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Tabellion M, Lisson JA. Three-dimensional analysis of palatal morphology and PAS in patients with cleft lip and palate prior to orthodontic treatment. Head Face Med 2024; 20:40. [PMID: 39090693 PMCID: PMC11293093 DOI: 10.1186/s13005-024-00440-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 07/16/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Since many different conclusions of craniofacial anomalies and their relation to the posterior airway space coexist, this comparative clinical study investigated the palatal morphology concerning volumetric size, posterior airway space dimension and the adenoids of patients with and without a cleft before orthodontic treatment. METHODS Three-dimensional intraoral scans and cephalometric radiographs of n = 38 patients were used for data acquisition. The patients were divided into three groups: unilateral cleft lip and palate (n = 15, 4 female, 11 male; mean age 8.57 ± 1.79 years), bilateral cleft lip and palate (n = 8, 0 female, 8 male; mean age 8.46 ± 1.37 years) and non-cleft control (n = 15, 7 female, 8 male; mean age 9.03 ± 1.02 years). The evaluation included established procedures for measurements of the palatal morphology and posterior airway space. Statistics included Shapiro-Wilk-Test and simple ANOVA (Bonferroni) for the three-dimensional intraoral scans and cephalometric radiographs. The level of significance was set at p < 0.05. RESULTS The palatal volume and cephalometric analysis showed differences between the three groups. The palatal volume, the superior posterior face height and the depth of the bony nasopharynx of patients with cleft lip and palate were significantly smaller than for non-cleft control patients. The superior posterior face height of bilateral cleft lip and palate patients was significantly smaller than in unilateral cleft lip and palate patients (BCLP: 35.50 ± 2.08 mm; UCLP: 36.04 ± 2.95 mm; p < 0.001). The percentage of the adenoids in relation to the entire nasopharynx and the angle NL/SN were significantly bigger in patients with cleft lip and palate than in the non-cleft control. In particular, the palatal volume was 32.43% smaller in patients with unilateral cleft lip and palate and 48.69% smaller in patients with bilateral cleft lip and palate compared to the non-cleft control. CONCLUSIONS Skeletal anomalies relate to the dimension of the posterior airway space. There were differences among the subjects with cleft lip and palate and these without a cleft. This study showed that the morphology of the palate and especially transverse deficiency of the maxilla resulting in smaller palatal volume relates to the posterior airway space. Even the adenoids seem to be affected, especially for cleft lip and palate patients.
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Affiliation(s)
- Maike Tabellion
- Department of Orthodontics (G56), Saarland University, Kirrberger Strasse 100, 66424, Homburg/Saar, Germany.
| | - Jörg Alexander Lisson
- Department of Orthodontics (G56), Saarland University, Kirrberger Strasse 100, 66424, Homburg/Saar, Germany
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Delay A, Bellier A, Giot JP, Bettega G, Morand B. The influence of three different primary treatment protocols on 5-year-old maxillary growth in patients with complete unilateral cleft lip and palate. J Craniomaxillofac Surg 2024; 52:922-930. [PMID: 38729845 DOI: 10.1016/j.jcms.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/13/2024] [Accepted: 04/27/2024] [Indexed: 05/12/2024] Open
Abstract
The study evaluated the effects of three different primary treatment protocols on maxillary growth in patients aged 5 years with complete unilateral cleft lip and palate (UCLP). The secondary objective was to assess the influence of initial cleft severity, family history of class III, and status of permanent lateral incisor on maxillary growth. In total, 54 patients with non-syndromic complete UCLP were included and grouped as follows: group An underwent lip adhesion, cheilorhinoplasty associated with tibial periosteal graft for hard palate repair, and finally veloplasty; group B underwent lip adhesion, then cheilorhinoplasty with intravelar veloplasty, and finally a hard-palate repair; group C underwent cheilorhinoplasty with intravelar veloplasty and then a hard-palate repair. Five-year maxillary growth was assessed on dental models, both clinically and digitally. No difference was found with GOSLON-Yardstick scoring. Five-year measurements showed that group C tended to have the best maxillary arch morphology (p = 0.012). Initial cleft severity did not impact maxillary growth, but status of permanent lateral incisor and family history of class III did (p = 0.019 and p = 0.004, respectively). In patients aged 5 years, the two-stage approach appeared to be the least detrimental to growth development. Predictive factors for growth retardation included the absence of lateral incisor and a family history of class III.
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Affiliation(s)
- Alexandra Delay
- Maxillo-facial and Plastic Surgery Department, Grenoble Alpes University Hospital, University Grenoble Alpes, F-38000, Grenoble, France.
| | - Alexandre Bellier
- Clinical Investigation Center, Grenoble Alpes University Hospital, University Grenoble Alpes, F-38000, Grenoble, France
| | - Jean-Philippe Giot
- Maxillo-facial and Plastic Surgery Department, Grenoble Alpes University Hospital, University Grenoble Alpes, F-38000, Grenoble, France
| | - Georges Bettega
- Maxillo-facial Surgery Department, Annecy Genevois Hospital, Annecy, France
| | - Beatrice Morand
- Maxillo-facial and Plastic Surgery Department, Grenoble Alpes University Hospital, University Grenoble Alpes, F-38000, Grenoble, France
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Agell Sogbe A, Mitiko Aseka Garcia M, Souza Lima Wan-Dall B, Sierra NE, da Silva Freitas R. Comparative Study of Maxillary Growth in Patients With Unilateral Cleft Treated With and Without Pre-Surgical Orthopedics. Cleft Palate Craniofac J 2024; 61:957-964. [PMID: 36655299 DOI: 10.1177/10556656221149784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Compare the maxillary growth of patients with Unilateral Cleft treated with pre-surgical Functional Maxillary Orthopedic (FMO) and that of who underwent a surgical procedure with no previous use of appliances. Prospective study, the patients were divided into 2 groups. G1, was composed of 12 patients who received no pre-surgical intervention and cheilorhinoplasty at 6 months of age and G2, included 12 patients treated using Pre-Surgical Funtional Maxilary Orthopedic; they underwent no surgery during the study. Measurements were taken at three times: before the first month of life, at 6 months and between 9-12 months of age. Cleft distance (anterior, medium and posterior), maxillary width (anterior, medium and posterior) and minor and major segment width were analyzed. Alveolar Cleft decrease was 79.82% in G1 and 52% in G2. Posterior Cleft decrease was 24.1% in G1 and 41.77% in G2. Greater Segment Width increase was 24.53% for the patients in G1, and 37.47% for the patients in G2. As for Inter Canine Width, a decrease of 5.16% in G1 and an increase of 9.19% in G2 were found. Medium Arch Width only increased in a statistically significant manner in G2 9.02%. Surgery allowed for the closure of the alveolar cleft. FMO made it possible to close the anterior and the posterior clefts through the growth of the maxillary segments, increased the transverse growth of the maxilla and could prevent maxillary collapse. Each team must individually evaluate whether to indicate or not the use of preoperative orthopedics.
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Affiliation(s)
- Adriana Agell Sogbe
- Pediatric Oral and Maxillofacial Surgery Unit, Vall d´Hebron University Hospital, Barcelona, Spain
| | | | | | - Nicolas E Sierra
- Pediatric Oral and Maxillofacial Surgery Unit, Vall d´Hebron University Hospital, Barcelona, Spain
- Comprehensive Cleft Care Center, Mobile Surgery International, Oaxaca, Mexico
| | - Renato da Silva Freitas
- Plastic Surgery Unit, Department of Surgery, School of Medicine, Federal University of Parana (UFPR), Curitiba, Brazil
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Kluge J, Bruggink R, Pandis N, Unkovskiy A, Jost-Brinkmann PG, Kuijpers-Jagtman AM, Bartzela T. Longitudinal Three-Dimensional Stereophotogrammetric Growth Analysis in Infants with Unilateral Cleft Lip and Palate from 3 to 12 Months of Age. J Clin Med 2023; 12:6432. [PMID: 37892569 PMCID: PMC10607132 DOI: 10.3390/jcm12206432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
This longitudinal study aimed to evaluate facial growth and soft tissue changes in infants with complete unilateral cleft lip, alveolus, and palate (CUCLAP) at ages 3, 9, and 12 months. Using 3D images of 22 CUCLAP infants, average faces and distance maps for the entire face and specific regions were created. Color-coded maps highlighted more significant soft tissue changes from 3 to 9 months than from 9 to 12 months. The first interval showed substantial growth in the entire face, particularly in the forehead, eyes, lower lip, chin, and cheeks (p < 0.001), while the second interval exhibited no significant growth. This study provides insights into facial soft tissue growth in CUCLAP infants during critical developmental stages, emphasizing substantial improvements between 3 and 9 months, mainly in the chin, lower lip, and forehead. However, uneven growth occurred in the upper lip, philtrum, and nostrils throughout both intervals, with an overall decline in growth from 9 to 12 months. These findings underscore the dynamic nature of soft tissue growth in CUCLAP patients, highlighting the need to consider these patterns in treatment planning. Future research should explore the underlying factors and develop customized treatment interventions for enhanced facial aesthetics and function in this population.
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Affiliation(s)
- Jennifer Kluge
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
| | - Robin Bruggink
- Radboudumc 3D Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, Freiburgstraße 7, 3010 Bern, Switzerland (A.M.K.-J.)
| | - Alexey Unkovskiy
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow 119146, Russia
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, Freiburgstraße 7, 3010 Bern, Switzerland (A.M.K.-J.)
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
- Faculty of Dentistry, Universitas Indonesia, Campus Salemba, Jalan Salemba Raya No. 4, Jakarta 10430, Indonesia
| | - Theodosia Bartzela
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
- Department of Orthodontics, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
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Moreira Machado MAA, Passucci Ambrosio EC, Bringel M, Moffa EB, Siqueira WL, Oliveira TM. Comparative 3D study of dental arches in children with microcephaly associated with congenital Zika syndrome, orofacial cleft, and without craniofacial anomalies. SPECIAL CARE IN DENTISTRY 2023; 43:572-578. [PMID: 36529535 DOI: 10.1111/scd.12800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 09/15/2022] [Accepted: 10/10/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The dentist participates in the treatment protocol for craniofacial anomalies in individuals from the first months of life. OBJECTIVE to compare in a retrospective cohort study the morphometry of the edentulous palate of children microcephaly associated with congenital Zika syndrome (CZS), unilateral complete cleft lip and alveolus (UCL), and without craniofacial anomalies. METHODS Forty-five digitized dental molds composed the sample divided into three groups: CZS; UCL; and without craniofacial anomalies (control group). The following measurements were evaluated: intercanine and intertuberosity distances; dental arch length, area, volume, and mismatch superimposition. Parametric and non-parametric tests were applied (α = 5%). RESULTS CZS group showed the smallest means of intercanine distance and area than those of the other groups (p = .001 and p = .010, respectively). The dental arch length was greater in the CZS group than in the control group (p = .020). The evaluation of the mismatch superimposition showed that the CZS group had the lowest means of maximum distance and root mean square than that of the UCL group (p = .025 and p = .005, respectively). CONCLUSION CZS participants tended to palatal narrowing, while UCL individuals had parameters similar to those of the control group, despite the alveolus defect.
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Affiliation(s)
| | - Eloá Cristina Passucci Ambrosio
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Mayara Bringel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Eduardo Buozi Moffa
- School of Dentistry, University Center - UNIFAE, São João da Boa Vista/São Paulo, Brazil
- School of Dentistry, Federal University of Alfenas, Alfenas, Brazil
| | - Walter Luiz Siqueira
- College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
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Ambrosio ECP, Furiatto AP, Coutinho MS, Quagliato DR, Carrara CFC, Machado MAAM, Oliveira TM, Jorge PK. What Are the Effects on Palate of Early Lip Surgery in Children With Cleft Lip and Palate? Cross-Sectional Evaluation From 5-Year-Old. J Craniofac Surg 2023; 34:1748-1751. [PMID: 37418613 DOI: 10.1097/scs.0000000000009501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 05/16/2023] [Indexed: 07/09/2023] Open
Abstract
This study aimed to evaluate the postsurgical effects from 5 years on the palate after surgical repair of the lip at 3 or 9 months of age in children with cleft lip and palate. Eighty-four digitized dental impressions were divided into the following groups: group 1 (G1): lip surgery at 3 months of life; group 2 (G2): lip surgery at 9 months of life; group 3 (G3): without orofacial cleft. Five angular (C'IC, ICM, IC'M', CMM', and C'M'M) and 3 linear parameters (C-C', c-c', and M-M') were evaluated. Statistical analysis was applied with α=5%. Intraclass Correlation Coefficient was significantly smaller in G1 than in G3 ( P =0.005), while IC'M' was significantly smaller in G3 than in G1 ( P <0.001). C'M'M was significantly smaller in G1 than in G2 and G3 ( P <0.001). The distances C-C' and c-c' were significantly smaller in G1 than in G2 and G3 ( P <0.001). There was a statistically significant difference in both G1 and G2 ( P <0.001, in all) in the analysis of palatal symmetry. Linear regression analysis showed that the, 11.2% of outcomes determined by c-c' distance can be explained by the age of lip repair ( P =0.013). In conclusion, lip surgery at 3 months of life showed a tendency toward more restriction in 5-year postsurgery palate development. The age of cheiloplasty is one of the factors that can influence palatal development; however, other factors may be associated and should be studied.
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Affiliation(s)
| | - Arthur P Furiatto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru/SP, Brazil
| | - Marcelli S Coutinho
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru/SP, Brazil
| | - Débora R Quagliato
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru/SP, Brazil
| | | | | | - Thais M Oliveira
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru/SP, Brazil
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru/SP, Brazil
| | - Paula K Jorge
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru/SP, Brazil
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A Narrative Review on Non-Invasive Diagnostic Tools for the Analysis of Dental Arches in Orofacial Cleft Patients. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101533. [PMID: 36291469 PMCID: PMC9600360 DOI: 10.3390/children9101533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/27/2022] [Accepted: 10/01/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND It is necessary to analyze and monitor the facial growth of orofacial cleft patients. The documentation should therefore begin before and after primary surgeries. Technological evolution has transformed plaster models into 3D images through scanners that allow rational storage, manipulation, and rotation without the possibility of breakage or damage. Based on this fact, this narrative review aims to provide a feature on the three-dimensional tools available for the assessment of dental arches in children with orofacial cleft and mixed dentition. MATERIAL AND METHODS Three databases were chosen (PubMed, ScienceDirect, and Scopus) and keywords were used to select papers. RESULTS During the database screening, 292 potentially relevant papers were found. After removing duplicates, titles, and abstracts, 32 papers presented qualifications for analysis. Through evaluating each document by reading it one by one, 24 papers fulfilled the eligibility criteria. CONCLUSIONS It was concluded that digital tools-i.e., benchtop scanners which evaluate the dental arches of children with cleft lip, palate, and mixed dentition-are reproducible and reliable, without the use of ionizing radiation, allow storage, manipulation with sustainability, and help preserve the environment.
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Jorge PK, Chagas NV, Ambrosio ECP, Carrara CFC, Valarelli FP, Machado MAAM, Oliveira TM. Surgical effects of rehabilitation protocols on dental arch occlusion of children with cleft lip and palate. BRAZILIAN JOURNAL OF ORAL SCIENCES 2022. [DOI: 10.20396/bjos.v21i00.8666343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: to evaluate the surgical effects of two rehabilitation protocols on dental arch occlusion of 5-year-old children with or without cleft lip and palate. Methods: this is a retrospective longitudinal study the sample comprised 45 digitized dental casts divided into followed groups: Group 1 (G1) – children who underwent to cheiloplasty (Millard technique) at 3 months and to one-stage palatoplasty (von Langenbeck technique) at 12 months; Group 2 (G2) – children who underwent to cheiloplasty (Millard technique) and two-stage palatoplasty (Hans Pichler technique for hard palate closure) at 3 months and at 12 months to soft palate closure (Sommerlad technique); and Group 3 (G3) – children without craniofacial anomalies. Linear measurements, area, and occlusion were evaluated by stereophotogrammetry software. Shapiro-Wilk test was used to verify normality. ANOVA followed by posthoc Tukey test and Kruskal-Wallis followed by posthoc Dunn tests were used to compared groups. Results: For the measures intercanine distance (C-C’), anterior length of dental arch (I-CC’), and total length of the dental arch (I–MM’), there were statistical differences between G1x G3 and G2xG3, the mean was smaller for G1 and G2. No statistically significant differences occurred in the intermolar distance and in the dental arch area among groups. The occlusion analysis revealed significant difference in the comparison of the three groups (p=0.0004). Conclusion: The surgical effects of two rehabilitation protocols affected the occlusion and the development of the anterior region of the maxilla of children with oral clefts when compared to children without oral clefts.
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Ambrosio ECP, Sartori IC, Jorge PK, Carrara CFC, Valarelli FP, Machado MAAM, Oliveira TM. Six-year post-surgical evaluation in the treatment protocols in the dental arches of children with oral cleft: longitudinal study. J Appl Oral Sci 2022; 30:e20220120. [PMID: 35920507 PMCID: PMC9586431 DOI: 10.1590/1678-7757-2022-0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/22/2022] [Indexed: 11/21/2022] Open
Abstract
Oral cleft surgical repairs are performed using different techniques worldwide.
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Affiliation(s)
- Eloá Cristina Passucci Ambrosio
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | - Isabela Castro Sartori
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | - Paula Karine Jorge
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | | | | | - Maria Aparecida Andrade Moreira Machado
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil.,Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | - Thais Marchini Oliveira
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil.,Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
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Evaluation of cheiloplasty and palatoplasty on palate surface area in children with oral clefts: longitudinal study. Br J Oral Maxillofac Surg 2022; 60:437-442. [PMID: 35351327 DOI: 10.1016/j.bjoms.2021.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/04/2021] [Indexed: 11/20/2022]
Abstract
This study evaluated the palatal surface area in children with different oral clefts after primary surgeries and at five years of age. This longitudinal study was composed by 216 digital models: unilateral complete cleft lip (UCL), unilateral complete cleft lip and palate (UCLP), and complete cleft palate (CP). The models were analysed at four time periods: T1 (before cheiloplasty), T2 (before palatoplasty), T3 (after palatoplasty); and T4 - (at five years of age). Area of the dental arches was measured through stereophotogrammetry software. Measurements evaluated with Student's test and ANOVA followed by the Tukey test (p<0.05) (AQ 1). In the UCL group, the palatal surface area significantly increased among phases. In the primary surgery periods, UCLP and CP significantly decreased (p<0.001). Palatal area in the UCLP group was significantly greater than the CP group. Overall, no statistically significant differences occurred among groups. At T4, the area of the palate in the UCL group was significantly greater than the UCLP group and no significant differences occurred between UCLP and CP groups. This study suggests that cheiloplasty did not inhibit the growth of the palatal surface area in children with UCL and UCLP. Palatoplasty significantly decreased the palatal area in children with UCLP and CP, demonstrating a significant negative effect of palatal repair on maxillary growth. At five years, children with UCLP and CP had a significantly smaller palate area than those with UCL.
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Singhania S, Bhojraj N. Early Maxillary Dentoalveolar Changes in Children with Unilateral Cleft Lip and Palate After Palatal Repair: A Pilot Study. Cleft Palate Craniofac J 2021; 59:1546-1554. [PMID: 34812086 DOI: 10.1177/10556656211053765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To assess early maxillary dentoalveolar changes in children with unilateral cleft lip and palate (UCLP) up to 6 months after palatoplasty. DESIGN Pilot study. PATIENTS AND PARTICIPANTS Eight children with UCLP at the age of 18 to 30 months, who were awaiting palatal repair, were included. INTERVENTIONS All participants with repaired lip were scheduled for palatal repair between 18 and 24 months by Bardach's technique. MAIN OUTCOME MEASURE(S) Arch widths, arch depths, and arch perimeter was measured on 32 dental casts of 8 participants at 4 time points: just prior to palatal repair (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after palatal repair. Manual method using digital vernier caliper (Zhart, India) was used for model analysis. Intraexaminer reliability was also assessed. RESULTS Only one examiner assessed all the dental casts after blinding. There was a significant decrease in the intercanine width (29.75 ± 1.98 mm at T1 to 26.42 ± 1.67 mm at T4; P < .001) and anterior arch depth (9.86 ± 1.07 mm at T1 to 8.29 ± 1.51 mm at T4; P < .001). Growth occurred in intertuberosity width (38.18 ± 1.40 mm at T1 to 39.76 ± 1.09 mm at T4; P < .001) and total arch depth (24.36 ± 1.21 mm at T1 to 26.79 ± 1.04 mm; P < .001) over 6 months post-surgery. CONCLUSIONS There was growth restriction in the anterior part of the palate, whereas the posterior region continued to grow after palatal repair. These changes were observable even in the early months after palatoplasty.
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Affiliation(s)
- Shreepriya Singhania
- 29240JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Nandlal Bhojraj
- 29240JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
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Falzoni MMM, Ambrosio ECP, Jorge PK, Sforza C, de Menezes M, de Carvalho Carrara CF, Valarelli FP, Soares S, Machado MAAM, Oliveira TM. 3D morphometric evaluation of the dental arches in children with cleft lip and palate submitted to different surgical techniques. Clin Oral Investig 2021; 26:1975-1983. [PMID: 34665341 DOI: 10.1007/s00784-021-04177-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 09/02/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aimed to compare dimensional alterations of dental arches in children with unilateral complete cleft lip and palate before and after different techniques of primary plastic surgeries. MATERIALS AND METHODS The sample was divided into two groups: group 1-cheiloplasty by Millard's technique and one-stage palatoplasty by von Langenbeck's technique; group 2-cheiloplasty by Millard's technique and two-stage palatoplasty: anterior palatoplasty by Hans Pichler's technique and posterior palatoplasty by Sommerlad's technique. Dental arches were evaluated before (T1), after the first phase (T2), and 1 year after the second phase (T3) of primary surgeries. Linear measurements and palatal area were assessed. To analyze the method's error, interclass correlation coefficient was applied. ANOVA (followed by Tukey test), dependent, and independent t-test were used (p < 0.05). RESULTS At T1, the intertuberosity distance was statistically greater in G2 (p = 0.004). At T2, the anterior length of the dental arch was statistically greater in G2 (p = 0.025), while the area of the smaller palatal segment (p = 0.001), cleft area (p = 0.014), and total area (p = 0.002) were statistically smaller in G2. At T3, the intertuberosity distance was statistically greater in G2 (p = 0.017). CONCLUSION This study suggests that cheiloplasty and one-stage palatoplasty resulted in smaller growth of maxilla than cheiloplasty and two-stage palatoplasty in the linear measurements (T-T' and I-CC') and total area of the dental arches. CLINICAL RELEVANCE Surgical protocols need to be evaluated to verify their effects aiming at improving the clinical practice of the interdisciplinary team, determining new parameters for the rehabilitation of individuals with cleft lip and palate.
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Affiliation(s)
- Maiara Miyuki Matsui Falzoni
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry - University of São Paulo, Bauru, São Paulo, Brazil
| | - Eloá Cristina Passucci Ambrosio
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry - University of São Paulo, Bauru, São Paulo, Brazil
| | - Paula Karine Jorge
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry - University of São Paulo, Bauru, São Paulo, Brazil
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Functional Anatomy Research Center (FARC), Faculty of Medicine and Surgery, Universita' Degli Studi Di Milano, Milan, Italy
| | - Márcio de Menezes
- Department of Restorative Dentistry, School of Health Science, State University of Amazonas, Manaus, Brazil
| | | | | | - Simone Soares
- Department of Prosthodontics, School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies - University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies - University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil.
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Digital Volumetric Monitoring of Palate Growth in Children With Cleft Lip and Palate. J Craniofac Surg 2021; 33:e143-e145. [PMID: 34636766 DOI: 10.1097/scs.0000000000008137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT This study aimed to evaluate longitudinally the volume of the dental arches in children with unilateral cleft lip and palate before and after the rehabilitative plastic surgeries. This is a longitudinal retrospective study was composed by 102 digitized dental casts of children with unilateral complete cleft lip (G1) and cleft lip and palate (G2). The palate volume was evaluated at 3 periods: preoperative (T1), postoperative 1 (T2), and postoperative 2 (T3). The intra- and inter-examiner reliability was analyzed by Wilcoxon test/Dahlberg formula and interclass correlation coefficient, respectively. The intragroup comparison was analyzed by Wilcoxon test and Friedman test followed by post-hoc Dunn test. Mann-Whitney test was applied for the intergroup comparison (α = 5%). G1 had a significant growth at T2 (P = 0.031). G2 demonstrated a positive development at T2, but decreased at T3 (P = 0.003). The intergroup analysis revealed that G2 showed a greater volume at T1 and T2 (P < 0.0001 and P = 0.0024, respectively). T2-T1 exhibited no statistically significant difference (P = 0.262). In conclusion, there was a volumetric increase in the dental arches after cheiloplasty followed by a reduction after palatoplasty. Further investigations are necessary to validate the preliminary results of the present study.
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Ambrosio ECP, Sforza C, Carrara CFC, Machado MAAM, Oliveira TM. Innovative method to assess maxillary arch morphology in oral cleft: 3d-3d superimposition technique. Braz Dent J 2021; 32:37-44. [PMID: 34614059 DOI: 10.1590/0103-6440202104148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/21/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to analyze the maxillary growth and development of children with oral clefts using the innovative method of 3D-3D superimposition technique. Children with unilateral complete cleft lip (UCL) and unilateral cleft lip and palate (UCLP) participated in the study. The impressions of the dental arches were executed 1 day before and 1 year after lip repair surgery. A 3D laser scanner digitized the dental models and the stereophotogrammetry system software analyzed the 3D-3D superimpositions in two groups of matches (same child, UCL and UCLP) and one group of mismatches (different individuals). The differences were evaluated by Root Mean Square (RMS) and expressed in millimeters (mm). Kruskal-Wallis test followed by post-hoc Dunn test and Mann-Whitney test were assessed to compare the groups (α=5%). RMS was 1.34 mm (± 0.37) in UCL group, 1.41 mm (± 0.32) in UCLP group, and 3.38 mm (± 1.28) in mismatches group. RMS was significantly greater in mismatches than in matches groups (p<0.0001). No statistically significant differences occurred between genders. The 3D-3D superimposition technique showed the maxillary development after lip repair surgery in the anterior region of the palate. Thus, it is suggested that the cleft amplitude and the palatal segments proportion influenced the morphological heterogeneity and, consequently, the development and maxillary growth of children with orofacial cleft.
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Affiliation(s)
- Eloá Cristina Passucci Ambrosio
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, , Bauru São Paulo, Brazil
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Functional Anatomy Research Center (FARC), Faculty of Medicine and Surgery, University of Milan , , Lombardia Milan, Italy
| | | | | | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, , Bauru São Paulo, Brazil.,Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
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15
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Pontes F, Callegaris G, Freitas RDS. Spontaneous Growth of the Palatal Plates in the Cleft Lip and Palate. Cleft Palate Craniofac J 2021; 58:1251-1256. [PMID: 33371740 DOI: 10.1177/1055665620982789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This is a prospective study examining palatal casts from patients with unilateral cleft lip and palate (UCLP) in the first month of life, immediately before cheiloplasty, and immediately before palatoplasty. None of the patients receives presurgical orthopedics (nasoalveolar molding). DESIGN In this prospective study, upper arch plaster models were taken 3 times during the treatment: in the first month of life (T1), before the cheiloplasty (T2), and before the palatoplasty (T3). Anatomic landmarks were defined and linear anthropometric measurements were obtained afterward. Dimensional analysis was performed using 3D software. Two-way analysis of variance followed by Tukey test was performed for statistical analysis. SETTING Tertiary, institutional. PARTICIPANTS Twelve patients with UCLP of either sex with less than 1 month of life and without any other syndrome. INTERVENTION No intervention was performed. MAIN OUTCOME MEASURE Reduction of the cleft without using orthopedics apparatus. RESULTS There was a statistically significant reduction in the cleft gap comparing T1 to T3. There was also a significant reduction in the intercanine width comparing T2 and T3, and T1 and T3. There was significant increase in the posterior arch width comparing T2 and T3, and T1 and T3. The palatal plate's width increased in all times analyzed. CONCLUSION The palatal cleft narrows spontaneously as well in both midpoint and posterior point during the first 6 months of patient's treatment. This event was enhanced by cheiloplasty. This surgery might have a greater influence on the anterior arch width than in the posterior arch region.
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Affiliation(s)
| | | | - Renato da Silva Freitas
- Plastic Surgery Unit, Department of Surgery, School of Medicine, Federal University of Parana (UFPR), Curitiba, Brazil
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Ambrosio ECP, Sforza C, de Menezes M, Carrara CFC, Soares S, Machado MAAM, Oliveira TM. Prospective cohort 3D study of dental arches in children with bilateral orofacial cleft: Assessment of volume and superimposition. Int J Paediatr Dent 2021; 31:606-612. [PMID: 32970887 DOI: 10.1111/ipd.12731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/25/2020] [Accepted: 09/15/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cohort studies have evaluated dental arches of children. AIM To evaluate the volumetric, linear, palatal surface area, and the dental arch superimposition of participants with bilateral complete cleft lip (BCL) and bilateral cleft lip and palate (BCLP) surgically treated in a specialized hospital. DESIGN One hundred and thirty six digitized dental models evaluated before cheiloplasty (T1), after cheiloplasty (T2), and after palatoplasty (T3). The stereophotogrammetry software analysed the volume, palate superimposition, linear, and area measurements. RESULTS In BCL group, at T2, C-C', T-T', area, and volume significantly increased (P = .000, P < .000, P = .010 e P = .003, respectively). In BCLP group, the comparison T3 × T1 showed that C-C' decreased, whereas T-T' and the area increased (P < .000, P < .000, P = .000). The volume increased at T2, but decreased at T3 (P < .000) in participants with BCLP. The intergroup analysis revealed that C-C', T-T', I-C', and I-C were significantly smaller in participants with BCLP (P < .000, P = .016, P = .001 e P = .020, respectively), whereas the volume, superimposition, and area were statistically similar between groups (P > .05). CONCLUSION The comparison between bilateral orofacial clefts showed reduction in the transversal and anteroposterior linear measurements, but not in the area and volume, which was confirmed by the superimposition of the dental arches.
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Affiliation(s)
- Eloá Cristina Passucci Ambrosio
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Chiarella Sforza
- Human Anatomy, Department of Biomedical Sciences for Health, Faculty of Medicine and Surgery, Functional Anatomy Research Center (FARC), University of Milan, Milan, Italy
| | - Márcio de Menezes
- Restorative Dentistry, School of Health Science, State University of Amazonas, Manaus, Brazil
| | | | - Simone Soares
- Department of Prosthesis, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.,Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | | | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.,Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
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Bruggink R, Baan F, Kramer G, Claessens C, Kuijpers-Jagtman AM, Bronkhorst EM, Maal TJJ, Ongkosuwito E. The effect of lip closure on palatal growth in patients with unilateral clefts. PeerJ 2020; 8:e9631. [PMID: 32821547 PMCID: PMC7396139 DOI: 10.7717/peerj.9631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/08/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives The objective of this study was to compare maxillary dimensions and growth in newborns with Complete Unilateral Cleft Lip and Palate (UCLP) to healthy newborns before and after cheiloplasty. Additionally, a palatal growth curve is constructed to give more information about the natural growth before surgical intervention. Methods Twenty-eight newborns with complete UCLP were enrolled in this study. Multiple plaster-casts of each child during their first year were collected and grouped in before and after cheiloplasty. A previous developed semi-automatic segmentation tool was used to assess the maxillary dimensions and were compared to a healthy control group. Z-scores were calculated to indicate differences between the two populations and if cheiloplasty had influence on maxillary growth. Furthermore, the prediction model created in a previous study was used to indicate differences between predictions and the outcome in UCLP measurements. The analysis was tested for inter- and intra-observer variability. Results Results show differences in alveolar and palatal shape in UCLP patients in comparison with healthy controls. Prior to cheiloplasty an increased width and alveolar length was observed while the palatal depth was decreased. After cheiloplasty the widths moved towards normal but were still significantly larger. Conclusion Infants with unilateral cleft lip and palate show a wider maxillary arch in comparison with the control population. Initial treatment has most influence on the width of the arch, which decreased towards normal.
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Affiliation(s)
- Robin Bruggink
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboudumc 3DLab, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frank Baan
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboudumc 3DLab, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gem Kramer
- "Alkmaarse Orthodontisten", Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - Colet Claessens
- Radboudumc 3DLab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, Groningen, The Netherlands.,Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland.,Faculity of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Ewald M Bronkhorst
- Department of Dentistry - Preventive and Restorative Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thomas J J Maal
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Edwin Ongkosuwito
- Radboudumc 3DLab, Radboud University Medical Center, Nijmegen, The Netherlands.,Amalia Cleft and Craniofacial centre, Radboud University Medical Center, Nijmegen, The Netherlands
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18
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Regional Differences in Municipal Solid Waste Collection Quantities in China. SUSTAINABILITY 2019. [DOI: 10.3390/su11154113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The rapid growth in urban population has led to a dramatic increase in municipal solid waste (MSW) generation, with ramifications more pronounced in developing countries. The regional Chinese governments have made great efforts to reduce MSW generation and collection quantities. However, the results of these efforts vary across cities. The purpose of this paper is to analyze the regional differences in MSW collection quantities. A two-level hierarchical linear model (HLM) was used to examine the variations in MSW collection quantities among 287 prefecture-level cites in China over the period from 2008 to 2017. The analysis reveals a strong negative correlation between the regional economic development level and the growth trend of MSW collection quantities. The empirical findings indicate that the level of economic development and waste collection measures are critical determinants of MSW collection quantities.
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Mustafa AG, Tashtoush AA, Alshboul OA, Allouh MZ, Altarifi AA. Morphometric Study of the Hard Palate and Its Relevance to Dental and Forensic Sciences. Int J Dent 2019; 2019:1687345. [PMID: 30809259 PMCID: PMC6369495 DOI: 10.1155/2019/1687345] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/25/2018] [Accepted: 01/08/2019] [Indexed: 11/24/2022] Open
Abstract
This study was conducted to identify the morphometric features of the hard palate and to test the reliability of using palatal morphology in sex determination. Three hundred maxillary casts were collected from dental clinics in north Jordan. The age and gender of the patient and the serial number for each cast were recorded. The age range was 6 to 50 years old. A caliper was used to perform the following measurements: the length, width, and depth of the hard palate. In addition, the size, shape, and position of the incisive papilla were also determined. All measurements were done by a trained examiner who was able to perform the measurements in a reproducible manner. Statistical analysis showed that the mean palatal length, width, and depth, and size of dental papilla in both groups were the highest in males. The full logistic regression model including all the three predictors (length, width, and depth) indicated that the three parameters were significantly correlated with gender in the adult group. However, in the child group, only width and length were significantly (p=0.001, p > 0.042 respectively) correlated with gender. Regarding the shape and size of the incisive papilla, they were significantly different between males and females in both adult (p > 0.03) and child (p=0.001) groups. These findings might be potentially relevant to anthropological studies aiming at individual and/or sex identification. Moreover, the results might have clinical value in prosthodontics, especially in fabricating complete maxillary dentures for edentulous patients.
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Affiliation(s)
- Ayman G. Mustafa
- College of Medicine, Qatar University, Doha, Qatar
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ayssar A. Tashtoush
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Othman A. Alshboul
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Mohammed Z. Allouh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ahmad A. Altarifi
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
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