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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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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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AMBROSIO ECP, PUCCIARELLI MGR, SFORZA C, SOARES S, MENEZES MD, CARRARA CFC, MACHADO MAAM, OLIVEIRA TM. Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study. Braz Oral Res 2023; 37:e021. [PMID: 37018803 DOI: 10.1590/1807-3107bor-2023.vol37.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/23/2022] [Indexed: 04/05/2023] Open
Abstract
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.
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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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Favorable Transverse Maxillary Development after Covering the Lateral Raw Surfaces with Buccal Fat Flaps in Modified Furlow Palatoplasty: A 3D Imaging-Assisted Long-Term Comparative Outcome Study. Plast Reconstr Surg 2022; 150:396e-405e. [PMID: 35687419 DOI: 10.1097/prs.0000000000009353] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The pedicled buccal fat flap has recently been applied to cover the lateral raw surfaces during palatoplasty as an attempt to mitigate scar-induced transverse maxillary constriction during growth, but with no formal long-term comparative analysis. This 3D imaging-assisted study assessed its impact on posterior transverse maxillary development. METHODS Cone beam computerized tomography scans from patients with unilateral cleft lip, alveolus and palate who received buccal fat flap (buccal fat group; n=22) or Surgicel (Surgicel group; n=32) for covering lateral raw surfaces during modified Furlow palatoplasty at 9-10 months old and had reached 9 years old were retrieved for analysis. Patients with unilateral cleft lip and alveolus (non-palatoplasty group; n=24) were also included for comparison. Using 3D maxillary image models, linear (U6T-MSP and U6J-MSP) and area measurements were calculated for cleft and non-cleft posterior maxillary sides as well as for total posterior transverse maxillary dimension. RESULTS The buccal fat group had significantly (all p<0.05) wider dimensions compared with the Surgicel group for all transverse maxillary measurements on both the cleft and non-cleft sides, with exception for U6J-MSP and posterior palatal area parameters on the cleft side (p>0.05). The buccal fat group had significantly (all p<0.05) wider total transverse maxillary dimensions compared with Surgicel and non-palatoplasty groups. CONCLUSION Covering the lateral raw surfaces with buccal fat flaps resulted in less posterior transverse maxillary constriction compared with the Surgicel-based covering procedure.
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Chaisooktaksin N, Chimruang J, Worasakwutiphong S, Tansalarak R. Three-dimensional Changes of Maxillary Alveolar Morphology After Using Modified Nasoalveolar Molding in Patients with Complete Unilateral Cleft lip and Palate. Cleft Palate Craniofac J 2022:10556656221086816. [PMID: 35285744 DOI: 10.1177/10556656221086816] [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 This study aimed to evaluate the three-dimensional changes in maxillary alveolar morphology after using modified NAM in patients with complete unilateral cleft lip and palate. DESIGN This is a retrospective study. SETTING The study was carried out in the dental hospital, Faculty of Dentistry of Naresuan University, Phitsanulok, which serves as a tertiary care center. PATIENTS The population sample consisted of 19 patients with nonsyndromic complete unilateral cleft lip and palate. INTERVENTION All patients received the modified NAM treatment based on the treatment protocol of the Naresuan University Cleft and Craniofacial Center, Thailand. MAIN OUTCOME MEASURE Dental models obtained at pre-treatment (T0) and post-treatment (T1) were scanned to construct the digital models. The maxillary digital models that showed dimensional changes between T0 and T1 were measured using a computer graphic software. RESULTS The modified NAM resulted in a significant decrease in the anterior cleft width, posterior cleft width, and anterior arch width. Conversely, it caused a significant increase in the length of the lesser cleft segment and the greater segment rotation. However, the change in the height of both segments and posterior arch width was not found to be significant. CONCLUSIONS The modified NAM was an effective device for reducing the alveolar cleft width while improving the alignment of alveolar cleft segments.
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Affiliation(s)
- Nuntabhorn Chaisooktaksin
- Department of Preventive Dentistry, Faculty of Dentistry, 59212Naresuan University, Phitsanulok 65000, Thailand
| | - Jutharat Chimruang
- Department of Preventive Dentistry, Faculty of Dentistry, 59212Naresuan University, Phitsanulok 65000, Thailand.,Naresuan University Cleft and Craniofacial Center, Phitsanulok 65000, Thailand
| | - Saran Worasakwutiphong
- Department of Surgery, Faculty of Medicine, 59212Naresuan University, Phitsanulok 65000, Thailand.,Naresuan University Cleft and Craniofacial Center, Phitsanulok 65000, Thailand
| | - Ratchawan Tansalarak
- Department of Preventive Dentistry, Faculty of Dentistry, 59212Naresuan University, Phitsanulok 65000, Thailand.,Naresuan University Cleft and Craniofacial Center, Phitsanulok 65000, Thailand
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Cone-beam computed tomography and digital model analysis of maxillary buccal alveolar bone thickness for vertical temporary skeletal anchorage device placement. Am J Orthod Dentofacial Orthop 2022; 161:e429-e438. [DOI: 10.1016/j.ajodo.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/19/2022]
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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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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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Huang W, Li YH, Guo KL, Zhou YC, Li XJ. [Finite element analysis of the comprehensive impact of scar and maxillary expansion combined with protraction on the development of maxilla with cleft lip and palate after repair operation]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:642-646. [PMID: 33377340 PMCID: PMC7738921 DOI: 10.7518/hxkq.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 09/07/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To study the comprehensive impact of scar and maxillary expansion combined with protraction on the development of maxilla with cleft lip and palate after repair operation. METHODS In the original finite element model of the maxilla with cleft palate, a finite element model of the maxilla with cleft lip and palate was established by using Boolean operation in ANSYS. Scar force after cleft lip and palate repair and maxillary expansion force combined with protraction were added simultaneously to process the stress analysis. RESULTS Maxillary deformation occurred in the three-dimensional direction. The comparison of displacements was as follows: X-axis>Z-axis>Y-axis. CONCLUSIONS Maxillary growth is significantly inhibited in the three-dimensional direction under the comprehensive impact of scar and maxillary expansion combined with protraction after repair operation, especially transverse and sagittal growth.
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Affiliation(s)
- Wei Huang
- Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang 050017, China
| | - Ying-Hui Li
- Dept. of Orthodontics, School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang 050017, China
| | - Kai-Li Guo
- School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang 050017, China
| | - Yong-Chuan Zhou
- Dept. of Pediatric Dentistry, School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang 050017, China
| | - Xiang-Jun Li
- Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang 050017, China
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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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