Arch Asymmetry in Patients With Cleft Lip and Palate After Rehabilitation Treatment Using Stereophotogrammetry

Abstract

Arch asymmetry in cleft patients is a current problem that interdisciplinary treatment aims to solve. This research proposed to analyze the final rehabilitation, according to the arch symmetry of these patients. Thirty-five patients aged between 18 and 30 years, rehabilitated with a fixed partial denture or implants in the cleft area. The analysis was performed using digitalized dental casts with a laser model scanner (R700TM; 3Shape A/S, Holmens Kanal 7, 1060, Copenhagen/Denmark), analyzed with a Vectra Analysis Module software program (VECTRA H1; Canfield Scientific, 4 Wood Hollow Road, Parsippany, NJ 07054). Three linear measurements were evaluated, incisal-canine, canine-molar, and incisalmolar distance. The Student t test was applied to test the significance (P ¼ 0.05) of an observed sample by correlation coefficient test (r-value). Female patients showed a significant correlation in arch symmetry. According to the rehabilitation treatment, patients who received implants showed a high correlation and significant symmetry at all maxillary distances. Finally, according to the cleft side in the maxillary dimensions, even though the majority of patients had clefts on the left side, only patients with a cleft on the right side showed symmetry in this area. Patients rehabilitated with implants in the cleft area showed a more symmetrical maxillary arch than those restored with fixed partial dentures.

Long-term follow-up of mandibular dental arch changes in patients with complete non-syndromic unilateral cleft lip, alveolus, and palate

“…The changes were partly due to continuous mandibular growth. A series of studies from Brazil in a convenience UCLP sample reported on short term changes (one year after treatment) primarily of the maxillary dental arch in relation to rehabilitation with a dental implant or anterior fixed bridgework ( Caballero et al, 2019 ; Rezende Pucciarelli et al, 2020 ; Pucciarelli et al., 2021 ; Soares et al, 2021a ; Soares et al, 2021b ). These studies showed that the maxillary arch was not stable until one year posttreatment regardless of the type of prosthetic rehabilitation.…”

“…Maxillary dental arch transverse dimensions and dental arch relationships following different treatment protocols for patients with orofacial clefts have been the topic of studies and systematic reviews that evaluated treatment outcome in relation to different treatment parameters such as timing of palatal surgery in relation to craniofacial outcome ( Kappen et al, 2018 ), timing of primary alveolar bone grafting ( Carbullido et al, 2021 ), outcome of maxillary distraction ( Kloukos et al, 2018 ), and rehabilitation of the maxillary arch with a dental implant or an anterior fixed partial denture replacing the missing lateral incisor at the cleft side ( Caballero et al, 2019 ; Rezende Pucciarelli et al, 2020 ; Pucciarelli et al., 2021 ; Soares et al, 2021a ; Soares et al, 2021b ). However, those studies did not pay much attention to concomitant changes in the mandibular arch of patients with cleft lip and palate that occur after treatment.…”

“…To our knowledge no studies are available in the literature that describe transverse changes in the mandibular arch. It is well-known that the maxillary arch, and in particular the transverse dimension, in patients with a cleft palate is prone to changes after treatment ( Marcusson & Paulin, 2004 ; Al-Gunaid et al, 2008 ; Semb, Ronning & Abyholm, 2011 ; Rezende Pucciarelli et al., 2020 ; Soares et al, 2021a ; Soares et al, 2021b ). Especially because often a considerable amount of expansion is needed during the orthodontic treatment to overcome the constrictive effect of palatal scar tissue.…”

Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study

“…5,[9][10][11] Symmetry in individuals with cleft lip and palate has been evaluated in both soft and hard tissues. 12 The analysis of palate symmetry in children is essential before and after surgical repairs. 5 Therefore, it is essential to analyze segments with and without clefts at the very beginning of the rehabilitation protocol to establish correlations between palatal parameters.…”

“…5 Therefore, it is essential to analyze segments with and without clefts at the very beginning of the rehabilitation protocol to establish correlations between palatal parameters. 12 In individuals with orofacial clefts, three-dimensional imaging technology provides quantitative data with proven accuracy and speed. 5,13 Palate asymmetry in children with craniofacial anomalies is correlated with factors such as orofacial cleft phenotype classification, treatment protocol, cleft length, and cleft width.…”