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Characteristics of Facial Morphology and Growth in Infants with Clefts

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Cleft Lip and Palate

Abstract

This subchapter provides a comprehensive analysis of the facial morphology and growth in a large consecutive sample of Danish children born with nonsyndromic cleft lip and palate based on three-projection infant cephalometry. The following subgroups of clefts are dealt with isolated cleft lip (CL), isolated cleft palate (CP), Robin sequence (RS), unilateral complete cleft lip and palate (UCCLP), and bilateral complete cleft lip and palate (BCCLP). Infants with cleft of the secondary palate, with or without cleft of the primary palate, share a number of characteristic morphological traits when compared to the norm: decreased posterior length of the maxilla, maxillary retrognathia, decreased posterior height of the maxilla, increased width of the maxilla and the nasal cavity, decreased length of the mandible, mandibular retrognathia, and reduced size of the pharyngeal airway. The amount of facial growth in infants with cleft of the secondary palate is close to the norm, but the direction of growth is, in general, more vertical than normal. We have observed that surgery to the lip and anterior part of the hard palate at 2 months of age in UCCLP children influences the development of the maxillary complex, as observed at 22 months of age, in a number of beneficial ways: the premaxilla is no longer relatively protruding, and it is less asymmetric; the nasal septum deviates less toward the noncleft side; the width of the nasal cavity and the posterior part of the maxilla becomes relatively more normal; and the transverse position of the lateral maxillary segment on the noncleft side is closer to normal. However, the posterior height of the maxilla is still reduced to the same degree, the mandible is still short to the same degree, and bimaxillary retrognathia is still present. We are suggesting that subjects with cleft of the secondary palate have a special “intrinsic” facial type, primarily characterized by bimaxillary retrognathia and increased maxillary width, and we are speculating that this facial type could be a “liability factor,” increasing the probability of CP and CLP.

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Authors and Affiliations

  1. Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, University of Copenhagen, Copenhagen, Denmark

    Sven Kreiborg DDS, Ph.D., DrOdont & Nuno V. Hermann DDS, Ph.D.

  2. 3D Craniofacial Image Research Laboratory, School of Dentistry, University of Copenhagen, Copenhagen, Denmark

    Tron A. Darvann M.Sci., Ph.D.

  3. Department of Oral and Maxillofacial Surgery, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

    Tron A. Darvann M.Sci., Ph.D.

Authors
  1. Sven Kreiborg DDS, Ph.D., DrOdont
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  2. Nuno V. Hermann DDS, Ph.D.
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  3. Tron A. Darvann M.Sci., Ph.D.
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Correspondence to Sven Kreiborg DDS, Ph.D., DrOdont .

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  1. Paradela Street 11035, Coral Gables, 33156, Florida, USA

    Samuel Berkowitz

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Kreiborg, S., Hermann, N.V., Darvann, T.A. (2013). Characteristics of Facial Morphology and Growth in Infants with Clefts. In: Berkowitz, S. (eds) Cleft Lip and Palate. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30770-6_9

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  • DOI: https://doi.org/10.1007/978-3-642-30770-6_9

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