Effect of cheiloplasty on the jaws of children with cleft lip and palate: 3D analysis of linear measurements, area and overlapping of the dental arches

Author(s)

Gabriela Mendonça Rando

• Document type: Master's Dissertation
• Press: Bauru.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia de Bauru (FOB/SDB)
• Defense date: 2023-03-17

Examining board members

Thais Marchini de Oliveira Valarelli; Cleide Felicio de Carvalho Carrara; Cristiane Duque; Simone Soares

• Advisor: Thais Marchini de Oliveira Valarelli

Abstract

The purpose of this study was to evaluate the best surgical time to perform cheiloplasty, evaluating the effect on the jaws of children with cleft lip and palate through 3D analysis of linear measurements, area, overlap and occlusal index. Methodology: This is a retrospective longitudinal study. The sample consisted of 252 plaster models divided into the following groups: Group 1 (G1) 50 participants cheiloplasty performed at 3 months of life, Group 2 (G2) 50 participants cheiloplasty performed at 5 and 6 months of life, Group 3 ( G3) 26 participants cheiloplasty performed from 8 to 10 months of age. All participants underwent cheiloplasty using the Millard technique and total palatoplasty using the von Langenbeck technique. The digitized models were evaluated at Time 1 (T1), before cheiloplasty and from 5 years of age, Time 2 (T2). The following linear measurements were analyzed: intercanine distance (C-C\') and intertuberosity (T-T\'), anterior (I-CC\') and anteroposterior (I-TT\') length of the dental arch, anterior distance of the dental arch without cleft (I-C) and side with cleft (I-C\'), anteroposterior distance of the dental arch on the side with cleft (I-T\') and side without cleft (I-T), in addition to anterior (P-P\') and posterior amplitudes of the fissure (U-U\'). The area, overlapping of the dental arches and Atack index were also measured. For statistical analysis, the Intraclass Correlation Coefficient was used to assess reliability. Paired t test and Wilcoxon test were applied in intragroup analyses. ANOVA followed by Tukey\'s Test and KruskalWallis Test followed by Dunn\'s Test were applied in the intergroup analyses. Spearman\'s correlation was used to assess the correlation between the cleft area and the Atack index (p<0.05). In G1, the intragroup comparison showed a statistically significant difference in the measures I-C\', C-C\', I-CC\' and sum of areas of segments with lower means at T2 (linear measures, p<0.0001 and sum of areas of segments , p=0.003). In G2, the intragroup comparison showed a statistically significant difference in the measures I-C\', C-C\', I-CC\' and sum of areas of the segments with lower means at T2 (p<0.001, p<0.001, p<0.001, p=0.0466, respectively). In G3, the intragroup comparison showed a statistically significant difference in the measures I-C\', C-C\', I-CC\', sum of areas of the segments with lower means at T2 (p<0.001, p=0.0007, p=0.0009 and p =0.0170, respectively). In T1, the intergroup analysis, G1 presented statistically significantly lower means of the measurements I-C\', I-C, C-C\' and sum of areas of the segments compared to G2 (p=0.0140, p=0.0082, p=0.0004, p<0.0001 , in this order). In T2, the intergroup analysis, G1 presented a statistically significant mean of the I-C\' measure when compared to G3 (p=0.0461). The analysis of the intergroup growth rate, G1 and G2 showed a statistically significant difference in the I-C\' measure compared to G3 (p=0.0003). In the analysis of the Atack index, Group 1 had a greater number of participants with index 4 (n=22, 44%). While, in Groups 2 and 3, index 3 was the most frequent (G2, n=24, 48% and G3, n=11, 42.4%). Thus, it was concluded that the patients operated on late showed better results in the growth and development of the dental arches. (AU)

• FAPESP's process: 20/07072-0 - Effect of cheiloplasty on the maxillary of children with cleft lip and palate: 3D analysis of linear measurements, area, volumetric and image superposition of dental arches
• Grantee: Gabriela Mendonça Rando
• Support Opportunities: Scholarships in Brazil - Master