Shape changes in the cleft palate maxilla: a longitudinal study.

Area of Science:

• Craniofacial morphology
• Medical imaging analysis
• Orthodontics

Background:

• Cleft lip and palate (CLP) is a common congenital condition affecting facial development.
• Surgical interventions aim to correct anatomical defects, but residual morphological changes may persist.
• Objective assessment of maxillary shape in treated CLP patients is crucial for understanding long-term outcomes.

Purpose of the Study:

• To compare the maxillary shape in Norma lateralis between patients with cleft lip and palate (CLP) and non-CLP controls.
• To identify residual shape changes in the treated maxilla of CLP patients using quantitative methods.
• To assess these changes in both early and late post-treatment stages.

Main Methods:

• Utilized longitudinal data from the Miami Craniofacial Anomalies Foundation.
• Selected two groups of CLP patients (early and late post-surgery) and matched them with controls.
• Applied elliptical Fourier functions (EFFs) to digitized lateral cephalometric radiographs to analyze maxillary shape.
• Standardized outlines for size and corrected for positioning in 2D space.

Main Results:

• Statistically significant maxillary shape differences were found between CLP patients and controls in both young and older groups.
• No significant gender-based shape differences were observed.
• Morphological analysis revealed a posterior repositioning of the nasal crest in CLP cases compared to controls.

Conclusions:

• Despite clinically satisfactory surgical outcomes, distinct differences in maxillary shape remain in treated CLP patients.
• The posterior repositioning of the nasal crest is a key morphological characteristic differentiating CLP patients.
• These findings highlight the need for continued monitoring and potential long-term management strategies for CLP patients.