Cephalometric evaluation of dentocraniofacial morphology of patients with unilateral cleft lip and palatate

Abstract

Introduction: Orthodontic treatment of the patients with unilateral cleft lip and palate (UCLP) still remains a significant challenge for practitioners. In order to have good treatment results, we must know which are the characteristic underlying orthodontic problems. Many studies have assessed craniomorphological deviations in patients with UCLP. However, there is controversy in the literature concerning many of these aspects. The goal of our study was: to evaluate the specific dentocraniofacial morphology of patients with unilateral cleft lip and palate with the aid of cephalometric analysis. Materials and methods: This investigation was designed as a retrospective observationa study. The studygroup comprised seven patients with UCLP, with the mean age of eightyears Measurement were taken from lateral cephalograms according to four methods, described by Tweed, McNamara, Rickets and Steiner, using AudaxCeph software.Statistical analysis was performed according to student t-test procedure. Results: Assessment of 51 variables and a total of 357 measurements revealed structural defficience specific to patients with UCLP. The maxilla had a retrusive position relative to cranial base confirmed by the calculated values of the angles SNA, ANB, A-N_Pg. Reduced posterior midfacial height and larger total anterior facial height demonstrate a backword rotation of the maxillo-mandibular complex. Sagital maxillary deficiency was associated with a retroclined position of the upper incisors, which is approved by significant deviations of the interincisival angle and Is / AN. Statistical important deviations of the parameters that describe the soft tissue profile, reported complex esthetic deviations of the upper lip and facial convexity. Conclusions: Cephalometric analysis of seven patiens with UCLP revealed several specific morphological dentocraniofacial characteristics. The maxillary skeletal retrusion was found to be one of the greatests problem to solve. A clockwise rotation of the maxillo-mandibular complex was determined to be induces by vertical posterior deficiencies. The upper incisors are in palatoversion and lock the lower incisors in linguoversion. In all the patients, it was determined a tendency to develop an unfavorable Class III skeletal pattern.