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Facial growth in unilateral cleft Lip and palate and cleft palate: associations with maxillary dimensions and cleft size in infancy
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.
2011 (English)Article in journal (Refereed) Submitted
Abstract [en]

Objective: To study facial growth from 5 to 19 years of age and the correlation with maxillary arch dimensions and cleft size in infancy in children with unilateral cleft lip and palate (UCLP) and cleft palate (CP).

Design: Retrospective longitudinal study.

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

Patients:  Thirty-three consecutive patients with UCLP, 64 with CP (51 with cleft palate only (CPo) and 13 with Pierre Robin Sequence (PRS)) were included in the study. 

Interventions: Lip repair at 3-4 months in UCLP children. Soft palate repair at 6-7 months and hard palate repair at 2 years in UCLP and CP. Secondary bone grafting at 9 years of age in UCLP.

Main Outcome Measures: Maxillary arch dimensions and cleft size were measured on dental casts taken in infancy. Cephalometrics was used to study facial growth from 5 to 19 years of age.

Results: Maxillary arch depths showed positive correlations to SNA and ANB. Cleft width in infancy was negatively correlated to SNA, ANB and NSBa. The growth rates for SNA and ANB were significantly more negative for the UCLP group compared to the CPo group.

Conclusions: Maxillary arch depths and cleft widths in infancy were associated with maxillary protrusion and sagittal jaw relationships during growth in both UCLP and CP children. Maxillary protrusion and sagittal jaw relation developed less favourably in UCLP compared to CPo.

Place, publisher, year, edition, pages
2011.
Keyword [en]
Unilateral cleft lip and palate, cleft palate, cleft size, maxillary arch dimensions, facial growth
National Category
Dentistry
Research subject
Oral and Maxillofacial Surgery
Identifiers
URN: urn:nbn:se:uu:diva-160177OAI: oai:DiVA.org:uu-160177DiVA: diva2:448625
Available from: 2011-10-17 Created: 2011-10-17 Last updated: 2011-11-23Bibliographically 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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