Dentofacial characteristics of Malay patients with repaired cleft lip and palate in Kelantan
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Date
2005-11
Authors
Alam, Md. Badrul
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Abstract
Cleft lip and palate (CLP) is the most common congenital facial defect.
Patients with CLP suffer from feeding, breathing, middle ear infections as well
as psychosocial and other problems. The treatment requires interventions from
multiple disciplines which start from the first day of life and continue up to the
age of 20 to 21 years. Prolong treatment from birth to adulthood is expensive
and is a burden for the patient, family and for the society. The facial
development of CLP patients often does not follow usual development of growth
even after corrective surgeries. Growth impairment becomes progressively
apparent as patients reach maturity regardless of the mechanisms. Therefore,
an understanding about the anomalies of dentofacial region is important as it
determine the facial harmony and balance. This is essential to achieve the ideal
goal of treatment of cleft patients.
A cross-sectional comparative study was done by direct facial measurements,
by measuring lateral cephalometry and dental cast of 75 treated cleft
and 75 noncleft Malay subjects. The age range was from 8 to 40 years. The
study subjects were divided into three age groups: children (8 to 12yrs),
adolescent (13 to 18 yrs) and adult (19 to 40 yrs) of both genders.
Results of this study revealed that the measurements of dental arch
dimensions and the upper and lower incisors' relation to the respective plane of
CLP patients were significantly different from that of the noncleft subjects of all
age groups. The anterior-posterior arch length, transverse dimensions in inter
canine region, inter second permanent premolar or deciduous second molar
region, inter first permanent molar region and in angular measurements for
upper and lower central incisors to the respective maxillary and mandibular
plane were found significantly higher in noncleft groups in all ages (p<0.05). The
philtrum width and skeletal anterior-posterior angular measurements were found
significantly higher for the cleft subjects while the upper lip height was
significantly higher for noncleft subjects among all age groups. The study further
revealed that certain facial (nasal width, nasal, philtrum and upper anterior facial
heights) and skeletal (anterior-posterior: Sella-Nasion-Point B, SNB and Point
A-Nasion-Point B, ANB; vertical: Maxilla-mandibular angle, MMA and anterior
lower facial height, ALFH) measurements were unique to children, adolescent
and adult study subjects.
These dentofacial characteristics of Malay patients with repaired cleft lip and
palate in Kelantan, as revealed by the present study, would be useful to develop
a more ideal treatment protocol. It will, therefore, contribute a better quality of
life to the CLP patients, their families and the society.
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Keywords
Malay patients with repaired cleft lip