Volume 7, Issue 2 (4-2019)                   J. Pediatr. Rev 2019, 7(2): 121-127 | Back to browse issues page


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Sutthidechanai W, Viriyasiri N, Viteporn S. Soft Tissue Profile Changes Following Orthodontic Treatment in Patients With Unilateral Cleft Lip and Palate. J. Pediatr. Rev 2019; 7 (2) :121-127
URL: http://jpr.mazums.ac.ir/article-1-178-en.html
1- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
2- Craniofacial Anomalies Clinic, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
3- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand. , smorntree@hotmail.com
Abstract:   (6980 Views)
Background: Anterior crossbite is a frequent malocclusion in patients with Unilateral Cleft Lip and Palate (UCLP). Several studies have investigated the effects of orthognathic surgery or orthopedic treatment on correction of this malocclusion. Only few studies evaluated the effect of conventional orthodontic treatment on growing patients
Objective: The present study investigated significant changes of facial profile as well as the underlying hard tissue following conventional orthodontic treatment in growing subjects with UCLP.
Methods: Lateral cephalograms of 32 non-syndromic children with UCLP (15 boys, 17 girls) with the Mean±SD age of 10.91±2.00 years were retrospectively collected. All patients had complete orthodontic records before and after treatments, indicating the acceptable treatment results, in respect of the degree of overbite, overjet, maximum intercuspation occlusion and facial profile. Cephalometric measurements represented dentoskeletal and soft tissue profile before and after treatments were evaluated, and significant changes were assessed by paired t test. One-sample t test was used to analyze significant differences between these measurements and the clinical norm. 
Results: The initial characteristics of the UCLP patients were skeletal class III maxillary retrusion with relative mandibular prognathism, retroclination of the incisors, negative overjet, and increased overbite and concave facial profile. After conventional orthodontic treatment, maxillary arch expansion and class III elastic traction, the acceptable overbite and overjet were achieved by proclination of the upper incisors. Significant changes of the soft tissue profile due to facial growth and treatment included increase in facial convexity, nose length, nose depth, columellar length, soft tissue face height ratio, upper and lower lip lengths and upper lip protrusion. The soft tissue profile was acceptable after the treatment, compared to the clinical norm. 
Conclusions: The early correction of the anterior crossbite with maxillary arch expansion and class III traction could improve the soft tissue facial profile of patients with UCLP. 
Full-Text [PDF 1205 kb]   (2909 Downloads) |   |   Full-Text (HTML)  (1963 Views)  
Type of Study: Original Article | Subject: Dentistry
Received: 2018/01/22 | Accepted: 2018/04/29 | Published: 2019/04/1

References
1. Fraser FC. The genetics of cleft lip and cleft palate. American Journal of Human Genetics. 1970; 22(3):336-52. [PMID] [PMCID] [PMID] [PMCID]
2. Li Y, Shi B, Song QG, Zuo H, Zheng Q. Effects of lip repair on maxillary growth and facial soft tissue development in patients with a complete unilateral cleft of lip, alveolus and palate. Journal of Cranio-Maxillofacial Surgery. 2006; 34(6):355-61. [DOI:10.1016/j.jcms.2006.03.005] [PMID] [DOI:10.1016/j.jcms.2006.03.005]
3. Mars M, Houston WJ. A preliminary study of facial growth and morphology in unoperated male unilateral cleft lip and palate subjects over 13 years of age. Cleft Palate Journal. 1990; 27(1):7-10. [DOI:10.1597/1545-1569(1990)0272.3.CO;2] [PMID] https://doi.org/10.1597/1545-1569(1990)027<0007:APSOFG>2.3.CO;2 https://doi.org/10.1597/1545-1569_1990_027_0007_apsofg_2.3.co_2 [DOI:10.1597/1545-1569(1990)0272.3.CO;2] [PMID]
4. Ye B, Wu Y, Zhou Y, Jing H, Hu J, Zhang G. A comparative cephalometric study for adult operated cleft palate and unoperated cleft palate patients. Journal of Cranio-Maxillofacial Surgery. 2015; 43(7):1218-23. [DOI:10.1016/j.jcms.2015.04.015] [PMID] [DOI:10.1016/j.jcms.2015.04.015]
5. Chaisrisookumporn N, Stella JP, Epker BN. Cephalometric profile evaluations in patients with cleft lip and palate. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. 1995; 80(2):137-44. [DOI:10.1016/S1079-2104(05)80191-X] [DOI:10.1016/S1079-2104(05)80191-X]
6. Dogan S, Oncag G, Akin Y. Craniofacial development in children with unilateral cleft lip and palate. British Journal of Oral and Maxillofacial Surgery. 2006; 44(1):28-33. [DOI:10.1016/j.bjoms.2005.07.023] [PMID] [DOI:10.1016/j.bjoms.2005.07.023]
7. Horswell BB, Levant BA. Craniofacial growth in unilateral cleft lip and palate: Skeletal growth from eight to eighteen years. The Cleft Palate Journal. 1988; 25(2):114-21. [PMID] [PMID]
8. Liu R, Lu D, Wamalwa P, Li C, Hu H, Zou S. Craniofacial morphology characteristics of operated unilateral complete cleft lip and palate patients in mixed dentition. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011; 112(6):e16-25. [DOI:10.1016/j.tripleo.2011.04.011] [PMID] [DOI:10.1016/j.tripleo.2011.04.011]
9. Moreira I, Suri S, Ross B, Tompson B, Fisher D, Lou W. Soft-tissue profile growth in patients with repaired complete unilateral cleft lip and palate: A cephalometric comparison with normal controls at ages 7, 11, and 18 years. American Journal of Orthodontics and Dentofacial Orthopedics. 2014; 145(3):341-58. [DOI:10.1016/j.ajodo.2013.11.018] [PMID] [DOI:10.1016/j.ajodo.2013.11.018]
10. Liu RK, Wamalwa P, Lu DW, Li CH, Hu HK, Zou S. Soft-tissue characteristics of operated unilateral complete cleft lip and palate patients in mixed dentition. Journal of Craniofacial Surgery. 2011; 22(4):1275-9. [DOI:10.1097/SCS.0b013e31821c6a96] [PMID] [DOI:10.1097/SCS.0b013e31821c6a96]
11. Al Waheidi EM, Harradine NW, Orth M. Soft tissue profile changes in patients with cleft lip and palate following maxillary osteotomies. The Cleft Palate-Craniofacial Journal. 1998; 35(6):535-43. [DOI:10.1597/1545-1569(1998)0352.3.CO;2] [PMID] https://doi.org/10.1597/1545-1569(1998)035<0535:STPCIP>2.3.CO;2 https://doi.org/10.1597/1545-1569_1998_035_0535_stpcip_2.3.co_2 [DOI:10.1597/1545-1569(1998)0352.3.CO;2] [PMID]
12. Yun YS, Uhm KI, Kim JN, Shin DH, Choi HG, Kim SH, et al. Bone and soft tissue changes after two-jaw surgery in cleft patients. Archives of Plastic Surgery. 2015; 42(4):419-23. [DOI:10.5999/aps.2015.42.4.419] [PMID] [PMCID] [DOI:10.5999/aps.2015.42.4.419]
13. Heliövaara A, Hukki J, Ranta R, Rintala A. Soft tissue profile changes after Le Fort I osteotomy in UCLP patients. Journal of Cranio-Maxillo-Facial Surgery. 2000; 28(1):25-30. [DOI:10.1054/jcms.2000.0109] [PMID] [DOI:10.1054/jcms.2000.0109]
14. Susarla SM, Berli JU, Kumar A. Midfacial volumetric and upper lip soft tissue changes after Le Fort I advancement of the cleft maxilla. Journal of Oral and Maxillofacial Surgery. 2015; 73(4):708-18. [DOI:10.1016/j.joms.2014.10.033] [PMID] [DOI:10.1016/j.joms.2014.10.033]
15. Markose E, Paulose J, Paul ET. Soft tissue changes in cleft lip and palate patients: Anterior maxillary distraction versus conventional Le-Fort I osteotomy. Journal of Maxillofacial and Oral Surgery. 2013; 12(4):429-35. [DOI:10.1007/s12663-012-0467-2] [PMID] [PMCID] [DOI:10.1007/s12663-012-0467-2]
16. Tindlund RS, Rygh P. Soft-tissue profile changes during widening and protraction of the maxilla in patients with cleft lip and palate compared with normal growth and development. The Cleft Palate-Craniofacial Journal. 1993; 30(5):454-68. [DOI:10.1597/1545-1569_1993_030_0454_stpcdw_2.3.co_2] [DOI:10.1597/1545-1569_1993_030_0454_stpcdw_2.3.co_2]
17. Tindlund RS, Rygh P. Maxillary protraction: Different effects on facial morphology in unilateral and bilateral cleft lip and palate patients. The Cleft Palate-Craniofacial Journal. 1993; 30(2):208-21. [DOI:10.1597/1545-1569(1993)0302.3.CO;2] [PMID] https://doi.org/10.1597/1545-1569(1993)030<0208:MPDEOF>2.3.CO;2 https://doi.org/10.1597/1545-1569_1993_030_0208_mpdeof_2.3.co_2 [DOI:10.1597/1545-1569(1993)0302.3.CO;2] [PMID]
18. Chen KF, Lai ying So L. Sagittal skeletal and dental changes of reverse headgear treatment in Chinese boys with complete unilateral cleft lip and palate. The Angle Orthodontist. 1996; 66(5):363-72. [PMID] [PMID]
19. Chen KF, Lai ying So L. Soft tissue profile changes of reverse headgear treatment in Chinese boys with complete unilateral cleft lip and palate. The Angle Orthodontist. 1997; 67(1):31-8. [PMID] [PMID]
20. Yatabe M, Garib DG, de Souza Faco RA, de Clerck H, Janson G, Nguyen T, et al. Bone-anchored maxillary protraction therapy in patients with unilateral complete cleft lip and palate: 3-dimensional assessment of maxillary effects. American Journal of Orthodontics and Dentofacial Orthopedics. 2017; 152(3):327-35. [DOI:10.1016/j.ajodo.2016.12.024] [PMID] [PMCID] [DOI:10.1016/j.ajodo.2016.12.024]
21. Schultes G, Gaggl A, Kärcher H. A comparison of growth impairment and orthodontic results in adult patients with clefts of palate and unilateral clefts of lip, palate and alveolus. British Journal of Oral and Maxillofacial Surgery. 2000; 38(1):26-32. [DOI:10.1054/bjom.1999.0132] [PMID] [DOI:10.1054/bjom.1999.0132]
22. Houston WJ. The analysis of errors in orthodontic measurements. American journal of orthodontics. 1983; 83(5):382-90. [DOI:10.1016/0002-9416(83)90322-6] [DOI:10.1016/0002-9416(83)90322-6]
23. Naqvi ZA, Shivalinga BM, Ravi S, Munawwar SS. Effect of cleft lip palate repair on craniofacial growth. Journal of Orthodontic Science. 2015; 4(3):59-64. [DOI:10.4103/2278-0203.160236] [PMID] [PMCID] [DOI:10.4103/2278-0203.160236]
24. Al-Abdwani R, Moles DR, Noar JH. Change of incisor inclination effects on points A and B. The Angle Orthodontist. 2009; 79(2):462-7. [DOI:10.2319/041708-218.1] [DOI:10.2319/041708-218.1]
25. Al Nimri KS, Hazza'a AM, Al Omari RM. Maxillary incisor proclination effect on the position of point A in Class II division 2 malocclusion. The Angle Orthodontist. 2009; 79(5):880-4. [DOI:10.2319/082408-447.1] [PMID] [DOI:10.2319/082408-447.1]
26. Chen Q, Zhang C, Zhou Y. The effects of incisor inclination changes on the position of point A in Class II division 2 malocclusion using three-dimensional evaluation: A long-term prospective study. International Journal of Clinical and Experimental Medicine. 2014; 7(10):3454-60. [PMID] [PMCID] [PMID] [PMCID]
27. Berg R. Stability of deep overbite correction. The European Journal of Orthodontics. 1983; 5(1):75-83. [DOI:10.1093/ejo/5.1.75] [PMID] [DOI:10.1093/ejo/5.1.75]
28. Ludwig M. A cephalometric analysis of the relationship between facial pattern, interincisal angulation and anterior overbite changes. The Angle Orthodontist. 1967; 37(3):194-204. [PMID] [PMID]
29. Jiuxiang L, Jinfuang H, Xiangleng Z. A cephalometric evaluation of hard and soft tissue changes during Class III traction. The European Journal of Orthodontics. 1985; 7(3):201-4. [DOI:10.1093/ejo/7.3.201] [DOI:10.1093/ejo/7.3.201]
30. Ufuk Toygar T, Okan Akçam M, Arman A. A cephalometric evaluation of lower lip in patients with unilateral cleft lip and palate. The Cleft Palate-Craniofacial Journal. 2004; 41(5):485-9. [DOI:10.1597/03-115.1] [PMID] [DOI:10.1597/03-115.1]
31. Nollet PJ, Katsaros C, Huyskens RW, Borstlap WA, Bronkhorst EM, Kuijpers Jagtman AM. Cephalometric evaluation of long-term craniofacial development in unilateral cleft lip and palate patients treated with delayed hard palate closure. International Journal of Oral and Maxillofacial Surgery. 2008; 37(2):123-30. [DOI:10.1016/j.ijom.2007.09.168] [PMID] [DOI:10.1016/j.ijom.2007.09.168]
32. Sadowsky C, Aduss H, Pruzansky S. The soft tissue profile in unilateral clefts. The Angle Orthodontist. 1973; 43(3):233-46. [PMID] [PMID]

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