title: Three-dimensional analysis of maxillary development in patients with unilateral cleft lip and palate during the first six years of life.
abstract: OBJECTIVE
  The purpose of this work was to analyse early upper-jaw development in patients with unilateral cleft lip and palate (UCLP) treated using two different concepts and to compare shape and size developments between these two groups and a group of noncleft patients.
  
  
  METHODS
  A total of 204 maxillary casts available for this study from 50 UCLP patients were analyzed for upper-jaw development based on three-dimensional measurements performed with a Reflex Microscope from birth up to 71 months of age. Thirty-five of these 50 patients were part of an early treatment group (two-stage cleft closure with single-stage palatoplasty at an age of 10-14 months) and 15 were part of a late treatment group (two-stage cleft closure with palatoplasty at an age of 4-7 years). The control group included 39 casts of 17 noncleft patients.
  
  
  RESULTS
  Analysis of shape and size between the patients in the three groups yielded statistically significant differences between the cleft and the noncleft patients. In both treatment groups, we made observations typically associated with cleft formation like lateralization, asymmetry of the greater and lesser cleft segments, and pronounced vertical deviations of the segments. Viewed in all dimensions, however, the patients in the early treatment group approached the control group more closely, although a statistically significant difference was still observed.
  
  
  CONCLUSIONS
  Our results suggest that the timing of hard-palate closure is not a decisive factor for upper-jaw development. Intrinsic factors (initial cleft width, presence of tooth buds) and the surgeon's skills appear to have a much more defining role.
authors.affiliation: Department of Orthodontics, University Medicine Leipzig, Leipzig, Germany.
authors.forename: Nadezhda
authors.initials: N
authors.lastname: Stancheva
authors.affiliation: Department of Orthodontics, University Medicine Leipzig, Leipzig, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Dannhauer
authors.affiliation: Department of Oral and Maxillofacial Plastic Surgery, University Medicine Leipzig, Leipzig, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hemprich
authors.affiliation: Department of Orthodontics and Orofacial Orthopedics, Center for Dentistry and Oral and Maxillofacial Surgery, Universitätsmedizin Greifswald, University Medicine Greifswald, Rotgerberstr. 8, 17475, Greifswald, Germany. kreyk@uni-greifswald.de.
authors.forename: Karl-Friedrich
authors.initials: KF
authors.lastname: Krey
mesh_terms: D000375:Aging / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000473:pathology* / Q000503:physiopathology; D002972:Cleft Palate / Q000473:pathology* / Q000503:physiopathology; D061827:Dimensional Measurement Accuracy; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008437:Maxilla / Q000254:growth & development / Q000473:pathology*; D003765:Models, Dental; D010159:Palate / Q000473:pathology* / Q000503:physiopathology; D012680:Sensitivity and Specificity; D014716:Vertical Dimension
keywords: 3D measurement; Reflex microscope; Treatment concept; Unilateral cleft lip and palate