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Alterations in occlusion and maxillary dental arch dimensions in adults with treated unilateral complete cleft lip and palate
Linköping University, Department of Neuroscience and Locomotion, Dental Surgery. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Neuroscience and Locomotion, Dental Surgery. Linköping University, Faculty of Health Sciences.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The purpose of this stndy was to evaluate the occlusion and maxillary dental arch dimensions in adults with repaired complete unilateral cleft lip and palate (UCLP) and to investigate the patterns of change in early adulthood. Study models from 39 subjects (25 men, 14 women) (mean age 24.7 years, range 20.2-29.3) with the diagnosis complete UCLP taken at a follow-up examination were analysed and compared with the study models taken at baseline examination (mean age 19.1 years, range 16.0-20.6). Lip closure was made according to the Millard technique and palatal closure according to the Wardill-Kilner technique. All subjects had received orthodontic treatment with fixed appliances. The subjects were divided into three groups according to the type of retention in the upper jaw: no retention (n = 15), retention with bonded twisted retainer (n = 13), onlay or fixed bridge (n = 11).

Occlusion was evaluated according to a scoring system (Huddart and Bodenham, 1972). The maxillary dental arch dimensions were measured with a video imaging system. In the total sample there was a significant deterioration in the total occlusal score during the follow-up period. The impairment was larger on the cleft side than on the non-cleft side. There were no significant differences in the frontal scores. A comparison of the transversal and sagittal maxillary arch dimensions revealed significant differences in all measurements during the follow-up interval. The reduction was largest for the maxillary second premolar width, followed by the first molar width. The oveijet differed significantly between the registrations. The occlusal score and the maxillary arch dimensions were reduced in all of the three subgroups, but there were no differences between the groups. No gender differences were found.

National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-81068OAI: oai:DiVA.org:liu-81068DiVA: diva2:550120
Available from: 2012-09-06 Created: 2012-09-06 Last updated: 2012-09-06Bibliographically approved
In thesis
1. Adult patients with treated complete cleft lip and palate: Methodological and clinical stndies
Open this publication in new window or tab >>Adult patients with treated complete cleft lip and palate: Methodological and clinical stndies
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The purpose of the present thesis was to investigate the quality of life, satisfaction with treatment, prevalence of temporomandibular disorders, psychosocial distress, and occlusal stability in a treated group of adults with complete cleft lip and palate (CLP).

Sixty-eight adults ( 44 men and 24 women) with a mean age of 24.2 years (range 19.5-29.2) with treated CLP were compared with a gender- and agematched group with no clefts. The CLP subjects were born between 1968 and 1977 and had undergone standardised plastic surgery at the Department of Plastic Surgery, University Hospital, Linköping, Sweden. Logopaedic, phoniatric, otological, and orthodontic examinations and treatment had been provided locally, supervised by the Cleft Palate Team.

The subjects answered a multidimensional, self-report, standardised questionnaire regarding psychological and somatic conditions. The subjects underwent a clinical TMD examination and an evaluation of the occlusion. The reliability of the multidimensional questionnaire was analysed for the CLP group by a test-retest study within a 2-3 week interval and most questions showed an overall good reliability. A panel of professionals judged the outcome of the surgical treatment on colour slides of the CLP subjects. The dental plaster casts of 39 subjects born with complete unilateral cleft lip and palate (UCLP) were analysed (mean age 24.7 years, range 20.2-29.3) and compared with the dental plaster casts taken at mean age of 19.1 years (range 16.0-20.6).

The overall level of quality of life was rather high in both groups. The CLP group rated some detached aspects, such as life meaning, family life, and private economy, significantly lower than did the group without clefts. Overall aspects such as well-being and social life were affected by having a treated cleft but not the more practical and tangible aspects of their daily living.

There was an overall high level of satisfaction with all the different part of the body in both groups, but the CLP group reported significantly moredissatisfaction with their nose, lips, mouth, profile, and overall facial appearance than the group without clefts. The professionals and the subjects with CLP were generally not very satisfied with the results of surgical treatment. Thirty of the subjects with CLP (47%) wished to have more operations. The professional group recommended further operations in 38 of the subjects (59%) in particular, rhinoplasties.

The CLP group had significantly higher frequencies of cross-bite than the group without clefts, but no differences regarding TMD pain were found between the two groups. In the subjects with treated UCLP, there was a significant deterioration in the occlusal score and the maxillary arch dimensions between 19 and 25 years. This was irrespective of the type of retention. The persisting morphological mal occlusion with a low frequency of interferences has had no influence on TMD symptoms in the group of CLP patients studied.

The conclusion is that the CLP subjects in the present study seemed to be psycho-socially well adjusted to their disability. However, 47 per cent wished to have further surgical treatment. The persisting malocclusions did not provoke TMD symptoms.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2001. 57 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 666
Series
Swedish Dental Journal Supplement, ISSN 0348-6672 ; 145
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25690 (URN)10066 (Local ID)91-7219-959-8 (ISBN)10066 (Archive number)10066 (OAI)
Public defence
2001-04-20, Berzeliussalen, Hälsouniversitetet, Linköping, 09:00 (Swedish)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-06Bibliographically approved

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Marcusson, AgnetaPaulin, Gunnar

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