Longitudinal Study on the Changes of Maxillary Arch Dimensions in Japanese Children with Cleft Lip and/or Palate: Infancy to 4 Years of Age

The focus of this study was an analysis of maxillary arch growth changes prior to the time of cheiloplasty up to 4 years of age. Serial dental casts were obtained and measured in 95 children with cleft lip and palate, or both: 7 unilateral cleft lip and alveolus (CLA), 52 unilateral cleft lip and palate (UCLP), 24 bilateral cleft lip and palate (BCLP), and 12 isolated cleft palate (CP). The children were treated at the Kyushu University Dental Hospital. The results are as follows: (1) Prior to cheiloplasty, the maxillary buccal segments in the subjects with cleft lip and palate showed lateral displacement. The premaxilla in BCLP subjects was protruded. (2) Cheiloplasty influenced maxillary anterior arch width, but not posterior width. The operation caused posterior displacement of the premaxilla in BCLP subjects. (3) Palatoplasty affected the growth of the maxillary arch in the transverse and anteroposterior dimensions. (4) A variety of growth patterns observed in the patients (e.g., increasing or decreasing of the maxillary arch dimensions) suggests that maxillary arch dimensions were affected not only by surgery, but also by other individual factors such as genetic facial pattern and severity of the cleft.

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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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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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Presurgical Nasoalveolar Molding Therapy for the Treatment of Unilateral Cleft Lip and Palate: A Preliminary Study

The Cleft Palate-Craniofacial Journal ◽

10.1597/06-009 ◽

2007 ◽

Vol 44 (1) ◽

pp. 8-12 ◽

Cited By ~ 55

Author(s):

Christopher F. Ezzat ◽

Carmen Chavarria ◽

John F. Teichgraeber ◽

Jung-Wei Chen ◽

Robin G. Stratmann ◽

...

Keyword(s):

Cleft Lip ◽

Significant Positive Correlation ◽

Cleft Lip And Palate ◽

Average Length ◽

Alveolar Cleft ◽

Arch Width ◽

Preliminary Study ◽

A Prospective Study ◽

Nasoalveolar Molding ◽

Maxillary Arch

Objective: To evaluate the outcome of presurgical nasoalveolar molding (PNAM) therapy in the treatment of patients with nonsyndromic unilateral cleft and palate (UCLP). Design: A prospective study with blinded measurements. Patients: Twelve patients with UCLP treated from 1997 to 2003. Interventions: The starting age for PNAM therapy was 26 days and the average length of the therapy was 110 days. Main Outcome Measures: Measurements of intraoral and extraoral casts were made, and statistical analyses were used to compare the differences between pre- and posttherapy measurements. Results: After PNAM therapy, there was a statistically significant decrease in both intersegment alveolar cleft distance and columellar deviation (p < .05). There was also a statistically significant increase in cleft nostril height, maxillary width, and columellar width (p < .05). Moreover, although there was no statistically significant reduction of the affected nostril width, it demonstrated on average 1.7-mm reduction after PNAM therapy. The length of the time the patient utilized the appliance and postmolding nostril height were found to have a statistically significant positive correlation (p < .05). Conclusions: PNAM therapy decreases intersegment alveolar cleft distance while permitting an increase in posterior maxillary arch width. It also increases nasal symmetry by decreasing columellar deviation, increasing nostril height on the affected side, maintaining bialar width of nose, increasing columellar width, and creating more symmetrical nostril heights and widths. The improvement of the height of the cleft nostril was correlated with the time the appliance was applied.

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Short-Term Efficacy of Presurgical Vacuum Formed Nasoalveolar Molding Aligners on Nose, Lip, and Maxillary Arch Morphology in Infants With Unilateral Cleft Lip and Palate: A Prospective Clinical Trial

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620966189 ◽

2020 ◽

pp. 105566562096618

Author(s):

Khadega Ali Al Khateeb ◽

Mai Aboul Fotouh ◽

Fatma Abdelsayed ◽

Fady Fahim

Keyword(s):

Clinical Trial ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Prospective Clinical Trial ◽

Posterior Arch ◽

Digital Models ◽

Short Term ◽

Arch Width ◽

Nasoalveolar Molding ◽

Maxillary Arch

Objectives: The purpose of this study was to evaluate the short-term effect of series of preadjusted vacuum formed nasoalveolar molding VF NAM aligners on the morphology of nose, lip, and maxillary arch in infants with unilateral cleft lip and palate (UCLP). Design: Prospective clinical trial. Setting: Unilateral cleft lip and palate patients referred to outpatients’ clinic. Patients: Sixteen nonsyndromic infants with UCLP, less than 2 months of age were included from April 2017 to April 2018. Interventions: All infants received VF NAM therapy. Standardized digital frontal and basilar photographs and 3D digital models were taken before initiation of VF NAM therapy (T1) and after completion of VF NAM therapy (T2). Main Outcome Measure(s): Changes in morphology of the nose, lip, and maxillary arch. Results: Statistical analysis comparing T1 and T2 measurements was performed. Frontal and basilar photographic analysis showed a statistically significant reduction of columella displacement, interlabial gap distance, and nostril width at cleft side (CS), while the nasal height, nostril height at CS, nostril width at noncleft side (NCS), columella deviation angle, nasal tip protrusion, and nostril area at both CS and NCS increased significantly with VF NAM therapy. The nasal width, nostril height at NCS showed no significant change after presurgical VF NAM aligners therapy. The analysis of digital models demonstrated a statistically significant reduction of alveolar cleft width, anterior arch width, arch length, midline deviation, and palatal cleft width, while the posterior arch width and arch perimeter increased significantly with VF NAM therapy. Conclusion: Vacuum formed NAM therapy was effective in reducing the nasoalveolar deformities associated with infants with UCLP and improved the alveolar morphology and nasal symmetry.

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Maxillary arch width in unoperated adult bilateral cleft lip and alveolus and complete bilateral cleft lip and palate

Orthodontics and Craniofacial Research ◽

10.1111/j.1601-6343.2009.01479.x ◽

2010 ◽

Vol 13 (2) ◽

pp. 82-88 ◽

Cited By ~ 6

Author(s):

BS Latief ◽

C Lekkas ◽

MAR Kuijpers

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Arch Width ◽

Bilateral Cleft Lip ◽

Maxillary Arch

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Maxillary Arch Dimensions in Bilateral Cleft Lip and Palate from Birth until Four Years of Age in Boys

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1998_035_0233_madibc_2.3.co_2 ◽

1998 ◽

Vol 35 (3) ◽

pp. 233-239 ◽

Cited By ~ 4

Author(s):

Kiki L.W.M. Heidbuchel ◽

Anne M. Kuijpers-Jagtman ◽

Gem J.C. Kramer ◽

Birte Prahl-Andersen

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

University Hospital ◽

Control Group ◽

Posterior Arch ◽

Anterior Arch ◽

Arch Width ◽

Bilateral Cleft Lip ◽

The University ◽

Maxillary Arch

Objective To describe the development of maxillary arch dimensions in children with bilateral cleft lip and palate (BCLP) during the first 4 years of life and to compare it with that in noncleft children. Design This was a retrospective, mixed-longitudinal study. Setting The study was conducted at the Cleft Palate Center of the University Hospital of Nijmegen. Subjects The sample consisted of 26 boys with BCLP who were born between 1976 and 1990 and treated at the University Hospital of Nijmegen. Data for a control group of 34 noncleft boys were collected at the University Hospital of Amsterdam. Method Palatal arch dimensions were digitized on dental casts. A comparison between BCLP and noncleft dimensions was made at fixed time intervals. Results At birth, anterior and posterior arch widths as well as arch depths were significantly larger in children with BCLP. After 7 months (lip closure), anterior arch width and arch depth diminished considerably in the cleft group. After 12 months (palatoplasty), a slight decrease in posterior arch width was observed, and arch depths showed slight catch-up growth. At 4 years of age, anterior arch width was significantly narrower and anterior arch depth was shorter in children with BCLP than in control subjects. Posterior arch width was significantly wider. Conclusions During the first 4 years of life, maxillary arch dimensions in children with BCLP show a unique development that is significantly different from that in noncleft children.

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Facial profile and maxillary arch dimensions in unilateral cleft lip and palate children in the mixed dentition stage

European Journal of Dentistry ◽

10.4103/ejd.ejd_238_16 ◽

2017 ◽

Vol 11 (01) ◽

pp. 076-082 ◽

Cited By ~ 3

Author(s):

Vellore Kannan Gopinath ◽

Ab Rani Samsudin ◽

Siti Noor Fazliah Mohd Noor ◽

Hady Youssef Mohamed Sharab

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Cranial Base ◽

Mixed Dentition ◽

Dental Arch ◽

Base Length ◽

Facial Profile ◽

Arch Width ◽

Significant Difference ◽

Maxillary Arch

ABSTRACT Objectives: The aim of this study was to evaluate the vertical and sagittal facial profile and maxillary arch width, depth, and length of patients with unilateral cleft lip and palate (UCLP) and to compare them with healthy noncleft children in the mixed dentition stage (7–13 years). Materials and Methods: This study is conducted at Hospital Universiti Sains Malaysia. UCLP group comprised 48 patients with nonsyndromic UCLP who have had the lip and palate repaired, whereas the control group comprised 48 healthy noncleft cases. The lateral cephalometrics measurements were used to determine the vertical height, sagittal depth of the face, and cranial base length and angle. Maxillary arch dimensions were measured on the study cast including arch width, depth, and length. Results: Vertical facial height and sagittal depth measurements showed a significant decrease (P < 0.05) in the mean growth pattern in UCLP group. The anterior cranial base length (S-N) was shorter in UCLP children (P < 0.001), while Ba-N length had no significant difference (P = 0.639). Nasion-Sella Tursica-Basion angle was significantly higher in the UCLP group (P = 0.016). Dental arch width with reference to canine-to-canine and first premolar-to- first premolar distance was significantly larger in control (P = 0.001). Conclusion: Mean vertical and sagittal facial dimensions in the UCLP children who do not undergo orthodontic treatment are significantly lesser in all directions of growth than healthy noncleft children. The maxillary dental arch had a normal depth but constricted in width and arch length.

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Function of Nasoalveolar Molding Devices in Bilateral Complete Cleft Lip and Palate: A 3-Dimensional Maxillary Arch Analysis

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665621990184 ◽

2021 ◽

pp. 105566562199018

Author(s):

Pawinee Tankittiwat ◽

Araya Pisek ◽

Montien Manosudprasit ◽

Pattama Punyavong ◽

Amornrut Manosudprasit ◽

...

Keyword(s):

Repeated Measures ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Case Series ◽

Posterior Arch ◽

3 Dimensional ◽

Time Points ◽

Arch Width ◽

Nasoalveolar Molding ◽

Maxillary Arch

Objective: This study aimed to observe and analyze the effects of nasoalveolar molding (NAM) on maxillary arch dimensions in patients with bilateral complete cleft lip and palate (BCLP) using 3-dimensional analyses. Design: Retrospective case series. Materials and Methods: Seventeen infants were treated using modified Khon Kaen University presurgical nasoalveolar molding devices (KKU-NAM). Dental casts were evaluated 3 dimensionally at 3 time points: pretreatment (T1), after using modified KKU-NAM for 2 weeks (T2), and before cheiloplasty (T3). Repeated-measures analysis of variance and Friedman test were used to compare the maxillary arch dimensions between time points. Results: Both sides of the cleft width, premaxilla deviation, and premaxilla protrusion had significantly reduced with the use of KKU-NAM. Premaxillary rotation had significantly improved, whereas the arch depth did not change significantly. Premaxilla width, posterior arch width, alveolar length, and height had significantly increased. The anterior arch width, intercanine width, and lateral sulcus width showed no significant changes. The intraclass correlation coefficient used to test the measurements indicated substantial reliability. Conclusion: The modified KKU-NAM is an effective device for reducing the severity of bilateral cleft deformities, especially in the premaxilla area.

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