Summary
Maxillary growth of adult patients with unoperated cleft has long been studied, but
results varied between different studies. The objectives of this study were to determine
the growth potential of adult patients with unoperated clefts compared to the normal
population and to differentiate the growth potential among types of clefts.
Methods
Subjects were from the same ethnic group, were more than 16 years of age with non-syndromic
cleft and no associated anomalies. The types of cleft included unilateral complete
cleft lip and palate (UCLP), bilateral complete cleft lip and palate (BCLP), unilateral
cleft lip (UCL) and isolated cleft palate (CP). The sella-nasion-A point (SNA) angle
from the cephalometry was measured, and a dental cast study using a three-dimensional
imaging system was performed.
Results
SNA measurements showed significant differences among different groups, the BCLP group
having larger values and the CP group having smaller values when compared with normal
values. Dental cast analysis measuring palatal surface area showed a significantly
smaller area in patients with cleft as compared to normal controls, but no difference
among the different types of cleft. From the linear measurement it was found that
the interdental distance was significantly more narrow in the anterior part up to
the first premolar region as compared to the control group, especially in the complete
cleft groups (UCLP and BCLP). Dentoalveolar arch was also deeper and longer in these
complete cleft groups.
Conclusion
There is an intrinsic tissue deficiency in all groups of patients with cleft; however,
the sagittal development is still comparable to that of a normal population. Tissue
deficiency mostly occurs in the anterior part. There is no difference in terms of
the deficiencies among the different groups of cleft.
Keywords
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References
- Facial growth of adults with unoperated clefts.Clin Plast Surg. 2004; 31: 361-371
- The complete unilateral cleft lip and palate: serial three-dimensional studies of excellent palatal growth.in: Bardach J. Lorris H.L. Multidisciplinary management of cleft lip and palate. WB Saunders, Philadelphia1990: 456-473
- Treatment variables affecting facial growth in complete unilateral cleft lip and palate.Cleft Palate J. 1987; 24: 5-77
- Treatment effects on facial development in patients with unilateral cleft lip and palate.Cleft Palate Craniofac J. 1994; 31: 437-445
- Median facial dysplasia in unilateral and bilateral cleft lip and palate: a subgroup of median cerebrofacial malformations.Plast Reconstr Surg. 1993; 91: 996-1005
- A rapid method of measuring the palatal surface area in cleft palate infants.Cleft Palate J. 1978; 15: 44-48
- Palatal surface area measurement: comparisons among different cleft types.Ann Plast Surg. 2003; 50: 18-23
- The Sri Lankan cleft lip and palate project: the unoperated cleft lip and palate.Cleft Palate J. 1990; 27: 3-6
- Cephalometric comparisons of individuals from India and Mexico with unoperated cleft lip and palate.Cleft Palate J. 1986; 23: 116-125
- A preliminary study of facial growth and morphology in unoperated male unilateral cleft lip and palate subjects over 13 years of age.Cleft Palate J. 1990; 27: 7-10
- Growth and development in patients with unoperated clefts.Cleft Palate Craniofac J. 2000; 37: 523-526
- Cephalometric measurement on adult patients with non-operated cleft palate.Plast Reconstr Surg. 1959; 24: 53-61
- A study of untreated adult cleft patients.Plast Reconstr Surg. 1966; 38: 36-41
- The unoperated adult bilateral cleft of the lip and palate.Br J Plast Surg. 1971; 24: 250-257
- Unoperated bilateral cleft lip and palate in a young adult: a thirty year follow up.Br J Plast Surg. 1991; 44: 378-383
- Craniofacial morphology of adult unoperated complete unilateral cleft lip and palate patients.Cleft Palate Craniofac J. 1993; 30: 376-381
- Unoperated oral clefts at maturation.Angle Orthod. 1960; 30: 78-85
- Morphology of facial bones in skulls with unoperated unilateral cleft palate.Cleft Palate J. 1967; 4: 18-30
- Cephalometric findings in a normal Nigerian population sample and adult Nigerians with unrepaired clefts.Cleft Palate J. 1984; 21: 323-328
- Analyze: a comprehensive, operator-interactive software package for multidimensional medical image display and analysis.Comput Med Imaging Graph. 1989; 13: 433-454
- Quantitative measurement on 3-dimensional computed tomography: an experimental validation using phantom objects.Chang Gung Med J. 2000; 23: 354-359
- Longitudinal study on the changes of maxillary arch dimensions in Japanese children with cleft lip and/or palate: infancy to 4 years of age.Cleft Palate Craniofac J. 1995; 32: 149-155
- Introductory concepts of the growth process.in: Enlow D.H. Handbook of facial growth. WB Saunders, Philadelphia1982: 24-34
- Comparative study between children with and without cleft lip and cleft palate, Part 2: electromyographic analysis.Cleft Palate Craniofac J. 2000; 37: 286-291
- World variation in human growth.2nd ed. Cambridge University Press, Cambridge, UK1990
- Hard palate repair timing and facial morphology in unilateral cleft lip and palate: before versus after pubertal peak velocity age.Cleft Palate Craniofac J. 2006; 43: 259-265
- Long-term effects of clefts on craniofacial morphology in patients with unilateral cleft lip and palate.Cleft Palate Craniofac J. 2005; 42: 601-609
- Long-term effects of palate repair on craniofacial morphology in patients with unilateral cleft lip and palate.Cleft Palate Craniofac J. 2005; 42: 594-600
- Cephalometric analysis of maxillofacial morphology in unoperated cleft palate patients.Cleft Palate Craniofac J. 1992; 29: 419-424
- Early craniofacial morphology and growth in children with unoperated isolated cleft palate.Cleft Palate Craniofac J. 2002; 39: 604-622
- Upper dental arch morphology of adult unoperated complete bilateral cleft lip and palate.Am J Orthod Dentofacial Orthop. 1998; 114: 154-161
- Dental arch dimension in unoperated adult cleft-palate patients: an analysis of 37 cases.J Craniofac Genet Dev Biol. 1994; 14: 69-74
- A study model analysis of adult unoperated Sri Lankans with unilateral cleft lip and palate.Cleft Palate J. 1990; 27: 146-154
Article info
Publication history
Published online: January 15, 2007
Accepted:
October 18,
2006
Received:
February 1,
2006
Footnotes
☆This paper was presented at the XI International Craniofacial Society Conference, Queensland, Australia, 10–14 September 2005.
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
