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Early dimensional changes in maxillary cleft size and arch dimensions of children with cleft lip and palate and cleft palate
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
2013 (English)In: The Cleft Palate-Craniofacial Journal, ISSN 1055-6656, E-ISSN 1545-1569, Vol. 50, no 4, 481-490 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To study changes in cleft size and maxillary arch dimensions from infancy to 5 years and evaluate these changes in relation to performed surgical procedures.

Design: Retrospective longitudinal study.

Setting:  The Cleft Lip and Palate Centre, Uppsala University Hospital, Sweden.

Patients: Dental study models of 79 consecutive children, 28 with unilateral cleft lip and palate (UCLP), 39 with cleft palate (CP) and 12 with Pierre Robin Sequence (PRS) were analyzed.

Interventions: Lip repair at 3-4 months, soft palate repair at 6-10 months and hard palate repair at 25-26 months of age.

Main Outcome Measures: Cleft size was measured before each surgical intervention up to 2 years and arch dimensions were measured before each surgical intervention and at 5 years.

Results: Cleft widths decreased from infancy up to 2 years, but the antero-posterior cleft length in CP was unchanged. Arch widths at C-C1and T-T1 and also the change over time in C-C1 and T-T1 differed significantly between the groups from infancy up to 5 years. 

Conclusions: Cleft widths decreased after lip closure and/or soft palate closure. The UCLP children had wider maxillary arch dimensions than the CP and PRS children during the first years of life, but after hard palate closure the transverse growth was reduced in the UCLP children. At 5 years the UCLP children had smaller maxillary widths than the CP and PRS children especially at the level of the cuspids.

Place, publisher, year, edition, pages
2013. Vol. 50, no 4, 481-490 p.
Keyword [en]
unilateral cleft lip and palate, cleft palate, cleft size, maxillary arch dimensions
National Category
Dentistry
Research subject
Oral and Maxillofacial Surgery
Identifiers
URN: urn:nbn:se:uu:diva-160176DOI: 10.1597/11-003ISI: 000327535400016PubMedID: 22122198OAI: oai:DiVA.org:uu-160176DiVA: diva2:448613
Available from: 2011-10-17 Created: 2011-10-17 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Cleft Size and Maxillary Arch Dimensions in Unilateral Cleft Lip and Palate and Cleft Palate
Open this publication in new window or tab >>Cleft Size and Maxillary Arch Dimensions in Unilateral Cleft Lip and Palate and Cleft Palate
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The wide variation in infant maxillary morphology and cleft size of children with unilateral cleft lip and palate (UCLP) and isolated cleft palate (CP) raise concerns about their possible influences on treatment outcome. The studies in this thesis aimed to investigate the relation between cleft size in infancy and crossbite at 5 years of age (Paper I); the impact of primary surgery on cleft size and maxillary arch dimensions from infancy to 5 years of age (Paper II); associations between cleft size, maxillary arch dimensions and facial growth in both UCLP and CP children (Paper III); and, to evaluate the relation between infant cleft size and nasal airway size and function in adults treated for UCLP (Paper IV).

In homogenously treated groups of children with UCLP and CP, dental casts were used to measure cleft size and maxillary arch dimensions from infancy up to 5 years of age, and for crossbite recording at 5 years. Serial lateral cephalometric radiographs taken between 5 and 19 years of age in the same groups were used to study facial growth. Nasal airway size and function were evaluated by acoustic rhinometry, rhinomanometry, peak nasal inspiratory flow and odour test in a group of adults treated for UCLP.

The main findings were: crossbite was a frequent malocclusion at 5 years of age in children with UCLP and large cleft widths at the level of the cuspid points in infancy were associated with less anterior and posterior crossbite in this group (Paper I). Cleft widths decreased after lip closure and/or soft palate closure in both UCLP and CP children. Initially, UCLP children had wider maxillary arch dimensions, but after hard palate closure, the transverse growth was reduced, and at 5 years, they had smaller maxillary arch widths than CP children had (Paper II). Maxillary arch depths and cleft widths in infancy were correlated with maxillary protrusion and sagittal jaw relationships in both UCLP and CP children (Paper III), but cleft width in infancy was not correlated with nasal airway size and function in adults treated for UCLP (Paper IV).

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 74 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 722
Keyword
Unilateral cleft lip and palate, cleft palate, cleft size, maxillary arch dimensions, crossbite, facial growth, nasal function
National Category
Dentistry
Research subject
Oral and Maxillofacial Surgery
Identifiers
urn:nbn:se:uu:diva-160178 (URN)978-91-554-8213-8 (ISBN)
Public defence
2011-12-09, Skoogsalen, Uppsala University Hospital, entrance 79, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2011-11-18 Created: 2011-10-17 Last updated: 2011-11-23Bibliographically approved

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Reiser, ErikaSkoog, Valdemar

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