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Method of Studying Palatal Fusion using Static Organ Culture
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Cleft palate midface is both hypoplastic and displaced.

Wojciech Dec1, Oscar Olivera, Pradip Shetye

  • 1From the Department of Plastic Surgery, New York University Medical Center, New York, NY 10016, USA.

The Journal of Craniofacial Surgery
|January 26, 2013
PubMed
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Cleft palate width results from both alveolar bone displacement and underdevelopment. Effective treatment requires addressing both the displaced and deficient alveolar segments in patients with cleft palate.

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Area of Science:

  • Craniofacial anatomy
  • Pediatric dentistry
  • Oral and maxillofacial surgery

Background:

  • Anatomical variations in cleft lip and palate persist despite treatment advances.
  • The etiology of cleft width is debated, with theories including alveolar displacement and palatoalveolar hypoplasia.

Purpose of the Study:

  • To investigate the anatomical basis of cleft width by comparing maxillary tuberosity position and volume in cleft and noncleft patients.
  • To inform presurgical orthopedics and tissue engineering strategies for cleft palate care.

Main Methods:

  • Acquisition of palatoalveolar casts from 17 noncleft and 11 unilateral complete cleft palate children.
  • Measurement of maxillary tuberosity positions using geodetic datum boxes and Cartesian coordinates.
  • Determination of palatoalveolar volumes via sand displacement.

Main Results:

  • Cleft palate patients exhibited significantly greater lateral displacement of maxillary tuberosities (8.7 mm) compared to noncleft controls (P < 0.05).
  • No significant differences in alveolar segment elevation or retroversion were found.
  • Palatoalveolar volume was significantly reduced in cleft patients (5.7 cm³) versus noncleft controls (7.2 cm³, P < 0.05).

Conclusions:

  • Palatal cleft width is attributed to a combination of alveolar tissue displacement and hypoplasia.
  • Optimal cleft palate management necessitates addressing both the displacement and deficiency of the alveolar segments.