To assess mandibular structure and spatial position following one-stage simultaneous repair of the unilateral cleft lip and palate.
Design:
Forty boys and 17 girls with complete unilateral cleft lip and palate who underwent one-stage simultaneous repair of the cleft by the same surgeon at the age of 9.23 months (standard deviation = 1.74) were selected. Lateral cephalograms taken at the age of approximately 10 years were analyzed and were compared with a sex- and age-matched control group that consisted of individuals with Angle Class I, no crossbite, positive overbite <5 mm, mild crowding (Incisor Irregularity Index <3.5 mm), and harmonious facial build.
Results:
No intergroup differences were demonstrated regarding structure of the cranial base. The mandible was found to be retruded and at a larger inclination to the cranial base as compared with controls. Both total mandibular length (ArGn) and length of the mandibular body were larger in the control group, at <2 mm. Height of the ramus and gonial angle were similar in both groups. Intergender comparison showed few significant differences in control subjects only (SN, SGo, and NMe variables).
Conclusions:
The mandible, following a one-stage simultaneous repair of cleft, was found to be retrusive, and the length of mandibular body was <2 mm shorter than that of the controls.
AdussH.Craniofacial growth in complete unilateral cleft lip and palate.Angle Orthod.1971; 41: 202–213.
2.
BardachJ.DaleR.M.YaleR.RosewallD.MooneyM.The influence of simultaneous cleft lip and palate repair on facial growth in rabbits.Cleft Palate J.1980; 17: 309–318.
3.
BardachJ.MooneyM.P.The relationship between lip pressure following lip repair and craniofacial growth: an experimental study in beagles.Plast Reconstr Surg.1984; 73: 544–555.
4.
BardachJ.RobertsD.M.KlausnerE.C.Influence of two-flap palatoplasty on facial growth in rabbits.Cleft Palate J.1979; 16: 402–411.
5.
BhatiaS.N.LeightonB.C.A Manual of Facial Growth: A Computer Analysis of Longitudinal Cephalometric Growth Data.Oxford: Oxford University Press;1993.
6.
BrattströmV.MølstedK.Prahl-AndersenB.SembG.ShawW.C.The Eurocleft study: intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 2: craniofacial form and nasolabial appearance.Cleft Palate Craniofac J.2005; 42: 69–77.
7.
Capelozza FilhoL.NormandoA.D.C.da Silva FilhoO.G.Isolated influences of lip and palate surgery on facial growth: comparison of operated and unoperated male adults with UCLP.Cleft Palate Craniofac J.1996; 33: 51–56.
8.
CapelozzaL.JrTaniguchiS.M.da SilvaO.G.Jr.Craniofacial morphology of adult unoperated complete unilateral cleft lip and palate patients.Cleft Palate Craniofac J.1993; 30: 376–381.
9.
CrabbJ.J.FosterT.D.Growth defects in unrepaired unilateral cleft lip and palate.Oral Surg Oral Med Oral Pathol.1977; 44: 329–335.
10.
da Silva FilhoO.G.NormandoA.D.C.Capelozza FilhoL.Mandibular growth in patients with cleft lip and/or palate—the influence of cleft type.Am J Orthod Dentofac Orthop.1993; 104: 269–275.
11.
da SilvaO.G.JrNormandoA.D.C.CapelozzaL.Jr.Mandibular morphology and spatial position in patients with clefts: intrinsic or iatrogenic?Cleft Palate Craniofac J.1992; 29: 369–375.
12.
DahlE.Transverse maxillary growth in combined cleft lip and palate. A longitudinal roentgencephalometric study by the implant method.Cleft Palate J.1979; 16: 34–41.
13.
HonigmannK.One-stage closure of uni- and bilateral cleft lip and palate.Br J Oral Maxillofac Surg.1996; 34: 214–219.
14.
JohnstonC.D.LeonardA.G.BurdenD.J.McSherryP.F.A comparison of craniofacial form in Northern Irish children with unilateral cleft lip and palate treated with different primary surgical techniques.Cleft Palate Craniofac J.2004; 41: 42–46.
15.
LeonardA.G.KneafseyB.McKennaS.JohnstonC.D.BurdenD.J.StevensonM.A retrospective comparison of craniofacial form in Northern Irish children with unilateral cleft lip and palate.Cleft Palate Craniofac J.1998; 35: 402–407.
16.
MarsM.HoustonW.J.A preliminary study of facial growth and morphology in unoperated male unilateral cleft lip and palate subjects.Cleft Palate J.1990; 27: 7–10.
17.
MarsM.PlintD.A.HoustonW.J.B.BerglandO.SembG.The Goslon Yardstick: a new system of assessing dental arch relationships in children with unilateral clefts of the lip and palate.Cleft Palate J.1987; 24: 314–322.
18.
MølstedK.Asher-McDadeC.BrattströmV.DahlE.MarsM.McWilliamJ.PlintD.A.Prahl-AndersenB.SembG.ShawW.C.. A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 2. Craniofacial Form and Soft Tissue Profile.Cleft Palate Craniofac J.1992; 29: 398–404.
19.
MølstedK.DahlE.BrattströmV.McWilliamJ.SembG.A six-center international study of treatment outcome in patients with clefts of the lip and palate: evaluation of maxillary asymmetry.Cleft Palate Craniofac J.1993; 30: 22–28.
20.
MorrisT.RobertsC.ShawW.C.Incisal overjet as an outcome measure in unilateral cleft lip and palate management.Cleft Palate Craniofac J.1994; 31: 142–145.
21.
OnyeasoC.O.Prevalence of malocclusion among adolescents in Ibadan, Nigeria.Am J Orthod Dentofac Orthop.2004; 126: 604–607.
22.
ÖztürkY.CuraN.Examination of craniofacial morphology in children with unilateral cleft lip and palate.Cleft Palate Craniofac J.1996; 33: 32–36.
23.
RioloM.L.MoyersR.E.McNamaraJ.A.JrHunterW.S.An Atlas of Craniofacial Growth.Ann Arbor, MI: Center for Human Growth and Development;1974, Craniofacial Growth Series, Monograph No. 2.
24.
Roberts-HarryD.SembG.HathornI.KillingbackN.Facial growth in patients with unilateral clefts of the lip and palate: a two-center study.Cleft Palate Craniofac J.1996; 33: 489–493.
25.
SavaciN.HosnuterM.TosunZ.DemirA.Maxillofacial morphology in children with complete unilateral cleft lip and palate treated by one-stage simultaneous repair.Plast Reconstr Surg.2005; 115: 1509–1517.
26.
SembG.A study of facial growth in patients with bilateral cleft lip and palate treated by the Oslo CLP Team.Cleft Palate Craniofac J.1991; 28: 22–39.
27.
ŠmahelZ.MullerovaZ.NejedlyA.HorakI.Changes in craniofacial development due to modifications of the treatment of unilateral cleft lip and palate.Cleft Palate Craniofac J.1998; 35: 240–247.
28.
SwennenG.BertenJ.L.KramerF.J.MalevezC.De MeyA.Schwestka-PollyR.HausamenJ.E.Mandibular morphology in complete unilateral cleft lip and palate.Cleft Palate Craniofac J.2004; 41: 403–409.
29.
TangE.L.The prevalence of malocclusion amongst Hong Kong male dental students.Br J Orthod.1994; 21: 57–63.
30.
TrotmanC.A.LongR.E.JrRosensteinS.W.MurphyC.JohnstonL.E.Jr.Comparison of facial form in primary alveolar bone-grafted and nongrafted unilateral cleft lip and palate patients: intercenter retrospective study.Cleft Palate Craniofac J.1996; 33: 91–95.
31.
WillemsG.De BruyneI.VerdonckA.FieuwsS.CarelsC.Prevalence of dentofacial characteristics in a Belgian orthodontic population.Clin Oral Invest.2001; 5: 220–226.
