty could mold the anterior portion of the maxillary dental arch palatally by exerting continuous pressure.

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Retrospective Evaluation of Treatment Outcome in Japanese Children with Complete Unilateral Cleft Lip and Palate. Part 1: Five-Year-Olds’ Index for Dental Arch Relationships

The Cleft Palate-Craniofacial Journal ◽

10.1597/06-069.1 ◽

2007 ◽

Vol 44 (4) ◽

pp. 434-443 ◽

Cited By ~ 11

Author(s):

Akira Suzuki ◽

Keigo Yoshizaki ◽

Yasuo Honda ◽

Masaaki Sasaguri ◽

Yasutaka Kubota ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

University Hospital ◽

Dental Arch ◽

Numerical Classification ◽

Japanese Children ◽

Lateral Cephalograms ◽

Dental Arch Width ◽

Dental Arch Length

Objective: To evaluate the dental arch relationships of Japanese children with complete unilateral cleft lip and palate (UCLP) and to examine the 5-year-olds’ index for its validity. Design: Retrospective study and comparison with previous reports. Subjects: One hundred thirty-six children with complete UCLP who received primary cheiloplasty and palatoplasty in the Kyushu University Hospital from 1966 to 1999. Materials: Dental models taken from children 53 to 67 months of age and their cephalograms. Methods: Study models were assessed using five scores; 1 = excellent, 2 = good, 3 = fair, 4 = poor, and 5 = very poor, in accordance with the 5-year-olds’ index and also evaluated using Huddart and Bodenham's numerical classification. Dental arch widths, three-dimensional maxillary dental arch form, and lateral cephalograms were traced and measured. The outcome by 5-year-olds’ index was compared with Huddart and Bodenham's numerical classification, dental arch dimensions, and cephalometric measurements. Results: Occlusal outcome evaluated by the 5-year-olds’ index was rated 2.95, which was classified as fair. This index rating showed a significant relationship with numerical classification and dental arch length, but not with dental arch width. The index showed a relationship with mandibular form and position, but not with maxillary position. Conclusion: The occlusal outcome of the cases with UCLP was fair as evaluated using the 5-year-olds’ index. The index evaluates the anteroposterior relationship of maxillary/mandibular dental arches but does not evaluate the collapse of maxillary segments.

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Craniofacial Morphology in Children with Complete Bilateral Cleft Lip and Palate: Does Infantile Size of the Premaxilla Predetermine Outcome?

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-021.1 ◽

2004 ◽

Vol 41 (4) ◽

pp. 410-415 ◽

Cited By ~ 6

Author(s):

Yu-Fang Liao ◽

Chiung-Shing Huang ◽

Ya-Yu Tsai ◽

M. Samuel Noordhoff

Keyword(s):

Retrospective Study ◽

Outcome Measures ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Craniofacial Morphology ◽

University Hospital ◽

Cephalometric Analysis ◽

Bilateral Cleft Lip ◽

Dental Cast ◽

Craniofacial Characteristics

Objective To evaluate the possible association between the size of the premaxilla in infants and craniofacial morphology in children with complete bilateral cleft lip and palate (CBCLP) and identify the characteristics of craniofacial morphology in children with CBCLP with median facial dysplasia (MFD). Design Retrospective study. Setting A university hospital craniofacial center. Subjects Thirty-four patients with nonsyndromic CBCLP, 24 boys and 10 girls, had large premaxilla (LP group). Thirty-six patients with nonsyndromic CBCLP, 16 boys and 20 girls, had small premaxilla (SP group). Thirteen CBCLP patients with MFD, five boys and eight girls (MFD group). Main Outcome Measures Infant maxillary dental cast at the age of 1 year was used to measure the size of the premaxilla. Cephalometric analysis was used to determine craniofacial morphology in children at the age of 5 years. Results The size of the premaxilla in infants with CBCLP varied greatly. The LP group tended to have a longer maxilla and a more protruded maxilla, producing a better interjaw relation. The opposite phenomena were observed in the MFD group; the SP group yielded results between those of the LP and the MFD groups. Conclusion The size of the premaxilla in infants with CBCLP can be used to predetermine subsequent craniofacial morphology at the age of 5 years. Children with nonsyndromic CBCLP had craniofacial characteristics that differed significantly from those of children with CBCLP with median facial dysplasia.

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Facial Growth in Patients with Bilateral Cleft Lip and Palate: A Cephalometric Study

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1994_031_0210_fgipwb_2.3.co_2 ◽

1994 ◽

Vol 31 (3) ◽

pp. 210-216 ◽

Cited By ~ 13

Author(s):

Kiki L.W.M. Heidbüchel ◽

Anne Marie Kuijpers-Jagtman ◽

Hans Peter M. Freihofer

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

University Hospital ◽

Long Term Results ◽

Facial Growth ◽

Nasolabial Angle ◽

Comparison Results ◽

Soft Tissue Profile ◽

Lateral Cephalograms ◽

Bilateral Cleft Lip

In this study, sagittal facial growth of bilateral cleft lip and palate (BCLP) patients between 6 and 20 years of age is analyzed. The data of Nljmegen were derived from 131 lateral cephalograms taken in 21 BCLP patients who were treated In the Cleft Lip and Palate Center of the University Hospital of Nljmegen. Reported data of 90 BCLP patients treated at the Center of Oslo were used as a reference for comparison. Results of this Investigation showed mandibular growth to be similar in both centers. In the premaxillary region some differences were found: The Nljmegen patients presented a more protrusive premaxilla than those at Oslo. The upper front teeth and hence, the premaxilla, were more retroclined In the Nljmegen sample. There were also statistically significant differences in the soft tissue profile. The mean z-score was positive for the nasolabial angle and negative for the angle N'-Sn-Pg'. At 18 years of age, these differences are still apparent. In comparison with Broadbent's values of normal individuals, the SNPg-angle was smaller and the mandibular angle greater in Nljmegen and Oslo. The profiles of the BCLP patients are more convex in Nljmegen and more concave in Oslo than In the noncleft group. Finally, the different treatment strategies of the Cleft Lip and Palate Centers of Nljmegen and Oslo are compared and discussed In terms of their long-term results.

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

The Cleft Palate-Craniofacial Journal ◽

10.1597/07-174.1 ◽

2008 ◽

Vol 45 (6) ◽

pp. 667-673 ◽

Cited By ~ 16

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.

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Use of Bauru Yardstick in Patients With Complete Bilateral Cleft Lip and Palate at an Indian Center

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665617730360 ◽

2017 ◽

Vol 55 (4) ◽

pp. 602-606

Author(s):

Puneet Batra ◽

Gopala Krishna Annavarapv ◽

Ashish Chopra ◽

Amit Srivastava ◽

Partha Sadhu ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Weighted Kappa ◽

Dental Arch ◽

Age Group ◽

Bilateral Cleft Lip ◽

Examiner Agreement ◽

Dental Cast ◽

Dental Arch Relationship ◽

Very High

Objective: To evaluate dental arch relationship in treated bilateral cleft lip and palate (BCLP) cases at an Indian cleft center using the Bauru yardstick. Patients and methods: Digital photographs of the dental cast of 50 consecutively treated patients (28 males and 22 females) with nonsyndromic BCLP at an Indian cleft center were rated by 2 examiners as per the Bauru yardstick for the 12-year-old age group. The average age group was 12 ± 0.62 years. All cases were treated with same surgical protocol. Results: The inter-examiner agreement between the 3 examiners was found to be very high, with weighted kappa values ranging from 0.894 to 0.951. The intraexaminer agreement between the 2 examinations for all the examiners was also found to be very high, with weighted kappa values ranging from 0.894 to 0.931. Seventy-eight percent of patients were rated with a Bauru yardstick score of 1+2. In addition, 10% of patients were rated with a score of 3, 8% as 4, and 4% as 5. The overall Bauru yardstick score for the center was 2.36. Conclusion: The protocol followed for the repair of BCLP cases by the center was found to be a good regimen in regard to the Bauru yardstick score.

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Maxillary Dental Arch Affected by Different Sleep Positions in Unilateral Complete Cleft Lip and Palate Infants

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1994_031_0179_mdaabd_2.3.co_2 ◽

1994 ◽

Vol 31 (3) ◽

pp. 179-184 ◽

Cited By ~ 7

Author(s):

Chiung-Shing Huang ◽

Hsin-Chung Cheng ◽

Yu-Ray Chen ◽

M. Samuel Noordhoff

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Longitudinal Change ◽

Sleep Position ◽

Dental Arch ◽

Initial Visit ◽

Arch Width ◽

Supine Sleep ◽

The Relationship ◽

Maxillary Arch

The development of the dental arch is well designed for adaptive and compensatory growth. In this study, the relationship between the sleep position and dental arch development was Investigated. A group of 42 infants with unilateral complete cleft lip and palate with either prone (16) or supine (26) sleep position were seen in the craniofacial center. All infants were less than 1 month of age at the initial visit. Dental impressions of the maxillary arch were taken at the initial visit and just before cheiloplasty. Ten arch dimensions were measured in each dental cast and the longitudinal change in each dimension was compared between the prone sleep group and the supine sleep group. Statistically significant changes were detected in the growth rate of the following dimensions: intercanine width, intertuberosity width, alveolar cleft width, anterior cleft width, and posterior cleft width. This study indicated that sleep position affected maxillary arch development. Infants sleeping in the prone sleep position tended to have narrower arch width and cleft width.

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

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1993_030_0175_rbcsad_2.3.co_2 ◽

1993 ◽

Vol 30 (2) ◽

pp. 175-181 ◽

Cited By ~ 19

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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