Characteristics of Maxillary Morphology in Unilateral Cleft Lip and Palate Patients Compared to Normal Subjects and Skeletal Class III Patients

Abstract

This study is to investigate the anatomical features of maxillae in unilateral cleft lip and palate (UCLP) patients with maxillary retrusion. Additionally, the dissimilarities of retruded maxillae between the UCLP patients and the skeletal class III patients were compared. Craniofacial measurements were carried out among 32 UCLP adult patients with maxillary retrusion (GC), 24 adult patients in class III (SNA < 80°, ANB < 0°) patients (GIII), and 32 normal controls (GN). The authors measured the width and length of the maxillae, as well as their relative positions to the coronal plane passing through basion. The independent sample group t test was performed, and P < 0.05 was regarded as statistically significant. In the GC group, the anterior and posterior maxillary length (A1-P3M⊥CP and P3M-P6M⊥CP) and overall maxillary length (A1-P6M⊥CP) at the dental level, the interdental widths of the maxillae, the maxillary volume (GM), and the volume consisting of maxilla and maxillary sinus (GT) significantly reduced compared with the GN group (P < 0.05). The distances from the points on the maxillae to the coronal plane (A1⊥CP, P3M⊥CP, and P6M⊥CP) in the GC and GIII groups were smaller than those in the GN group (P < 0.05). In summary, for the UCLP patients, the decreased prominence of maxillary complex could be mainly caused by the shortened maxillary length; meanwhile, posterior position of the maxillary body may have some influence on the maxillary protrusion. While for the class III patients, maxillary retrusion was resulted from malposition and malmorphology on an equal basis.

Retrognathic maxilla in individuals born with oral clefts is due to intrinsic factors and not only due to early surgical treatment

“…The most prevalent congenital anomalies in the human face are clefts of the lip and palate. 4 In individuals affected with cleft lip and palate, a high frequency of Class III phenotype is found compared to the general population, 3 and this difference may be caused by the surgical procedures done to repair the defect 5,6 and innate growth deficiency. [7][8][9][10] Studies that investigated intrinsic maxillary deficiency in cleft lip and palate were performed in unoperated cleft lip and palate patients and there are controversies in the literature.…”

Imaging study of midface growth with bone-borne trans-sutural distraction osteogenesis therapy in growing cleft lip and palate patients

“…This phenomenon is attributed to 2 aspects: intrinsic growth deficiency and iatrogenic factors caused by operation-based sequential therapy 5–7 . Their combined effects ultimately result in not only a retrusive midface position relative to the cranial base but also reduced maxillary size in three dimensions (3D) 8,9 . Therefore, the treatment targets of midfacial hypoplasia should include both the advancement of whole midfacial skeleton and the expansion of maxillary size to restore a harmonious facial appearance and occlusal relationship.…”

The pterygomaxillary junction: An imaging study for surgical information of LeFort I osteotomy

“…The abnormal maxillary morphology in the unilateral cleft patients has been suggested by Jiang et al . 45 , noticing that there was a significantly shortened maxillary length in the unilateral cleft compared with the normal control group at the dental level. It may be related to some asymmetric growth pattern that tends to collapse the cleft side, which does not happen in the bilateral cleft cases.…”