Unilateral Cleft Lip And Alveolus Research Articles

Prevalence of Simonart's band in cleft children at a cleft center in Indonesia: A nine-year retrospective study.

Simonart's band is a soft tissue band that connects the cleft gap of the base of the nostril or the margin of the alveolus. While research on the prevalence of Simonart's band in cleft lip and palate cases has been carried out in various countries, research on Simonart's band in Indonesia has yet to be conducted. This study aimed to determine the prevalence of different types of Simonart's band at a cleft center in Indonesia. The data of cleft patients were reviewed retrospectively over a 9-year period at the Cleft Lip and Palate Center Center, Harapan Kita Women and Children Hospital, Jakarta, Indonesia. The patients were divided based on the type of cleft and the type of Simonart's band. The results were analyzed by means of descriptive statistics. Out of 638 cleft patients from the period 2008-2016, 77 patients had Simonart's band. The liptolip band was most commonly found (52 cases, 67.5%). The lip-to-alveolus band was found in 20 cases (26.0%) and the alveolus-to-alveolus band had the lowest prevalence of 5 cases (6.5%). Associations between the cleft type (unilateral cleft lip and palate (UCLP), unilateral cleft lip and alveolus (UCLA), and bilateral cleft lip and palate (BCLP)) and Simonart's band type were all significant (p = 0.001, according to Fisher's exact test), which indicates significant differences in the distribution of the bands with regard to different cleft types. There was a significant difference in the distribution of the bands between the UCLP and UCLA groups (p = 0.000). On the other hand, the distribution of the bands in the UCLP group did not differ much from that in the BCLP group (p = 0.065). The prevalence of Simonart's band was significantly higher in the patients with the unilateral complete cleft of the primary and secondary palate than in the subjects with the cleft of the primary palate. In the UCLP group, most patients had the lip-to-lip band type. In the BCLP group, the majority also had the lip-to-lip band type. In contrast, in the UCLA group, the majority showed the lip-to-alveolus band type.

Three-Dimensional Analysis of Vomer Volume and Deviation in Patients With Unilateral Cleft Lip and Alveolus.

Since almost all patients with an alveolar cleft have a deviated and thickened vomer bone, the purpose of this study was to investigate the relationship between the vomer shape and the size of the alveolar cleft in patients with unilateral cleft lip and alveolus (CLA). A total of 40 adult patients with unilateral CLA were enrolled, and 40 normal adults without CLA were enrolled as controls. All patients underwent preoperative computed tomography scans and analysis by computer-aided engineering software to obtain the vomer volume (VV), deviated septal angle (DSA), and alveolar cleft volume (ACV). An independent-sample t test or nonparametric test was used to compare the VV and DSA between the unilateral CLA and control groups. The correlation between ACV, VV, and DSA in the unilateral CLA group was assessed using Pearson correlation analysis or Spearman correlation analysis. Vomer volume was significantly higher in patients with CLA (1595.35±48.45mm3) than in the control group (1043.2±164.976mm3) (P<0.001), as was DSA (13.099±7.0 versus 3.4398±1.74 degrees) (P<0.001). In the CLA group, VV and DSA were significantly associated with ACV (VV and ACV: r=0.886, P<0.001; DSA and ACV: r=0.543, P<0.001), and VV was significantly correlated with DSA (VV and DSA: r=0.582, P<0.001). In conclusion, the vomer is thicker and more convex in patients with unilateral CLA than in people without, and the vomer angle and degree of volume deviation correlate with alveolar cleft severity.

Does absence of maxillary lateral incisor affect the status of maxillary canine before and after secondary alveolar bone grafting in patients with unilateral alveolar cleft?

ABSTRACT Objectives To investigate whether absence of maxillary lateral incisor (MXLI) would affect the status of maxillary canine (MXC) before and after secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and alveolus (UCLA) and unilateral cleft lip and palate (UCLP). Materials and Methods 47 male patients with UCLA and UCLP, whose Bergland indices were type I or II after SABG, were divided into the MXLI-absence (n = 26) and MXLI-presence groups (n = 21). Using panoramic radiographs, the position, angulation, and development status of MXC on the cleft side, and the cleft width before SABG (T1) were evaluated. After full eruption of the permanent dentition (T2), the root length, root shape, and frequency of forced eruption of MXC on the cleft side were investigated. Then, statistical analysis was performed. Results Compared to the MXLI-presence group, the MXLI-absence group showed higher frequencies of mesial angulation of MXC at T1 (criteria: &amp;gt;25°; 46.2% vs 14.3%, P &amp;lt; .05) and dilaceration of MXC at T2 (26.9% vs 4.8%, P &amp;lt; .001). MXC on the cleft side showed positive correlations between horizontal position at T1 and forced eruption at T2, and between vertical position and mesial angulation at T1 and dilaceration at T2 (all P &amp;lt; .01). Conclusions In patients with UCLA and UCLP whose SABG outcome was successful, absence of MXLI on the cleft side increased only the frequencies of mesial angulation of MXC at T1 and dilaceration of MXC at T2, not frequency of forced eruption at T2.

Evaluation of Lip Morphology and Nasolabial Angle in Non-Syndromic Cleft Lip and/Palate and Non-Cleft Individuals

Objective: To investigate the variation between the non-syndromic cleft lip and/or palate (NSCLP) and non-cleft (NC) subjects in relation to the lip morphology (LM) and nasolabial angle (NLA). Materials and Methods: Lateral cephalogram (Late. Ceph.) of 123 individuals (92 NSCLP [29 = bilateral cleft lip and palate (BCLP), 41 = unilateral cleft lip and palate (UCLP), 9 = unilateral cleft lip and alveolus (UCLA), 13 = unilateral cleft lip (UCL)], and 31 NC) who did not undergo any orthodontic treatment were investigated. By WebCeph, an artificial intelligence- (A.I.) driven software, 2 (two) parameters of LM, namely upper lip to E line (LM-1) and lower lip to E line (LM-2), and NLA analysis was carried out for each individual. Multiple tests were carried out for statistical analysis. Results: The mean ± SD observed for LM-1, LM-2, and NLA for NC individuals were 1.56 ± 2.98, 0.49 ± 3.51, and 97.20 ± 16.10, respectively. On the other hand, the mean ± SD of LM-1, LM-2, and NLA for NSCLP individuals were 4.55 ± 4.23, 1.68 ± 2.82, and 82.02 ± 14.66, respectively. No significant variation was observed with respect to gender and side. NSCLP (different types) and NC individuals showed significant disparities in LM-1 and NLA. Conclusion: It can be concluded that parameters of lip morphology such as LM-1, LM-2, and NLA vary among NSCLP and NC individuals.

Sagittal Jaw Relationship of Different Types of Cleft and Non-cleft Individuals.

To investigate whether the craniofacial sagittal jaw relationship in patients with non-syndromic cleft differed from non-cleft (NC) individuals by artificial intelligence (A.I.)-driven lateral cephalometric (Late. Ceph.) analysis. The study group comprised 123 subjects with different types of clefts including 29 = BCLP (bilateral cleft lip and palate), 41 = UCLP (unilateral cleft lip and palate), 9 = UCLA (unilateral cleft lip and alveolus), 13 = UCL (unilateral cleft lip) and NC = 31. The mean age was 14.77 years. SNA, SNB, ANB angle and Wits appraisal was measured in lateral cephalogram using a new innovative A.I driven Webceph software. Two-way ANOVA and multiple-comparison statistics tests were applied to see the differences between gender and among different types of clefts vs. NC individuals. A significant decrease (p < 0.005) in SNA, ANB, Wits appraisal was observed in different types of clefts vs. NC individuals. SNB (p > 0.005) showed insignificant variables in relation to type of clefts. No significant difference was also found in terms of gender in relation to any type of clefts and NC group. The present study advocates a decrease in sagittal development (SNA, ANB and Wits appraisal) in different types of cleft compared to NC individuals.

Dental Characteristics of Different Types of Cleft and Non-cleft Individuals.

ObjectiveThe objective of this study was to compare the novel artificial intelligence (A.I.)-driven lateral cephalometric (Late. Ceph.) analysis of 14 different dental characteristics (DC) among different types of cleft lip and palate (CLP) and non-cleft (NC) individuals.Materials and MethodsA retrospective study was conducted on 123 individuals [31 = NC, 29 = BCLP (bilateral cleft lip and palate), 41 = UCLP (unilateral cleft lip and palate), 9 = UCLA (unilateral cleft lip and alveolus), and 13 = UCL (unilateral cleft lip)] with an average age of 14.77 years. Demographic details were gathered from the clinical records. A novel artificial intelligence-driven Webceph software has been used for the Late. Ceph. analysis. A total of 14 different types of angular and linear DC measurements were analyzed and compared among groups. Two-way ANOVA and multiple-comparison statistics tests were applied to see the differences between gender and among different types of CLP versus NC subjects.ResultsOf the 14 DC tested, no significant gender disparities were found (p > 0.05). In relation to different types of CLP versus NC subjects, 8 over 14 DC were statistically significant (p < 001 to p = 0.03). Six other DC variables show insignificant (p > 0.05) noteworthy alterations in relation to type of CLP.ConclusionBased on the results, type of CLP revealed significantly altered DC compared to NC. Among different types of CLP, BCLP exhibited a maximum alteration in different DC.

Relationship Between Crown to Root Ratio and Alveolar Bone Support in Patients With Unilateral Cleft Lip and Alveolus.

To evaluate the tooth lengths, crown to root ratios (CRRs), and alveolar bone support (ABS) around cleft-adjacent maxillary central incisors (U1s) in patients with unilateral cleft lip and alveolus (UCLA) and to investigate the relationships between CRR and ABS. This is a retrospective study. Cleft Lip and Palate Care Center of Shanghai Ninth People's Hospital, Shanghai, China. Fifty-eight Chinese patients with UCLA. Cone beam computed tomography data from 58 nonsyndromic patients with UCLA (36 males, 22 females; mean age = 12.65 ± 3.64 years) were evaluated. Crown length and root length, alveolar bone thickness (ABT), and the distances between the cementoenamel junction and alveolar bone crest on 4 surfaces of cleft-adjacent U1 were measured and compared with those of noncleft side in the same patients. Crown to root ratio and frequency of dehiscence were calculated and comparisons were also made between cleft and noncleft sides. Regression analysis was performed to explore the association between CRR and ABS. The CRR of cleft-adjacent U1 and alveolar bone crest heights (ACHs) on the 4 surfaces were significantly greater than those of noncleft side (P < .01). A 3 mm labial, all lingual, and apico-distal ABTs decreased on the cleft side (P < .01). A positive correlation was found between lingual ACH and CRR (R = 0.316, P < .05), between the 3 mm (R = 0.417, P < .05) and 6 mm labial (R = 0.448, P < .05) ABT and CRR. A negative correlation was found between the 3 mm and 6 mm labial ABTs and the root length. It can be suggested that the CRR is related to ACH and ABT. The lingual ACH, the 3 mm, and 6 mm labial ABTs tend to increase with the increasing CRR.

Evaluation of Sella Turcica Bridging and Morphology in Different Types of Cleft Patients.

ObjectivesTo evaluate sella turcica (ST) bridging, associated anomalies, and morphology, in subjects with four different types of clefts, and compare them with non-cleft (NC) subjects.Materials and MethodsA total of 123 (31 NC and 92 cleft) Saudi subjects who had their lateral cephalogram (Late. Ceph.), orthopantomogram (OPG), and clinical details for ordinary diagnosis were included in the study. Among 92 cleft subjects, 29 had bilateral cleft lip and palate (BCLP), 41 had unilateral cleft lip and palate (UCLP), nine had unilateral cleft lip and alveolus (UCLA), and 13 with unilateral cleft lip (UCL). ST bridging and seven parameters related to ST morphology and skeletal malocclusion were analyzed using Late. Ceph. Associated dental anomalies in ST bridging subjects were investigated using OPG. The images were investigated using artificial intelligence driven Webceph software. Multiple statistical tests were applied to see the differences between gender and among cleft vs NC subjects.ResultsST bridging was found to be higher in cleft subjects (22.82%). Most of the cleft subjects had severe skeletal Class III malocclusion associated with multiple types of dental anomalies (impacted canines, congenital missing, and presence of supernumerary teeth). No significant gender disparities in all seven parameters of ST morphology were found between NC and cleft groups. However, there were significant differences when compared among four different types of cleft individuals vs NC subjects.ConclusionST bridging is more prevalent in cleft subjects along with Class III malocclusion and associated dental anomalies. ST morphometry differs significantly between cleft vs NC subjects. BCLP exhibits smaller values of all seven parameters as compared to all other groups.

Three-dimensional evaluation of mandibular volume in patients with cleft lip and palate during the deciduous dentition period.

To examine the relationship between mandibular volume and craniofacial morphology in patients with cleft lip and palate using cone beam computed tomography (CBCT) and to compare these findings with control (noncleft) patients undergoing CBCT for other purposes during the deciduous dentition period. Eighty-four patients were categorized into the unilateral cleft lip and alveolus (UCLA) group (n = 25; mean age, 4.60 ± 0.40 years), unilateral cleft lip and palate (UCLP) group (n = 23; mean age, 4.52 ± 0.39 years), bilateral cleft lip and palate (BCLP) group (n = 22; mean age, 4.54 ± 0.37 years), and control group without cleft (n = 14; mean age, 5.19 ± 0.52 years). Mandibular volume and craniofacial cephalometric measurements were obtained using CBCT. All measurements were assessed by analysis of covariance (ANCOVA) using Bonferroni post hoc pairwise comparison tests. ANCOVA revealed no statistically significant differences in mandibular volume among the groups. SNA° and ANB° were significantly larger in the UCLA and BCLP groups than in the control group. SN-MP° was smallest in the UCLA group. Co-A in the UCLP group was shorter than in the UCLA and BCLP groups. Go-Gn was shortest in the UCLP and BCLP groups compared with the control group. Three-dimensional evaluation of craniofacial morphology using CBCT can provide valuable information on malocclusion and other dentoskeletal problems among patients with CLP.

Nasolabial symmetry and esthetics in cleft lip and palate: analysis of 3D facial images.

To determine the relationship between nasolabial symmetry and esthetics in subjects with orofacial clefts. Eighty-four subjects (mean age 10 years, standard deviation 1.5) with various types of nonsyndromic clefts were included: 11 had unilateral cleft lip (UCL); 30 had unilateral cleft lip and alveolus (UCLA); and 43 had unilateral cleft lip, alveolus, and palate (UCLAP). A 3D stereophotogrammetric image of the face was taken for each subject. Symmetry and esthetics were evaluated on cropped 3D facial images. The degree of asymmetry of the nasolabial area was calculated based on all 3D data points using a surface registration algorithm. Esthetic ratings of various elements of nasal morphology were performed by eight lay raters on a 100 mm visual analog scale. Statistical analysis included ANOVA tests and regression models. Nasolabial asymmetry increased with growing severity of the cleft (p = 0.029). Overall, nasolabial appearance was affected by nasolabial asymmetry; subjects with more nasolabial asymmetry were judged as having a less esthetically pleasing nasolabial area (p < 0.001). However, the relationship between nasolabial symmetry and esthetics was relatively weak in subjects with UCLAP, in whom only vermilion border esthetics was associated with asymmetry. Nasolabial symmetry assessed with 3D facial imaging can be used as an objective measure of treatment outcome in subjects with less severe cleft deformity. In subjects with more severe cleft types, other factors may play a decisive role. Assessment of nasolabial symmetry is a useful measure of treatment success in less severe cleft types.

3D asymmetry of operated children with oral clefts

To explore three-dimensional (3D) facial asymmetry differences in operated children with oral clefts and to compare the results with a control group. The sample comprised one hundred and three 8- to 12-year-old children: 40 with unilateral cleft lip and palate (UCLP); 23 with unilateral cleft lip and alveolus (UCLA); 19 with bilateral cleft lip and palate (BCLP); 21 with cleft palate (CP) and 80 sex- and age-matched controls living in the North East of England. 3D stereophotogrammetric facial scans were recorded for each participant at rest. Thirty-nine landmarks were recorded for each scan. The x, y and z coordinates for each landmark were extracted. Kruskal-Wallis and Mann-Whitney tests were conducted to identify 3D landmark asymmetry differences between the groups. Statistically significant differences were observed between all the groups. The UCLP and UCLA patients displayed the greatest asymmetry, followed by the BCLP group. The CP group was the least asymmetric among the cleft groups. Asymmetry was present to a lesser extent in the control group. Shape analysis indicates the possible differences in the aetiology and growth pattern of the CP group compared to UCLA or UCLP and BCLP groups.

両側性唇顎口蓋裂と片側性唇顎裂を示した一卵性双生児姉妹の治療経験

The incidence of monozygotic twins with cleft lip and palate is very low, and there have been few studies of longitudinal observations. The observation of monozygotic twins with different types of cleft lip and palate from the perspective of jaw growth facilitates comparison and evaluation of the effects of extrinsic and intrinsic factors. In this study, we observed monozygotic twin sisters with bilateral cleft lip and palate (BCLP) and unilateral cleft lip and alveolus (UCLA). In the child with BCLP in whom collapse occurred during jaw development, we placed a palatal plate and maxillary expansion appliance in infancy, and longitudinally compared her with her sister with UCLA. Although there were no marked differences in the growth or development of the middle face between the sister with BCLP, in whom jaw guidance was performed from birth, and the sister with UCLA at the age of 7 years and 11 months, mandibular growth in the inferior direction was noted in the sister with BCLP.The results suggest that careful follow-up of both patients, including occlusal control, is necessary.

3D comparison of average faces in subjects with oral clefts

This prospective cross-sectional, case-controlled morphometric study assessed three dimensional (3D) facial morphological differences between average faces of 103 children aged 8-12 years; 40 with unilateral cleft lip and palate (UCLP), 23 with unilateral cleft lip and alveolus (UCLA), 19 with bilateral cleft lip and palate (BCLP), 21 with isolated cleft palate (ICP), and 80 gender and age-matched controls. 3D stereophotogrammetric facial scans were recorded for each participant at rest. Thirty-nine landmarks were digitized for each scan, and x-, y-, z-coordinates for each landmark were extracted. A 3D photorealistic average face was constructed for each participating group and subjective and objective comparisons were carried out between each cleft and control average faces. Marked differences were observed between all groups. The most severely affected were groups where the lip and palate were affected and repaired (UCLP and UCLA). The group with midsagittal palatal deformity and repair (ICP) was the most similar to the control group. The results revealed that 3D shape analysis allows morphometric discrimination between subjects with craniofacial anomalies and the control group, and underlines the potential value of statistical shape analysis in assessing the outcomes of cleft lip and palate surgery, and orthodontic treatment.

Three-dimensional geometric morphometrics applied to the study of children with cleft lip and/or palate from the North East of England

This prospective cross-sectional, case-controlled morphometric study investigated three-dimensional facial morphological variation among and between 8- and 12-year-old children [40 with a unilateral cleft lip and palate (UCLP), 23 with a unilateral cleft lip and alveolus (UCLA), 19 with a bilateral cleft lip and palate (BCLP), and 21 with an isolated cleft palate (ICP)]. Eighty gender- and age-matched individuals comprised the control group. The mean shape of each group was computed using generalized Procrustes analysis (GPA). Differences in shape between group means were assessed using multivariate analysis of variance and permutation tests, and shape differences were visualized for interpretation using warpings of the grand mean shape and transformation grids computed using thin plate splines (TPA). Statistically significant differences between the mean facial shapes and forms (shape plus size) of all groups were found. The greatest difference was in the BCLP group and the second greatest in the UCLP group. The study of asymmetry indicated different degrees and differences in the nature of asymmetry that characterize different cleft lip and palate (CLP) deformities. Principal component analyses (PCA) of form space and of means, plus reflected means, were informative with respect to the differences in facial size and shape and asymmetry between these groups. The results highlight differences in the aetiology of ICP and CLP groups and underline the potential value of statistical shape analysis in assessing the outcomes of CLP treatment.

Maxillary arch width in unoperated adult of the unilateral cleft lip and alveolus patients

The transversal measurement on the dento-alveolar fragments of the maxilla, in the unoperated adult patients with unilateral cleft lip and alveolus are rare and have not been well documented and archived in the scientific journals. The effect of the congenital malformation is obvious in the Unilateral Cleft Lip and Alveolus (UCLA) patients and is well documented. The aim of this study is to investigate whether there are any influences of the final transversal development of the maxilla based on the location and extent of the defect in patients with UCLA. 168 adult unoperated UCLA patients (study group) and 24 non cleft patients (control group) participated in this study. Plaster of Paris (POP) casts were made of the maxillary dentition and mesurement were taken using coordinate measuring machine (CCM) (Zeiss Numere, Carl Zeiss, Stuttgart, Germany). The mean values of maxillary transverse measurement of first premolar through the second molar of the UCLA and control group patients showed no statistically significant difference. The inter-canine distance was significantly smaller in the UCLA patients than non-cleft patients The maxillary inter-canine distance in untreated UCLA patients were significantly different from that of non cleft patients. There is narrow and constricted maxillary growth in UCLA patients causing maxillary morphological changes and cosmetic facial changes.

Growth and development in unoperated adult unilateral cleft lip and alveolus patients. A study of cephalometric and dental cast

Background and Objectives: Patients with unilateral cleft lip and alveolus (UCLA) who undergo early surgery, at maturity develop maxillary hypoplasia, collapse of dentoalveolar, crowding and retroinclination of the upper incisor. Factors underlying this sequelae are not fully understood. The aim of this study was to analyse growth and development through cephalometric and dental cast in unoperated adult UCLA at maturity.

Change in Grafted Secondary Alveolar Bone in Patients with UCLP and UCLA

To evaluate changes in the grafted bone after secondary alveolar bone graft (ABG) with iliac bone using 3-dimensional computed tomography (3D-CT). The sample consisted of 10 patients with unilateral cleft lip and palate (UCLP) and 5 patients with unilateral cleft lip and alveolus (UCLA) (mean age = 10 years). 3D-CT data (Sensation 10, Siemens, Munchen, Germany), which was obtained 1 month before (T0), 3 months after (T1), and 12 months (T2) after ABG, were used to measure the height, labiolingual thickness (LLT), and volume of the grafted bone using V-Works 4.0 program (Cybermed Inc, Seoul, Korea). All of the UCLA patients showed the lingual process in the cleft area at T0, but the UCLP did not. During T1-T2, there was a significant decrease in height of the upper part of the grafted bone; however, volumes of both the upper and lower parts were decreased. Unilateral cleft type and presence of ULI in the cleft area did not affect the change in height and volume of the grafted bone. The resorption amount (RA) was significantly larger in the lower part than in the upper part, while the resorption rate (RR) exhibited an opposite result. In addition, there was significantly more RA in the labial side in UCLA than UCLP (P < .05). There was no correlation between the initial cleft width and changes in height, LLT, and volume of the grafted bone. Overpacking and/or excessive condensation of the grafted bone is not necessary in UCLA with the lingual process because of the greater chance of resorption on the labial side of the grafted bone.

Congenital Missing Permanent Teeth in Korean Unilateral Cleft Lip and Alveolus and Unilateral Cleft Lip and Palate Patients

To investigate the differences in the congenital missing teeth pattern in terms of tooth type (permanent maxillary lateral incisor [MLI] and maxillary second premolar [MSP]) and sidedness (cleft vs noncleft) between boys and girls in Korean unilateral cleft lip and alveolus (UCLA) and unilateral cleft lip and palate (UCLP) patients. This study used the charts, models, radiographs, and intraoral photographs of 90 UCLA patients and 204 UCLP patients (ages 6 to 13 years). Binomial test, chi-square test, Fisher exact test, maximum likelihood analysis of variance, and the odds ratio were performed. According to the relationship between the congenital missing teeth pattern and the cleft type, the UCLP patients had 2.98 times more missing MLIs and 1.80 times more missing MSPs than did the UCLA patients. The MLI was congenitally missing more in boys than in girls, but the MSP showed the opposite tendency. Boys had a higher frequency of congenital missing MLIs and MSPs on the cleft side than did girls. However, on the noncleft side and both sides, girls had a higher frequency of congenital missing MLIs and MSPs than did boys. Results showed a gender-dominant pattern of congenital missing MLIs and MSPs. These results suggest that gender and cleft type might affect the congenital missing teeth pattern in terms of tooth type and sidedness.

Cleft sidedness and congenitally missing or malformed permanent maxillary lateral incisors in Korean patients with unilateral cleft lip and alveolus or unilateral cleft lip and palate

The purpose of this study was to investigate the differences in the prevalence of cleft sidedness, the number of congenitally missing or malformed permanent maxillary lateral incisors (MLIs), and the presence of supernumerary teeth in Korean patients with unilateral cleft lip and alveolus (UCLA) and those with unilateral cleft lip and palate (UCLP). Seventy-five patients with UCLA and 129 patients with UCLP (ages, 6.0 to 13.0 years) were studied by using their charts, models, radiographs, and intraoral photographs. The chi-square test, the binomial test, and the relative risk assessment were used. There was a male dominant tendency in both UCLP (P <.001) and UCLA (P <.05) patients. The UCLP patients were 1.3 times more involved on the left side and had 2.2 times more congenital missing MLI than did the UCLA patients. When an MLI was present, malformation occurred more frequently than normal shape in the UCLA (P <.001) and UCLP (P <.01) patients. Incidence of supernumerary teeth was 4.6 times higher in UCLA than in UCLP patients. When the cleft extended to the secondary palate, left-sided involvement was more predominant than in UCLA patients. When cleft involvement was confined to the primary palate, present MLIs were more common than congenitally missing teeth, and supernumerary teeth were more prevalent than in UCLP patients. These are important characteristics to be considered in the diagnosis and treatment planning of cleft patients.

A Longitudinal Study on Influence of Primary Facial Deformities on Maxillofacial Growth in Patients with Cleft Lip and Palate

The goal of this study was to use three-dimensional (3D) analysis to characterize the primary facial deformities in children with unilateral cleft lip and palate (UCLP) and then serially analyze the relationships between facial deformities and maxillofacial growth from infancy to adolescence. Twenty-one Japanese subjects with unilateral cleft lip and alveolus (UCLA) and 20 with UCLP who had been operated on and then followed up for more than 15 years were enrolled in this study. Facial cast models taken at cheiloplasty were scanned with a 3D laser scanner. Lateral cephalographs taken when subjects were 15 years of age or older were traced, and linear and angular measurements were calculated. The correlation between primary facial forms and maxillofacial morphology in adolescence was analyzed. Three-dimensional analysis showed larger ocular hypertelorism, wider cleft, greater deviation of the columella base, and more severe retruded position of the affected nasal alar base in subjects with UCLP than those with UCLA. Total surface area of the upper lips in subjects with UCLP was significantly smaller than those with UCLA. Correlation analyses revealed that the width of cleft lip, deviation of the columella base, difference of the nose base width, and surface area of the upper lip were statistically correlated with the maxillary length, the anterior position of the maxillary alveolar base, the posterior facial height, and the high angle of the mandible. The subjects who had less severe facial deformities and more tissue volume of the upper lips at cheiloplasty showed better maxillofacial growth.