Preoperative Cleft Lip Measurements and Maxillary Growth in Patients with Unilateral Cleft Lip and Palate

Antonarakis, Gregory S.; Tompson, Bryan; Fisher, David M.

doi:10.1597/14-274

Cited by 29 publications

(24 citation statements)

References 51 publications

(81 reference statements)

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“…14 The extent of this hypoplasia has also been shown to correlate with dental arch relationships, the prevalence of dental anomalies, and maxillary growth deficiencies. [15][16][17] The purpose of the study was to determine whether there is a difference between the presurgical anthropometric lip measurements of left versus right unilateral complete cleft lips. Our hypothesis is that there is a difference in preoperative anthropometrics in infants with left versus right unilateral complete cleft lip and/or palate.…”

Section: Ementioning

confidence: 99%

Comparison of Presurgical Anthropometric Measures of Right and Left Complete Unilateral Cleft Lip and/or Palate

Chong

Somasundaram

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Left clefts occur twice as frequently as right ones. The sidedness has been suggested to influence certain outcomes. Some surgeons consider a right cleft more challenging to repair. This is often attributed to their reduced prevalence. The authors question whether this may be caused by morphologic differences. The authors' hypothesis is that there are anthropometric differences between left and right complete cleft lips. Methods: Patients with complete unilateral cleft lip, with or without cleft palate, operated on at the age of 3 to 6 months, between 2000 and 2018, by a single surgeon, were included. Eight standardized anthropometric measurements of the cleft lip, collected just before cleft lip repair, compare lip and vermillion dimensions and ratios between left and right clefts. Results: One hundred thirty-nine left and 80 right unilateral cleft lips were compared. A significant difference was found between left and right clefts for cleft-side to non-cleft-side ratios comparing the lateral lip element vertical heights and vermillion heights. Conclusions: Patients with right cleft lips have a greater degree of lateral lip element hypoplasia, demonstrating greater deficiencies of lateral lip element vertical height and vermillion height when compared to patients with left clefts. This has clinical implications for preoperative assessment, choice of surgical technique, and postoperative and long-term outcomes.

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Section: Ementioning

confidence: 99%

Comparison of Presurgical Anthropometric Measures of Right and Left Complete Unilateral Cleft Lip and/or Palate

Chong

Somasundaram

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…These include factors intrinsic to the child with the cleft, [7][8][9][10][11][12][13] but also extrinsic factors such as the age of the child at the time of surgery [14][15][16][17][18][19] and the surgical technique or protocol used. [20][21][22] However, findings are inconsistent 16,23 and there is currently no national-or international-level agreement with respect to the optimal timing and surgical technique or protocol for primary surgical closure of cleft lip and palate.…”

Section: Introductionmentioning

confidence: 99%

Surgical sequence, timing and volume, and variation in dento‐facial outcome, speech and secondary surgery in children with unilateral cleft lip and palate: The Cleft Care UK Study

Slator

Perisanidou

Sell

et al. 2022

Orthod Craniofacial Res

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Objectives: To estimate both the association of surgical variables in complete unilateral cleft lip and palate (cUCLP) in the UK with outcomes at age 5 years, and the association of secondary speech surgery, volume of surgery, and surgeon with the same outcomes. Setting and Sample Population:The Cleft Care UK study, a cross-sectional study of 268 5-year-olds, born from 2005 to 2007, with cUCLP.Materials and Methods: Information on surgical variables was extracted from a standardized questionnaire. Dento-facial outcomes were derived from dental study casts of dental arch relationships. Three speech outcomes -intelligibility, structure and articulation -were derived using the Cleft Audit Protocol for Speech-Augmented tool.Results: Surgical and outcome data were available for 211 (79%) children from all cleft centres in the UK. Later soft palate surgery was associated with a 17% increased chance of a poor intelligibility score (P = .02), and high volume surgery with a 249% increased chance of a good articulation score (P = .01). There were no between surgeon effects identified. No association between the surgical variables examined and dento-facial outcome, or secondary speech surgery by the age of 5 years were found. Conclusion:This study found associations between surgical variables and speech outcomes at 5 years of age, but not between surgical variables and dento-facial outcome, nor between surgical variables and secondary speech surgery. High surgical volume should be maintained, and any changes towards later surgery monitored for changes in speech outcome.

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“…Moreover, dental anomalies are significantly more frequent in patients with CLP than in the general population, with studies reporting that about 94% of patients with CLP present at least one dental anomaly [ 8 ]. An orthodontist has an important role in the interdisciplinary team, because some characteristics of patients with CLP may lead to the development of malocclusions (e.g., anterior or posterior crossbites, open bite, skeletal Class III and crowding) [ 9 , 10 ]. However, the majority of studies regarding orthodontic treatment in patients with CLP presented differences in the treatment protocols, measurement of outcomes (e.g., cephalometric analysis), characteristics of retrieved data and differences between control groups [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Cleft Orthodontic Care in Europe: A Cross-Sectional Survey

et al. 2022

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(1) Background: Orthodontists have an important role in cleft care. Over the two decades since the Eurocleft studies, a significant improvement in healthcare systems has been achieved but there has been no critical assessment regarding the establishment of proposed standard protocols. This study aimed to describe the current provider characteristics, orthodontic appliances, services offered, orthodontic complications, and cost analysis of cleft treatment in Europe. (2) Methods: A cross-sectional 22-question online survey, accessible from January 2021 to July 2021, was sent to 214 practitioners, pertaining to provider characteristics, orthodontic appliances, services offered, orthodontic complications, and cost analysis. Descriptive statistics were calculated for each question. Fisher’s exact test was used to assess the association between categorical variables. (3) Results: A total of 79 responses from 23 European countries completed the survey (response rate = 37%), with 69 surveys being assessed after the exclusion of incomplete surveys. Rapid maxillary expansion was the preferred expansion protocol (45%). Distraction osteogenesis was the most reported alternative treatment to secondary bone grafts (19%), with private practitioners being less likely to perform these treatments (Fisher’s exact test, p = 0.001). Orthodontic services offered were, however, rather similar in the various locations of provision (hospital and/or university, private). Compromised oral hygiene (77%) was the most reported orthodontic complication. The National Health Services support the majority of cleft orthodontic care (67%) in Europe. (4) Conclusion: An apparent improvement in orthodontic healthcare provision has been achieved within Europe in the last two decades, but there are several discrepancies, namely regarding treatment timing and the appliances offered.

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Preoperative Cleft Lip Measurements and Maxillary Growth in Patients with Unilateral Cleft Lip and Palate

Abstract: Patients with cUCLP present with varying degrees of lateral lip hypoplasia. Preoperative measures of lateral lip deficiency are related to later observed deficiencies of maxillary length, protrusion, and height.

Cited by 29 publications

References 51 publications

Comparison of Presurgical Anthropometric Measures of Right and Left Complete Unilateral Cleft Lip and/or Palate

Comparison of Presurgical Anthropometric Measures of Right and Left Complete Unilateral Cleft Lip and/or Palate

Surgical sequence, timing and volume, and variation in dento‐facial outcome, speech and secondary surgery in children with unilateral cleft lip and palate: The Cleft Care UK Study

Cleft Orthodontic Care in Europe: A Cross-Sectional Survey

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