scholarly journals Retrognathic maxilla in individuals born with oral clefts is due to intrinsic factors and not only due to early surgical treatment

2020 ◽  
Author(s):  
Rosa Helena W. Lacerda ◽  
Alexandre R. Vieira
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Craniofacial Morphology ◽  
Class I ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Oral Clefts ◽  
Intrinsic Factors ◽  
Facial Height ◽  
Mandibular Position

ABSTRACT Objectives To determine if the skeletal form of individuals born with oral clefts was associated with maxillary position. Materials and Methods Lateral cephalometric radiographs of 90 individuals 8 to 12 years old born with or without cleft lip and palate paired by age and sex were used. Skull base length, cranial base angle, cranial deflection angle, and maxillary skeletal length and position were studied. Also, mandibular skeletal length and position, lower anterior facial height, and dental position were defined. Individuals were divided into three groups: 30 individuals born with cleft lip and palate with Class III malocclusion (UCLP Class III), 30 individuals born with cleft lip and palate with Class I malocclusion (UCLP Class I), and 30 individuals born without cleft lip and palate with Class III malocclusion (non-cleft Class III). Results When comparing the UCLP Class III group with the UCLP Class I group, there were differences in maxillary position (P < .001) and mandibular position (P = .004) found. No differences were found when comparing the UCLP Class III group with the non-cleft Class III group. Conclusions There are intrinsic factors that affect craniofacial morphology of individuals born with cleft lip and palate.

scholarly journals Base of the skull morphology and Class III malocclusion in patients with unilateral cleft lip and palate

2015 ◽  
Vol 20 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Mariana Maciel Tinano ◽  
Milene Aparecida Torres Saar Martins ◽  
Cristiane Baccin Bendo ◽  
Ênio Mazzieiro
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Care Center ◽  
Class I ◽  
Control Group ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Skull Morphology ◽  
Cleft Lip Palate ◽  
Base Of The Skull

OBJECTIVE: The aim of the present study was to determine the morphological differences in the base of the skull of individuals with cleft lip and palate and Class III malocclusion in comparison to control groups with Class I and Class III malocclusion. METHODS: A total of 89 individuals (males and females) aged between 5 and 27 years old (Class I, n = 32; Class III, n = 29; and Class III individuals with unilateral cleft lip and palate, n = 28) attending PUC-MG Dental Center and Cleft Lip/Palate Care Center of Baleia Hospital and PUC-MG (CENTRARE) were selected. Linear and angular measurements of the base of the skull, maxilla and mandible were performed and assessed by a single calibrated examiner by means of cephalometric radiographs. Statistical analysis involved ANCOVA and Bonferroni correction. RESULTS: No significant differences with regard to the base of the skull were found between the control group (Class I) and individuals with cleft lip and palate (P > 0.017). The cleft lip/palate group differed from the Class III group only with regard to CI.Sp.Ba (P = 0.015). Individuals with cleft lip and palate had a significantly shorter maxillary length (Co-A) in comparison to the control group (P < 0.001). No significant differences were found in the mandible (Co-Gn) of the control group and individuals with cleft lip and palate (P = 1.000). CONCLUSION: The present findings suggest that there are no significant differences in the base of the skull of individuals Class I or Class III and individuals with cleft lip and palate and Class III malocclusion.

Face perception in patients with unilateral cleft lip and palate and patients with severe Class III malocclusion compared to controls

2011 ◽  
Vol 39 (3) ◽  
pp. 158-163 ◽  
Author(s):  
Philipp Meyer-Marcotty ◽  
Janka Kochel ◽  
Hartmut Boehm ◽  
Christian Linz ◽  
Uwe Klammert ◽  
...  
Keyword(s):  
Face Perception ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Class Iii Malocclusion

Quality of Life and Temporomandibular Disorders in Patients With Skeletal Class III Malocclusion With Cleft Lip and Palate

2021 ◽  
pp. 105566562110434
Author(s):  
Bernardo Olsson ◽  
Isabela Polesi Bergamaschi ◽  
Erika Calvano Küchler ◽  
Aline Monise Sebastiani ◽  
Guilherme dos Santos Trento ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Temporomandibular Disorders ◽  
Psychological Factors ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Skeletal Class ◽  
Better Than

Objective The aim of the study was to assess the quality of life (QOL), oral health-related QOL (OHRQOL), temporomandibular disorders (TMDs), and psychological factors in patients with skeletal Class III malocclusion with cleft lip and palate (CLP) and without CLP. Design Case–control. Setting Primary care, institutional practice. Patients One hundred thirty-six patients with skeletal Class III malocclusion with CLP (n = 68) and without CLP (n = 68). Main outcome measures QOL and OHRQOL were assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire and the Oral Health Impact Profile-14 questionnaire, respectively. TMDs and psychological factors were assessed using the Research Diagnostic Criteria for TMD (RDC/TMD). Results No differences in QOL were found between the groups ( P >  0.05). Patients with CLP reported a better OHRQOL ( P = 0.025) in the physical pain, physical disability, and psychological disability domains ( P <  0.05). Patients with CLP presented with less myofascial pain (OR, 0.28; 95% CI, 0.11-0.71] and other articular conditions (OR 0.24; 95% CI 0.06-0.90]. More patients with CLP reported no chronic pain ( P = 0.012). The QOL of patients with CLP with no depression or with no nonspecific physical symptoms including pain (NSPSIP) was better than that of patients without CLP. The OHRQOL of patients with CLP without TMDs or no psychological factors was better than that of patients without CLP. Conclusions Patients with skeletal Class III malocclusion who require orthognathic surgery with CLP have better OHRQOL and present with fewer TMDs than those patients without CLP.

An Oral Health-Related Quality of Life Comparison Between Adults With Unilateral Cleft Lip and Palate and Class III Malocclusion

2019 ◽  
Vol 56 (10) ◽  
pp. 1359-1365
Author(s):  
Leandro Almeida Nascimento Barros ◽  
Flávia Aline Silva Jesuino ◽  
João Batista de Paiva ◽  
José Rino-Neto ◽  
José Valladares-Neto
Keyword(s):  
Oral Health ◽  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Health Related Quality ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Related Quality ◽  
Health Related

Objective: To compare oral health-related quality of life (OHRQoL) before treatment of adults with unilateral cleft lip and palate (UCLP) and surgical Class III malocclusion, and to consider if clefts needing different orthodontic treatment protocols could influence people’s self-perception. Design: Cross sectional. Setting: Cleft Lip and Palate Center and Clinic of Orthognathic Surgery from a School of Dentistry. Participants: A sample of adults with repaired nonsyndromic UCLP (n = 52) which was age- and sex-matched with a noncleft Class III malocclusion sample seeking orthognathic surgery (n = 51). In turn, the cleft group was subdivided according to treatment planning into nonsurgical orthodontic and surgical orthodontic approaches. Main Outcome Measure: The whole sample was assessed using the short-form oral health impact profile (OHIP-14), with higher scores indicating a poorer OHRQoL. Statistical comparisons were performed with Mann-Whitney U and Kruskal-Wallis tests, and effect size. Bonferroni adjustment was used for post hoc tests ( P < .017). Results: The OHIP-14 scores of the UCLP and Class III groups were significantly different ( P = .001, η2 = 0.108), and higher in Class III. The largest commitment was in the physical disability, physical pain, and psychological disability domains. In addition, no differences were found when the UCLP treatment planning was considered. Conclusion: Surgical Class III malocclusion have a poorer OHRQoL when compared to patients with UCLP, irrespective of whether they are treated surgically or orthodontically. Therefore, the greater commitment of OHRQoL appears to be influenced by the etiology of Class III, and not by treatment plan.

Evaluation of Lefort I Osteotomy Line and Pterygomaxillary Junction Region in Patients With Cleft Lip and Palate

2020 ◽  
pp. 105566562096957
Author(s):  
Bahadır Sancar ◽  
Şuayip Burak Duman
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Le Fort I Osteotomy ◽  
Maxillary Hypoplasia ◽  
Le Fort ◽  
Osteotomy Line ◽  
Le Fort I ◽  
Pterygomaxillary Junction

Objective: This study aimed to evaluate the Le Fort I osteotomy line and pterygomaxillary junction via cone-beam computed tomography in individuals with cleft lip and palate (CLP). Design: Retrospective study. Patients and Methods: The study included individuals older than 16 years with CLP, who were scheduled for repositioning of the maxilla by Le Fort I osteotomy, and those with class III malocclusion with maxillary hypoplasia, who were scheduled for Le Fort I osteotomy. The measurements made in the area of the cleft of individuals with CLP were compared with both the side with no cleft and those with class III malocclusion with maxillary hypoplasia. A total of 11 measurements were made on the axial section parallel to the Frankfurt Horizontal plane, corresponding to the lower 1/5 of the distance between the infraorbital foramen and the anterior nasal spine. Results: There were significant differences both in the comparisons made between the individuals with CLP and those without CLP in terms of the canal-anterior alveolar crest (G) and sinus-anterior alveolar crest (L) measurements ( P < .05). The mean measurement values showed that the measurement results were higher in individuals with CLP in general. Conclusion: In conclusion, we believe that there might be difficulties both in osteotomy and down fracture stages during Le Fort I osteotomies performed in individuals with CLP.

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.

Longitudinal Craniofacial Growth Patterns in Patients with Orofacial Clefts: Geometric Morphometrics

2004 ◽  
Vol 41 (2) ◽  
pp. 136-143 ◽  
Author(s):  
G. D. Singh ◽  
Jasmin Rivera-Robles ◽  
Jaime de Jesus-Vinas
Keyword(s):  
Cleft Lip ◽  
Cranial Base ◽  
Growth Patterns ◽  
Class I ◽  
Size Increase ◽  
Scaling Analysis ◽  
Craniofacial Growth ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Growth Guidance

Objective To demonstrate craniofacial developmental patterns in repaired cleft lip and cleft palate (CLP). Design Retrospective, longitudinal. Setting Center for Craniofacial Disorders, San Juan, Puerto Rico. Sample Males aged 9 to 17 years: 13 noncleft (NC) Class I occlusion (NCC1); 13 NC Class III malocclusion (NCC3); 12 CLP Class I occlusion (CLPC1); and 15 CLP Class III malocclusion (CLPC3). Main Outcome Measures Form changes (ages 10, 13, and 16 years), using finite-element scaling analysis. Results NCC1, 10 to 13 interval: 30% size increase in upper midface (p < .05), mental region (p < .01), mandibular body (p < .05); 13 to 16 interval: 10% to 35% size increase in bimaxillary region and ramus (p < .01). NCC3, 10 to 13 interval: 10% to 40% size increase in posterior cranial base, upper midface, and mandible (p < .05); 13 to 16 interval: 10% to 30% size increase in bimaxillary region (p < .01), especially ramus. CLPC1, 10 to 13 interval: 10% to 15% size increase in posterior cranial base (p < .01), midface (p < .05), and mandibular ramus (p < .05); 13 to 16 interval: 8% to 20% size increase in upper midface (p < .01), lower midface (p < .05), and mandible (p < .05). CLPC3, 10 to 13 interval: no significant changes; 13 to 16 interval: upper midface and cranial base show nonsignificant size decreases, but ramus showed size increase. Conclusions Noncleft and CLP Class 1 occlusion groups show similar craniofacial growth patterns. Noncleft Class III groups show excessive cranial and mandibular growth. Class III malocclusion in CLP patients is associated with clinically deficient craniomaxillary growth. Growth guidance may be indicated in children with CLP with unfavorable craniofacial growth patterns.

Vertical and Sagittal Growth in Patients with Unilateral and Bilateral Cleft Lip and Palate—A Retrospective Cephalometric Evaluation

2009 ◽  
Vol 46 (5) ◽  
pp. 512-520 ◽  
Author(s):  
Alexandra I. Holst ◽  
Stefan Holst ◽  
Emeka Nkenke ◽  
Matthias Fenner ◽  
Ursula Hirschfelder
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class I ◽  
Growth Spurt ◽  
Pubertal Growth Spurt ◽  
Skeletal Class ◽  
Pubertal Growth ◽  
Facial Height ◽  
Bilateral Cleft Lip ◽  
Male Patients

Objective: To investigate whether the craniofacial vertical and sagittal jaw relationship in patients with cleft lip and palate (CLP) differed from that of age-matched noncleft controls, before and after the pubertal growth spurt. Design: Retrospective observational study. Patients: The study group comprised 126 patients with CLP, subdivided according to gender and cleft type, and the control group comprised 53 age-matched skeletal class I patients. Methods: Angular and linear measurements were taken from prepubertal and postpubertal lateral cephalograms of all patients. Results: In patients with cleft lip and palate, the maxillary retrognathism became more remarkable with increasing age; whereas, the retrognathic position of the mandible became less pronounced as compared with controls. Reduced posterior midfacial height, a common prepubertal finding in patients with cleft lip and palate, was significant in postpubertal girls and young women with unilateral cleft lip and palate (p  =  .002). The total anterior facial height in male patients with bilateral cleft lip and palate was larger than in control patients (p  =  .002) after the pubertal growth spurt due to an increased anterior midfacial height. In male patients with unilateral cleft lip and palate, this finding was due to an increased anterior lower facial height (p < .001). Conclusions: Patients with cleft lip and palate treated according to a standardized treatment concept had adequate craniofacial jaw relationships after puberty. Despite a measured skeletal class I in both male and female patients with cleft lip and palate regardless of cleft type, there was a slight tendency toward a skeletal class III. Findings were similar for all groups of cleft lip and palate patients irrespective of the type of orthodontic treatment performed.

Tomographic Pharyngeal Dimensions in Individuals with Unilateral Cleft Lip/Palate and Class III Malocclusion are Reduced When Compared with Controls

2017 ◽  
Vol 54 (5) ◽  
pp. 502-508 ◽  
Author(s):  
Trindade-Suedam Ivy Kiemle ◽  
Freire Lima Thiago ◽  
Dominguez Campos Letícia ◽  
Faria Yaedú Renato Yassutaka ◽  
Filho Hugo Nary ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Cone Beam ◽  
Control Group ◽  
Craniofacial Anomalies ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Cross Sectional ◽  
Cleft Lip Palate

Objective The objective of this study was to three-dimensionally evaluate the pharyngeal dimensions of individuals with complete nonsyndromic unilateral cleft lip and palate (UCLP) using cone beam computed tomography. Design This was a cross-sectional prospective study. Setting The study took place at the Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil. Patients and Participants The control group (CON) consisted of 23 noncleft adults with class III malocclusion, and the cleft group (UCLP) consisted of 22 individuals with UCLP and class III malocclusion. Two subgroups of individuals with class III malocclusion as a result of maxillary retrusion with (UCLP'; n = 19) and without (CON'; n = 8) clefts were also assessed. Interventions Pharyngeal volume, pharyngeal minimal cross-sectional area (CSA), location of CSA, pharyngeal length, sella-nasion-A point angle (SNA), sella-nasion-B point angle (SNB), and A point-nasion-B point angle (ANB), and body mass index were assessed using Dolphin software. Main Outcome Measure The pharyngeal dimensions of UCLP individuals are smaller when compared with controls. Results Mean pharyngeal volume (standard deviation) for the UCLP patients (20.8 [3.9] cm3) and the UCLP’ patients (20.3 [3.9] cm3) were significantly decreased when compared with the CON (28.2 [10.0] cm3) and CON’ patients (29.1 [10.2] cm3), respectively. No differences were found in the pharyngeal minimal CSA, ANB, or pharyngeal length values between groups (CON versus UCLP and CON’ versus UCLP'). CSAs were located mostly at the oropharynx, except in the UCLP’ patients, which were mainly at the hypopharynx. Mean SNA in the UCLP (76.4° [4.6°]) and UCLP’ groups (75.1 [3.1°]) were significantly smaller than those in the CON (82.8° [4.1°]) and CON’ groups (78.6° [1.2°]). SNB values were statistically smaller only for the comparison of CON versus UCLP patients. Conclusion The pharynx of individuals with UCLP and class III malocclusion is volumetrically smaller than that of individuals with class III malocclusion and no clefts.

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