Head Posture in Cleft Lip and Palate Patients with Oronasal Fistula and Its Relationship with Craniofacial Morphology

Abstract

This study aimed to evaluate the relationship between head posture and craniofacial morphology in nonsyndromic cleft lip and palate children with oronasal fistula. A total of 31 cleft lip and palate patients with a mean skeletal age of 7.59 (+/-2.11) years were involved. Fifteen had complete unilateral cleft lip and palate, 13 had complete bilateral cleft lip and palate, and three had complete cleft palate. Each of the cleft patients was matched with a noncleft Class I subject, on the basis of sex and skeletal age. Lateral cephalograms were taken of all subjects in the standardized upright posture and in orthoposition. Sixteen postural parameters and 44 morphological parameters were evaluated. The correlations with the cranio-cervical and mandibulo-cervical parameters indicated a trend of retrusion in the incisors with extention of the head. The positive nontopographical relationship between the nasolabial angle and some of the postural parameters supplemented the retrusion tendency in the upper incisors with head extension. Vertical skeletal morphological parameters correlated with the postural parameters. Cranio-cervical parameters seemed to be mostly related to mandibular position. Most of the cranio-cervical parameters measured confirmed an increased cranio-cervical angulation in the cleft sample when compared to controls. This head posture change was associated with alterations in tooth position and craniofacial morphology when comparisons were made to the control group.