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Craniofacial growth in bilateral cleft lip and palate: ages six years to adulthood
1Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor 48109-1078.
Insights
Children with complete bilateral cleft lip and palate show specific craniofacial growth differences, particularly in the midface and nasal region, compared to typical development. These changes normalize somewhat by adulthood.
Area of Science:
- Craniofacial biology
- Genetics and developmental biology
- Pediatric dentistry
Background:
- Complete bilateral cleft lip and palate (CBC) is a complex congenital condition affecting facial development.
- Understanding the specific craniofacial growth patterns in CBC is crucial for effective treatment planning.
- Longitudinal growth studies are essential to track developmental changes from childhood to adulthood.
Purpose of the Study:
- To precisely map craniofacial abnormalities in children with CBC.
- To analyze average growth trajectories in this population.
- To compare these findings against a non-cleft normative sample.
Main Methods:
- Longitudinal cephalometric analysis of 30 males with CBC from childhood to adulthood.
- Comparison with an age-matched non-cleft control group.
- Utilized both traditional cephalometrics and tensor biometrics for comprehensive analysis.
Main Results:
- Minimal impact on cranial base midline structures.
- Initial premaxillary protrusion normalized by adulthood.
- Increased nasal bone length and protrusion observed.
- Hypoplastic posterior maxillary segments and narrower pharynx.
- Posterior teeth over-eruption and reduced mandibular gonial area.
Conclusions:
- CBC presents distinct craniofacial alterations, primarily affecting the midface and nasal structures.
- Growth patterns show some normalization over time, but residual differences persist.
- Cephalometric and tensor biometric analyses provide complementary insights into CBC morphology.
Abstract:
The purpose of the study was to localize the characteristic craniofacial abnormalities in young children with complete bilateral cleft lip and palate, to average their growth changes, and to compare all these to observations from a normative sample. A longitudinal sample of 30 males with complete bilateral cleft lip and palate was obtained from the files of the Craniofacial Center at The Hospital for Sick Children, Toronto. An age-matched noncleft control sample was selected from the Burlington Orthodontic Research Center. All individuals had lateral cephalometric radiographs at approximately 6 years, 12 years, and as adults. These were analyzed by cephalometrics and by tensor biometrics. The results of the two methods of analysis were in agreement and tended to complement each other. In the cleft sample, there was little clefting effect on the midline structures of the cranial base; the premaxilla was initially protruded but became normal in the adult; the nasal bone was longer and more protruded; the posterior maxillary segments were hypoplastic and the bony pharynx narrower; there was over-eruption of the posterior teeth; and the mandibular gonial area was smaller.