scholarly journals Upper airway assessment using four different maxillary expanders in cleft patients: A cone-beam computed tomography study

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 ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cone Beam ◽  
Nasal Passage ◽  
Maxillary Expansion ◽  
Computed Tomography Images ◽  
Intergroup Comparison ◽  
Significant Difference

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.

Cone-Beam Computed Tomography Evaluation of Skeletal Deformities and Pharyngeal Airway in Chinese Han Individuals With Nonsyndromic Unilateral Cleft Lip and Palate

2019 ◽  
Vol 57 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Yuan Zhang ◽  
Yuhua Wang ◽  
Yaoyuan Zhang ◽  
Sheng Li ◽  
Lin Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cone Beam ◽  
Skeletal Deformities ◽  
Pharyngeal Airway ◽  
Face Height ◽  
Computed Tomography Images ◽  
Significant Difference

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.

Three-Dimensional Assessment of Cervical Vertebrae Anomalies in Patients With Cleft Lip and Palate

2020 ◽  
pp. 105566562098022
Author(s):  
Gabriella L. de Rezende Barbosa ◽  
Luiz A. Pimenta ◽  
Donald A. Tyndall ◽  
Trishul V. Allareddy ◽  
Saulo L. Sousa Melo
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cervical Vertebrae ◽  
Cone Beam ◽  
Os Odontoideum ◽  
Posterior Arch ◽  
Computed Tomography Images ◽  
Significant Difference

Objective: To evaluate the occurrence of cervical vertebrae anomalies (CVA) in patients with unilateral (UCLP) and bilateral cleft lip and palate (BCLP) using cone beam computed tomography (CBCT) examinations. Design: Retrospective assessment of CBCT images. Descriptive statistics were calculated. Fisher exact test or χ2 test was performed to evaluate the differences among each CVA between sex and type of cleft. Setting: School of Dentistry. Participants: One hundred fifty-one patients with cleft lip and palate (103 UCLP/48 BCLP). Interventions: No relevant intervention. Main Outcome Measures: Cone beam computed tomography images were assessed for the presence or absence of 12 most commonly observed CVA: spina bifida, dehiscence, cleft of the posterior arch, cleft of the anterior arch, fusion between cervical vertebrae, block fusion, occipitalization, narrowing of the intervertebral space, posterior ponticle, os odontoideum, ossiculum terminale, and subdental cartilaginous remnants. Results: The presence of subdental cartilaginous remnants was the most frequently observed alteration—found in 81.45% of the sample—and it was the only CVA with statistically significant frequencies in the individuals with BCLP. Considering only the other CVA, 22.51% presented 1 and 5.29% presented 2 or more CVA. Conclusions: Patients with cleft lip and palate may present an overall high incidence of CVAs. However, when comparing the distribution of the CVAs among sex and types of cleft, the only significant difference noted was a higher incidence of subdental cartilaginous remnants among patients with BCLP.

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
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cone Beam ◽  
Control Group ◽  
Mandibular Asymmetry ◽  
Computed Tomography Images ◽  
Normal Occlusion ◽  
Bilateral Cleft Lip

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.

scholarly journals Evaluation of mandibular transverse widths in patients affected by unilateral and bilateral cleft lip and palate using cone beam computed tomography

2015 ◽  
Vol 85 (4) ◽  
pp. 611-615 ◽  
Author(s):  
Mevlut Celikoglu ◽  
Suleyman K. Buyuk ◽  
Abdullah Ekizer ◽  
Ahmet E. Sekerci
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cone Beam ◽  
Computed Tomography Images ◽  
Normal Occlusion ◽  
Bilateral Cleft Lip ◽  
The One ◽  
Post Hoc

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.

Predictors of Velopharyngeal Dysfunction in Individuals With Cleft Palate Following Surgical Maxillary Advancement: Clinical and Tomographic Assessments

2019 ◽  
Vol 56 (10) ◽  
pp. 1314-1321 ◽  
Author(s):  
Maria Natália Leite de Medeiros-Santana ◽  
Jamie L. Perry ◽  
Renato Yassutaka Faria Yaedú ◽  
Ivy Kiemle Trindade-Suedam ◽  
Renata Paciello Yamashita
Keyword(s):  
Computed Tomography ◽  
Cleft Palate ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cone Beam ◽  
Point Scale ◽  
Maxillary Advancement ◽  
Significant Difference ◽  
T1 And T2

Objective: To investigate whether morphofunctional velopharyngeal aspects may be considered predictors of appearance or worsening of hypernasality in patients with cleft palate after surgical maxillary advancement (MA). Design: Prospective. Setting: National referral center for cleft lip and palate rehabilitation. Participants: Fifty-two patients with repaired cleft palate, skeletal class III malocclusion, and normal speech resonance completed speech audio recordings and cone-beam computed tomography examination before (T1) and, on average, 14 months after (T2) MA. Interventions: Hypernasality was rated by 3 experienced speech-language pathologists using a 4-point scale and morphofunctional aspects on a 3-point scale. Cone-beam computed tomography image measurements were performed using Amira and Dolphin 3D software. For each velopharyngeal morphofunctional aspect analyzed, patients were compared according to the absence (G1) and presence (G2) of postoperative hypernasality. Main Outcome Measures: Comparison of hypernasality scores between T1 and T2 and association between hypernasality and each velopharyngeal morphofunctional aspect. Results: Significant difference was observed between T1 and T2 for hypernasality ( P = .031) and between G1 and G2 ( P = .015) for velar mobility, with significant association between this variable and hypernasality on T2 ( P = .041). Conclusions: Levator veli palatini mobility influenced the appearance of hypernasality after MA.

scholarly journals Cone-Beam computed tomography evaluation of maxillary expansion in twins with cleft lip and palate

2012 ◽  
Vol 17 (2) ◽  
pp. 42.e1-42.e11 ◽  
Author(s):  
Luciane Macedo de Menezes ◽  
Fabiane Azeredo ◽  
André Weissheimer ◽  
Juliana Lindemann Rizzato ◽  
Susana Maria Deon Rizzatto
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cone Beam ◽  
Maxillary Expansion

scholarly journals Alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients using cone-beam computed tomography evaluation

2021 ◽  
Author(s):  
Marcin Stasiak ◽  
Anna Wojtaszek-Słomińska ◽  
Bogna Racka-Pilszak
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Contralateral Side ◽  
Cone Beam ◽  
Rank Test ◽  
Cross Sectional ◽  
Alveolar Bone Grafting

Abstract Purpose The aims of this retrospective cross-sectional study were to measure and compare labial and palatal alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients, following STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Patients and methods The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography was performed at least one year after secondary alveolar bone grafting. The experimental side was the cleft side and the contralateral side without congenital cleft was the control. Measurements were performed on incisors’ midsagittal cross-sections. The Wilcoxon signed-rank test was used for intergroup comparisons. Results The labial and palatal distances between alveolar bone crests and cementoenamel junctions were significantly greater on the cleft side than on the noncleft side. Mean differences were 0.75 and 1.41 mm, respectively. The prevalence of dehiscences at the cleft side maxillary central incisors was 52% on the labial surface and 43% on the palatal surface. In the controls, it was 19% and 14%, respectively. Conclusion The cleft-adjacent maxillary central incisors had more apically displaced alveolar bone crests on the labial and palatal sides of the roots than the controls. Higher prevalence of dehiscences was found on the cleft side. Bone margin differences predispose to gingival height differences of the central incisors. These differences could increase the demands of patients to obtain more esthetic treatment results with orthodontic extrusion and periodontal intervention on the cleft side.

scholarly journals Effects of rapid maxillary expansion in cleft patients resulting from the use of two different expanders

2016 ◽  
Vol 21 (6) ◽  
pp. 82-90 ◽  
Author(s):  
Daniel Santos Fonseca Figueiredo ◽  
Lucas Cardinal ◽  
Flávia Uchôa Costa Bartolomeo ◽  
Juan Martin Palomo ◽  
Martinho Campolina Rebello Horta ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rapid Maxillary Expansion ◽  
Cone Beam ◽  
Tomographic Image ◽  
Maxillary Expansion ◽  
Downward Movement ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Maxillary Region

ABSTRACT Objective: The aim of this study was to evaluate the skeletal and dental effects of rapid maxillary expansion (RME) in cleft patients using two types of expanders. Methods: Twenty unilateral cleft lip and palate patients were randomly divided into two groups, according to the type of expander used: (I) modified Hyrax and (II) inverted Mini-Hyrax. A pretreatment cone-beam computed tomographic image (T0) was taken as part of the initial orthodontic records and three months after RME, for bone graft planning (T1). Results: In general, there was no significant difference among groups (p > 0.05). Both showed a significant transverse maxillary expansion (p < 0.05) and no significant forward and/or downward movement of the maxilla (p > 0.05). There was greater dental crown than apical expansion. Maxillary posterior expansion tended to be larger than anterior opening (p < 0.05). Cleft and non-cleft sides were symmetrically expanded and there was no difference in dental tipping between both sides (p > 0.05). Conclusions: The appliances tested are effective in the transverse expansion of the maxilla. However, these appliances should be better indicated to cleft cases also presenting posterior transverse discrepancy, since there was greater expansion in the posterior maxillary region than in the anterior one.

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