Association between Dental Arch Widths and Interarch Relationships in Children with Operated Unilateral Complete Cleft Lip and Palate

Santos, Patrícia Bittencourt Dutra dos; Janson, Guilherme; Assis, Vivian Helena; Battisti, Maíra de Paula Leite; Garib, Daniela Gamba

doi:10.1597/12-171

Cited by 12 publications

(4 citation statements)

References 20 publications

(23 reference statements)

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“…The disparity between our results and those of investigations involving linear, area, and volumetric assessments by Bittencourt et al [32] and Generali et al [33] is also noteworthy. These studies reported maxillary arch constriction in the cleft area and width similarity in the molar region in preadolescent patients with UCLP compared to controls.…”

Section: Discussioncontrasting

confidence: 99%

Alveolar Bone Grafting in Unilateral Cleft Lip and Palate: Impact of Timing on Palatal Shape

Brudnicki,

Petrova,

Dubovska

et al. 2023

JCM

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Alveolar bone grafting (ABG) is a critical surgical intervention in patients with a cleft of the alveolus, aimed at reconstructing the alveolar ridge to facilitate proper eruption, periodontal support, and alignment of adjacent permanent teeth. The optimal timing for ABG remains debated, with late secondary ABG between the ages of 9 and 11 being widely adopted. This study compared the palatal shapes of 28 children at a mean age of 9.5 years (SD = 0.7) who underwent early secondary ABG at a mean age of 2.1 years (SD = 0.6) or 33 children at a mean age of 10.8 years (SD = 1.5) who underwent late secondary ABG at a mean age of 8.6 years (SD = 1.3) to 60 non-cleft controls at a mean age of 8.6 years (SD = 1.2). The palatal shapes were captured with 239 landmarks digitized on the palate on a digital model. Utilizing geometric morphometric methods, i.e., generalized Procrustes superimpositions, principal component analysis, and permutation tests, we assessed the impact of ABG timing on palatal morphology. The first five principal components (PCs) explained 64.1% of the total shape variability: PC1 = 26.1%; PC2 = 12%; PC3 = 11.9%; PC4 = 7.8%; and PC5 = 6.4%. The Procrustes distance between both cleft groups and the control group was more than twice as large as the Procrustes distance between the early ABG and late ABG groups. Nonetheless, all intergroup differences were statistically significant. Our findings suggest that early ABG has a limited negative effect on palatal shape, providing comparable outcomes to late ABG. The study highlights the potential suitability of early ABG, challenging conventional practices and encouraging further exploration into its long-term effects on maxillary growth.

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Section: Discussioncontrasting

confidence: 99%

Alveolar Bone Grafting in Unilateral Cleft Lip and Palate: Impact of Timing on Palatal Shape

Brudnicki,

Petrova,

Dubovska

et al. 2023

JCM

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“…[3][4][5] Recent inter-centre studies observed high frequencies of poor interarch relationship in patients with CUCLP. 6,7 Multiple factors may cause maxillary growth deficiency, including surgical techniques, age, number of surgeries, surgeon´s skill, familial growth pattern and initial cleft width. [8][9][10] In particular, initial cleft width in patients with CUCLP varies widely.…”

Section: Introductionmentioning

confidence: 99%

“…After primary surgeries, the growth pattern changes, resulting in maxillary retrusion and in maxillary vertical and transversal deficiency 3‐5 . Recent inter‐centre studies observed high frequencies of poor interarch relationship in patients with CUCLP 6,7 . Multiple factors may cause maxillary growth deficiency, including surgical techniques, age, number of surgeries, surgeon´s skill, familial growth pattern and initial cleft width 8‐10 .…”

Section: Introductionmentioning

confidence: 99%

Is the early mixed dentition dental arch relationship related to the anteroposterior alignment of the maxillary segments in infants with CUCLP?

Baessa

Ozawa

Garib

et al. 2020

Orthod Craniofacial Res

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Objective: Midface retrusion is a concern in patients with complete unilateral cleft lip and palate (CUCLP). Maxillary segment alignment may influence the prognosis after corrective surgery. This study assessed the association between maxillary segment alignment and interarch relationship observed in the early mixed dentition. The null hypothesis was that there is no relation between the initial alignment of cleft segments and the width of the cleft in the infant, and the early mixed dentition interarch relationship. Setting and Sample Population: The sample consists of 352 children with CUCLP treated at the Hospital for Rehabilitation of Craniofacial Anomalies/USP. Material And Methods: Dental models were obtained before lip repair at three months and at the age of six. Based on the first, the sample was then divided into two groups: anteroposterior aligned and anteroposterior misaligned maxillary segments. They were also divided into 4 groups according to the cleft width (Narrow, Medium, Wide and Very Wide). Interarch relationship was graded using the 5-year-old index. The statistical association was evaluated using the chi-squared test (P < .05). Results: Cleft width was inversely related to interarch relationship in the early mixed dentition phase. Interarch relationship at the age of six was more favourable in children with misaligned maxillary segments than in children with aligned segments (P = .048). Conclusion: Five-year interarch relationship in patients with CUCLP is related to the anteroposterior relationship of infant maxillary segments and initial cleft width before primary surgeries. Wide alveolar clefts and sagittally aligned maxillary segments showed a worse interarch relationship in the early mixed dentition.

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“…1 BCLP causes serious esthetical, functional, anatomic and psychosocial disorders requiring early surgery repair. 2 The rehabilitation protocol for BCLP includes lip and palate repair, alveolar bone graft and orthodontics, isolated or combined with orthognatic surgery. 3 At birth, a patient with complete BCLP presents severe convex facial profile due to premaxilla projection.…”

Section: Introductionmentioning

confidence: 99%

Facial profile esthetics in operated children with bilateral cleft lip and palate

Lauris

Filho

Calil

et al. 2017

Dental Press J. Orthod.

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Objective: The aim of this study was to evaluate the facial profile esthetics of rehabilitated children with complete bilateral cleft lip and palate (BCLP), comparing the judgment of professionals related and not related to cleft rehabilitation and laypersons. Methods:Thirty children in the mixed dentition (24 male; 6 female) with a mean age of 7.8 years were evaluated using facial profile photographs by 25 examiners: 5 orthodontists and 5 plastic surgeons with experience in cleft care, 5 orthodontists and 5 plastic surgeons without experience in oral cleft rehabilitation and 5 graduated laymen. Their facial profiles were classified into esthetically unpleasant (grade 1 to 3), esthetically acceptable (grade 4 to 6), and esthetically pleasant (grade 7 to 9). Intraexaminer and interexaminer errors were evaluated using Spearman correlation coefficient and Kendall’s test, respectively. Inter-rater differences were analyzed using Friedman test and Student-Newman-Keuls test for multiple comparisons. Results: Orthodontists dealing with oral clefts rehabilitation considered the majority of the sample as esthetically pleasant. Plastic surgeons of the cleft team and laypersons classified most of the sample as esthetically acceptable. Most of the orthodontists and plastic surgeons not related to cleft care evaluated the facial profile as esthetically unpleasant. The structures associated to unpleasant profiles were the nose, the midface and the upper lip. Conclusions: The facial profile of children with BCLP was classified as esthetically acceptable by laypersons. Professionals related to cleft rehabilitation were more lenient and those not related to cleft care were stricter to facial esthetics than laypersons.

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Association between Dental Arch Widths and Interarch Relationships in Children with Operated Unilateral Complete Cleft Lip and Palate

Abstract: Operated UCLP patients with more severe sagittal discrepancies tend to show more severe transverse maxillary arch deficiencies.

Cited by 12 publications

References 20 publications

Alveolar Bone Grafting in Unilateral Cleft Lip and Palate: Impact of Timing on Palatal Shape

Alveolar Bone Grafting in Unilateral Cleft Lip and Palate: Impact of Timing on Palatal Shape

Is the early mixed dentition dental arch relationship related to the anteroposterior alignment of the maxillary segments in infants with CUCLP?

Facial profile esthetics in operated children with bilateral cleft lip and palate

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