Do Patients With Cleft Lip and Palate Differ From Normal Individuals in Skeletal Maturity?

Abstract

Orthopedic treatment to improve deficient maxillary growth of cleft lip and palate patients is an important part of treatment. The success of this treatment is strongly dependent on the time of initiation of therapy. There has been a large controversy in the available literature regarding the skeletal age of these patients. The aim of the present study was to compare the skeletal age of cleft lip and palate patients with normal individuals.37 unilateral and 14 bilateral cleft lip and palate patients and 47 healthy individuals participated in this cross-sectional study. The patients were classified into 8 to 10 and 11 to 14-year-old individuals. Cervical vertebral maturational stage of participants was evaluated in the lateral cephalometry. The skeletal age of cleft lip and palate patients was compared with normal controls. Chi-square was used for statistical analysis. There was not a significant difference in the skeletal developmental stage of unilateral and bilateral cleft compared to their normal peers according to their age and sex. Also, significant difference in skeletal maturational stage of cleft lip and palate patients was not found between boys and girls (P = 0.8). Similarly, no significant difference was found in the skeletal age of the 3 studied groups without considering the age and sex of participants (P = 0.5). Regarding the similar skeletal maturational stage of cleft lip and palate patients with normal controls in our study, their maxillofacial orthopedic treatment can be initiated at similar time to normal peers.

Skeletal Maturation in Patients With Cleft Lip and/or Palate: A Systematic Review

“…The sex composition varied among the included articles. Three articles consisted of more males than females (Menius et al, 1966; Akarsu-Guven et al, 2015; Cesur et al, 2018); 3 articles consisted of more females than males (Pisek et al, 2013; Ravi and Ravikala, 2013; Jahanbin et al, 2020), and 1 article included the same number of males and females (Ozturk et al, 2020). Three articles only included males (Jensen et al, 1983; Sun and Li, 2012; Batwa et al, 2018), while 1 article only included females (Sun and Li, 2013).…”

“…The maximum patient age in this review was 20 years. Six studies subdivided their populations according to chronological age to investigate skeletal maturation in each age bracket (Sun and Li, 2012; Sun and Li, 2013; Ravi and Ravikala, 2013; Batwa et al, 2018; Cesur et al, 2018; Jahanbin et al, 2020). The detailed group distribution according to chronological age in each study is presented in Table 1.…”

“…Three studies included patients with unilateral cleft lip and palate (UCLP) (Ravi and Ravikala, 2013; Batwa et al, 2018; Cesur et al, 2018) and one study included patients with bilateral cleft lip and palate (BCLP) (Akarsu-Guven et al, 2015). A mix of different cleft types was studied in 3 articles, including patients with UCLP, BCLP, cleft lip, and CP (Sun and Li, 2012; Sun and Li, 2013; Jahanbin et al, 2020). Six articles did not describe the specific type of CL/P included in their studies (Menius et al, 1966; Jensen et al, 1983; Pisek et al, 2013; Flieger et al, 2015; Komala et al, 2019; Ozturk et al, 2020).…”

“…To evaluate skeletal maturity, 2 articles used both CVM and HWM (Batwa et al, 2018; Ozturk et al, 2020), 9 articles used CVM only (Sun and Li, 2012; Ravi and Ravikala, 2013; Sun and Li, 2013; Pisek et al, 2013; Akarsu-Guven et al, 2015; Flieger et al, 2015; Cesur et al, 2018; Komala et al, 2019; Jahanbin et al, 2020), and 2 articles used HWM only (Menius et al, 1966; Jensen et al, 1983). Cervical vertebral maturation was evaluated by lateral cephalograms, while HWM was evaluated using handwrist radiographs.…”

“…However, the results of these studies are contradictory (Aduss, 1971; Ross, 1987; Cunningham and Jerome, 1997; van der Plas et al, 2012). Some studies (Menius et al, 1966; Sun and Li, 2012; Sun and Li, 2013; Cesur et al, 2018) reported that the skeletal maturation of CL/P children is delayed, while others (Komala et al, 2019; Jahanbin et al, 2020) reported that there was no statistically significant difference in skeletal maturation. Furthermore, some previous studies have reported that patients with CL/P have advanced growth potential (Ross, 1987; Pisek et al, 2013).…”