Effects of Presurgical Orthopedic Treatment in Infants with Complete Bilateral Cleft Lip and Palate

1998 ◽  
Vol 35 (3) ◽  
pp. 227-232 ◽  
Author(s):  
Katsuaki Mishima ◽  
Toshio Sugahara ◽  
Yoshihide Mori ◽  
Katsuhiro Minami ◽  
Masayoshi Sakuda
Keyword(s):  
Discriminant Analysis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Predictor Variables ◽  
Measuring Apparatus ◽  
Orthopedic Treatment ◽  
Wire Frame ◽  
Bilateral Cleft Lip ◽  
Posterior Shift

Objective To align the protruding premaxilla in infants with bilateral cleft lip and palate (BCLP), an intraoral appliance (i.e., Hotz plate) and an extraoral appliance consisting of a band covering the head and elastics are used as a presurgical orthopedic treatment in our clinic. The aim of this study was to analyze the configuration and position of the premaxilla and the vomer in infants with BCLP and to investigate the factors generating deviation and bending of the vomer and twisting of the premaxilla. Patients Palatal casts were obtained serially from 10 infants with complete BCLP from 1 to 3 months of age. Measurements These casts were automatically measured using a highly accurate contact-type measuring apparatus. After three-dimensional wire frame models generated from the serial casts were automatically superimposed, the magnitude and direction of the shift were calculated. A discriminant analysis was used for investigation of predictor variables generating the twisting or bending vomer. Results and Conclusions The vomer was found to be bent in two infants and the premaxilla was twisted in three infants. In the infants whose vomers were bent, the magnitude of the posterior shift of the premaxilla was greater than that of the inferior shift. A discriminant analysis indicated that at 1 month of age, a greater inclination and a smaller deviation of the vomer and a longer distance between the cleft edges of the lateral segments had a tendency to be associated with bending of the vomer or twisting of the premaxilla.

Three-Dimensional Analysis of the Pharyngeal Airway Volume and Craniofacial Morphology in Patients With Bilateral Cleft Lip and Palate

2020 ◽  
pp. 105566562094698
Author(s):  
Wenying Kuang ◽  
Jie Zheng ◽  
Shaolin Li ◽  
Shiyu Yuan ◽  
Hong He ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Tertiary Hospital ◽  
Craniofacial Morphology ◽  
Class I ◽  
Oropharyngeal Airway ◽  
Pharyngeal Airway ◽  
Bilateral Cleft Lip ◽  
Maxilla And Mandible

Objective: This study aimed to determine the correlations between the craniofacial morphology and pharyngeal airway volume in patients with complete bilateral cleft lip and palate (BCLP). Design: Retrospective study. Setting: Tertiary hospital. Participants: Twenty-seven patients with complete BCLP and 27 class I control patients, aged 10 to 14 years. Main Outcome Measure: The pharyngeal airway volume and craniofacial morphology were evaluated using cone-beam computed tomography. Measurements were compared between groups and any correlations were identified. Results: A significantly smaller total pharyngeal airway volume (TPV), oropharyngeal airway volume, and upper (UOPV) and lower (LOPV) oropharyngeal airway volume were found in patients with BCLP than in class I control patients, with no difference in the nasopharyngeal volume between groups. Furthermore, the craniofacial morphology measurements of N-Me, S-Go, Or-C, Ptm-C, Me-C, Co-Go, Go-Me, Ptm-Or, N-S-Ar, and Ar-Go-Me significantly differed between the BCLP and control groups (all P < .05). Multiple regression analysis indicated that Ptm-C and Me-C; Ptm-C, Or-C, and Me-C; and Me-C explained 20.3%, 38.9%, and 17.1% of the variations in TPV ( P = .025), UOPV ( P = .002), and LOPV ( P = .018), respectively. Conclusions: Total pharyngeal airway volume, TPV, OPV, UOPV, and LOPV were significantly smaller in patients with BCLP than in class I controls. In patients with BCLP, the maxilla showed inhibited sagittal development and a retrograde position; moreover, the pharyngeal airway volume was weakly associated with the position of the maxilla and mandible relative to the coronal plane.

Reliability of Linear Measurements on a Virtual Bilateral Cleft Lip and Palate Model

2006 ◽  
Vol 43 (5) ◽  
pp. 519-523 ◽  
Author(s):  
Barbara C. M. Oosterkamp ◽  
Wicher J. van der Meer ◽  
Majelle Rutenfrans ◽  
Pieter U. Dijkstra
Keyword(s):  
Reference Point ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Plaster Cast ◽  
Reference Points ◽  
Virtual Model ◽  
Linear Measurements ◽  
Bilateral Cleft Lip ◽  
Top View

Objective: To assess the reliability and validity of measurements performed on three-dimensional virtual models of neonatal bilateral cleft lip and palate patients, compared with measurements performed on plaster cast models. Materials and Methods: Ten high-quality plaster cast models of bilateral cleft lip and palate patients were scanned with an LDI-scanner to obtain a three-dimensional virtual model. Linear measurements were performed on the plaster cast models using a digital caliper and also on the three-dimensional virtual model using Viscam RP version 2.1 software. The measurements were performed by two observers on two occasions. Results: Intraclass correlations ranging from .81 to .96 were found for all measurements except the measurement between the constructed reference point pr and reference point i (intraclass correlation = .40). A post hoc procedure in which top-view screen prints of the three-dimensional virtual model were used to perform the measurement between reference points pr and i demonstrated an intraclass coefficient of .90. Conclusions: Three-dimensional virtual models obtained by laser scanning neonatal cast models of bilateral cleft lip and palate patients can be used reliably and validly to perform linear measurements between existing reference points on the surface of the model using Viscam RP version 2.1 software. Measurements between reference points constructed outside the surface of the model cannot be validly performed on the three-dimensional virtual model with the software used in this study. For these measurements, top-view screen prints of the three-dimensional virtual model can be used.

Three-dimensional sonographic imaging of fetal bilateral cleft lip and palate in the first trimester

2009 ◽  
Vol 34 (1) ◽  
pp. 119-120 ◽  
Author(s):  
T. Ghi ◽  
T. Arcangeli ◽  
D. Radico ◽  
D. Cavallotti ◽  
E. Contro ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
First Trimester ◽  
Bilateral Cleft Lip ◽  
Sonographic Imaging

scholarly journals Three-dimensional Digital Evaluation of Dental Arches in Infants with Cleft Lip and/or Palate

2015 ◽  
Vol 26 (3) ◽  
pp. 297-302 ◽  
Author(s):  
Viviane Mendes Fernandes ◽  
Paula Karine Jorge ◽  
Cleide Felício Carvalho Carrara ◽  
Márcia Ribeiro Gomide ◽  
Maria Aparecida Andrade Moreira Machado ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
3D Scanner ◽  
Primary Surgery ◽  
Digital Evaluation ◽  
Bilateral Cleft Lip ◽  
Scanned Images ◽  
Intercanine Distance ◽  
Dental Casts

The aim of this study was to measure and compare the dimensions of the dental arches on three-dimensional digital study models in children with and without cleft lip and palate before the primary surgery. The sample consisted of 223 digital models of children aged 3-9 months, divided into 5 groups: without craniofacial deformities, unilateral and bilateral incomplete cleft lip and alveolus, unilateral and bilateral complete cleft lip and alveolus, unilateral cleft lip and palate, and bilateral cleft lip and palate. Dental casts of the maxillary dental arches of the children were used. The dental casts underwent a process of scanning through 3D scanner and the measurements used for the correlation among groups were made on the scanned images. Statistical analysis was performed by t test and ANOVA followed by Tukey test. The results showed that the intercanine distance and anterior cleft width was wider in children with unilateral cleft lip and palate. The intertuberosity distances and posterior cleft width was wider in children with bilateral cleft lip and palate among the groups. Children with cleft lip and palate before the primary surgery had wider maxillary arch dimensions than the children without cleft lip and palate.

Comparison between the Palatal Configurations in Complete and Incomplete Unilateral Cleft Lip and Palate Infants under 18 Months of Age

2001 ◽  
Vol 38 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Katsuaki Mishima ◽  
Yoshihide Mori ◽  
Toshio Sugahara ◽  
Masayoshi Sakuda
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Measuring System ◽  
Posterior Arch ◽  
Orthopedic Treatment ◽  
Arch Width ◽  
Significant Difference ◽  
The Difference ◽  
Arch Forms

Objective The purpose of this study was to examine the three-dimensional characteristics of the palatal configurations in incomplete unilateral cleft lip and palate (UCLP) patients and to determine whether there are differences in the effect of early orthopedic treatment between complete and incomplete UCLP patients. Design Eight infants with incomplete UCLP and 12 infants with complete UCLP, selected at random, wore Hotz plates, and 8 other infants with complete UCLP did not. Palatal impressions were taken of these patients immediately after birth and at 1, 2, 3, 4 (just before cheiloplasty), 6, and 18 months of age (just before palatoplasty). Using our measuring system, the palatal casts were measured and compared three-dimensionally. Results and Conclusions The palate of the incomplete UCLP patients measured immediately after birth, compared with complete UCLP, showed: (1) smaller posterior arch width; (2) sagittal arch length did not differ; (3) incisal point was located more mesially; (4) the gap between the alveolar arch forms of the major and minor segments was smaller; and (5) the curvature of the palatal surface forward the nasal cavity in the minor segment was less. At 18 months of age, the following characteristics could be observed: (1) the difference observed at birth in the posterior arch width between the incomplete and complete UCLP infants vanished; (2) a significant difference in the location of the incisal point was observed only between the incomplete UCLP infants and the complete UCLP infants with a Hotz plate; and (3) the curvature was less in the incomplete UCLP infants than in the complete UCLP infants. Furthermore, the morphological change of the palatal surface was less in the incomplete UCLP infants than in the complete UCLP infants. This suggested that any influence of the Hotz appliance might be less in incomplete UCLP than in complete UCLP.

Three-Dimensional Nasolabial Changes After Nasoalveolar Molding and Primary Lip/Nose Surgery in Infants With Bilateral Cleft Lip and Palate

2021 ◽  
pp. 105566562110128
Author(s):  
Laura Mancini ◽  
Shayna Avinoam ◽  
Barry H. Grayson ◽  
Roberto L. Flores ◽  
David A. Staffenberg ◽  
...  
Keyword(s):  
Reconstructive Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Primary Repair ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Control Sample ◽  
Surgical Correction ◽  
Bilateral Cleft Lip ◽  
Nasoalveolar Molding

Objective: Utilize 3-dimensional (3D) photography to evaluate the nasolabial changes in infants with bilateral cleft lip and palate (BCLP) who underwent nasoalveolar molding (NAM) and primary reconstructive surgery. Design: This is a retrospective serial longitudinal study of consecutively enrolled infants from September 2012 to July 2016 with BCLP who underwent NAM before primary lip and nose reconstructive surgery. It included infants who had digital 3dMD stereophotogrammetry records at initial presentation (T1), completion of NAM (T2), and 3 weeks following primary repair (T3). Twelve infants fulfilled the inclusion criteria. 3dMD Vultus software was used to orient images and plot 16 nasolabial points with x, y, z coordinates to obtain the linear and angular measurements. Nasal form changes were measured and analyzed between T1 (0.5 months old), T2 (5 months old), and T3 (6 months old). Intraclass correlation coefficient was performed for intrarater reliability. Averaged data from the 3D images was statistically analyzed from T1 to T2 and T2 to T3 with Wilcoxon tests. Unaffected infant norms from the Farkas publication were used as a control sample. Results: After NAM therapy, statistically significant changes in the position of subnasale and labius superius improved nasolabial symmetry. Both retruded after NAM were displaced downward after NAM and surgical correction with respect to soft tissue nasion. The nasal tip’s projection was maintained with NAM and surgical correction. The columella lengthened from 1.4 to 4.71 mm following NAM. Conclusions: There was a significant improvement in the nasolabial anatomy after NAM, and this was further enhanced after primary reconstructive surgery.

Effects of Cleft Type, Facemask Anchorage Method, and Alveolar Bone Graft on Maxillary Protraction: A Three-Dimensional Finite Element Analysis

2012 ◽  
Vol 49 (2) ◽  
pp. 221-229 ◽  
Author(s):  
Ii-Hyung Yang ◽  
Young-Ii Chang ◽  
Tae-Woo Kim ◽  
Sug-Joon Ahn ◽  
Won-Hee Lim ◽  
...  
Keyword(s):  
Finite Element ◽  
Stress Distribution ◽  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Three Dimensional ◽  
Bilateral Cleft Lip ◽  
Dimensional Finite Element ◽  
Three Dimensional Finite Element

Objective To investigate biomechanical effects of cleft type (unilateral/bilateral cleft lip and palate), facemask anchorage method (tooth-borne and miniplate anchorage), and alveolar bone graft on maxillary protraction. Design Three-dimensional finite element analysis with application of orthopedic force (30° downward and forward to the occlusal plane, 500 g per side). Model Computed tomography data from a 13.5-year-old girl with maxillary hypoplasia. Intervention Eight three-dimensional finite element models were fabricated according to cleft type, facemask anchorage method, and alveolar bone graft. Main Outcome Measure(s) Initial stress distribution and displacement after force application were analyzed. Results Unilateral cleft lip and palate showed an asymmetric pattern in stress distribution and displacement before alveolar bone graft and demonstrated a symmetric pattern after alveolar bone graft. However, bilateral cleft lip and palate showed symmetric patterns in stress distribution and displacement before and after alveolar bone graft. In both cleft types, the graft extended the stress distribution area laterally beyond the infraorbital foramen. For both unilateral and bilateral cleft lip and palate, a facemask with a tooth-borne anchorage showed a dentoalveolar effect with prominent stress distribution and displacement on the upper canine point. In contrast, a facemask with miniplate anchorage exhibited an orthopedic effect with more favorable stress distribution and displacement on the middle maxilla point. In addition, the facemask with a miniplate anchorage showed a larger stress distribution area and suturai stress values than did the facemask with a tooth-borne anchorage. The pterygopalatine and zygomatico-maxillary sutures showed the largest suturai stress values with a facemask with a miniplate anchorage and after alveolar bone grafting, respectively. Conclusion In this three-dimensional finite element analysis, it would be more advantageous to perform maxillary protraction using a facemask with a miniplate anchorage than a facemask with a tooth-borne anchorage and after alveolar bone graft rather than before alveolar bone graft, regardless of cleft type.

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