Examination of Craniofacial Morphology in 10-Month to 5-Year-Old Children with Cleft Lip and Palate

1997 ◽  
Vol 34 (6) ◽  
pp. 490-497 ◽  
Author(s):  
Carmen Casal ◽  
Alejandro Rivera ◽  
Germán Rubio ◽  
Joan Sentís-Vilalta ◽  
Alfonso Alonso ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Craniofacial Morphology ◽  
Consecutive Series ◽  
Growth Reduction ◽  
Short Term ◽  
Isolated Cleft Palate ◽  
Cephalometric Measurements ◽  
Control Study ◽  
Mandibular Incisors

Objective: The purpose of this study was to assess craniofacial growth In children from 10 months to 5 years of age with cleft lip and/or palate and to develop a systematic method of cephalometric measurements. Design: A case-control study. Setting: Craniofacial unit of a teaching hospital for children. Patients: A consecutive series of the first 22 patients with cleft lip and/or palate who underwent early reconstructive treatment [isolated cleft lip (CL) 6; isolated cleft palate (CP) 7; unilateral cleft lip and palate (UCLP) 7; and bilateral complete cleft lip and palate (BCLP) 2] (mean age, 27.9 months) and 22 age- and sex-matched noncleft children. Interventions: Lateral cephalometric headfilms of the children were taken using a pediatric cephalostat. Main Outcome Measures: Cephalometric landmarks were measured according to Ricketts cephalometry. Results: As compared with controls, CL patients had a lingual position and inclination of maxillary and mandibular incisors, an increase of interincisal angle and a decrease of incisor overjet, an increase in facial convexity, and a decrease in facial depth and mandible body length. In CP patients, palatal plane inclination and mandible arch were significantly reduced. In UCLP patients, there was a decrease in molar relation and incisor overbite, an increase in interincisal angle, reduced position and inclination of maxillary incisors and inclination of mandibular incisors, an increase in facial convexity, and lower facial height. Conclusions: Based on the absence of midface growth reduction, these short-term results suggest a tendency toward normal maxillomandibular growth.

Changes in Craniofacial Development Due to Modifications of the Treatment of Unilateral Cleft Lip and Palate

1998 ◽  
Vol 35 (3) ◽  
pp. 240-247 ◽  
Author(s):  
Zbyněk Šmahel ◽  
Živa Müllerova ◽  
Aleš Nejedly ◽  
Ivan Horak
Keyword(s):  
Bone Grafting ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Craniofacial Morphology ◽  
Consecutive Series ◽  
Posterior Displacement ◽  
Surgical Methods ◽  
Primary Bone ◽  
Fixed Appliances

Objective The objective of this study was to evaluate the craniofacial morphology of children with unilateral cleft lip and palate (UCLP) resulting from differing management protocols practiced in Prague from 1945 to 1976. Design The craniofacial morphologies of four groups of patients were compared. Two groups were assessed retrospectively (individuals born from 1945 to 1963), and two groups were followed on a longitudinal basis (individuals born from 1966 to 1976). Setting The study was conducted at the Cleft Lip and Palate Center at the Department of Plastic Surgery, Prague, which has a catchment area population of 6 million. Patients The subjects were a consecutive series of adult males (n = 84) who had complete UCLP without associated malformations. Interventions Patients born from 1945 to 1955 did not receive centralized orthodontic therapy. From 1945 to 1965, the alveolar process in the area of the cleft was not surgically repaired. Primary bone grafting was used for the group born from 1965 to 1972, and primary periosteoplasty was used in the subsequent period. Throughout the period covered by the study, the palate was operated on by pushback and pharyngeal flap surgery. From 1945 to 1965, the lip was repaired initially according to Veau, and later according to Tennison and Randall, and during this time, fixed appliances were used for orthodontic treatment. Results The results for the period from 1945 to 1955 are characterized by mandibular overclosure with anterior crossbite. Centralized orthodontic treatment in the later period improved sagittal jaw relations due to the posterior displacement of the mandible and an edge-to-edge bite was attained, but maxillary retrusion was unchanged. Primary bone grafting increased retrusion of the maxilla, which was compensated by further posterior displacement of the mandible. An edge-to-edge bite was also obtained. Primary periosteoplasty reduced maxillary retrusion, and the marked proclination of the upper dentoalveolar component with fixed appliances resulted in a positive overjet. It was no longer necessary to push the mandible back to the extent required in bone grafting. Conclusion Effective orthodontic treatment made the greatest contribution to improved facial development. It allowed compensation of maxillary retrusion by changes in the position of the mandible or by proclination of the upper dentoal-veolar component with fixed appliances. The applied surgical methods using primary bone grafting caused deterioration of the anterior growth of the maxilla.

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.

Longitudinal Study of Craniofacial Growth in Subjects with Cleft Lip and Palate: From Cheiloplasty to 8 Years of Age

1995 ◽  
Vol 32 (2) ◽  
pp. 156-166 ◽  
Author(s):  
Byeong-Ju Han ◽  
Akira Suzuki ◽  
Hideo Tashiro
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Growth Increment ◽  
Craniofacial Morphology ◽  
Craniofacial Growth ◽  
Anterior Maxilla ◽  
Gonial Angle ◽  
Growth Increments ◽  
Linear Dimensions ◽  
Isolated Cleft Palate

Craniofacial morphology was compared in 10 patients with unilateral cleft lip and alveolus (UCLA), 33 with complete unilateral cleft lip and palate (UCLP), and 14 patients with isolated cleft palate (CP). Serial lateral and posteroanterior cephalograms, obtained just before lip repair at 4 months or palatoplasty at 2 years, and at 4 and 8 years of age, were analyzed through comparisons with the means and growth increments of craniofacial dimensions. Facial forms at 8 years of age were compared with those of 33 noncleft subjects. Wider upper facial width before lip repair in the UCLP patients diminished slightly following surgery, but the condition persisted up to 8 years of age. Less forward growth of the maxilla was found in the subjects who received palatoplasty and a larger vertical growth increment in anterior maxilla occurred in the UCLP patients. Posterior maxillary height showed no significant differences in its growth increment among patients with clefts, but shorter posterior maxillary height in the UCLP patients continued. Linear dimensions of the mandible did not differ among cleft subjects, but a larger intercondylar width, a larger gonial angle, and a slightly retruded mandible in the CP patients and UCLP patients suggested compensation of the mandible to a wider and retroinclined nasomaxillary complex.

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.

scholarly journals Maxillary Growth Evaluation Of Patients With Unilateral Complete Cleft Lip And Palate After Two Flap Palatoplasty With Honey Oral Drops

2019 ◽  
Vol 5 (2) ◽  
pp. 211-219
Author(s):  
Prasetyanugraheni Kreshanti ◽  
Siti Handayani ◽  
Forry Fortuna ◽  
Julieta Pancawati ◽  
Amila Jeni Susanto ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Type Iv ◽  
Long Term Effect ◽  
Growth Evaluation ◽  
Maxillary Growth ◽  
Cephalometric Measurements ◽  
Dental Cast ◽  
Control Study

Background : Honey given as oral drops significantly precipitate epithelialization of the lateral palatal defects post two-flap palatoplasty by 2.1 times. Honey is believed to reduce wound contraction, scar formation, and would contribute as an important factor that will result in a satisfactory maxillary growth. The aim of this study is to evaluate maxillary growth as the long-term effect of rapid epithelialization of the palates treated by honey oral drops. Method : This is a case control study consisting of 2 groups; comparing maxillary growth of the UCCLP patients that were and were not given honey as oral drops following their two-flap palatoplasty in 2011-2012. The cephalometric measurements were recorded and the dental cast are evaluated using GOSLON Yardstick method.Result : This study included a total of 20 patients. Goslon Yardstick type IV are the most frequent GOSLON on both groups (40%) with moderate inter-rater reliability between examiner 1-2 and 2-3 (kappa; 0.583 and 0.512) and substantial between examiner 1-3 (kappa 0.716). Forty-percent of SNA angle in the honey group were considered as normal, while only 20% normal SNA angle were found in the control group.Conclusion: Honey oral drops following two-flap palatoplasty resulted in satisfactory SNA angle. As the completion of maxillary growth occurs at the age of 20, the results of this study would only serve as a preliminary report. Other measures to support maxillary growth should also be taken into account. Further studies are warranted to discover innovations in surgical technique that may be a major contributing factor in maxillary growth. Keywords: Maxillary growth, Two Flap Palatoplasty, honey

Benchmarking Speech, Velopharyngeal Function Outcomes and Surgical Characteristics Following the Sommerlad Protocol and Palate Repair Technique

2020 ◽  
Vol 57 (10) ◽  
pp. 1197-1215 ◽  
Author(s):  
Lauren Baillie ◽  
Debbie Sell
Keyword(s):  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
District General Hospital ◽  
Muscle Quality ◽  
Consecutive Series ◽  
Cross Sectional ◽  
Flap Repair ◽  
Velopharyngeal Function ◽  
Isolated Cleft Palate

Objective: To report speech and velopharyngeal function (VPF) outcomes, and surgical characteristics, at age 5 following early complete palate closure using the Sommerlad protocol. Design: A retrospective, descriptive, cross-sectional consecutive series. Setting: A regional twin site center; a district general hospital and tertiary children’s hospital. Participants: Between 1993 and 2006, 877 participants underwent surgery; 712 (81%) were eligible for inclusion; 391 (55%) were included, 321 (45%) excluded. Thirteen percent had bilateral cleft lip and palate (CLP), 40% unilateral CLP, and 47% isolated cleft palate. Intervention: Lip and vomerine flap repair at 3 months of age (BCLP, UCLP) with soft palate closure using radical muscle dissection and retropositioning at a mean age of 6.6 months, range 4 to 23 months, as described and undertaken by Sommerlad. Outcome Measures: Velopharyngeal Composite (VPC) CAPS-A and articulation summary scores derived from analysis using the Cleft Audit Protocol for Speech-Augmented. Results: A VPC-SUM CAPS-A score of “0” was found in 97% reflecting adequate VPF; 73% had no cleft articulation difficulties. The BCLP group had the poorest articulation. Secondary speech surgery rate was 2.6% and 10.7% had fistula repair. Levator muscle quality and degree of retropositioning was associated with speech outcomes related to VPF. 2.6% had current features of VPI. Conclusions: Complete palate closure by around 6 months of age by the surgeon who described the technique led to excellent perceived VPF and very good speech outcomes at age 5, with less speech therapy and secondary speech surgery than commonly reported. These findings serve as a benchmark for the Sommerlad protocol and technique.

Differentiation between Cleft Lip with or without Cleft Palate and Isolated Cleft Palate Using Parental Cephalometric Parameters

1997 ◽  
Vol 34 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Peter A. Mossey ◽  
John H. Mccoll ◽  
David R. Stirrups
Keyword(s):  
Discriminant Analysis ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Health ◽  
Craniofacial Morphology ◽  
Stepwise Discriminant Analysis ◽  
Separate Analysis ◽  
Orofacial Clefting ◽  
Isolated Cleft Palate

Objective The purpose of this study was to identify and compare lateral cephalometric measurements in noncleft parents of children with cleft palate (CP) and cleft lip (CL), and cleft lip and palate (CLP). The hypothesis was that discriminant analysis would enable identification of morphometric features that predispose to orofacial clefting and that differ for CP, CL, and CLP and are unevenly distributed within parental pairs. Design This was a prospective, parametric analysis. Setting The study was conducted by the Department of Dental Health, University of Dundee, and the Department of Statistics, University of Glasgow, Scotland. Subjects From a completely ascertained sample of 286 children with cleft lip and/or palate born in the West of Scotland between January 1, 1980, and December 31, 1984, a sample of 83 parents of children with nonsyndromic clefts volunteered for lateral cephalometric examination. Methods Thirty-seven cranial and 99 facial landmarks were identified and 37 linear, angular, and area parameters were used to describe the craniofacial skeleton. Analysis of variance was used for a three-way comparison of CL/CLP/CP, and stepwise discriminant analysis was used to determine which variables discriminate best between cleft lip with or without cleft palate [CL(P)] and isolated cleft palate (CP) parents. Results There were no significant differences whatsoever in the craniofacial morphology between the parents of children with CL and CLP, but differences were found between the CL(P) and CP groups. The most significant of these were in mandibular length, ramus length, mandibular area, and cranial area. Mandibular ramus length alone discriminated between the two groups in 71.4% of CP and in 62.5% of CL(P) cases, while separate analysis of fathers and mothers showed that ramus length and cranial height together reliably distinguish between mothers in 75% of CP and 80% of CL(P) cases. Conclusions Previous studies suggests that unaffected parents with nonsyndromic children with cleft lip and/or palate have differences in their craniofacial morphology when compared to the general population. This study indicates that these morphologic features differ for CP and CL(P).

scholarly journals Characteristics of craniofacial morphology and factors affecting them in patients with isolated cleft palate

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11297
Author(s):  
Kyoko Tsuji ◽  
Naoto Haruyama ◽  
Shunsuke Nomura ◽  
Naohisa Murata ◽  
Keigo Yoshizaki ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Morphological Characteristics ◽  
Craniofacial Morphology ◽  
Mean Values ◽  
Factors Affecting ◽  
Skeletal Class Ii ◽  
Isolated Cleft Palate

Background Myriad maxillo-mandibular occlusal relationships are observed in patients with isolated cleft palate (ICP), unlike in patients with other cleft types, such as cleft lip and palate. Objectives This study aimed to categorise the characteristics of craniofacial morphology in patients with ICP, and investigate the clinical factors affecting these categorised morphological characteristics. Methods Thirty-six girls with ICP (age (mean ± SD): 5.36 ± 0.36 years) underwent cephalometric measurement. Their craniofacial morphology was categorised using cluster analysis. Profilograms were created and superimposed onto the standard Japanese profilograms to visualise the morphological characteristics of each group (cluster). The mean values and variations in the linear and angular measurements of each group were compared with the Japanese standards and statistically analysed using Dunnett’s test after the analysis of variance. Fisher’s exact test was used to analyse the differences between the cleft types (cleft in the hard and/or soft palate) and skills of the operating surgeons in the groups. Results Cluster analysis of craniofacial morphologies in patients with ICP resulted in the formation of three categories: the first cluster exhibited a relatively harmonious anteroposterior relationship between the maxilla and the mandible (22.2%); the second cluster exhibited crossbite owing to a significantly smaller maxilla (33.3%); and the third cluster exhibited a smaller mandible with posterior rotation showing skeletal class II malocclusion (44.4%). Differences in cleft types and surgeons were not associated with the distribution of patients in each cluster. Conclusions Patients with ICP exhibited characteristic morphological patterns, such as bimaxillary retrusion or severe mandibular retrusion, besides the anterior crossbite frequently found in patients with cleft lip and palate . Understanding the typical morphological characteristics could enable better diagnostic categorisation of patients with ICP, which may eventually improve orthodontic treatment planning.

Sign in / Sign up

Export Citation Format

Share Document