Mandibular morphology in complete unilateral cleft lip and palate.

The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association

PubMedID: 15222791

Swennen G, Berten JL, Kramer FJ, Malevez C, De Mey A, Schwestka-Polly R, Hausamen JE. Mandibular morphology in complete unilateral cleft lip and palate. Cleft Palate Craniofac J. 2004;41(4):403-9.
OBJECTIVE
The purpose of this study was to evaluate and compare mandibular morphology and spatial position in children with complete unilateral cleft lip and palate (UCLP) treated at two different cleft centers (Hannover and Brussels) following different surgical treatment protocols.

PATIENTS
A total of 62 Caucasian children (40 boys, 22 girls) with nonsyndromic complete unilateral cleft lip and palate (UCLP) were evaluated by means of conventional cephalometric analysis at approximately the age of 10 years. Data of both cleft groups were compared with a control, noncleft group (n = 40) matched according to age and sex.

INTERVENTIONS
The Hannover children with cleft (n = 36) underwent lip repair at a mean age of 5.83 +/- 1.16 months. The hard and soft palates were closed at a mean age of 29.08 +/- 4.68 and 32.25 +/- 4.29 months, respectively. The Brussels children with cleft (n = 26) were treated according to the Malek surgical protocol with soft palate repair at a mean age of 3.04 +/- 0.20 months and simultaneous lip and hard palate repair at a mean age of 6.15 +/- 0.68 months.

RESULTS
Statistical analysis (analysis of variance with post hoc Tukey's test) showed a significant (p =.001) smaller mandibular ramus length (Co-Go) in the Brussels cleft group, compared with the control group. The Hannover-Brussels comparison data revealed that the S-N-B angle was significantly (p =.047) less in the Brussels cleft group.

CONCLUSIONS
The influence of surgical procedures in patients with UCLP might not be restricted to the maxilla but could influence mandibular spatial position to the cranial base. Because of these positional changes of the mandible, both cleft groups showed facial balance.