Anthropometric Analysis of the Dental Arches of Five-Year-Old Children With Cleft Lip and Palate

Development of Artificial Neural Network-Based Prediction Model for Evaluation of Maxillary Arch Growth in Children with Complete Unilateral Cleft Lip and Palate

INTRODUCTION

Cleft lip and palate (CLP) are the most common congenital craniofacial deformities that can cause a variety of dental abnormalities in children. The purpose of this study was to predict the maxillary arch growth and to develop a neural network logistic regression model for both UCLP and non-UCLP individuals.

METHODS

This study utilizes a novel method incorporating many approaches, such as the bootstrap method, a multi-layer feed-forward neural network, and ordinal logistic regression. A dataset was created based on the following factors: socio-demographic characteristics such as age and gender, as well as cleft type and category of malocclusion associated with the cleft. Training data were used to create a model, whereas testing data were used to validate it. The study is separated into two phases: phase one involves the use of a multilayer neural network and phase two involves the use of an ordinal logistic regression model to analyze the underlying association between cleft and the factors chosen.

RESULTS

The findings of the hybrid technique using ordinal logistic regression are discussed, where category acts as both a dependent variable and as the study's output. The ordinal logistic regression was used to classify the dependent variables into three categories. The suggested technique performs exceptionally well, as evidenced by a Predicted Mean Square Error (PMSE) of 2.03%.

CONCLUSION

The outcome of the study suggests that there is a strong association between gender, age, and cleft. The difference in width and length of the maxillary arch in UCLP is mainly related to the severity of the cleft and facial growth pattern.

Comparative 3D study of dental arches in children with microcephaly associated with congenital Zika syndrome, orofacial cleft, and without craniofacial anomalies

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.

Maxillary arch dimensions, occlusion assessment and space conditions in patients with cleft palate in the period of deciduous dentition-A retrospective study

PURPOSE

The aim of this study was to evaluate the maxillary arch dimensions, dentoalveolar relationships and spacing conditions in patients with cleft palate in comparison with the control group.

METHODS

The subjects consisted of 31 children with cleft palate only (CP) aged 5.5 ± 0.51 (20 with a cleft of hard and soft palate (SHPC group) and 11 with a cleft of soft palate only (SPC group)). In the control group 30 subjects had a normal occlusion at age 5. Maxillary arch dimensions, dentoalveolar relationship according to the Huddard Bodenham index (HBI) and space conditions were compared with the control group.

RESULTS

In all variables of maxillary arch dimensions except for total arch height the control group exhibited greater values. Most of the significant differences were on account of differences between the control and the SHPC group, with only three comparisons yielding significant results when comparing the two groups of children with clefts (SHPC vs SPC, IV-IV central: p_{Dunnett T3}= 0.0002, 95%CI_Difference=-9.9-(-3.18); V-V distopalatal cusps: p_{Dunnett T3}= 0.0002, 95%CI_Difference=-9.97-(-3.17); Total arch length: p_{Dunnett T3}= 0.0014, 95%CI_Difference=1.74-7.85). The three groups differed significantly in anterior HBI only (H_{Kruskal-Wallis}=15.56, p = 0.0067). The spacing conditions in both jaws were also shown to be significantly dependent on the group of subjects studied (Upper jaw: χ²_omnibus= 16.79, p = 0.0018; lower jaw: χ²_omnibus= 13.75, p = 0.0102).

CONCLUSIONS

The growth of the upper dental arch at the age of five is impeded in participants with CP in comparison to a control group. It is important to assess the effect of cleft subtypes on growth and development to get a better understanding.

Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study

This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.

A Narrative Review on Non-Invasive Diagnostic Tools for the Analysis of Dental Arches in Orofacial Cleft Patients

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.

Six-year post-surgical evaluation in the treatment protocols in the dental arches of children with oral cleft: longitudinal study

Oral cleft surgical repairs are performed using different techniques worldwide.

Evaluation of cheiloplasty and palatoplasty on palate surface area in children with oral clefts: longitudinal study

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.

Digital Volumetric Monitoring of Palate Growth in Children With Cleft Lip and Palate

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.

Innovative method to assess maxillary arch morphology in oral cleft: 3d-3d superimposition technique

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.

Prospective cohort 3D study of dental arches in children with bilateral orofacial cleft: Assessment of volume and superimposition

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.

Maxillary Arch Dimensions in 6-Year-Old Cleft Children in Northern Finland: A Cross-Sectional Study

The aim was to cross-sectionally examine the maxillary arch dimensions in 6-year-old children with cleft lip and/or palate and to compare them with the initial cleft sizes among patients with cleft palate. The study included 89 patients with clefts treated at the Oulu University Hospital. The subjects were divided into three groups: cleft palate, cleft lip, and cleft lip and palate. Study casts were scanned, and the maxillary arch dimensions were examined using a 3D program (3Shape Orthoanalyzer, Copenhagen, Denmark). The statistical methods Student's t-test and one-way ANOVA were used to compare the means (SD) between the groups. Spearman's correlation coefficient was used to determine the correlation between cleft severity and maxillary dimensions. A significant difference was found between different initial cleft sizes in terms of distance between the second deciduous molar and the first incisor on the right side. The intermolar width showed a negative correlation with the initial cleft size. The dimensions were shorter for clefts affecting the palate and largest for clefts affecting only the lip. Larger clefts resulted in a shorter maxilla on the right side. Many dimensions became shorter when the initial cleft was larger. Clefts of the palate resulted in smaller maxillas.