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Growth status of children treated for unilateral cleft lip and palate
P H Buschang1, J N Schroeder, E Genecov
1Department of Orthodontics, Baylor College of Dentistry, Dallas, Tex.
Insights
Children with unilateral cleft lip and palate show distinct skeletal differences, particularly a vertically short posterior maxilla and a steeper palatal plane. These findings aid in understanding craniofacial development in clefting conditions.
Area of Science:
- Craniofacial development
- Orthodontics
- Pediatric surgery
Background:
- Unilateral cleft lip and palate (UCLP) presents complex craniofacial challenges.
- Understanding skeletal variations in UCLP is crucial for effective treatment planning.
Purpose of the Study:
- To compare cephalometric measurements between children with UCLP and unaffected controls.
- To identify specific skeletal differences in UCLP patients treated with consistent methods.
Main Methods:
- Cephalometric analysis of 32 children (5-8 years) with UCLP.
- Comparison with age- and sex-matched controls with normal skeletal relationships.
- Standardized surgical and orthodontic treatment for the UCLP group.
Main Results:
- No significant differences in overall facial proportions, convexity, or prognathism.
- UCLP group exhibited a vertically short posterior maxilla and a horizontally longer maxilla, leading to a steeper palatal plane.
- Retruded zygoma and orbits, longer posterior cranial base, and longer mandibular length were observed in the UCLP group.
Conclusions:
- Skeletal discrepancies in UCLP primarily involve the maxilla's posterior vertical dimension and palatal plane angulation.
- Craniofacial morphology in UCLP is characterized by specific maxillary and mandibular differences compared to unaffected individuals.
Abstract:
Cephalometric distances, angles, and proportions were evaluated for 32 children 5 to 8 years of age treated for unilateral cleft lip and palate. The children were age and sex matched with untreated controls with normal skeletal relationships. The unilateral cleft lip and palate sample was treated by the same surgeon and orthodontist using the same techniques and appliances. Measures of overall facial proportions, facial convexity, and prognathism were not significantly different between the two groups. The primary group differences pertain to the posterior aspect of the maxilla, which is vertically short in the unilateral cleft lip and palate sample. Horizontally, the maxilla of the unilateral cleft lip and palate children was significantly longer, producing a steeper palatal plane. In addition, the zygoma and orbits of unilateral cleft lip and palate children were somewhat retruded; the posterior cranial base and total mandibular length also were longer in the unilateral cleft lip and palate children.