An innovative analysis of nasolabial dynamics of surgically managed adult patients with unilateral cleft lip and palate using 3D facial motion capture.

AIM: To compare dynamic nasolabial movement between end-of-treatment cleft and a matched non-cleft group in adult patients. MATERIALS AND METHODS: Thirteen treated adult participants with unilateral cleft lip and palate had images taken using a facial motion capture system performing a maximum smile. Seventeen landmarks were automatically tracked. For each landmark pair, on either side of the midline, changes in the x, y, and z directions were used to analyze the magnitude of displacement and path of motion. An asymmetry score was developed at rest, mid-smile, and maximum smile to assess the shape of the mouth and/or nose. RESULTS: At maximum smile, displacement of right and left cheilion was clinically and statistically (p < 0.05) less in the cleft group. The lip asymmetry score was greater (p < 0.05) at each time point in the cleft group using the clinical midline. Using Procrustes superimposition, the differences were significant (p < 0.05) only at rest and mid-smile. The alar bases were displaced significantly less (p < 0.05) in the z direction in the cleft group. The asymmetry score of the alar base was significantly higher using the clinical midline than using Procrustes superimposition in patients with cleft conditions (p < 0.001). In the cleft group, at maximum smile, the right and left cristae philter moved significantly less (p < 0.05) in the x and z directions. CONCLUSIONS: There was an increase in asymmetry score of the corners of the mouth and alar bases from rest to maximum smile. The lips were similar in shape but oriented differently in the faces of patients with cleft conditions than in individuals without those conditions.

Maxillary dental arch and occlusion in repaired clefts of the secondary palate: influence of surgical closure with minimal denudation of bone.

A change in the method of surgical repair of cleft palate initiated this study of 64 patients with various degree of clefts of the secondary palate. Study casts were obtained at different ages. Certain measurements were taken and compared with those made in a previous investigation of similar patients operated on by the so-called "push-back" technique. Growth in the width of the maxillary dental arch and occlusion had improved, but there were significant differences only for the patients with velar clefts.

Features of maxillary arch and nasal cavity in infancy and their influence on deciduous occlusion in unilateral cleft lip and palate.

The purpose of this study was to test the statistical relationship between certain preoperative characteristics of the maxilla and nasal cavity and later occlusal development in patients born with complete unilateral cleft lip and palate. The sample consisted of 51 patients and 22 of them had undergone surgical treatment which included vomer flap and pushback palatal repair, while the remaining 29 patients were treated with a routine characterized by delayed closure of the hard palate. Twelve variables related to 4 different maxillary and nasal areas were recorded from maxillary casts and frontal cephalograms obtained in infancy. Crossbite scores and maxillary intercanine width were determined from dental casts taken at 3 years of age. Multiple linear regression analysis showed that the preoperative variables selected as predictors of maxillary development at the age of 3 did not explain more than half of the variation found in our subjects. Also, the predictors were not the same in the two surgical subgroups. To improve our ability to predict, further variables should be tested and, if possible, added to the regression formulae.