The aim of this retrospective investigation was to qualify and quantify changes of the vertical skeletal morphology during puberty in cleft patients compared with an age-matched noncleft control.
Methods
Patients with unilateral cleft lip and palate (UCLP; n = 12) and bilateral cleft lip and palate (BCLP; n = 11) who fulfilled strict inclusion criteria according to the Hanover treatment protocol were evaluated by means of cephalometric analysis. Lateral cephalograms were analyzed for each cleft patient at age 10 and 15 and compared with corresponding data of a noncleft control (n = 20).
Results and Conclusions
It was concluded that a vertical growth impairment of the maxilla is found in patients with cleft lip and palate. The maxilla of cleft patients shows a significant clockwise rotation, whereas the inclination of the mandible shows little difference. Consequently, there is a skeletal superposition of the jaws. The posterior height of the maxilla is significantly shorter in patients both with UCLP and BCLP at T0 and T1. An increase of the anterior height of the mandible is found in the cleft groups.
AthanasiouA.E., MoyersR.E., MazaheriM., ToutountzakisN.. Frontal cephalometric evaluation of transverse dentofacial morphology and growth of children with isolated cleft palate.J Craniomaxillofac Surg.1991; 19: 249–253.
2.
AthanasiouA.E., TsengC.Y., ZarrinniaK., MazaheriM.. Frontal cephalometric study of dentofacial morphology in children with bilateral clefts of lip, alveolus and palate.J Craniomaxilofac Surg.1990; 18: 49–54.
3.
BrochJ., SlagsvoldO., RöslerM.. Error in landmark identification in lateral radiograph headplates.Eur J Orthod.1981; 3: 9–13.
4.
CapelozzaL.Jr, TaniguchiS.M., da SilvaO.G.Jr. Craniofacial morphology of adult unoperated complete unilateral cleft lip and palate patients.Cleft Palate Craniofac J.1993; 30: 376–381.
5.
da Silva FilhoO.G., Carvalho LaurisR.C., Capelozza FilhoL., SembG.. Craniofacial morphology in adult patients with unoperated complete bilateral cleft lip and palate.Cleft Palate Craniofac J.1998; 35: 111–119.
6.
da Silva FilhoO.G., NormandoA.D., Capelozza FilhoL.. Mandibular growth in patients with cleft lip and/or cleft palate—the influence of cleft type.Am J Orthod Dentofacial Orthop.1993; 104: 269–275.
7.
HausamenJ.E.. Die chirurgische rehabilitation von Patienten mit Lippen-KieferGaumen-Spalten.Die Quintessenz.1986; 37: 195–203.
8.
HausamenJ.E., TränkmannJ.. Planung und Durchführung einer kombinierten kieferorthopädisch-chirurgischen Behandlung in Spätfällen von Lippen-Kiefer-Gaumen-Spalten.Fortschr Kieferorthop.1986; 47: 547–557.
9.
HayashiI., SakudaM., TakimotoK., MiyazakiT.. Craniofacial growth in complete unilateral cleft lip and palate: a roentgenocephalometric study.Cleft Palate J.1976; 13: 215–237.
10.
HeidbuchelK.L., Kuijpers-JagtmanA.M., FreihoferH.P.. Facial growth in patients with bilateral cleft lip and palate: a cephalometric study.Cleft Palate Craniofac J.1994; 31: 210–216.
11.
LambrechtJ.T., KreuschT., SchulzL.. Position, shape, and dimension of the maxilla in unoperated cleft lip and palate patients: review of the literature.Clin Anat.2000; 13: 121–133.
12.
LissonJ.A.. Quer- und Längsschnittuntersuchungen von Patienten mit beidseitiger Lippen-Kiefer-Gaumen-Spalte, Behandlungsverläufe nach dem Hannoveraner Konzept. Hannover, Germany; 1995. Doctoral thesis.
13.
LissonJ.A., SchilkeR., TränkmannJ.. Transverse changes after surgical closure of complete cleft lip, alveolus and palate.Clin Oral Invest.1999; 3: 18–24.
14.
LissonJ.A., TränkmannJ.. Longitudinaluntersuchung von Patienten mit einseitiger Lippen-Kiefer-Gaumen-Spalte.Inf Orthod Kieferorthop.1996; 28: 337–349.
15.
LissonJ.A., TränkmannJ.. Comparative survey of osteomized and nonosteomized BCLP patients.Cleft Palate Craniofac J.1997; 34: 430–437.
16.
MiethkeR.R.. Zur Lokalisationsgenauigkeit kephalometrischer Referenzpunkte.Prakt Kieferorthop.1989; 3: 107–110.
17.
OpitzC.. Kieferorthopädische Behandlung von Patienten mit Lippen-KieferGaumen-Spalten.Berlin: Quintessenz;2002.
18.
ÖztürkY., CuraN.. Examination of craniofacial morphology in children with unilateral cleft lip and palate.Cleft Palate Craniofac J.1996; 33: 32–36.
19.
PaulinG., ThilanderB.. Dentofacial relations in young adults with unilateral cleft lip and palate. A follow-up study.Scand J Plast Reconstr Surg Hand Surg.1991; 25: 63–72.
20.
RossR.B.. Treatment variables affecting facial growth in complete unilateral cleft lip and palate.Cleft Palate J.1987; 24: 5–77.
21.
RossR.B.. Growth of the facial skeleton following the Malek repair for unilateral cleft lip and palate.Cleft Palate Craniofac J.1995; 32: 194–198.
22.
SmahelZ., MachovaP., MullerovaZ., SkvarilovaB.. Growth and development of the face in complete unilateral cleft lip and palate during prepubertal and pubertal periods.Acta Chir Plast.1992; 34: 163–177.
23.
SölzerR.. Kephalometrische Untersuchungen am Fernröntgenseitenbild- eine intra- und interfamiliäre Longitudinalstudie. Hannover, Germany; 1985. Doctoral thesis.
24.
TränkmannJ.. Die kieferorthopädische Behandlung im Gebiß der ersten Dentition bei Lippen-Kiefer-Gaumen-Spalten.Fortschr Kieferorthop.1986; 47: 467–476.
25.
TränkmannJ.. Orthodontic treatment of the primary dentition with clefts of lip, alveolus and palate following presurgical orthodontics, labioplasty and palatoplasty.J Craniomaxillofac Surg.1989; 17: 5–7.
26.
TränkmannJ., LissonJ.A.. Behandlungsergebnisse nach beidseitigen Lippen-Kiefer-Gaumen-Spalten.Kieferorthop.1996; 10: 169–180.
