Regional facial asymmetries in unilateral orofacial clefts

Kuijpers, Mette A.R.; Desmedt, Dries; Nada, Rania M.; Bergé, Stefaan; Fudalej, Piotr; Maal, T.J.J.

doi:10.1093/ejo/cju104

Cited by 32 publications

(25 citation statements)

References 20 publications

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“…Based on information obtained from previous studies by Bughaigis et al 2014 and Kuijpers et al 2015 , a standard deviation of 1 and an effect size of 0.7 for average asymmetry scores was observed. It was calculated that 22 participants in the UCLP group and assuming a ratio of 3:1 for controls: cases ( Hennessy et al, 1999 ), 66 noncleft volunteers would need to be recruited for the above study assuming a power of 80%, in order to detect differences between the UCLP group and the noncleft control group.…”

Section: Methodsmentioning

confidence: 97%

An Innovative Assessment of the Dynamics of Facial Movements in Surgically Managed Unilateral Cleft Lip and Palate Using 4D Imaging

Gattani

Gillgrass³

et al. 2020

The Cleft Palate-Craniofacial Journal

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Objective: Assess facial asymmetry during maximum smile in patients with surgically managed unilateral cleft lip and palate (UCLP), using a dynamic 3-dimensional (3D) imaging (4-dimensional) system. Design: Prospective 2 cohort comparative study. Methods: Twenty-five surgically managed UCLP cases and 75 controls at 8 to 10 years of age were recruited. Facial movements during maximum smile were recorded using video stereophotogrammetry at a rate of 60 3D facial images per second. Maximum smile took approximately 3 seconds and generated 180 3D facial images for the analysis. A generic facial mesh which consists of more than 7000 quasi landmarks was used for the assessment of facial asymmetry at 5 key 3D frames representing the pattern of maximum smile. Results: Statistically significant differences were seen regarding the magnitude of facial asymmetry between the UCLP group and the noncleft controls. Higher average asymmetry in the UCLP group was seen in the 3D frame midway between maximum smile and rest (frame 4) followed by the frame at peak expression of maximum smile (frame 3). The average magnitude of nasolabial asymmetry of the control group was within 0.5 mm in comparison with the UCLP cases which was about 1.8 mm. Conclusion: This study provided for the first time, an objective tool for analysis of the dynamics of muscle movements which provided an unprecedented insight into the anatomical basis of the residual dysmorphology. The research demonstrates the limitations of the primary lip repair in achieving symmetrical results and underpins the required refinements to improve the quality of surgical repair of cleft lip.

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Section: Methodsmentioning

confidence: 97%

An Innovative Assessment of the Dynamics of Facial Movements in Surgically Managed Unilateral Cleft Lip and Palate Using 4D Imaging

Gattani

Gillgrass³

et al. 2020

The Cleft Palate-Craniofacial Journal

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“…Until now, several studies have been conducted in relation to symmetry in skeletal, dental and soft tissues in individuals with cleft lip and palate. While vermilion symmetry, lip symmetry, nose symmetry, nostril symmetry and facial symmetry were evaluated among soft tissues, evaluation of hard tissues focused on palatal symmetry, condylar symmetry and mandibular symmetry . In CLP patients, an asymmetry in the macro‐aesthetic elements of the face is the most significant factor that may affect the facial aesthetics.…”

Section: Introductionmentioning

confidence: 99%

Dental crown symmetry in unilateral cleft lip and palate patients: A three‐dimensional analysis on digital dental models

Di̇ndaroğlu

Duran

Doğan

2019

Orthod Craniofacial Res

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Objectives The purpose of this study was to conduct a 3‐dimensional assessment of possible dental crown asymmetry in dental crown shape and/or size that was not clinically visible in unilateral cleft lip and palate (UCLP) patients on the maxilla and mandible and make a comparison to the control group without CLP. Setting and Sample Population The maxillary and mandibular digital models of orthodontically treated 35 individuals with non‐syndromic UCLP (mean age: 14.6 ± 2.1 years) and 35 class I individuals without CLP (mean age 14.1 ± 1.5 years). Materials and Methods The crowns of the anterior and posterior teeth were segmented and the teeth on the cleft side were mirrored in UCLP patients considering the arbitrary midsagittal plane as reference. The first alignment was landmark‐based and it was followed by the best‐fit method. After aligning the images, millimetric differences (deviation analysis) between aligned surfaces were analysed. Independent Samples t test and Mann‐Whitney U test were used for statistical comparisons. Results The highest difference between the cleft side and non‐cleft side in the UCLP group was observed in the central incisors (1.85 ± 0.79 mm). The mean difference between the groups in the central incisors was 1.20 mm (95% CI: −1.70; −0.69; P < 0.001). The mean of median values was found to be highest in the central incisors in the UCLP group as 0.72 ± 0.27 mm. It was 0.15 ± 0.05 mm in the control group. Conclusion The difference between the cleft and non‐cleft side may exceed 1 mm in the maxillary central incisors of unilateral CLP patients.

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“…Several studies have explored the residual asymmetry in the nasolabial regions following the surgical repair of cleft lip and palate. 7,8,12,20,25,31 These studies quantified the residual asymmetry at rest; however, the impact of facial expressions on the residual facial asymmetry has not been fully investigated. The expression of a smile plays a vital role in daily communications and the lips are a focus of attention during social interactions.…”

Section: Introductionmentioning

confidence: 99%

The effect of facial expression on facial symmetry in surgically managed unilateral cleft lip and palate patients (UCLP)

Al-Rudainy

Mehendale

et al. 2019

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Regional facial asymmetries in unilateral orofacial clefts

Abstract: Each type of cleft has its own distinct asymmetry pattern. Children with unilateral clefts show more facial asymmetry than children without clefts.

Cited by 32 publications

References 20 publications

An Innovative Assessment of the Dynamics of Facial Movements in Surgically Managed Unilateral Cleft Lip and Palate Using 4D Imaging

An Innovative Assessment of the Dynamics of Facial Movements in Surgically Managed Unilateral Cleft Lip and Palate Using 4D Imaging

Dental crown symmetry in unilateral cleft lip and palate patients: A three‐dimensional analysis on digital dental models

The effect of facial expression on facial symmetry in surgically managed unilateral cleft lip and palate patients (UCLP)

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