Anterior Arch Width Research Articles

Analysis of the relationship among maxillary anterior teeth width, anterior arch perimeter and anterior segment depth

To analyze the relationship between the width of the maxillary anterior teeth and the anterior arch perimeter, to analyze the change rule of the width of the anterior teeth and the anterior arch perimeter, when altered the convexity of the anterior arch, with the width of the maxillary anterior arch keeping constant, and to provide a reliable basis for later digitized and personalized aesthetic analysis of front teeth. In the study, 61 front teeth complete and well-arranged models had been selected from the working models after the prostheses in Department of Prosthodontics, Peking University School and Hospital of Stomatology, including 22 male models and 39 female models. A photograph was taken from the occlusal surface of each model using the fixed magnification with a single lens reflex camera. The width of anterior teeth, the width of anterior arch and the convexity of anterior arch had been measured using the Photoshop software. The ratio of the width of the anterior teeth to the width of the anterior arch was calculated. Keeping the width of anterior arch unchanged, the layer free transformation function used to add or decrease the curvature of the anterior arch from 1-5 mm, each circumference of the anterior arch was measured. According to the proportion of their anterior teeth in the anterior arch perimeter, the width of each anterior teeth crown under different convexities of anterior arch was calculated. SPSS 23.0 was used to analyze the ratio of the width anterior teeth to the anterior arch perimeter and correlation between the convexity of the anterior arch and the width of the anterior teeth. The percentages of the median length of the anterior arch in the central incisor, lateral incisor and canine were 36.2%±1.3%, 30.2%±1.5%, and 33.6%±1.4%, respectively. The proportions were normal distributions and not related to the perimeter of the anterior arch. When the width of the anterior arch was constant, there was a positive correlation between the convexity of anterior arch in the range of 5 mm and the width of anterior teeth or the front arch circumference. With each increase or decrease of 1 mm of the convexity of anterior arch, the width of the middle incisor increased or decreased by about 0.18 mm, the half circumference of the anterior arch increased or decreased by about 0.50 mm. The width of the anterior teeth in the middle-distal direction remained stable in the anterior arch circumference. Within a certain range, when the width of the maxillary anterior arch remains unchanged, the width of the anterior teeth and the perimeter of the anterior teeth are positively correlated to the convexity of the anterior arch.

Early Progressive Maxillary Changes with Nasoalveolar Molding: Randomized Controlled Clinical Trial.

Quantitative assessment of 3-dimensional progressive changes of the maxillary geometry in unilateral cleft lip palate (UCLP) with and without nasoalveolar molding (NAM). The study was designed as a prospective 2-arm randomized controlled clinical trial conducted in parallel. Forty infants with nonsyndromic UCLP were randomly assigned into a NAM-treated group (n = 20) and non-NAM treated group (n = 20). A total of 120 laser-scanned maxillary casts were collected and blindly analyzed via a modified algorithm at T0 (initial visit; baseline), T1 (after 3 wk; first interval), and T2 (after 6 wk; second interval). The main outcome measures were the amount and rate of cleft gap changes, the midline position, and the transverse, sagittal, and vertical growth through intervals. More than 50% of the cleft gap (56.42%; P < 0.001) was reduced in the first 3 wk of alveolar molding (AM). The end point of the AM was obtained in 6 wk (86.25%; P < 0.001); then, the kinks of the greater segment were noticed. The AM effect decreased as far as posterior; the anterior arch width reduced slightly (1.23%; P < 0.001), while the middle and posterior arches increased slightly (P > 0.999 and P = 0.288, respectively). The posterior arch width was the least changing and was considered a baseline, while the anterior was the pivot of the segment rotation. Both groups showed different patterns of segment rotation and sagittal growth. The non-NAM treated group showed a slight increase in cleft gap length, arch width, and midline position. Based on this study, it was concluded that the NAM treatment is effective in minimizing cleft severity and realigning maxillary segments without the deterioration of the transverse and vertical arch growth. Near follow-up visits are recommended to monitor the rapid gap reduction within the first 3 wk. Further trials are recommended to compare the outcomes regarding the sagittal growth to reference values (ClinicalTrials.gov NCT03029195). The results of this study will help clinicians understand nasoalveolar molding biomechanics that may improve the treatment outcomes for patients with unilateral cleft lip and palate. The trial data can be a valuable guide to the qualitative and quantitative predictive virtual molding in computer aided design-simulated nasoalveolar molding therapy. The modified algorithm can be used by researchers to quantify the rate, the sequence, and the direction of the maxillary segments movement in unilateral cleft lip and palate.

Changes of mandibular dental arch shape during adolescence and its influence on late mandibular incisor crowding.

The aim was to analyze the changes in mandibular dental arch shape during adolescence and assess its relation to late mandibular incisor crowding. Longitudinal study included 68 orthodontically untreated subjects (49% female) and analyzed their data for the ages of 12, 15, 18 and 21 years. Measurements included anterior arch depth, intercanine, interpremolar/anterior and intermolar/posterior width, Little's Irregularity and Bolton's index and the ratio between anterior arch depth and width. Males had significantly greater posterior widths than females at any age (p < 0.05). The anterior arch depth continuously decreased (p < 0.05), while width increased after the age of 18 years. Mandibular incisor crowding increased during all investigated periods (p < 0.05). The increase of intercanine width at 12-21 years of age reduced the risk for mandibular incisor crowding in the same period by 74% (OR: 0.265: 95% CI 0.076-0.931; p = 0.045). The shape of mandibular dental arch continues to change during adolescence becoming more squared while mandibular incisor crowding increases. The increase in mandibular intercanine width reduces the risk of crowding.

Anatomical study in exposed area and operating space of extended endonasal approach to the ventral region of cranio-cervical junction

Objective To explore the scope, feasibility and indications of extended neuroendoscopic endonasal approach to reveal the region of cranial-cervical junction. Methods Ten (20 sides) intact frozen adult cadaveric heads were used to simulate the extended neuroendoscopic endonasal approach to remove the anterior tubercle of atlas, part of the atlas anterior arch, odontoid and part of the slope. In the cranial-cervical junction area, we observed the exposed range and measured the distance from the nostril to the anterior tubercle of atlas, the height and width of the anterior arch of the atlas, the distance of bilateral medial margin of occipital condyle, the distance of bilateral medial margin of the foramen lacerum, the vertical distance from the occipital condyle to the homolateral foramen lacerum, and the height, anteroposterior diameter and transverse diameter of the odontoid. Results The exposed range of the extended neuroendoscopic endonasal approach was as follows: when the lesion was located at the foramen magnum, the medial margin of the occipital condyle was the boundary of both sides, the root of the odontoid was the lower boundary, and the lower edge of the occipital bone was the upper boundary. When the lesion was located at the region of cranial-cervical junction, the upper edge of the foramen lacerum on both sides was the upper boundary, and the foramen lacerum and the outer edge of the occipital condyle were the boundaries of both sides of the bone window. By measurement, the distance from the nostril to the anterior tubercle of atlas was 8.9-9.7 cm, with an average of 9.3±0.3 cm. The height of the anterior arch of the atlas was 2.3-3.0 cm, with an average of 2.7±0.3 cm; the width was 1.5-2.0 cm, with an average of 1.8±0.2 cm; the distance of bilateral medial margin of occipital condyle was 1.5-2.0 cm, with an average of 1.8±0.2 cm; the distance of bilateral medial margin of the foramen lacerum was 2.1-2.9 cm, with an average of 2.4 ±0.3 cm; the vertical distance from the occipital condyle to the homolateral foramen lacerum was 1.6-2.2 cm, with an average of 1.9±0.3 cm; the height of the odontoid was 0.9-1.3 cm, with an average of 1.1±0.2 cm, its length was 0.8-1.3 cm, with an average of 1.1±0.2 cm; the transverse diameter of the dentate was 0.9-1.2 cm, with an average of 1.0±0.1 cm.The maximum exposed area of cranio-cervical junction was 6.4-9.8 cm2, with an average of 8.6±1.6 cm2. Conclusion The extended neuroendoscopic endonasal approach with removal of the anterior tubercle of atlas and part of the atlas anterior arch could effectively reveal the cranial-cervical junction area which is suitable for the treatment of odontoid deformity, skull base depression and atlantoaxial joint dislocation as well as resection of epidural tumors in the cranial-cervical junction and ventral and ventral midline tumors. Key words: Natural orifice endoscopic surgery; Anatomy; Cranio-cervical junction; Extended endonasal approach

Evaluation of the Effects of Cheiloplasty on Maxillary Arch in UCLP Infants Using Three-Dimensional Digital Models.

To analyze and identify changes in the maxillary dental arch before and after cheiloplasty in a group of unilateral complete cleft lip and palate (UCLP) infants. This is a cohort study. Study models from 16 infants with nonsyndromic UCLP, who were treated at Khon Kaen University, were taken before (T1) and after cheiloplasty (T2). The dental models underwent a process of scanning through a 3D scanner, from which 9 linear and 2 angular landmarks were evaluated. Paired t test was used to compare the measurement statistically between T1 and T2. Alveolar cleft gap (G-L), anterior basal angle (∠GC-CC'), and anterior arch curvature angle on greater segment (∠GIC) were significantly decreased (P < .05). Contrarily, anterior ridge length of greater segment (C-I), anterior ridge length of lesser segment (L-C'), and posterior arch width (T-T') were significantly increased (P < .05) after cheiloplasty. While, anterior portion of greater segment (I-G), anterior arch width (C-C'), anterior arch depth (I⊥CC'), arch length (G⊥TT'), and arch circumference (T-C-I-G-L-C'-T') showed no significant difference. The measurements were tested using the Intraclass correlation coefficient. The coefficients indicated high reliability. Cleft gap significantly decreased after lip repair, and the anterior part of maxillary dental arch was also bent palatally after cheiloplasty without any other intervention except cheiloplasty. More studies are needed to assess the amount of lip pressure. If any convincing force is presented, an appliance to prevent undesirable pressure is indicated.

The effect of retraining hypofunctional jaw muscles on the transverse skull dimensions of adult rats

Objective: To experimentally investigate the effects of increased masticatory muscle function on the transverse cranial dimensions on adult rats with an earlier reduced masticatory muscle function.Material and method: Sixty young male rats were used. The experimental group received soft diet for a prolonged period, so that the animals developed weak masticatory muscles. A control group received ordinary hard food during the whole experimental period (27 weeks). After 21 weeks when the animals had nearly ceased their body growth the rats in the experimental group were divided into two groups. One group continued with soft diet until the end of the experiment (hypofunctional group). The other group received ordinary hard food to get the possibility to retrain their masticatory muscles (rehabilitation group). At week 21 and at the end of the experimental period (week 27), axial cephalograms were taken. Fourteen landmarks were defined to measure seven transverse distances of the skull.Results: The increase of the anterior zygomatic arch width and interzygomatic width during the experimental period were larger in the rehabilitation group compared to both the normal and the hypofunctional group.Conclusion: Retraining of masticatory muscles in adult rats leads to increase of some transverse cranial dimensions.

Three-dimensional evaluation of alveolar changes induced by nasoalveolar molding in infants with unilateral cleft lip and palate: A case-control study.

ObjectiveThe objectives of this study were to evaluate linear and volumetric alveolar changes induced by nasoalveolar molding (NAM) in infants with complete unilateral cleft lip and palate (UCLP) and compare the maxillary dimensions after NAM with the normal dimensions in infants without clefts.MethodsA total of 26 infants with UCLP treated by NAM (mean age before and after NAM: 14.20 ± 8.09 days and 118.16 ± 10.06 days, respectively) comprised the treatment group, while 26 infants without clefts (mean age: 115.81 ± 8.71 days) comprised the control group. Changes in the maxillary dimensions following NAM were measured on three-dimensional models using Mimics software, version 17.0.ResultsDuring NAM, there was a decrease in the cleft widths, maxillary arch depths, and rotation of the greater segment. While the anterior alveolar arch width exhibited a significant decrease, the posterior arch width was mostly maintained. There were no changes in the anterior vertical deviations of the alveolar segments. The alveolar crest lengths, arch circumference, and bilateral posterior volumetric measures exhibited an increase. After NAM, the anterior arch width was comparable between the treatment and control groups, whereas the posterior arch width and anterior vertical deviations were greater in the treatment group than in the control group. The maxillary arch depths, alveolar crest lengths, and maxillary volumes were smaller in the NAM group than in the control group.ConclusionsDuring NAM in infants with UCLP, the cleft width and anteroposterior and transverse alveolar dimensions exhibited a decrease while the vertical dimensions were maintained. Compared with infants without clefts, those with UCLP treated by NAM exhibited sagittal and vertical alveolar growth deficiencies and tissue insufficiency.

Change in Anterior Crowding over 20 Years from Third Decade of Life in Untreated Angle Class I Crowding.

Many studies have investigated age-related change in normal occlusion and during the post-retention phase of orthodontic treatment. None, however, have investigated such change in malocclusion. The purpose of this study was to compare age-related change in Angle Class I crowding with that in normal occlusion. Dental casts obtained from 10 men and 2 women in their 20s and then again in their 40s were digitized with a 3-dimensional laser scanner to measure anterior crowding, angulation, inclination, andarch width and length. A paired t -test was used to evaluate change in these values betweenthe two sets of casts. A student's t -test was used to compare values between the crowdingand normal groups. The casts obtained from individuals with untreated Angle Class Icrowding revealed that anterior crowding increased with age due to a decrease in thelength of the maxillary arch. Clear lingual inclination of the maxillary incisors and mesiolingual inclination of the maxillary canines were also observed. A decrease was observedin the anterior arch width and an increase in crowding due to lingual inclination of themandibular canines in the mandible. The space between the mandibular central incisors and between the mandibular lateral incisors and canines was particularly associated withan increase in crowding, suggesting that this was age-related. A comparison betweenpatients in their 40s with Angle Class I crowding and those with normal occlusion revealedthat the increase in maxillary anterior crowding was greater in the former. Mandibularanterior crowding increased at around the same rate, however.

Differences of patients with Angle class I type 1 profile before and after treated with removable orthodontic appliance

ABSTRACTIntroduction: Children with bad habit and the persistence of deciduous teeth can caused malposition of anterior permanent teeth or Angle Class I Type 1 malocclusion. One of the curative treatment is removable orthodontic appliance. The purpose of this study was to determine the difference of dental arch width, overjet and overbite in patients with Angle Class I Type 1 before and after treated with removable orthodontic appliance in Dental Student Clinic in Faculty of Dentistry Padjadjaran University. Method: The research was conducted using 33 patient study models of Angle Class I Type 1 who were treated with removable appliance from year 2014 to 2015 in accordance with the criteria. Research method statistically analyzed with paired t-test sample. The dental arch width, overjet and overbite were measured with caliper of patient study models before and after treatment with removable orthodontic appliance. Results: The difference value before and after treatment using removable orthodontic appliance were 2.8% for anterior dental arch width, 2.4% for posterior dental arch width, 10.7% for overjet and 11% for overbite. Conclusion: The differences value of dental arch width, overjet and overbite in patients with Angle Class I Type 1 before and after treated with removable orthodontic appliance showed only a little progress of the treatment caused by multiple factors. Keywords: Angle class I type 1, Dental arch width, Overjet, Overbite

Assessment of Role of Palatal Dimensions on Speech in Cleft Lip And Palate Patients Treated with And Without Presurgical Orthopaedics.

To evaluate and compare the speech in unilateral and bilateral cleft lip and palate children treated with and without presurgicalorthopaedics based on their palatal dimensions.Perceptual and digital evaluation of speech in cleft lip and palate childrencompared with there palatal dimensions.Twenty subjects with a history of cleft lip and palate or velopharyngeal dysfunction and speech disorder.Group differences in speech parameters were compared between those who did and those who did not receive the presurgicalnaso alveolar moulding appliance. The results were compared perceptually and digitally by two speech pathologists. The collected data was analyzed and subjected to Independent sample T test and Inter reliability Analysis.On evaluation of the maxillary arch,anterior arch width, antero-posterior arch length and Palatal depth was increased and Alveolar cleft width was significantly decreased in PNAM cases compared to cases treated without PNAM.The speech parameters like hyper nasality,audible nasal air emission were found to be significantly reduced in PNAM cases compared to cases treated without PNAM but consonant production error and voice disorder showed no improvement.Also,the speech understandability and acceptability was remarkably increased with PNAM. All the findings of the study indicated better speech and growth in maxillary arch form and symmetry in PNAM treated cases as compared to Non PNAM. Additionally,further research is needed to analyse other benefits of PNAM other than improvement in speech.

The effects of surgical expansion of the maxillary arch and its consequences for the incisor axis

Reduced transverse maxillary dental arch width may be treated either by surgically supported rapid maxillary expansion (SRME) with conservative orthodontic appliances or by means of Le Fort I osteotomy (LFIO). Both are means of transverse maxillary expansion. Both surgical methods (SRME and LFIO) were evaluated with regard to the presurgical and postsurgical form of the maxillary dental arch and its consequences for the incisor axis by means of 32 dental casts and cephalometric analysis. In both groups, anterior and posterior dental arch width showed significant changes after surgery, but changes in anterior dental arch width were less significant after LFIO (p=0.004) than after SRME (p<0.000; t-test). Cephalometric analysis (OK1/N1) did not show any significant differences between the two surgical methods (p=0.1266; t-test). Anterior arch length was not reduced after LFIO but significantly reduced after SRME. Thus, the ideal elliptical shape of the dental arch was lost in the SRME group, which may impede esthetic outcome of the maxillary dental arch. Le Fort I osteotomy achieving direct transverse expansion should be favored over surgically supported rapid maxillary expansion if transverse expansion does not exceed 7mm.

THE MAXILLARY ARCH AND CEPHALOMETRIC MEASUREMENTS: COMPARING ETHNIC MALAYS AND ETHNIC CHINESE IN MALAYSIA

A cross-sectional study was conducted to compare maxillary arch and head measurements between ethnic Malays and Chinese. Mean ages were 23.5 years (Malay) and 21.1 years (Chinese), and both groups were brachycephalic with the cephalic index 86.4 for Malay and 85.9 for Chinese which is not significantly different between them. Means of anterior arch width (AAW), posterior-arch-width (PAW) and arch-length were significantly different between two groups. AAW and PAW were significantly different from their corresponding indices for Malays but not for Chinese. The Pont’s and Korkhaus’ Indices could not be applied to the Malays but moderately to the Chinese.

Maxillary arch width and buccal corridor changes with orthodontic treatment. Part 1: Differences between premolar extraction and nonextraction treatment outcomes

In this retrospective study, we examined and compared the pretreatment and posttreatment arch widths and buccal corridor changes in subjects who had received orthodontic treatment either with or without premolar extractions. Pretreatment and posttreatment casts, frontal smiling photographs, and lateral cephalograms of 30 extraction and 27 nonextraction patients were analyzed to determine any significant differences in arch widths, buccopalatal inclinations of the teeth, and buccal corridor widths and areas, both within and between the 2 groups. Relationships between buccal corridor measurements and corresponding arch widths and buccopalatal inclinations of the teeth were also examined. There was a significant increase in the posttreatment maxillary intercanine width in the extraction group but not in the nonextraction group. Both the pretreatment and posttreatment arch widths between the maxillary first molars and at the level of the posterior rugae were greater in the nonextraction group than in the extraction group. There were no significant differences in any buccal corridor widths or areas measured between the extraction and nonextraction subjects. Because they reflect different morphologies, there are likely to be significant differences in average maxillary anterior and posterior posttreatment arch widths in those treated with or without extractions. However, these arch width differences are not likely to be discernible in extraction and nonextraction patients as differences in the buccal corridor widths and areas.

Evaluation of dental and basal arch forms using cone-beam CT and 3D virtual models of normal occlusion

Abstract Objectives: To evaluate the relationship between the mandibular dental and basal arches using CBCT, and to assess the correlation between basal arch dimensions derived from CBCT and 3-dimensional (3D) virtual models in a cohort sample exhibiting normal occlusions. Methods: The facial axis (FA) and root centre (RC) points of mandibular teeth were identified on 32 CBCT images. FA and WALA points were digitised on 3D models of 28 mandibular casts from the same sample. The relationships between dental and basal arch dimensions, and between the two basal depth dimensions derived from RC and WALA points were statistically assessed by Pearson’s correlation. Results: Strong correlations were found between dental and basal intercanine and intermolar arch widths. Also, the basal intercanine width showed a moderate correlation with dental intermolar width and depth. The basal intercanine and intermolar widths measured on 3D models showed moderate correlations with those measurements on CBCT, whereas the basal canine and molar depths showed no correlations. Conclusions: The dental and basal anterior and posterior arch widths were strongly correlated in normal occlusion. No correlations were found between the arch depths measured from WALA points and RC points. Hence, RC points may represent more useable landmarks compared to WALA points in the evaluation of basal arch forms. It is recommended that the relationship between the dental and basal arches is evaluated during treatment planning in order to improve arch co-ordination.

Premaxillary characteristics in complete bilateral cleft lip and palate: A predictor for treatment outcome

Objectives:The aim of the current study was to investigate how bilateral cleft lip and palate (BCLP) cases responded differently to presurgical orthopedics (PSO) and primary lip repair (LR) based on premaxillary characteristics. We suggest a clinically oriented descriptive classification for BCLP based on premaxillary characteristics.Design and Setting:A retrospective longitudinal comparative study where available records of all non-syndromic patients with complete BCLP attending the Cleft Clinic, affiliated to the Oral and Maxillofacial Surgery department, Ain-Shams University, Cairo, Egypt were assessed.Sample Population and Methodology:Twenty-two cases were collected over a 4-years period from 2008 to 2011 (15 boys and 7 girls). Model assessment was performed for serial models representing four stages of treatment; M1: Prior to start of PSO, M2: At the end of PSO, M3: One month after LR, M4: Three months after LR. The premaxillary and vomerine widths were measured on M1. Models (M1-M4) were assessed for changes in anteroposterior projection, anterior arch width, intercanine width and posterior arch width and results were statistically analyzed. Intra-and postoperative surgical findings during and after primary LR were recorded. The sample was divided into two groups based on the premaxillary size and characteristics; Group R: Rudimentary premaxilla and Group P: Prominent premaxilla.Results:There was a highly significant difference in premaxillary width between the two groups (P = 0.00), changes in anteroposterior projection of the premaxilla were significant one and three months after LR. Changes in maxillary anterior arch width, intercanine and posterior arch widths were non-significant between groups. Mean age difference between the two groups was only statistically significant at the stage of LR. Surgical differences were noted between the two groups. Postoperatively as compared to group R; group P showed more premaxillary bulge and show at rest, as well as more prolabial stretching. In addition, facial profile was more convex in group P.Conclusion:The two types of BCLP outlined in this study are different from several aspects, and hence management should be modified according to each case. This descriptive classification provides a useful tool for evaluation and planning of patients with BCLP.

Arch Widths after Extraction and Nonextraction Treatment in Class I Patients

To compare pretreatment and post-treatment dental arches in relation to intercanine and intermolar width changes in extraction and nonextraction treatment in class I patients. In this retrospective study pretreatment and post-treatment dental casts of 60 patients (30 extractions of first premolars and 30 nonextractions) were selected. Anterior and posterior arch widths in the canine and molar regions from the most labial aspect of buccal surfaces, the canines and the molars were measured with the help of digital caliper on the study models and compared statistically to determine whether the dental arches were narrower after extraction treatment. At the start of the treatment there were no statistically significant differences in maxillary and mandibular intercanine widths in both groups. At the end of treatment in both the groups anterior and posterior arch width changes were not significant except for the intercanine dimension which was 0.82 mm larger (p < 0.05) in the extraction group. The extraction treatment does not result in narrower dental arches than nonextraction treatment in intercanine and intermolar region. It is documented that the arch widths determine smile esthetics and treatment stability. According to the findings of the present study the arch widths in extraction treatments are not narrower than nonextraction so there will not be any compromising effects on esthetics and treatment stability.

Maxillary arch dimensions in cleft infants in Northern Finland

Objective. The aim of this study was to examine the maxillary arch dimensions in cleft lip and/or palate infants in Northern Finland before surgery. Materials and methods. The subjects consisted of 70 Finnish cleft patients born between 1997–2004 in Northern Ostrobothnia Hospital District in Finland. The study casts were obtained before surgery at the mean age of 5.6 months (SD = 2.2). There were 42 children with cleft palate (CP) (26 girls/16 boys), 13 with unilateral cleft lip and palate (UCLP) (eight girls/five boys), eight children with cleft lip (CL)(two girls/six boys) and seven with bilateral cleft lip and palate (BCLP) (two girls/five boys). Conventionally-used landmarks were marked on study casts and cleft width, arch circumference, anterior and posterior arch width and arch length were measured with a digital sliding calliper. The statistical method was ANOVA. Results. The prevalence of CP in this study, 60% of all clefts, is higher than the average standards. There were statistically significant differences in cleft width, posterior and anterior arch width, arch length and arch circumference, when different cleft groups were compared. When differences between girls and boys were compared, boys had larger cleft size and arch dimensions generally, but the results were not statistically significant. Conclusions. The results show the large variation in the severity of cleft lip and/or palate deformity at birth and in maxillary arch dimensions between different cleft types. It also demonstrates the effect of phenotypic variability within the groups of cleft lip and/or palate.

Maxillary Arch Dimensions and Spectral Characteristics of Children With Cleft Lip and Palate Who Produce Middorsum Palatal Stops

The purpose of this study was twofold: (a) to determine maxillary arch dimensions of children with repaired cleft lip and palate (CLP) who produced middorsum palatal stops and (b) to describe some spectral characteristics of middorsum palatal stops. Maxillary arch width, length, and height dimensions and first spectral moments of /t/-/k/ contrast words were determined for three groups of children ages 7-11 years: (a) with CLP who were clinically judged to produce middorsum palatal stops ( n = 5), (b) with CLP but without middorsum palatal stops ( n = 6), and (c) typically developing controls ( n = 8). Validity of clinical judgments of middorsum palatal stops was assessed by adult listeners via forced-choice identification of /t/-/k/ contrast words. Listeners confirmed production of middorsum palatal stops for 4 of 5 children with CLP. These children had (a) the narrowest anterior maxillary arch width relative to posterior arch width ( p = .011) and (b) the lowest first spectral moment for /t/ targets ( p = .001) and the lowest /t/-/k/ difference ( p = .010). Middorsum palatal stops may occur in children with repaired CLP in response to limited anterior oral cavity space due to restricted (or collapsed) maxillary arches. First spectral moment characteristics of middorsum palatal stops are consistent with backed lingual placement during stop release.

Longitudinal Study of Effect of Hotz's Plate and Lip Adhesion on Maxillary Growth in Bilateral Cleft Lip and Palate Patients

To investigate the effects of infant orthopedic treatment and lip adhesion on maxillary growth of patients with bilateral cleft lip and palate (BCLP). Prospective longitudinal study. The present study was conducted at the Cleft Lip and Palate Center, Harapan Kita Children and Maternity Hospital, Indonesia, and the Department of Oral and Maxillofacial Surgery, Kyushu University Hospital, Japan. The study sample consisted of 53 patients with complete BCLP and 10 noncleft patients with other diseases. Patients with BCLP were divided into three groups: H (-), 11 patients treated without Hotz's plate; H (+), 24 treated with Hotz's plate; and LA-H, 18 treated with lip adhesion and Hotz's plate. Serial dental casts were obtained from each BCLP child at the following four time points: first visit, labioplasty, palatoplasty, and 5 years of age. Each maxillary dental cast was scanned, and the linear and angular dimensions were measured. Lip adhesion showed a temporary negative effect. In all patients with BCLP, the surgeries affected the growth of the anterior arch width until the age of 5 years. Collapse of the premaxilla following labioplasty in the H (-) group affected the growth of dental arch length until the age of 5 years. Treatment using Hotz's plate prevented collapse of the premaxilla, and the growth of the arch length was comparable to that observed in the noncleft group.

Relationship between occlusal findings and orofacial myofunctional status in primary and mixed dentition

The aim of this study was to provide basic representative data on the prevalence of malocclusions involving space deficiency in both primary and early mixed dentition and to examine the relationship between these malocclusions and orofacial dysfunctions. The results should be viewed from an orthodontic prevention and early treatment perspective. Orthodontic findings in the maxilla and mandible as well as the myofunctional status of 766 children in primary dentition and 2,209 children in mixed dentition were examined clinically in a cross-sectional study. The following parameters from each jaw were subjected to orthodontic analysis: crowding in the anterior and posterior regions of the maxilla and mandible in primary and mixed dentitions, deviations from normal maxillary arch forms in the primary dentition, deviations from normal anterior maxillary arch width in mixed dentition and maxillary apical base morphology in mixed dentition. Static and dynamic orofacial dysfunctions were documented with reference to specific parameters and clinical tests. Crowding was observed in every tenth child in primary dentition (10.8%) and in every second child in mixed dentition (49.7%). Habitual open mouth posture, visceral swallowing, articulation disorders and oral habits were statistically significantly more frequent in children in primary dentition presenting a narrow maxillary arch. Reduced anterior maxillary arch width (compression) was statistically more frequent in children in early mixed dentitions with habitual open mouth posture. A narrow maxillary apical base correlated positively with all the orofacial dysfunctions analyzed. Deviations from a regular arch form become apparent very early during dentition development and coexist with specific orofacial dysfunctions. They are thus important indicators for the early detection of functional abnormalities, causing deviations from normal dentition development. In children with orofacial dysfunctions the development of a narrow maxillary dental arch should be prevented by myofunctional therapy and by educating the parents. Interceptive orthodontic measures to treat a narrow maxillary arch in primary and early mixed dentition should also focus on eliminating functional disturbing factors, such as orofacial dysfunctions. Interdisciplinary cooperation with specialists in other fields of medicine, e.g. otorhinolaryngology and speech therapy, is essential to achieve this goal.