Prognosis of facial growth in patients with unilateral complete clefts of the lip, alveolus and palate

TY - JOUR

T1 - Prognosis of facial growth in patients with unilateral complete clefts of the lip, alveolus and palate

AU - Scheuer, H A

AU - Höltje, W J

AU - Hasund, A

AU - Pfeifer, G

PY - 2001/8/1

Y1 - 2001/8/1

N2 - AIM: Unfavourable facial growth in patients with cleft lip, alveolus, and palate may occur during puberty. Usually this development is not predictable in a young patient. The aim of the present study was to find an individual growth prediction at an early age that would allow us to decide whether later orthognathic surgery should be included in the treatment plan.MATERIAL AND METHODS: Lateral cephalograms of 41 patients with unilateral clefts of lip, alveolus and palate (uCLAP) with observation intervals of 4 years were computerized, correlations between the variables of the first and second radiograph were calculated and regression equations were established.RESULTS: The skeletal change of the intermaxillary relationship can be explained purely by the lack of midfacial growth. An individual prediction of the angle SNA over a period of 4 years is possible with a correlation coefficient of 0.95. Additional predictions for SNB, Holdaway angle and the index of anterior facial height proportions are demonstrated.CONCLUSION: The prediction procedure elaborated in this paper facilitates the decision at the age of 12 years already, whether or not orthodontic occlusal treatment has been successfully completed at an early age. The alternative is to limit orthodontic treatment to the simple alignment of the two dental arches independently of their intermaxillary relation, and then to correct the facial skeleton and the dental occlusion simultaneously by combining surgical and orthodontic treatment after the completion of growth.

AB - AIM: Unfavourable facial growth in patients with cleft lip, alveolus, and palate may occur during puberty. Usually this development is not predictable in a young patient. The aim of the present study was to find an individual growth prediction at an early age that would allow us to decide whether later orthognathic surgery should be included in the treatment plan.MATERIAL AND METHODS: Lateral cephalograms of 41 patients with unilateral clefts of lip, alveolus and palate (uCLAP) with observation intervals of 4 years were computerized, correlations between the variables of the first and second radiograph were calculated and regression equations were established.RESULTS: The skeletal change of the intermaxillary relationship can be explained purely by the lack of midfacial growth. An individual prediction of the angle SNA over a period of 4 years is possible with a correlation coefficient of 0.95. Additional predictions for SNB, Holdaway angle and the index of anterior facial height proportions are demonstrated.CONCLUSION: The prediction procedure elaborated in this paper facilitates the decision at the age of 12 years already, whether or not orthodontic occlusal treatment has been successfully completed at an early age. The alternative is to limit orthodontic treatment to the simple alignment of the two dental arches independently of their intermaxillary relation, and then to correct the facial skeleton and the dental occlusion simultaneously by combining surgical and orthodontic treatment after the completion of growth.

KW - Adolescent

KW - Cephalometry

KW - Child

KW - Cleft Lip

KW - Cleft Palate

KW - Female

KW - Humans

KW - Linear Models

KW - Male

KW - Maxillofacial Development

KW - Patient Care Planning

KW - Predictive Value of Tests

KW - Prognosis

U2 - 10.1054/jcms.2001.0227

DO - 10.1054/jcms.2001.0227

M3 - SCORING: Journal article

C2 - 11562088

VL - 29

SP - 198

EP - 204

JO - J CRANIO MAXILL SURG

JF - J CRANIO MAXILL SURG

SN - 1010-5182

IS - 4

ER -