To investigate associations between anthropometric lip measurements and dental arch
relationships in patients with complete unilateral cleft lip and palate (CUCLP).
Design
Retrospective cross-sectional study.
Patients
Children with CUCLP.
Methods
Anthropometric lip measurements, made immediately prior to lip repair, were available
for each patient. The dental arch relationships were evaluated on dental study casts
(8.6 ± 0.9 years) taken prior to any orthodontic treatment and prior to alveolar bone
graft, using the modified Huddart and Bodenham (MHB) scoring system. The presence of
associations between anthropometric lip measurements and dental arch relationships was
determined using linear regression analysis.
Results
In the 63 patients included in the study, the cleft lateral lip element was deficient
in height in 87% and in transverse width in 86% of patients. Patients with more
deficient cleft-side lateral lip height were more likely to present with more negative
MHB scores (r = .443; P < .001). Conversely,
patients with more deficient cleft-side lateral lip transverse width more often
presented with more positive MHB scores (r = .281; P =
.025).
Conclusions
In patients with CUCLP, there is a wide variability in the degree of deficiency of the
cleft-side lateral lip element, both in the vertical and in the transverse dimension.
The extent of this deficiency may, in part, predict the resulting dental arch
relationships.
AltalibiM., SaltajiH., EdwardsR., MajorP.W., Flores-MirC.Indices to assess malocclusion in patients with cleft lip and
palate.Eur J Orthod.2013; 35:
772–782.
2.
BerglandO., SidhuS.S.Occlusal changes from the deciduous to the early mixed dentition in
unilateral complete clefts.Cleft Palate J.1974; 11:
317–326.
3.
BoorerC.J., ChoD.C., VijayasekaranV.S., FisherD.M.Presurgical unilateral cleft lip anthropometrics: implications for the
choice of repair technique.Plast Reconstr Surg.2011; 127:
774–780.
4.
ChiuY.T., LiaoY.F.Is cleft severity related to maxillary growth in patients with unilateral
cleft lip and palate?Cleft Palate Craniofac J.2012; 49:
535–540.
5.
ChiuY.T., LiaoY.F., ChenP.K.Initial cleft severity and maxillary growth in patients with complete
unilateral cleft lip and palate.Am J Orthod Dentofacial Orthop.2011; 140:
189–195.
6.
DaskalogiannakisJ., MehtaM.The need for orthognathic surgery in patients with repaired complete
unilateral and complete bilateral cleft lip and palate.Cleft Palate Craniofac J.2009; 46:
498–502.
7.
DelestanC., MontoyaP., DoucetJ.C., BigorreM., BaümlerC., HerlinC., DauresJ.P., CaptierG.New neonatal classification of unilateral cleft lip and palate—part 1: to
predict primary lateral incisor agenesis and inherent tissue hypoplasia.Cleft Palate Craniofac J.2014; 51:
392–399.
8.
DobbynL.M., WeirJ.T., MacfarlaneT.V., MosseyP.A.Calibration of the modified Huddart and Bodenham scoring system against the
GOSLON/5-year-olds’ index for unilateral cleft lip and palate.Eur J Orthod.2012; 34:
762–767.
9.
DoucetJ.C., DelestanC., MontoyaP., MateiL., BigorreM., HerlinC., BaümlerC., DauresJ.P., CaptierG.New neonatal classification of unilateral cleft lip and palate—part 2: to
predict permanent lateral incisor agenesis and maxillary growth.Cleft Palate Craniofac J.2014; 51:
533–539.
GrayD., MosseyP.A.Evaluation of a modified Huddart/Bodenham scoring system for assessment of
maxillary arch constriction in unilateral cleft lip and palate subjects.Eur J Orthod.2005; 27:
507–511.
13.
GraysonB.H., SantiagoP.E., BrechtL.E., CuttingC.B.Presurgical nasoalveolar molding in infants with cleft lip and
palate.Cleft Palate Craniofac J.1999; 36:
486–498.
14.
HondaY., SuzukiA., NakamuraN., OhishiM.Relationship between primary palatal form and maxillofacial growth in
Japanese children with unilateral cleft lip and palate: infancy to
adolescence.Cleft Palate Craniofac J.2002; 39:
527–534.
15.
HoustonW.J.The analysis of errors in orthodontic measurements.Am J Orthod.1983; 83:
382–390.
16.
HsiehY.J., LiaoY.F., ShettyA.Predictors of poor dental arch relationship in young children with
unilateral cleft lip and palate.Clin Oral Investig.2012; 16:
1261–1266.
17.
HuangC.S., CheungH.C., ChenY.R., NoordhoffM.S.Maxillary dental arch affected by different sleep positions in unilateral
complete cleft lip and palate infants.Cleft Palate Craniofac J.1994; 31:
179–184.
18.
HuddartA.G., BodenhamR.S.The evaluation of arch form and occlusion in unilateral cleft palate
subjects.Cleft Palate J.1972; 9:
194–209.
19.
JohnsonN., WilliamsA., SingerS., SouthallP., SandyJ.Initial cleft size does not correlate with outcome in unilateral cleft lip
and palate.Eur J Orthod.2000; 22:
93–100.
20.
LandisJ.R., KochG.G.An application of hierarchical kappa-type statistics in the assessment of
majority agreement among multiple observers.Biometrics.1977; 33:
363–374.
21.
LiaoY.F., PrasadN.K., ChiuY.T., YunC., ChenP.K.Cleft size at the time of palate repair in complete unilateral cleft lip
and palate as an indicator of maxillary growth.Int J Oral Maxillofac Surg.2010; 39:
956–961.
22.
MeazziniM.C., DonatiV., GarattiniG., BrusatiR.Maxillary growth impairment in cleft lip and palate patients: a simplified
approach in the search for a cause.J Craniofac Surg.2008; 19:
1302–1307.
23.
MeazziniM.C., TortoraC., MorabitoA., GarattiniG., BrusatiR.Factors that affect variability in impairment of maxillary growth in
patients with cleft lip and palate treated using the same surgical
protocol.J Plast Surg Hand Surg.2011; 45:
188–193.
24.
MosseyP.A., ClarkJ.D., GrayD.Preliminary investigation of a modified Huddart/Bodenham scoring system for
assessment of maxillary arch constriction in unilateral cleft lip and palate
subjects.Eur J Orthod.2003; 25:
251–257.
25.
NakamuraN., SuzukiA., TakahashiH., HondaY., SasaguriM., OhishiM.A longitudinal study on influence of primary facial deformities on
maxillofacial growth in patients with cleft lip and palate.Cleft Palate Craniofac J.2005; 42:
633–640.
26.
NoordhoffM.S.The Surgical Technique for the Unilateral Cleft Lip-Nasal Deformity.Taipei, Taiwan: Noordhoff Craniofacial
Foundation;1997.
27.
PeltomäkiT., VendittelliB.L., GraysonB.H., CuttingC.B., BrechtL.E.Associations between severity of clefting and maxillary growth in patients
with unilateral cleft lip and palate treated with infant orthopedics.Cleft Palate Craniofac J.2001; 38:
582–586.
28.
ReiserE., SkoogV., GerdinB., Andlin-SobockiA.Association between cleft size and crossbite in children with cleft palate
and unilateral cleft lip and palate.Cleft Palate Craniofac J.2010; 47:
175–181.
29.
RossR.B.Treatment variables affecting facial growth in complete unilateral cleft
lip and palate.Cleft Palate J.1987; 24:
5–77.
30.
SeckelN.G., van der TweelI., ElemaG.A., SpeckenT.F.Landmark positioning on maxilla of cleft lip and palate infant—a
reality?Cleft Palate Craniofac J.1995; 32:
434–441.
31.
ShawW.C., DahlE., Asher-McDadeC., BrattströmV., MarsM., McWilliamJ., MølstedK., PlintD.A., Prahl-AndersenB., RobertsC.. A six-center international study of
treatment outcome in patients with clefts of the lip and palate: part 5. General
discussion and conclusions.Cleft Palate Craniofac J.1992; 29:
413–418.
32.
StaudtC.B., KiliaridisS.Divergence in prevalence of mesiocclusion caused by different diagnostic
criteria.Am J Orthod Dentofacial Orthop.2009; 135:
323–327.
33.
SuzukiA., MukaiY., OhishiM., MiyanoshitaY., TashiroH.Relationship between cleft severity and dentocraniofacial morphology in
Japanese subjects with isolated cleft palate and complete unilateral cleft lip and
palate.Cleft Palate Craniofac J.1993; 30:
175–181.
34.
WiggmanK., LarsonM., LarsonO., SembG., BrattströmV.The influence of the initial width of the cleft in patients with unilateral
cleft lip and palate related to final treatment outcome in the maxilla at 17 years of
age.Eur J Orthod.2013; 35:
335–340.
