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Morphologic variability of nonsyndromic operated patients affected by cleft lip and palate: A geometric morphometric study

2014; Elsevier BV; Volume: 146; Issue: 3 Linguagem: Inglês

10.1016/j.ajodo.2014.06.002

1097-6752

Viviana Toro‐Ibacache, Juan Cortés Araya, Alejandro Díaz Muñoz, Germán Manríquez Soto,

dental development and anomalies

•We compared the facial shapes of subjects affected and unaffected by unilateral cleft lip and palate (UCLP). •The operated UCLP patients had a broader range of craniofacial features than did the controls. •The main features in the operated UCLP group were a Class III profile and a smaller centroid size. •Upper and lower face covariation was stronger in the operated UCLP group and related to Class III features. •Postsurgery, normal occlusion would be a key to a harmonic craniofacial development in patients with UCLP. Introduction In this study, we compared patterns of morphologic variations of the craniofacial skeleton between patients affected by clefts who were operated on and unaffected subjects, aiming to discuss possible morpho-functional consequences of treatment in craniofacial development. Methods The lateral cephalograms of 76 subjects, comprising patients with operated unilateral cleft lip and palate (OpC) and a group matched for sex and age without cleft, were used. Thirteen landmarks were used as variables in geometric morphometric tests quantifying and describing overall shape variation, differences between group means, allometry, and upper-lower face covariation. Results The OpC group showed broader shape variations including noncleft group characteristics, but mainly a retrognathic maxilla, a vertically elongated face, a more open mandibular angle, and a more closed basicranial angle. Group means differed mainly in the maxillomandibular relationships. Allometry differed between groups, with the smallest OpC patients showing the most altered morphology. Upper and lower face covariation was stronger in the OpC group, showing mainly vertical changes in the anterior face. Conclusions Operated patients affected by clefts achieve a broad range of morphologies; the most altered were found in those with skeletal Class III and small size. Furthermore, their strongest upper and lower face shape covariation suggests that a harmonic dental occlusion could be a key factor in achieving "normal" craniofacial morphology.