The aim: (1) to analyze the growth of cleft palate in patients with complete unilateral cleft of the lip and palate (cUCLP) after cheiloplasty with primary periosteoplasty, and (2) to compare the results with published data of younger cUCLP patients after neonatal cheiloplasty. Materials and methods: The study deals with the longitudinal growth changes of the palate, including alveolar segments and its variability within the analysed group of 14 patients with cUCLP. Twenty eight dental plaster casts obtained from each patient in the two examinations (before cheiloplasty and before palatoplasty) were used for the analysis. The first dental plaster cast was taken from patients with an average age of 8.5 months, while the average age for second continuous casting was 4.5 years. Dental casts were scanned using a 3D laser scanner and then analysed, using methods of geometric morphometrics. Results: Palatal morphology did not differ significantly between the sexes, but a statistically significant growth of palate was detected. A detailed colour-coded map identified the most marked growth at the anterior and posterior ends of both segments. Growth insufficiency of the smaller upper jaw segment after cheiloplasty with periosteoplasty was detected. Conclusion: The reconstructed lip of both compared groups (neonatal and later cheiloplasty) exerts a natural formative effect on the actively growing anterior parts of split segments, which grow towards each other. But on top of that, neonatal cheiloplasty has many other benefits (wound healing, feeding facilitation, socialization), and so it is the most common surgical approach in the Czech Republic now.

• MeSH
• čelisti MeSH
• lidé MeSH
• neonatologie MeSH
• novorozenec MeSH
• plastická chirurgie MeSH
• rozštěp patra * MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND: A new method of early neonatal cheiloplasty has recently been employed on patients having complete unilateral cleft lip and palate (cUCLP). We aimed to investigate (1) their detailed palatal morphology before surgery and growth during the 10 months after neonatal cheiloplasty, (2) the growth of eight dimensions of the maxilla in these patients, (3) the development of these dimensions compared with published data on noncleft controls and on cUCLP patients operated using later operation protocol (LOP; 6 months of age). METHODS: Sixty-six virtual dental models of 33 longitudinally evaluated cUCLP patients were analysed using metric analysis, a dense correspondence model, and multivariate statistics. We compared the palatal surfaces before neonatal cheiloplasty (mean age, 4 days) and before palatoplasty (mean age, 10 months). RESULTS: The palatal form variability of 10-month-old children was considerably reduced during the observed period thanks to their undisturbed growth, that is, the palate underwent the same growth changes following neonatal cheiloplasty. A detailed colour-coded map identified the most marked growth at the anterior and posterior ends of both segments. The maxilla of cUCLP patients after neonatal cheiloplasty had a growth tendency similar to noncleft controls (unlike LOP). CONCLUSIONS: Both methodological approaches showed that early neonatal cheiloplasty in cUCLP patients did not prevent forward growth of the upper jaw segments and did not reduce either the length or width of the maxilla during the first 10 months of life.

• MeSH
• algoritmy MeSH
• antropometrie metody   MeSH
• kojenec MeSH
• lidé MeSH
• maxila růst a vývoj   MeSH
• novorozenec MeSH
• patro růst a vývoj   MeSH
• rozštěp patra chirurgie   MeSH
• rozštěp rtu chirurgie   MeSH
• velikost orgánu MeSH
• zákroky plastické chirurgie MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To evaluate the facial morphology of pre-school patients with various types of orofacial cleft after neonatal cheiloplasty in pre-school aged children; and to compare facial variability and mean shape with age-corresponding healthy controls. MATERIALS AND METHODS: The sample included 40 patients with unilateral cleft lip (CL), 22 patients with unilateral cleft lip and palate (UCLP), and 10 patients with bilateral cleft lip and palate (BCLP). Patients were divided into two age categories, with a mean age of 3 years and 4.5 years, respectively. The group of healthy age-matched controls contained 60 individuals. Three-dimensional virtual facial models were evaluated using geometric morphometry and multivariate statistics methods. RESULTS: Statistically significant differences were found between each of the cleft groups and the controls. Color-coded maps showed facial shape deviations, which were located mainly in the nasal area and philtrum in all groups examined, and also in the buccal region and the chin in patients with UCLP or BCLP. These differences became more apparent, but not significantly so, in the older age category. CONCLUSION: Facial deviations typical of patients with clefts were observed in all of the patient groups examined. Although the analysis showed statistically significant differences in overall facial shape between patients and controls among all groups tested, the facial morphology in patients who have undergone only neonatal cheiloplasty (CL) is influenced to a small extent and may be considered satisfactory. More severe cleft types (UCLP, BCLP) together with palatoplasty, are reflected in more marked impairments in facial shape.

• MeSH
• anatomická značka MeSH
• lidé MeSH
• maxilofaciální vývoj * MeSH
• předškolní dítě MeSH
• rozštěp patra chirurgie   MeSH
• rozštěp rtu chirurgie   MeSH
• studie případů a kontrol MeSH
• zobrazování trojrozměrné * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH