Cone Beam Computed Tomographic Evaluation of Mandibular Asymmetry in Patients with Cleft Lip and Palate

2018 ◽  
Vol 55 (7) ◽  
pp. 919-924 ◽  
Author(s):  
Maryam Paknahad ◽  
Shoaleh Shahidi ◽  
Ehsan Bahrampour ◽  
Amir Saied Beladi ◽  
Leila Khojastepour

Objective: The purpose of the present study was to compare mandibular vertical asymmetry in patients with unilateral and bilateral cleft lip and palate and subjects with normal occlusion. Materials and Methods: Cone beam computed tomography scans of three groups consisting of 20 patients with unilateral cleft lip and palate, 20 patients affected by bilateral cleft lip and palate, and a control group of 20 subjects with normal occlusion were analyzed for this study. Condylar, ramal, and condylar plus ramal asymmetry indices were measured for all subjects using the method of Habets et al. Kruskal-Wallis and Mann-Whitney tests were used to determine any significant differences between the groups for all indices at the 95% level of confidence. Results: There were no significant differences regarding sex for all mandibular asymmetry indices in all three groups. All Asymmetry indices (condylar, ramal, and condylar plus ramal asymmetry) were significantly higher in the unilateral cleft group compared with the other two groups. Conclusion: Cone beam computed tomography images showed that patients with cleft lip and palate suffered from mandibular asymmetry. Subjects with unilateral cleft lip and palate had a more asymmetric mandible compared with the bilateral cleft lip and palate and control groups. Therefore, the mandible appears to be the leading factor in facial asymmetry in subjects with unilateral cleft lip and palate.

2015 ◽  
Vol 85 (4) ◽  
pp. 611-615 ◽  
Author(s):  
Mevlut Celikoglu ◽  
Suleyman K. Buyuk ◽  
Abdullah Ekizer ◽  
Ahmet E. Sekerci

ABSTRACT Objective:  To evaluate the mandibular dental, alveolar, and skeletal transversal widths in patients affected by unilateral (UCLP) and bilateral (BCLP) cleft lip and palate and to compare the findings with a well-matched normal occlusion sample using cone beam computed tomography images. Materials and Methods:  The study sample consisted of 75 patients divided into three groups: the UCLP (29 patients; mean age: 15.40 ± 3.22 years), BCLP (18 patients; mean age: 15.54 ± 3.72 years), and normal occlusion (28 patients; mean age: 15.82 ± 2.11 years) groups. Mandibular dental (intercanine and -molar), alveolar (intercanine and -molar), and skeletal (bigonial width) transversal measurements were performed three-dimensionally and analyzed using the one-way variance analysis and post hoc Tukey tests. Results:  Patients affected by UCLP and BCLP had statistically significantly lower intercanine alveolar widths (P < .05 and P < .001, respectively) and larger intermolar (P < .001 and P < .05, respectively) and intermolar alveolar widths (P < .001) compared with the normal occlusion group. Furthermore, the patients affected by UCLP and BCLP had similar mandibular dental, alveolar, and skeletal transversal widths (P > .05). Conclusion:  The UCLP and BCLP groups showed statistically significantly smaller values for intercanine alveolar widths and larger values for intermolar dental and alveolar widths compared with the normal occlusion group. This shows the importance of using individualized archwires according to the pretreatment arch widths of the patients affected by UCLP and/or BCLP.


2009 ◽  
Vol 46 (5) ◽  
pp. 503-511 ◽  
Author(s):  
Snehlata Oberoi ◽  
Radhika Chigurupati ◽  
Pawandeep Gill ◽  
William Y. Hoffman ◽  
Karin Vargervik

Objective: To assess the radiographic outcome of secondary alveolar bone grafting in individuals with nonsyndromic unilateral or bilateral cleft lip and palate using cone beam computed tomography. Methods: This prospective study was conducted at the University of California at San Francisco Center for Craniofacial Anomalies on 21 consecutive nonsyndromic complete cleft lip and palate individuals between 8 and 12 years of age who required alveolar bone grafting. Seventeen unilateral and four bilateral cleft lip and palate individuals had preoperative and postoperative cone beam computed tomography scans that were analyzed using Amira 3.1.1 software. Results: The average volume of the preoperative alveolar cleft defect in unilateral cleft lip and palate was 0.61 cm3, and the combined average volume of the right and left alveolar cleft defects in bilateral cleft lip and palate was 0.82 cm3. The average percentage bone fill in both unilateral cleft lip and palate and bilateral cleft lip and palate was 84%. The outcome of alveolar bone grafting was assessed in relation to (1) type of cleft, (2) size of preoperative cleft defect, (3) presence or absence of lateral incisor, (4) root development stage of the maxillary canine on the cleft side, (5) timing, and (6) surgeon. None of these parameters significantly influenced the radiographic outcome of alveolar bone grafting. Conclusions: Secondary alveolar bone grafting of the cleft defect in our center was successful, based on radiographic outcome using cone beam computed tomography scans. Volume rendering using cone beam computed tomography and Amira software is a reproducible and practical method to assess the preoperative alveolar cleft volume and the adequacy of bone fill postoperatively.


2017 ◽  
Vol 152 (4) ◽  
pp. 458-464
Author(s):  
Mevlut Celikoglu ◽  
Suleyman Kutalmis Buyuk ◽  
Mukerrem Hatipoglu ◽  
Ahmet Ercan Sekerci ◽  
Mehmet Ertugrul Ciftci

2015 ◽  
Vol 86 (4) ◽  
pp. 617-624 ◽  
Author(s):  
Carolina Morsani Mordente ◽  
Juan Martin Palomo ◽  
Martinho Campolina Rebello Horta ◽  
Bernardo Quiroga Souki ◽  
Dauro Douglas Oliveira ◽  
...  

ABSTRACTObjective: To evaluate the anterior and posterior maxillary width, the nasal passage volume, the oropharyngeal minimum axial area, and volume changes in unilateral cleft lip and palate patients treated with one of the following four expanders: Hyrax, Fan-Type, inverted mini-hyrax supported on the first permanent molars (iMini-M), or inverted mini-hyrax supported on the first premolars (iMini-B).Materials and Methods: A total of 40 patients with transverse maxillary deficiency who were submitted for rapid maxillary expansion were divided in four groups according to type of expander used. Cone-beam computed tomography images were taken before and 3 months after expansion. One-way analysis of variance was used to analyze the differences among the groups, and paired t-tests were used to evaluate the changes in each group.Results: All groups showed a significant increase in the anterior maxillary width, with no intergroup differences. The iMini-B was the only group that did not show a significant increase in the posterior maxillary width. The intergroup comparison demonstrated differences among all groups except between Hyrax and iMini-M, which showed the greatest posterior expansions. The intragroup analysis showed a significant increase in the nasal passage volume in hyrax and inverted mini-hyrax on the molar groups, but the intergroup comparison revealed a significant difference only between Fan-Type and inverted mini-hyrax on the molars. None of the expanders caused significant changes in the oropharyngeal measurements.Conclusions: Only the Hyrax and inverted mini-hyrax on the molar expanders effectively increased the nasal passage volume, and none of the expanders evaluated in this study modified the oropharyngeal airway.


2019 ◽  
Vol 57 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Yuan Zhang ◽  
Yuhua Wang ◽  
Yaoyuan Zhang ◽  
Sheng Li ◽  
Lin Wang ◽  
...  

Objective: This study examined the relationships between skeletal deformities and the pharyngeal airway of patients with nonsyndromic unilateral cleft lip and palate (UCLP). Design: Retrospective study. Setting: Orthodontics and Oral and Maxillofacial Surgery Departments in the Affiliated Hospital of Stomatology, Nanjing Medical University, China. Patients, Participants: The sample comprised 30 nonsyndromic UCLP patients and 30 healthy controls. Each group has 23 males and 7 females. Interventions: All cone-beam computed tomography images were obtained with the participant in the standard supine position and asked to bite with intercuspal position without swallowing or moving their heads and tongues during scanning. Main Outcome Measure(s): SNA, SNB, ANB, anterior cranial base, Wits appraisal, maxillary length (PTM-ANS || FH), maxillary position (S-PTM || FH), mandibular length (Go-Pog || MP), FMA, posterior face height, anterior face height, Posterior-Anterior face height, lower face height, pharyngeal airway volumes, and areas were evaluated by Dolphin imaging software. Results: The UCLP group showed significantly decreased SNA, SNB, ANB, PTM-ANS || FH, S-PTM || FH, P-A Face Height compared with the controls. However, the airway volumes and areas showed no significant difference between 2 groups. The total airway volume and minimum cross-sectional area in UCLP patients were related to the Go-Pog || MP and FMA. Conclusions: Patients with UCLP have both the maxillary and mandibular deficiencies in the sagittal dimension. Both the sagittal and vertical relationships of the jaw might affect the airway volume and area. However, no significant difference was detected in airway volume and area in UCLP patients when compared with the controls.


2017 ◽  
Vol 54 (5) ◽  
pp. 509-516 ◽  
Author(s):  
Narayan H. Gandedkar ◽  
Chai Kiat Chng ◽  
Mohammad Abdul Basheer ◽  
Por Yong Chen ◽  
Vincent Kok Leng Yeow

Objective To evaluate the pharyngeal airway space changes in complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) individuals, and compare with age and sex-matched noncleft (NC) control subjects. Design Retrospective study. Setting Cleft and Craniofacial Centre, KK Women's and Children's Hospital, Singapore. Materials and Methods Twenty UCLP (mean age: 13.4 ± 0.5 years), 18 BCLP (mean age: 13.5 ± 0.5 years) and 20 skeletal Class I subjects (mean age: 13.4 ± 0.6 years) were included in the study. Cone beam computed tomography scans were assessed for pharyngeal airway space (PAS) (oropharyngeal, nasopharyngeal, total airway space volume), and compared with PAS of age and sex-matched skeletal Class I NC individuals. Results Pharyngeal airway space showed statistically significant differences in the UCLP, BCLP, and NC control subjects. Oropharyngeal (9338 ± 1108 mm3, P < .05), nasopharyngeal (2911 ± 401 mm3, P < .05), and total airway space (12 250 ± 1185 mm3, P < .05) volumes of BCLP individuals showed significant reduction in comparison to UCLP and NC. There were no gender differences of PAS in any of the groups tested ( P > .05). Conclusion The pharyngeal airway space was significantly reduced in the BCLP group than were those in UCLP and control groups. This reduced PAS should be taken into account when planning treatment for these individuals.


2016 ◽  
Vol 86 (3) ◽  
pp. 431-436 ◽  
Author(s):  
Suleyman Kutalmis Buyuk ◽  
Esra Ercan ◽  
Mevlut Celikoglu ◽  
Ahmet Ercan Sekerci ◽  
Mukerrem Hatipoglu

ABSTRACT Objective:  To evaluate the presence of dehiscence and fenestration defects around anterior teeth in the cleft region and to compare these findings with the noncleft side in the same patients using cone beam computed tomography (CBCT). Materials and Methods:  CBCT scans of 44 patients (26 males, 18 females; mean age, 14.04 ± 3.81 years) with unilateral cleft lip and palate (UCLP) were assessed to define dehiscences and fenestrations of the anterior teeth in both cleft and noncleft sides of the UCLP patients and a control group of noncleft patients (51 patients; 21 males, 30 females; mean age, 14.52 ± 1.16 years). Data were analyzed using Pearson’s χ2 and Student’s t-test. Results:  The prevalence of dehiscences at the maxillary central incisors, lateral incisors, and canines teeth were 43.2%, 70.6%, and 34.1% on the cleft side and 22.7%, 53.1%, and 27.3% on the noncleft side of UCLP patients, and 13.7%, 7.8%, and 13.7% in controls, respectively (statistically no difference between the sides of cleft patients). The cleft patients had a statistically significantly higher prevalence of dehiscences than did the controls on both the cleft and noncleft sides (P &lt; .05), except for the maxillary central incisors. Fenestrations for these teeth were significantly more common on the cleft side in UCLP patients compared with controls (P &lt; .05), whereas the difference for maxillary lateral incisors was not statistically significant. Conclusions:  Patients with UCLP showed a higher prevalence of dehiscence and fenestration defects around the maxillary anterior teeth.


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