Three-Dimensional Morphology of the Palate in Patients with Bilateral Complete Cleft Lip and Palate at the Stage of Permanent Dentition

2009 ◽  
Vol 46 (4) ◽  
pp. 399-408 ◽  
Author(s):  
Zbyněk Šmahel ◽  
Jana Velemínská ◽  
Pavel Trefný ◽  
Živa Müllerová
Keyword(s):  
Laser Scanning ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Substantial Reduction ◽  
Three Dimensional ◽  
Permanent Dentition ◽  
Cross Sectional ◽  
Size And Shape ◽  
Control Study ◽  
Dental Casts

Objective: Three-dimensional analysis of palate size and shape in 30 patients with complete bilateral cleft lip and palate (BCLPc) at the stage of permanent dentition. Design: Cross-sectional study based on laser scanning. Subjects: Thirty dental casts of boys approximately 15 years old with BCLPc and 28 dental casts of healthy boys of the same age. Interventions: Arched-lip suture with periosteoplasty and push-back of the palate with pharyngeal-flap surgery. Main Outcome Measures: Data on palate height in the 210 defined locations and on palate widths and profile area in 10 transverse sections. Results: The palate in patients with BCLPc was conical and narrower than in control study subjects, much more anteriorly than posteriorly. From the canines posteriorly, the palate was of almost constant height of 10 mm in the midline, being higher than in control study subjects at this location and lower more posteriorly (by 24% to 29% between molars). The area of transverse sections was reduced as compared with control study subjects from the first premolars posteriorly and reached more than 40% between molars. The length of the palate up to the first molars was not changed. Conclusion: BCLPc subjects exhibited narrow, low, and flat palate. Palate size and shape differences indicate a substantial reduction of the space for the tongue.

Three-Dimensional Morphology of the Palate in Subjects with Unilateral Complete Cleft Lip and Palate at the Stage of Permanent Dentition

2004 ◽  
Vol 41 (4) ◽  
pp. 416-423 ◽  
Author(s):  
Zbynek Šmahel ◽  
Pavel Trefný ◽  
Pavel Formánek ◽  
Živa Müllerová ◽  
Miroslav Peterka
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Permanent Dentition ◽  
Maximum Height ◽  
Anterior Portion ◽  
Posterior Direction ◽  
The Difference ◽  
Reduced Space ◽  
Dental Casts

Objective Three-dimensional analysis of palate size and shape in patients with complete unilateral cleft lip and palate (UCLP) at the stage of permanent dentition. Subjects Thirty randomly selected dental casts of boys approximately 15 years old with complete UCLP and 28 dental casts of normal boys of the same age. Interventions All patients underwent lip repair according to Tennison with primary periosteoplasty (mean age 8.5 months) and palate repair by pushback and pharyngeal flap surgery (mean age 4.9 years). Main Outcome Measures Data on the palate height in 210 defined locations. Results The palate in patients with UCLP was narrower throughout its whole extent, more anteriorly than posteriorly. From the canines posteriorly, it was also lower, and the difference as compared with controls increased in a posterior direction up to the level of second premolars (up to 30%) and then slightly diminished (to 21% between the first molars). The reduction of area of transverse sections reached 45% between premolars and 39% between first molars. The palate in the anterior portion was highest on the cleft side and in a posterior direction the maximum height of the palate shifted toward the midline and even beyond that line toward the noncleft side. Palatal height did not depend on dentoalveolar arch width. Conclusion The smaller width and height of the palate confirm the substantially reduced space for the tongue in patients with UCLP. The reduction is only slightly larger than in previously examined patients with isolated cleft palate. Palatal vault is asymmetrical, highest anteriorly on the cleft side and posteriorly on the noncleft side.

The Hyoid Bone in Malay Infants with Cleft Lip and Palate

2006 ◽  
Vol 43 (5) ◽  
pp. 532-538 ◽  
Author(s):  
Zainul A. Rajion ◽  
Grant C. Townsend ◽  
David J. Netherway ◽  
Peter J. Anderson ◽  
Toby Hughes ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Software Package ◽  
Hyoid Bone ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Cross Sectional ◽  
Computed Tomography Scans ◽  
Age Range

Objective: To compare morphological and positional variations of the hyoid bone in unoperated infants with cleft lip and palate (CL/P) with those in noncleft infants. Design: Retrospective, cross sectional. Patients and Methods: Three-dimensional computed tomography scans were obtained from 29 unoperated CL/P infants of Malay origin aged between 0 and 12 months and from 12 noncleft infants in the same age range. Observations were made and measurements were obtained with a software package developed at the Australian Craniofacial Unit. The sizes of the hyoid bones and the position of the hyoid body and epiglottis in relation to the cervical spine were measured. Anatomical anomalies of the hyoid and prevalence of aspiration pneumonia were also documented. Results: The hyoid bones and epiglottis were found to be located more inferiorly in CL/P infants compared with the noncleft infants. Also, 17% (5/29) of the CL/P infants had nonossified hyoid bodies. Conclusion: The results suggest that there are differences in the location and genesis of the hyoid bone in infants with CL/P that warrant further investigation.

scholarly journals Three-Dimensional Outcome Assessments of Surgical Correction in Cleft and Noncleft Patients with Class III Skeletal Relation: A Case-Control Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Te-Ju Wu ◽  
Cheng-Chun Wu ◽  
Chi-Yu Tsai ◽  
Yi-Hao Lee ◽  
Yu-Jen Chang ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Case Control Study ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Vertical Movement ◽  
Case Control ◽  
Class Iii ◽  
Vertical Movements ◽  
Receiver Operating Characteristic Curves ◽  
Control Study

Background. The orthognathic strategies to treat patients with a concave profile but different tissue conditions remain controversial. The aim of this case-control study was to investigate the outcome predictability of orthognathic surgery in cleft lip and palate (CLP) patients and matched controls. Methods. Fifty consecutive CLP and 45 matched non-CLP patients who received whole-piece Le Fort I and bilateral sagittal split osteotomy to correct class III skeletal relations were enrolled. The outcome discrepancies (ODs) from simulations among all groups were evaluated with consideration of the possible influences from planned surgical movements (PSM). Receiver operating characteristic curves were used to determine threshold values of PSMs that yielded clinically relevant OD. Results. Unilateral CLP (UCLP) patients had comparable postsurgical OD to non-CLP patients in both jaws, whereas bilateral CLP (BCLP) patients had greater deviations from predicted results. Vertical movement of the A − point > 1.33   mm and yaw   correction > 1.65 ° in the BCLP patients was associated with clinically relevant maxillary OD. Conclusions. The OGS outcomes of BCLP patients were less predictable than those of the UCLP and noncleft patients. Vertical movements of the A − point > 1.33   mm and yaw   correction > 1.65 ° in BCLP patients increased OD to a clinically relevant extent.

Difference in the Prevalence of Enamel Alterations Affecting Central Incisors of Children with Complete Unilateral Cleft Lip and Palate

2005 ◽  
Vol 42 (4) ◽  
pp. 392-395 ◽  
Author(s):  
Suzana Papile Maciel ◽  
Beatriz Costa ◽  
Marcia Ribeiro Gomide
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sao Paulo ◽  
Permanent Dentition ◽  
Permanent Teeth ◽  
Homogeneous Distribution ◽  
São Paulo ◽  
Craniofacial Anomalies ◽  
Cross Sectional ◽  
Enamel Defects

Objective To evaluate the prevalence of enamel alterations affecting the deciduous and permanent central maxillary incisors of children with complete unilateral cleft lip and palate and to verify their characteristics. Design Cross-sectional. Setting Hospital for Rehabilitation of Craniofacial Anomalies–University of São Paulo, Bauru, São Paulo, Brazil. Patients A sample of 90 patients attending the Hospital for Rehabilitation of Craniofacial Anomalies, presenting with complete cleft lip and palate, of both genders, ages 2 to 11 years old. Methodology The buccal surfaces of the maxillary central incisors of patients were analyzed for observation of the presence of enamel defects, their type, number, and location. The prevalence of defects was compared between deciduous and permanent teeth and between the incisors at the cleft and noncleft sides. Results There was a higher frequency of defects among incisors on the cleft side for both deciduous and permanent dentitions compared with the noncleft side (p < .05); the permanent central incisor was more frequently affected than the deciduous. Evaluation of the types of defects for both incisors in both dentitions demonstrated a homogeneous distribution, except for a lower proportion of yellow opacity in the permanent dentition on the cleft side. In general, the most affected area in all dentitions was the incisal third. Conclusion The prevalence of enamel alterations affecting incisors adjacent to the cleft was higher than for incisors on the noncleft side. This difference also was present in the permanent dentition.

A Three-Dimensional Computed Tomographic Analysis of the Cervical Spine in Unoperated Infants with Cleft Lip and Palate

2006 ◽  
Vol 43 (5) ◽  
pp. 513-518 ◽  
Author(s):  
Zainul A. Rajion ◽  
Grant C. Townsend ◽  
David J. Netherway ◽  
Peter J. Anderson ◽  
Asilah Yusof ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Abnormal Development ◽  
Posterior Arch ◽  
Cross Sectional ◽  
Computed Tomography Scans ◽  
Vertebral Bodies

Objective: To investigate anatomical variations and abnormalities of cervical spine morphology in unoperated infants with cleft lip and palate. Design: Retrospective cross-sectional investigation of infants born with nonsyndromic cleft lip and palate using computed tomography scans acquired for investigation of a spectrum of clinical conditions. Setting: Computed tomography scan data were obtained from 29 unoperated cleft lip and palate infants and 12 noncleft infants of Malay origin, ages 0 to 12 months. Methods: Observational study of cervical spine computed tomography scans. Heights of cervical vertebral bodies (C2-C7) and intervertebral spaces were measured from landmarks identified from computed tomography reformats and three-dimensional computed tomography reconstructions. Linear modeling of heights and spaces, with age as a covariate, was undertaken to identify differences between the samples. Results: Anomalous features observed in the cleft lip and palate sample included short posterior arch of C1 (2/29), abnormal development of the anterior arch of C1 (2/29), and fusions of the posterior arch of C2 and C3 (2/29). No anomalies of the cervical spine were observed in the noncleft sample. Although the heights of three cervical vertebral bodies were significantly smaller and two intervertebral spaces were significantly larger in infants with cleft lip and palate compared with noncleft infants (p < .05), overall length of the cervical spine did not differ significantly between the samples. Conclusion: There was evidence for subtle upper spinal anomalies in the infant cleft lip and palate population. Our finding of reduced size of some cervical vertebral bodies may reflect delayed upper spinal development in infants with cleft lip and palate.

scholarly journals Changes in the Transverse Dimension of the Maxillary Arch of 5-Year-Olds Born With UCLP Since the Introduction of Nationwide Guidance

2021 ◽  
pp. 105566562110285
Author(s):  
Charlotte Molyneaux ◽  
Martyn Sherriff ◽  
Yvonne Wren ◽  
Anthony Ireland ◽  
Jonathan Sandy
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Transverse Dimension ◽  
Advisory Group ◽  
Second Primary ◽  
Primary Molar ◽  
Cross Sectional ◽  
Significant Difference ◽  
Maxillary Arch ◽  
Dental Casts

Objective: To determine whether the transverse dimensions of the maxillary arch of 5-year-old children with unilateral cleft lip and palate (UCLP) have changed following centralization of cleft services in the United Kingdom. Design: Retrospective cross-sectional study. Setting: Digital analysis of UCLP maxillary dental casts. Participants: All available maxillary dental casts from 5-year-old participants of the Clinical Standards Advisory Group (CSAG, N = 114) and Cleft Care UK (CCUK, N = 175) studies. Interventions: Quantitative measurements of the intercanine width (ICW), intermolar width (IMW), and the distance from the midline to the greater and lesser side canine (GC/LC) and greater side and lesser side second primary molar (GE/LE). Degree measurements of the greater and lesser arch form angles, arch length, anterior palatal depth (APD), and posterior palatal depth were also measured. Main outcome: Differences between the transverse dimensions of the maxillary arch for the CSAG and CCUK cohorts. Results: In 5 (ICW, IMW, LC, LE, and APD) of the 11 measurements, there was a statistically significant difference between the CSAG and CCUK cohorts. In all of these, the CCUK values were greater than CSAG. Conclusions: There have been small but positive improvements for the transverse maxillary dimensions since centralization of the UK cleft service.

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.

Dentoalveolar Growth of Patients with Complete Unilateral Cleft Lip and Palate by Early Two-Stage Furlow and Push-Back Method: Preliminary Results

2004 ◽  
Vol 41 (5) ◽  
pp. 519-525 ◽  
Author(s):  
Taiji Kitagawa ◽  
Hiroshi Kohara ◽  
Taiji Sohmura ◽  
Junzo Takahashi ◽  
Takashi Tachimura ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Laser Scanner ◽  
Japanese Patients ◽  
Horizontal Direction ◽  
Two Stage ◽  
Cross Sectional ◽  
Growth Changes ◽  
Deciduous Molar

Objective This study examined dentoalveolar growth changes prior to the time of palatoplasty up to 3 years of age by the early two-stage Furlow and push-back methods. Subjects Thirty-four Japanese patients with complete unilateral cleft lip and palate (UCLP) treated with either a two-stage Furlow procedure (Furlow group: seven boys, eight girls) from 1998 to 2002 or a push-back procedure (push-back group; 12 boys, 7 girls) from 1993 to 1997. Method Consecutive plaster models were measured by three-dimensional laser scanner, before primary palatoplasty, before hard palate closure (Furlow group only), and at 3 years of age. Bite measures were taken at 3 years of age. Results In the Furlow group, arch length, canine width, first and second deciduous molar width and cross-sectional area, and depth and volume at midpoint showed greater growth than in the push-back group. In the Furlow group, the crossbite score was also better than in the push-back group at 3 years of age. In comparison with the push-back group, inhibition of growth impediment in the anterior region was observed in the horizontal direction in the Furlow group. In the midregion, it was observed in the horizontal and vertical directions, and in the posterior region it was observed in the horizontal direction. Conclusion The results demonstrate that the early two-stage Furlow method showed progressive alveolar growth. Therefore, the early two-stage Furlow method is a more beneficial procedure than the push-back method.

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