Studies on the craniofacial morphology of adult cleft patients using euclidean distance matrix analysis (EDMA): a cephalometric study

The aim of this study was to compare the craniofacial morphology of a group of orthognathic adults to adult patients with unilateral cleft lip and palate who had undergone delayed cleft closure.

Lateral cephalograms of 38 adult patients with unilateral cleft lip and palate (cleft group) were submitted for cephalometric analysis with Onyx Ceph((R)) and the x-y coordinates compared to measurements from a reference group of 103 untreated orthognathic adults (non-cleft group). Comparison was based on the cephalometric variables, and a Euclidean distance matrix analysis (EDMA) was applied to identify morphological differences, and describe their size and location.

Cephalometric analysis revealed a mesial basal jaw relationship with a retrognathic craniofacial morphology in the cohort with unilateral cleft. EDMA revealed an increase in the vertical distances between A-Pog, ANS-Pog and N-Or. Deficits in the sagittal and vertical distances of the midface (S-ANS, Ba-A) were more pronounced. Differences in the mandibular morphology were also apparent (Ba-Go).

Key morphological characteristics of cleft patients are pronounced underdevelopment of the midface in vertical and sagittal dimensions, as well as shortening and clockwise rotation of the mandible. Therefore, bimaxillary procedures should be con- sidered for the purposes of surgical correction, rather than correction of the maxillary position alone.