Longitudinal craniofacial growth patterns in patients with orofacial clefts: geometric morphometrics.
OBJECTIVE
To demonstrate craniofacial developmental patterns in repaired cleft lip and cleft palate (CLP).


METHODS
Retrospective, longitudinal.


METHODS
Center for Craniofacial Disorders, San Juan, Puerto Rico.


METHODS
Males aged 9 to 17 years: 13 noncleft (NC) Class I occlusion (NCC1); 13 NC Class III malocclusion (NCC3); 12 CLP Class I occlusion (CLPC1); and 15 CLP Class III malocclusion (CLPC3).


METHODS
Form changes (ages 10, 13, and 16 years), using finite-element scaling analysis.


RESULTS
NCC1, 10 to 13 interval: 30% size increase in upper midface (p <.05), mental region (p <.01), mandibular body (p <.05); 13 to 16 interval: 10% to 35% size increase in bimaxillary region and ramus (p <.01). NCC3, 10 to 13 interval: 10% to 40% size increase in posterior cranial base, upper midface, and mandible (p <.05); 13 to 16 interval: 10% to 30% size increase in bimaxillary region (p <.01), especially ramus. CLPC1, 10 to 13 interval: 10% to 15% size increase in posterior cranial base (p <.01), midface (p <.05), and mandibular ramus (p <.05); 13 to 16 interval: 8% to 20% size increase in upper midface (p <.01), lower midface (p <.05), and mandible (p <.05). CLPC3, 10 to 13 interval: no significant changes; 13 to 16 interval: upper midface and cranial base show nonsignificant size decreases, but ramus showed size increase.


CONCLUSIONS
Noncleft and CLP Class 1 occlusion groups show similar craniofacial growth patterns. Noncleft Class III groups show excessive cranial and mandibular growth. Class III malocclusion in CLP patients is associated with clinically deficient craniomaxillary growth. Growth guidance may be indicated in children with CLP with unfavorable craniofacial growth patterns.
School of Medicine, University of Puerto Rico, San Juan, Puerto Rico. gdsingh@rcm.upr.edu
G D
GD
Singh
Jasmin
J
Rivera-Robles
Jaime
J
de Jesus-Vinas
D000293:Adolescent; D016022:Case-Control Studies; D002508:Cephalometry; D002648:Child; D002971:Cleft Lip / Q000503:physiopathology; D002972:Cleft Palate / Q000503:physiopathology* / Q000601:surgery; D020342:Finite Element Analysis; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008313:Malocclusion, Angle Class III / Q000503:physiopathology; D008445:Maxillofacial Development; D012189:Retrospective Studies; D019291:Skull Base / Q000254:growth & development