Maxillary Hypoplasia in the Cleft Patient

Lee, Justine C.; Slack, Ginger; Walker, Ryann; Graves, Lindsay L.; Yen, Sandra; Woo, Jessica G.; Ambaram, Rishal; Martz, Martin G.; Kawamoto, Henry K.; Bradley, James P.

doi:10.1097/01.prs.0000436857.63021.f0

Cited by 32 publications

(12 citation statements)

References 19 publications

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“…Given that implementation of surgical techniques to delay hard palate closure were largely ineffective, 3,4 we feel the potential role of intrinsic factors has been widely under-recognized. Prior studies evaluating the role of dental agenesis in maxillary growth restriction have utilized lateral cephalometric analysis 9,12 and the need to undergo LeFort 1 advancement 13,[23][24][25] as outcome measures. We present the first analysis correlating dental agenesis with maxillary bone volume.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Dental Agenesis and Maxillary Hypoplasia in Patients With Cleft Lip and Palate

Janes

Bazina

Morcos

et al. 2021

Journal of Craniofacial Surgery

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Both dental agenesis and maxillary growth restriction are well-recognized sequelae in patients with unilateral cleft lip and palate, but their etiology remains controversial. The aim of this study was to evaluate the relationship between hypodontia and maxillary volume. A retrospective review of patients age 6 to 9 with Veau III (unilateral) cleft palate who underwent Cone Beam Computer Tomography in preparation for alveolar bone grafting at 2 major Children's Hospitals between 2010 and 2016 was conducted and serial panoramic radiographs were reviewed. Thirty-eight patients were identified that met inclusion criteria and had adequate imaging. Group 1 (''poor growers'') consisted of the bottom 50% of Sella-Nasion-A point minus Sella-Nasion-B point (ANB) angles and Group 2 (''good growers'') consisted of the top 50% of ANB angles. Group 1 had a significantly higher mean number of missing teeth (1.58 AE 0.28 missing teeth) compared to Group 2 (0.74 AE 0.23 missing teeth), and significantly lower maxillary volume (12.88 AE 0.61 cm 3 versus 15.24 AE 0.88 cm 3 , respectively). The severity of maxillary hypoplasia in cleft patients increases with increased dental agenesis. These data indicate that intrinsic factors play a significant role in maxillary growth restriction in cleft patients, independent of the sequelae of surgical intervention.

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Section: Discussionmentioning

confidence: 99%

The Relationship Between Dental Agenesis and Maxillary Hypoplasia in Patients With Cleft Lip and Palate

Janes

Bazina

Morcos

et al. 2021

Journal of Craniofacial Surgery

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“…9 However, orthodontic gap closure can lead to a maxillary hypoplasia in both transversal and anteroposterior dimensions, with the need for future orthognathic surgery. 10,11 It can also create ventilatory disorders by reducing the intercanine distance and thus the size of the anterior nasal apertures. 12 In addition, orthodontic gap closure can have aesthetic repercussions by creating an asymmetrical dental arch and by moving the upper interincisal point from the midline.…”

Section: Ementioning

confidence: 99%

Impact of orthodontic gap closure versus prosthetic replacement of missing maxillary lateral incisor on dental arch relationships and symmetry on 212 cleft patients: a retrospective study Missing lateral incisor gap in cleft patients (39/40 characters max)

Quenel

Keribin²,

Salagnac

et al. 2022

Plastic &Amp; Reconstructive Surgery

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left lip and cleft palate are the most common congenital orofacial deformities, affecting one in 1000 births in Europe. 1 Patients with cleft lip and/or cleft palate need medical care as newborns, throughout their childhood and adolescence, and until early adulthood, coordinated by a multidisciplinary team involving surgeons and dental practitioners.Several dental anomalies are often associated with this deformity. 2 Maxillary lateral incisor agenesis or hypoplasia is the most frequent for patients with cleft lip and/or palate. [3][4][5][6][7][8] Maxillary lateral incisors are often missing because of agenesis or extraction and the orthodontist and surgeon collaborate to plan the best option to manage the gap left by the missing incisors.The first option is orthodontic gap closure. This treatment brings the homolateral canine

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“…3 Some children with CLP exhibit significant maxillary retrusion deformity and maxillofacial dysfunction owing to endogenous developmental deficits and sequential treatments (surgical and nonsurgical). [6][7][8][9][10] This deformity mainly manifests as a retrusion deformity of the infraorbital, zygomatic, nasal regions, and maxilla. [11][12][13][14] In addition to affecting appearance, it can also affect children's masticatory and speech functions, and even cause respiratory problems, such as obstructive sleep apnea syndrome.…”

mentioning

confidence: 99%

“…Some children with CLP exhibit significant maxillary retrusion deformity and maxillofacial dysfunction owing to endogenous developmental deficits and sequential treatments (surgical and non-surgical) 6–10. This deformity mainly manifests as a retrusion deformity of the infraorbital, zygomatic, nasal regions, and maxilla 11–14.…”

mentioning

confidence: 99%

Effect of Bone-Borne Trans-Sutural Distraction Osteogenesis Therapy on the Cranial Base of Children With Midfacial Hypoplasia Due to Cleft Lip and Palate

Zhang

Tong

Chen

et al. 2022

Journal of Craniofacial Surgery

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Bone-borne trans-sutural distraction osteogenesis (TSDO) is widely used to treat midfacial hypoplasia in children with cleft lip and palate; however, its effects on the cranial base are still poorly understood. The authors aimed to study morphological changes in the cranial base after TSDO. Pre and postoperative computed tomography (CT) images of cleft lip and palate children with midfacial skeleton dysplasia who underwent TSDO were collected retrospectively, and their corresponding 3-dimensional models were measured. Results showed no significant change in the length of the anterior or posterior cranial fossa, but the length of the middle cranial fossa increased significantly. The anterior cranial base rotated upward with the sella turcica at the center, whereas the cranial base angle increased. The sphenoid bone exhibited morphological changes. Post-TSDO, the lateral plate of the pterygoid process increased in length. The angle of the 2 lateral plates of the pterygoid process, the greater wings of the sphenoid bone, and the smaller wings of the sphenoid bone decreased. Posterior inclination of the pterygoid process increased. Mean volume of the sphenoidal sinus increased postoperatively compared with the preoperative volume. Apparent changes in the cranial base after TSDO are primarily in the middle cranial fossa, manifesting as an increase in the sphenoid bone body length, expansion of the sphenoidal sinus volume, growth of the pterygoid process forward and downward, a decrease in the angle of both the greater and smaller wings of the sphenoid bone, and an increase in the posterior inclination of the pterygoid process.

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Maxillary Hypoplasia in the Cleft Patient

Abstract: Therapeutic, III.

Cited by 32 publications

References 19 publications

The Relationship Between Dental Agenesis and Maxillary Hypoplasia in Patients With Cleft Lip and Palate

The Relationship Between Dental Agenesis and Maxillary Hypoplasia in Patients With Cleft Lip and Palate

Impact of orthodontic gap closure versus prosthetic replacement of missing maxillary lateral incisor on dental arch relationships and symmetry on 212 cleft patients: a retrospective study Missing lateral incisor gap in cleft patients (39/40 characters max)

Effect of Bone-Borne Trans-Sutural Distraction Osteogenesis Therapy on the Cranial Base of Children With Midfacial Hypoplasia Due to Cleft Lip and Palate

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