Three-dimensional evaluation of surgical techniques in neonates with orofacial cleft

Abstract

Background:Individuals with cleft lip and palate have many anatomic and functional alterations compromising esthetics, hearing, speech, occlusion, and development/craniofacial growth. The rehabilitative treatment of these patients is very challenging and starts at birth aiming at the best treatment for all functional demands. This study aimed to evaluate the dimensional alterations of the dental arches of neonates with cleft lip and palate after two different primary surgical techniques.Materials and Methods:The sample comprised 114 digital models of children aged from 3 to 36 months, with unilateral complete cleft lip and palate divided into two groups. Two different phases were evaluated: precheiloplasty and 1 year after palatoplasty. The evaluation was performed through the digital models of each child obtained by scanning digitalization (3D Scanner). Dental arches measurements were accomplished through Appliance Designer software. The following measurements were assessed: dental arch area, anterior amplitude of the cleft, total length of dental arch, intercanine distance, and intertuberosity distance. t-test was applied to compare differences between groups.Results:No statistically significant differences were observed between groups at precheiloplasty phase. At 1 year after palatoplasty, the groups differed in the total length of dental arch (P = 0.002), with greater values for Group I.Conclusion:This study suggests that the results of the different surgical techniques may alter the growth and development of the dental arches of neonates with cleft lip and palate.

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

“…The choice of the interincisive point as the axis of symmetry was applied in this study similarly to other anthropometric studies. 16,17,19 The data in the present study corroborate the intrinsic difference in the development of cleft lip and palate. The limitation of anterior linear growth on the cleft side was significant and concurs with the findings of previous studies.…”

“…[16][17][18] Anatomic landmarks and linear parameters were used in the dental arch evaluations according to previous studies with children. 8,9,16,19,20 The following parameters were measured: P-P' -Anterior cleft width (straight line between the most anterior points of the alveolar bone crests); M-M' -Middle cleft width (straight line between the points located in the medial region of the palatal segments adjacent to the cleft); U-U' -Posterior cleft width (straight line between the most posterior points of the palatal segments adjacent to the cleft); I-C' -Anterior intersegment distance (between the interincisive point and the primary canine cusp in the smaller bone segment); I-C -Anterior intrasegment distance (between the interincisive point and the primary canine cusp in the greater bone segment); I-T' -Total intersegment distance (between the interincisive point and the tuberosity of the smaller bone segment); I-T -Total intrasegment distance (between the interincisive point and the tuberosity of the greater bone segment); C'-T' -Cleft-side canine tuberosity distance (between the primary canine cusp and the tuberosity of the smaller bone segment); and C-T -Non-cleft-side canine tuberosity distance (between the primary canine cusp and the tuberosity of the greater bone segment). All the parameters were quantified in mm (Figure 1).…”

Assessment of dental arch stability after orthodontic treatment and oral rehabilitation in complete unilateral cleft lip and palate and non-clefts patients using 3D stereophotogrammetry

“…To evaluate the stability of dental arches, the change between T1 and T2 was obtained through the following formula: Δ = T2-T1 for each of the measures: intercanine distances (C-C′) [18,[25][26][27], inter-molar distances (M-M'), arch length (I-M) [25,27,28], palatal surface and volume [5,24] (Table 1).…”

Evaluation of Palatal Volume in Children With Cleft Lip and Palate: A Comparison of Two Surgical Protocol

“…The literature lacks longitudinal studies on the use of digital resources to measure the palatal volume in children with oral clefts, in the first childhood, after the primary plastic surgeries. Thus, this study complements the literature on the analysis of the dental arches of children with oral clefts submitted to surgical approaches at the first months of life [5,11,17,18,20,21]. In this present study, the palatal growth after the two surgical protocols was modified.…”

“…The rehabilitative protocol begins with the primary surgeries (cheiloplasty -lip repair surgery -and palatoplasty -palate repair surgery), which are aimed at restoring the face symmetry and correcting the anatomic defect, improving esthetics and function to enable favorable conditions and quality of life [5,6]. The Millard technique of cheiloplasty comprises the projection of relaxing incisions that enable the flap rotation to close the lip [7].…”