Cone-beam computed tomography-synthesized cephalometric study of operated unilateral cleft lip and palate and noncleft children with Class III skeletal relationship.

Abstract

Our objective was to compare the craniofacial hard and soft tissue characteristics between children with operated unilateral cleft lip and palate (UCLP) and children with noncleft lip and palate (non-CLP) with a Class III skeletal relationship. The study sample consisted of 30 subjects (18 boys, 12 girls; mean age, 10.21years) affected by UCLP and 30 non-CLP subjects (17 boys, 13 girls; mean age, 10.19years) as the control group. All subjects were in the mixed dentition with a Class III skeletal relationship. Cone-beam computed tomography-synthesized cephalograms were traced and evaluated, and craniofacial hard and soft tissue morphologies were compared between the UCLP and non-CLP groups. Maxillary length and gonial angle were 2.66mm shorter and 3.67° greater, respectively, in the UCLP group than those in the non-CLP group. The SNA and SNB angles describing the sagittal positions of the maxilla and mandible, respectively, relative to the cranial base were significantly smaller in the UCLP group (P<0.001 and P=0.003, respectively). However, the 2 groups had similar sagittal intermaxillary relationships with similar ANB angles (P=0.669). In the vertical dimension, the mandibular plane angle and the growth direction vector were significantly greater in the UCLP group (P=0.007 and P<0.001, respectively). Lastly, the UCLP group had a more concave soft tissue profile, manifested by a reduced facial convexity angle, as well as an acute nasolabial angle and a more protruded lower lip. Although the 2 groups had similar sagittal intermaxillary relationships, patients in the UCLP group had more retrusive maxillary and mandibular positions relative to the cranial base and more severe vertical discrepancies. Additionally, the soft tissue profiles of patients affected by UCLP were more concave, and the compensatory adaptation was less satisfactory.