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Craniofacial integration and modularity in untreated cleft lip and palate
Sariesendy Sumardi1, Anne Marie Kuijpers-Jagtman2,3,4, Benny S Latief5
1Department of Orthodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
Clinical Oral Investigations
|March 31, 2025
Summary
Untreated orofacial clefts significantly alter craniofacial organization, impacting skull base, maxilla, and mandible integration and modularity in adults. This highlights the need for personalized treatment strategies.
Area of Science:
- Craniofacial biology
- Developmental biology
- Geometric morphometrics
Background:
- Orofacial clefts represent common congenital anomalies affecting facial development.
- Understanding craniofacial variation, integration, and modularity in unoperated individuals is crucial for comprehending developmental processes and planning interventions.
Purpose of the Study:
- To quantify craniofacial variation, integration, and modularity in adults with unoperated unilateral cleft lip and alveolus (UCLA) and unilateral cleft lip, alveolus, and palate (UCLAP) compared to unaffected controls (NORM).
Main Methods:
- Utilized geometric morphometrics on lateral cephalograms of 295 adult Proto-Malayid individuals (243 clefts, 50 controls).
- Analyzed 14 cephalometric landmarks to assess craniofacial shape variability (PCA), group differences (CVA), integration, and modularity using RV coefficient and covariance ratio.
Main Results:
- Craniofacial shape variability was primarily driven by vertical and sagittal relationships (PC1-PC6 explained 72%).
- Significant differences in craniofacial shape were observed among UCLA, UCLAP, and NORM groups, with the largest distances between NORM and UCLAP.
- Cleft-affected individuals exhibited distinct anterior and posterior modules, differing from controls' modular organization (skull base, maxilla, mandible).
Conclusions:
- Unoperated unilateral UCLA and UCLAP significantly affect craniofacial integration and modularity.
- Individualized treatment approaches considering congenital craniofacial organization are essential for optimizing functional and aesthetic outcomes.
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