Craniofacial Morphology and Growth Comparisons in Children with Robin Sequence, Isolated Cleft Palate, and Unilateral Complete Cleft Lip and Palate

2003 ◽  
Vol 40 (4) ◽  
pp. 373-396 ◽  
Author(s):  
N. V. Hermann ◽  
S. Kreiborg ◽  
T. A. Darvann ◽  
B. L. Jensen ◽  
E. Dahl ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Nasal Cavity ◽  
Growth Pattern ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Craniofacial Morphology ◽  
Facial Morphology ◽  
Facial Growth ◽  
Pharyngeal Airway ◽  
Isolated Cleft Palate

Objective Comparison of early craniofacial morphology and growth in children with nonsyndromic Robin Sequence (RS), isolated cleft palate (ICP), and unilateral complete cleft lip and palate (UCCLP). Subjects One hundred eight children with cleft: 7 with RS, 53 with ICP, and 48 with UCCLP were included in the study. The children were drawn from the group of all Danish children with cleft born 1976 through 1981. Method Three-projection infant cephalometry. Results The craniofacial morphology in the RS, ICP, and UCCLP groups had some common characteristics: a wide maxilla with decreased length and posterior height, wide nasal cavity, short mandible, bimaxillary retrognathia, and reduced pharyngeal airway. The shortest mandible was found in RS followed by ICP and UCCLP; the pharyngeal airway was reduced in RS and ICP, compared with UCCLP; and the maxillary complex and nasal cavity were wider in UCCLP than in the other groups. The amount of facial growth in all three groups was similar; however, the direction was more vertical in UCCLP than in RS and ICP. Conclusion Except for a shorter RS mandible, the facial morphology of infants with RS and ICP was similar, as was the amount of facial growth and the growth pattern. The differences in facial morphology can be ascribed to the difference in the primary anomaly. The amount of facial growth was similar in the three groups; however, the growth pattern showed a more vertical direction in UCCLP than in RS and ICP. It is hypothesized that the mandibular retrognathia in RS represents the outer end of that of the ICP distribution.

Early Craniofacial Morphology and Growth in Children with Unoperated Isolated Cleft Palate

2002 ◽  
Vol 39 (6) ◽  
pp. 604-622 ◽  
Author(s):  
N.V. Hermann ◽  
S. Kreiborg ◽  
T.A. Darvann ◽  
B.L. Jensen ◽  
E. Dahl ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Growth Pattern ◽  
Cleft Lip ◽  
Growth Direction ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Facial Morphology ◽  
Facial Growth ◽  
Vertical Growth ◽  
Isolated Cleft Palate

Objective Analysis of craniofacial morphology and growth in children with untreated isolated cleft palate (ICP) (cleft of the secondary palate only) at 2 and 22 months of age and comparison of the morphology and growth to that of a control group with unilateral incomplete cleft lip (UICL). Material and Methods A total of 98 cleft children (53 with ICP and 45 with UICL) drawn from a larger group representing all Danish children with cleft born in the period 1976 to 1981 were included in the study. Craniofacial morphology and growth were analyzed using three-projection infant cephalometry. Results The ICP group differed significantly from the UICL group. The most striking findings in the ICP group were: short maxilla; reduced posterior maxillary height; increased posterior maxillary width (in the 2-month-old); short mandible; reduced posterior height of the mandible; bimaxillary retrognathia; and reduced pharyngeal depth, height, and area. The facial growth pattern was fairly similar in the two groups except for a somewhat more vertical growth direction in the ICP group. Conclusion The facial morphology in ICP children differs significantly from that of children with UICL of the same age. The differences in facial morphology can be ascribed to the difference in the primary anomaly in the ICP group. The facial growth pattern was fairly similar in the ICP and UICL group; however, a somewhat more vertical growth direction was observed in the ICP group.

Early Craniofacial Morphology and Growth in Children with Bilateral Complete Cleft Lip and Palate

2004 ◽  
Vol 41 (4) ◽  
pp. 424-438 ◽  
Author(s):  
N. V. Hermann ◽  
T. A. Darvann ◽  
B. L. Jensen ◽  
E. Dahl ◽  
S. Bolund ◽  
...  
Keyword(s):  
Growth Pattern ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Displacement Vector ◽  
Craniofacial Morphology ◽  
Individual Growth ◽  
Control Group ◽  
Facial Growth ◽  
X Ray ◽  
Pharyngeal Airway

Purpose Analysis of craniofacial morphology and growth in children with bilateral complete cleft lip and palate (BCCLP), compared with a control group with unilateral incomplete cleft lip (UICL), before any treatment as well as 20 months after lip closure. Material The children were drawn from a group representing all Danish children with cleft born 1976 to 1981. Sixty-four children were included in the study (19 BCCLP and 45 UICL). The ages were 2 and 22 months at examinations 1 and 2, respectively. Method The method of investigation was infant cephalometry in three projections. The craniofacial morphology was analyzed using linear, angular, and area variables. Growth was defined as the displacement vector from the coordinate of the corresponding landmark in the x-ray at examination 1 to its coordinate at examination 2, corrected for x-ray magnification. The growth of an anatomical region in a patient was assessed by investigating the growth pattern formed by a collection of individual growth vectors in that region. Results The BCCLP group differed significantly from the UICL group. The most striking findings in BCCLP were an extremely protruding premaxilla; markedly increased posterior maxillary width; increased width of the nasal cavity; short maxilla with reduced posterior height; short mandible; bimaxillary retrognathia; severe reduction in the size of the pharyngeal airway; and a more vertical facial growth pattern. Conclusion Our findings indicate that a facial type including a wide and posterior short maxilla, short mandible, and bimaxillary retrognathia might be a liability factor that increases the probability of developing cleft lip and palate.

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.

A Six-Center International Study of Treatment Outcome in Patients with Clefts of the Lip and Palate: Part 2. Craniofacial Form and Soft Tissue Profile

1992 ◽  
Vol 29 (5) ◽  
pp. 398-404 ◽  
Author(s):  
Kirsten Mølsted ◽  
Catherine Asher-Mcdade ◽  
Viveca Brattström ◽  
Erik Dahl ◽  
Michael Mars ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Soft Tissue ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Craniofacial Morphology ◽  
Facial Morphology ◽  
X Rays ◽  
Full Cohort ◽  
Soft Tissue Profile

The craniofacial morphology and the soft tissue profile were evaluated in this part of the intercenter study of the European Cleft Lip and Palate Research Group. The sample was comprised of cephalometric x-rays of the full cohort of 151 cases from the six European cleft palate centers. The facial morphology in complete unilateral cleft lip and patate patients was evaluated by means of roentgen cephalometry. Approximately 25 consecutive cases from each of six European cleft palate centers were compared. Only one center showed notable and consistent differences from the others. A contributing factor for these differences may be an inconsistent treatment regimen with many surgeons involved. Analysis of the soft tissue profile between the centers showed more pronounced differences than analysis of the skeletal profile. The treatment outcome in centers with more complex or expensive programs was no better than those centers using simpler management approaches.

Early Craniofacial Morphology and Growth in Children with Nonsyndromic Robin Sequence

2003 ◽  
Vol 40 (2) ◽  
pp. 131-143 ◽  
Author(s):  
N. V. Hermann ◽  
S. Kreiborg ◽  
T. A. Darvann ◽  
B. L. Jensen ◽  
E. Dahl ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Displacement Vector ◽  
Growth Direction ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Anatomical Location ◽  
Facial Morphology ◽  
Facial Growth ◽  
Pharyngeal Airway ◽  
Robin Sequence

Purpose Craniofacial morphology and growth comparisons in children with untreated nonsyndromic Robin Sequence (RS) and a control group with unilateral incomplete cleft lip (UICL) in which the lip was surgically closed at 2 months of age. Material The 52 children (7 RS and 45 UICL) included in the study were drawn from a group representing all Danish cleft children born 1976 through 1981. The ages of the children were 2 and 22 months at the time of examination 1 and 2, respectively. Method The method of investigation was three-projection cephalometry. Craniofacial morphology was analyzed by means of linear, angular, and area variables. Growth at a specific anatomical location in a patient was defined as the displacement vector from the coordinate of the corresponding landmark at examination 1 to its coordinate at examination 2. Results The most striking findings in the RS group were markedly increased posterior maxillary width, increased width of the nasal cavity, short maxilla with reduced posterior height, short mandible, bimaxillary retrognathia, and severe reduction in size of the pharyngeal airway. The amount of facial growth was similar in the two groups; however, a tendency toward a more vertical growth direction was observed in the RS group. Conclusion Facial morphology in children with RS differed significantly from that of children with UICL at both 2 and 22 months of age. The magnitude of facial growth was similar in the two groups, whereas a tendency toward a more vertical facial growth direction was observed in the RS group.

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.

Hard Palate Repair Timing and Facial Growth in Unilateral Cleft Lip and Palate: A Longitudinal Study

2006 ◽  
Vol 43 (5) ◽  
pp. 547-556 ◽  
Author(s):  
Yu-Fang Liao ◽  
Timothy J. Cole ◽  
Michael Mars
Keyword(s):  
Longitudinal Study ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sri Lankan ◽  
Facial Morphology ◽  
Facial Growth ◽  
Clinical Notes ◽  
Timing Effect ◽  
Palate Repair

Objective: To investigate whether timing of hard palate repair had a significant effect on facial growth in patients with unilateral cleft lip and palate (UCLP). Design: Retrospective longitudinal study. Setting: Sri Lankan Cleft Lip and Palate Project. Patients: A total of 104 patients with nonsyndromic UCLP who had hard palate repair by age 13 years, with their 290 cephalometric radiographs taken after lip and palate repair. Main Outcome Measures: Clinical notes were used to record surgical treatment histories. Cephalometry was used to determine facial morphology and growth rate. Results: Timing of hard palate repair had a significant effect on the length and protrusion of the alveolar maxilla (PMP-A and SNA, respectively) and the anteroposterior alveolar jaw relation (ANB) at age 20 years but not on their growth rates. Conclusion: Timing of hard palate repair significantly affects the growth of the maxilla in patients with UCLP. Late hard palate repair has a smaller adverse effect than does early hard palate repair on the growth of the maxilla. This timing effect primarily affects the anteroposterior development of the maxillary dentoalveolus and is attributed to the development being undisturbed before closure of the hard palate.

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