Alveolar bone grafting (ABG) is a critical surgical intervention in patients with a cleft of the alveolus, aimed at reconstructing the alveolar ridge to facilitate proper eruption, periodontal support, and alignment of adjacent permanent teeth. The optimal timing for ABG remains debated, with late secondary ABG between the ages of 9 and 11 being widely adopted. This study compared the palatal shapes of 28 children at a mean age of 9.5 years (SD = 0.7) who underwent early secondary ABG at a mean age of 2.1 years (SD = 0.6) or 33 children at a mean age of 10.8 years (SD = 1.5) who underwent late secondary ABG at a mean age of 8.6 years (SD = 1.3) to 60 non-cleft controls at a mean age of 8.6 years (SD = 1.2). The palatal shapes were captured with 239 landmarks digitized on the palate on a digital model. Utilizing geometric morphometric methods, i.e., generalized Procrustes superimpositions, principal component analysis, and permutation tests, we assessed the impact of ABG timing on palatal morphology. The first five principal components (PCs) explained 64.1% of the total shape variability: PC1 = 26.1%; PC2 = 12%; PC3 = 11.9%; PC4 = 7.8%; and PC5 = 6.4%. The Procrustes distance between both cleft groups and the control group was more than twice as large as the Procrustes distance between the early ABG and late ABG groups. Nonetheless, all intergroup differences were statistically significant. Our findings suggest that early ABG has a limited negative effect on palatal shape, providing comparable outcomes to late ABG. The study highlights the potential suitability of early ABG, challenging conventional practices and encouraging further exploration into its long-term effects on maxillary growth.

• Klíčová slova
• alveolar bone grafting, cleft palate, early secondary bone grafting, palatal shape,
• Publikační typ
• časopisecké články MeSH

The degree of deviation of palatal shape from the norm may reflect facial growth disturbance in cleft lip and palate (CLP). The objective of this study was to compare the palatal morphology in children treated with different surgical protocols. Palatal shape was assessed with geometric morphometrics (GM) including Procrustes superimposition, principal component analysis (PCA), and permutation tests with 10,000 permutations, in 24 children treated with two-stage repair with a late palatoplasty (Prague group; mean age at assessment 8.9 years), 16 children after two-stage repair with early palatoplasty (Bratislava group; mean age 8.2 years), and 53 children treated with a one-stage repair (Warsaw group, mean age 10.3 years). The non-cleft control group comprised 60 children at 8.6 years. The first five principal components (PCs) accounted for a minimum of 5% of the total shape variability (65.9% in total). The Procrustes distance was largest for the Prague vs. Control pair and smallest for the Prague vs. Bratislava pair. Nonetheless, all intergroup differences were statistically significant (p < 0.01). One can conclude that variations in palatal shape roughly correspond to cephalometric and dental arch relationship findings from prior research. Among the children who underwent a one-stage repair of the complete cleft, their palatal morphology most closely resembled that of the non-cleft controls. Conversely, children who received late palatoplasty exhibited the greatest degree of deviation.

• Klíčová slova
• cleft lip and palate, geometric morphometrics, palatal shape, surgical protocol,
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: To demonstrate the advantages of dense surface models in the evaluation of surgical-assisted rapid maxillary expansion's effect (SARME) on palatal morphology. Furthermore, we compared the palatal surface before (T1) and after (T2) therapy with controls. SETTING AND SAMPLE POPULATION: Surgical-assisted rapid maxillary expansion's effect group of 15 adult patients (Le Fort I and midpalatal sagittal osteotomy, hyrax screw) and 50 adult individuals. Patients were treated in General Faculty Hospital, Prague. MATERIALS AND METHODS: Eighty plaster casts were digitized using a three-dimensional laser scanner and evaluated using traditional and geometric morphometrics. RESULTS: An unpaired Student's t-test on the controls and the SARME T1 group revealed significant differences in all width measurements. Between the controls and the SARME T2 group, significant differences were only related to the interdental angle between the first molars and particularly to the palatal height. The most remarkable differences between the pre- and post-treatment palatal morphology were a widening of the dental arch and buccal shift of the lateral teeth associated with apparent flattening of the alveolar crest. CONCLUSIONS: Dense surface model provided descriptive visualization of the treatment effect and was helpful in the evaluation of palatal shape variability including detection of the most difficult patients. Correction of the dental arch width discrepancy by SARME was successfully achieved. After therapy, palatal shape variability of most of the patients was comparable to the variability of the control group.

• Klíčová slova
• dental models, imaging, linear models, palatal expansion technique, three-dimensional,
• MeSH
• lidé MeSH
• maxila MeSH
• moláry MeSH
• techniky palatinální expanze * MeSH
• zubní oblouk chirurgie   MeSH
• zuby MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Facial development of patients with unilateral complete cleft lip and palate (UCLP) is associated with many problems including deformity of the palate. The aim of this study was to evaluate palatal morphology and variability in patients with UCLP compared with Czech norms using methods of geometric morphometrics. The study was based on virtual dental cast analysis of 29 UCLP patients and 29 control individuals at the age of 15 years. The variability of palatal shape in UCLP patients was greater than that in nonclefted palates. Only 24% of clefted palates fell within the variability of controls. The palatal form of UCLP patients (range from 11.8 to 17.2 years) was not correlated with age. Compared with control palates, palates of UCLP patients were narrower, more anteriorly than posteriorly. Apart from the praemaxilla region, they were also shallower, and the difference increased posteriorly. The UCLP palate was characterised by the asymmetry of its vault. The maximum height of the palatal vault was anterior on the clefted side, whereas it was posterior on the nonclefted side. The slope of the UCLP palate was more inclined compared with the control group. The praemaxilla was therefore situated more inferiorly.

• Klíčová slova
• 3-D geometric morphometrics, Dense correspondence analysis, Palatal shape, Surface scanning, Unilateral cleft of lip and palate,
• MeSH
• anatomická variace MeSH
• anatomická značka patologie   MeSH
• dítě MeSH
• kefalometrie metody   MeSH
• lidé MeSH
• maxila patologie   MeSH
• mladiství MeSH
• patro patologie   MeSH
• počítačové zpracování obrazu metody   MeSH
• rozštěp patra patologie   MeSH
• rozštěp rtu patologie   MeSH
• uživatelské rozhraní počítače MeSH
• věkové faktory MeSH
• zákroky plastické chirurgie metody   MeSH
• zobrazování trojrozměrné metody   MeSH
• zubní modely MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

Bilateral complete cleft lip and palate (BCLP) is the most severe of the common orofacial clefts and is associated with the greatest deformity during development. The aim of this study was to use geometric morphometrics to evaluate palatal shape and size variability in patients with BCLP in comparison to nonclefted Czech boys. The variability of palatal size and shape in BCLP patients was greater when compared with the nonclefted population. Though palate variability in BCLP was wide, nonclefted palatal shapes were generally different (a high, wide and vaulted palate) and fell almost outside the range of BCLP variability. The palatal size and shape of BCLP patients (range from 12.1 to 16.5 years) was not correlated with age. A comparison of the mean shapes of the clefted and nonclefted groups showed that the BCLP palate is flatter and narrower. The most notable size difference was found in the area between the maxilla and premaxilla. This phenomenon is associated with the persisting separation of the premaxilla from the rest of the palate. The shape of the palatal configuration of the premaxilla and adjacent area was concave in the nonclefted group and convex in BCLP patients.

• MeSH
• analýza hlavních komponent metody   MeSH
• analýza metodou konečných prvků MeSH
• anatomická značka patologie   MeSH
• chirurgické laloky MeSH
• dítě MeSH
• kefalometrie metody   MeSH
• lasery MeSH
• lidé MeSH
• maxila patologie   MeSH
• mladiství MeSH
• ortodoncie korekční metody   MeSH
• patro patologie   MeSH
• počítačové zpracování obrazu metody   MeSH
• rozštěp patra patologie   terapie   MeSH
• zákroky plastické chirurgie metody   MeSH
• zobrazování trojrozměrné metody   MeSH
• zubní modely MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

The aim of this study was to determine the amount of deviation in nasolabial shape in patients with a cleft compared with an average non-cleft face, and to assess whether this difference is related to nasolabial aesthetics. Three-dimensional stereophotogrammetric images of 60 patients with a unilateral cleft were used. To quantify shape differences, four average non-cleft faces were constructed from stereophotogrammetric images of 141 girls and 60 boys. Three-dimensional shape differences were calculated between superimposed cleft faces and the average non-cleft face for the same sex and age group. Nasolabial aesthetics were rated with the modified Asher-McDade Aesthetic Index using a visual analogue scale (VAS). Mean VAS scores ranged from 51.44 to 60.21 for clefts, with lower aesthetic ratings associated with increasing cleft severity. Shape differences were found between cleft faces and the average non-cleft face. No relationship was found for the VAS, age, and sex, except that a lower VAS was related to a higher nose and lip distance between the superimposed cleft and average non-cleft faces for nasal profile (P= 0.02), but the explained variance was low (R2=0.066). In conclusion, except for nasal profile, nasolabial aesthetics were not influenced by the extent of shape differences from the average non-cleft face.

• Klíčová slova
• aesthetics, cleft lip, cleft palate, face, photogrammetry, three-dimensional imaging,
• MeSH
• estetika stomatologická MeSH
• lidé MeSH
• nos MeSH
• rozštěp patra * MeSH
• rozštěp rtu * MeSH
• zobrazování trojrozměrné MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The study is based on a longitudinal cephalometric follow-up of X-ray films of patients with a complete unilateral cleft lip and palate during puberty. Carthesian x, y coordinates of the total of 22 landmarks on the lateral films of 25 patients with the same diagnosis and therapy were established, which served as outcome data for shape analysis. The changes in facial shape experienced by patients between their 10th and 15th year were evaluated by the thin-plate splines (TPS) method. We used the TPS method to find a function which transforms the shape of the face at the age of 10 as well as the square TPS grid into the facial shape at the age of 15 years with the deformed TPS grid. With the help of Geometric PCA for Bookstein's coordinates we found individuals with different shapes who develop abnormally during puberty and whose development is not well predictable. During puberty the face becomes relatively elongated. The most pronounced deformation is caused by the shift of the first permanent molar anteriorly, or a relative shortening of the frontal part of the dental arch. In the anterior direction the position of landmarks changed only in the area of nose; the alveolar process shows retrusion. The position of the mandible in relation to the maxilla change mainly in the inferior direction; the mandibular angle shifts posteriorly. The shape of skeletal profile was compared with a group of patients with the same diagnosis who underwent different therapy.

• MeSH
• dítě MeSH
• kefalometrie metody   MeSH
• kraniofaciální abnormality diagnostické zobrazování   MeSH
• lebka růst a vývoj   MeSH
• lidé MeSH
• lineární modely MeSH
• mladiství MeSH
• následné studie MeSH
• nosní přepážka chirurgie   MeSH
• radiografie MeSH
• rozštěp patra chirurgie   MeSH
• rozštěp rtu chirurgie   MeSH
• studie případů a kontrol MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

In craniofacial surgery and orthodontics, three-dimensional computer models of the dental arch and palate have recently entered usage in diagnosis assessment, treatment planning, case presentations and evaluation of treatment progress and outcome. In this contribution, we show how effective visualisation and evaluation of changes in the size and shape of the dental arch and palate in a given patient can be performed using superimposition of two or more 3D computer models that record the condition before and after treatment. We also present a method of three-dimensional measurement of the dental arch and palate suitable for evaluation of treatment results within retrospective and prospective studies in larger samples of subjects.

• MeSH
• anatomické modely MeSH
• lidé MeSH
• patro anatomie a histologie   chirurgie   MeSH
• pooperační období MeSH
• stomatochirurgické výkony MeSH
• tělesné váhy a míry MeSH
• zobrazování trojrozměrné metody   MeSH
• zubní modely MeSH
• zubní oblouk anatomie a histologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• antropometrie MeSH
• kojenec MeSH
• lidé MeSH
• rozštěp patra komplikace   chirurgie   MeSH
• rozštěp rtu komplikace   chirurgie   MeSH
• získané deformity nosu chirurgie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: Three-dimensional analysis of palate size and shape in patients with complete unilateral cleft lip and palate (UCLP) at the stage of permanent dentition. SUBJECTS: Thirty randomly selected dental casts of boys approximately 15 years old with complete UCLP and 28 dental casts of normal boys of the same age. INTERVENTIONS: All patients underwent lip repair according to Tennison with primary periosteoplasty (mean age 8.5 months) and palate repair by pushback and pharyngeal flap surgery (mean age 4.9 years). MAIN OUTCOME MEASURES: Data on the palate height in 210 defined locations. RESULTS: The palate in patients with UCLP was narrower throughout its whole extent, more anteriorly than posteriorly. From the canines posteriorly, it was also lower, and the difference as compared with controls increased in a posterior direction up to the level of second premolars (up to 30%) and then slightly diminished (to 21% between the first molars). The reduction of area of transverse sections reached 45% between premolars and 39% between first molars. The palate in the anterior portion was highest on the cleft side and in a posterior direction the maximum height of the palate shifted toward the midline and even beyond that line toward the noncleft side. Palatal height did not depend on dentoalveolar arch width. CONCLUSION: The smaller width and height of the palate confirm the substantially reduced space for the tongue in patients with UCLP. The reduction is only slightly larger than in previously examined patients with isolated cleft palate. Palatal vault is asymmetrical, highest anteriorly on the cleft side and posteriorly on the noncleft side.

• MeSH
• asymetrie obličeje patologie   MeSH
• dentice trvalá MeSH
• dítě MeSH
• Fourierova analýza MeSH
• kefalometrie MeSH
• lidé MeSH
• maxilofaciální vývoj * MeSH
• mladiství MeSH
• moire topografie MeSH
• počítačové zpracování obrazu MeSH
• referenční hodnoty MeSH
• rozštěp patra patologie   MeSH
• rozštěp rtu patologie   MeSH
• studie případů a kontrol MeSH
• tvrdé patro patologie   MeSH
• zubní modely MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH