Assessment of dental arch stability after orthodontic treatment and oral rehabilitation in complete unilateral cleft lip and palate and non-clefts patients using 3D stereophotogrammetry

Abstract

Background: Although arch stability has been studied in patients without a cleft, evidence for patients with a cleft is sparse. Therefore, we compared the dimensions and stability of dental arches in cleft lip and palate patients and those without a cleft. Methods: Forty participants, 20 with a complete unilateral cleft lip and palate and 20 non-cleft patients aged from 18 to 30 years, with anterior and/or posterior crossbite and receiving orthodontic treatment were evaluated retrospectively. Eighty gypsum casts were digitized using a laser model scanner casts for both groups made immediately after the orthodontic treatment was completed (T1). Also, for the Cleft Lip and Palate group, casts were obtained and digitized 1 year after implant-supported rehabilitation (T2) and for the Non-Cleft Lip and Palate group, 1 year after the conclusion of the orthodontic treatment (T2). The formula: Δ = T2-T1 evaluated the stability of dental arches for inter-canine distances (C-C′), inter-molar distances (M-M'), arch length (I-M), palate surface and volume. The dimensions of the dental arches were measured digitally. The independent t test was used for statistical analysis (α = 0.05). Results: A statistical difference was found in the stability of the groups for inter-canine (cleft area) measurement. At the times T1 and T2, a statistically significant difference was found in the arch length, surface and volume. Conclusions: This study concluded that in the Cleft Lip and Palate group, the maxillary dimensions were not stabilized after 1 year of orthodontic and prosthodontic treatment (mainly for the inter-canine linear measurement) and that the transverse arch dimensions were smaller compared with those of non-cleft patients.

Long-term follow-up of mandibular dental arch changes in patients with complete non-syndromic unilateral cleft lip, alveolus, and palate

“…The changes were partly due to continuous mandibular growth. A series of studies from Brazil in a convenience UCLP sample reported on short term changes (one year after treatment) primarily of the maxillary dental arch in relation to rehabilitation with a dental implant or anterior fixed bridgework ( Caballero et al, 2019 ; Rezende Pucciarelli et al, 2020 ; Pucciarelli et al., 2021 ; Soares et al, 2021a ; Soares et al, 2021b ). These studies showed that the maxillary arch was not stable until one year posttreatment regardless of the type of prosthetic rehabilitation.…”

“…Maxillary dental arch transverse dimensions and dental arch relationships following different treatment protocols for patients with orofacial clefts have been the topic of studies and systematic reviews that evaluated treatment outcome in relation to different treatment parameters such as timing of palatal surgery in relation to craniofacial outcome ( Kappen et al, 2018 ), timing of primary alveolar bone grafting ( Carbullido et al, 2021 ), outcome of maxillary distraction ( Kloukos et al, 2018 ), and rehabilitation of the maxillary arch with a dental implant or an anterior fixed partial denture replacing the missing lateral incisor at the cleft side ( Caballero et al, 2019 ; Rezende Pucciarelli et al, 2020 ; Pucciarelli et al., 2021 ; Soares et al, 2021a ; Soares et al, 2021b ). However, those studies did not pay much attention to concomitant changes in the mandibular arch of patients with cleft lip and palate that occur after treatment.…”

“…To our knowledge no studies are available in the literature that describe transverse changes in the mandibular arch. It is well-known that the maxillary arch, and in particular the transverse dimension, in patients with a cleft palate is prone to changes after treatment ( Marcusson & Paulin, 2004 ; Al-Gunaid et al, 2008 ; Semb, Ronning & Abyholm, 2011 ; Rezende Pucciarelli et al., 2020 ; Soares et al, 2021a ; Soares et al, 2021b ). Especially because often a considerable amount of expansion is needed during the orthodontic treatment to overcome the constrictive effect of palatal scar tissue.…”

Avaliação da simetria do arco dentário em pacientes com fissura labiopalatina que receberam prótese sobre implante na região da fenda após tratamento ortodôntico/reabilitador

“…Os dados de pacientes com FLP, incluindo modelos de gesso, devem ser mantidos e armazenados, e a tecnologia 3D tornou-se uma ferramenta importante que melhora a avaliação e o gerenciamento dos arcos dentários, além de simplificar a pesquisa (CABALLERO et al, 2019;REZENDE PUCCIARELLI et al, 2020), facilitando várias análises em diferentes fases do tratamento.…”

Avaliação da simetria dos arcos dentários em pacientes com fissura labiopalatina reabilitados com prótese parcial fixa na região da fenda, após tratamento ortodôntico

“…As alternativas de reabilitação com próteses variam, proporcionando maior satisfação psicológica, e devem ser consideradas(MALGAJ et al, 2020). Dessa forma, muitos pacientes necessitam de diferentes tipos de próteses dentárias para reabilitar a área da fenda edêntula, normalmente a área dos incisivos laterais(CABALLERO et al, 2019;PUCCIARELLI et al, 2020). A intervenção reabilitadora com próteses fixas se tornou uma necessidade quando a extensão edêntula permanece após a conclusão do tratamento ortodôntico e geralmente é considerada um elo final para a reabilitação oral completa em paciente com fissura labiopalatina(FREITAS et al, 2013).…”