ABSTRACT
BACKGROUND: Treatment of cleft lip and palate (CLP) requires a comprehensive interdisciplinary approach and long-term follow-up. Only a few studies are available that reported on changes after treatment, which showed that in particular the transverse dimension, in patients with CLP is prone to changes after treatment. However, those studies did not pay attention to concomitant changes in the mandibular arch that occur after treatment. OBJECTIVES: To evaluate mandibular transverse dental arch dimensions and interarch transverse changes in patients with complete non-syndromic unilateral cleft lip, alveolus, and palate (CUCLAP) up to five years after treatment. MATERIAL AND METHODS: Retrospective longitudinal study in 75 consecutive patients with CUCLAP directly after comprehensive treatment (T0), two (T2), and 5 years after treatment (T5). Great Ormond Street, London and Oslo (GOSLON) scores were available for all patients. Three-dimensional scans of all dental casts were made. Inter premolar and intermolar distances between the mandibular contralateral teeth were measured. The modified Huddart Bodenham (MHB index) was applied to assess the transverse interarch relationship. Paired t-tests and ANOVA were used to analyze transverse and interarch transverse changes. Linear regression analysis was done to define contributing factors. RESULTS: Paired t-tests showed a significant decrease of the mandibular inter first and second premolar distances (p < 0.05) and an increase of the inter second molar distance, whilst the MHB Index deteriorated at all time points for all segments and for the total arch score (p < 0.05). Linear regression showed no significant contributing factors on the decrease of the transverse distances. However, inter arch transverse relationship was significantly affected by age at the end of treatment, missing maxillary lateral incisor space closure, and the GOSLON Yardstick score at the end of treatment (p < 0.05), especially during the first two years after treatment. CONCLUSIONS: Changes occurred in the mandibular arch expressed as changes in the transverse dimensions and interarch relationship measured by the MHB Index. A younger age at the end of treatment, space closure for a missing maxillary lateral incisor and a higher GOSLON score at the end of treatment negatively influence the interarch transverse deterioration especially in the first two years after treatment. For the transverse dimensional changes in the mandibular arch such influencing factors could not be determined.
ABSTRACT
Objective: To determine the skeletal and dental components in patients with facial asymmetry treated at the orthodontic specialist clinic of the Faculty of Dentistry, Universitas Indonesia. Material and Methods: This was a descriptive study using secondary data from the tracing of postero-anterior cephalograms of patients aged >14 years 4.2 months for males and >11 years 6.2 months for females using the Grummons analysis. A total of 46 patients were selected through purposive sampling. Data were analyzed using descriptive statistics. Results: The proportions of asymmetric direction based on the deviation of the mandibular menton, maxillary midline, and mandibular midline tending to the left and the right sides of the face were 58.7% and 41.3%, respectively. The skeletal component found in the vertical direction showed a greater mean value difference than that observed in the transverse direction. The mean value difference was greater in the midline of the mandibular teeth than in the maxillary teeth. Conclusion: Facial asymmetry tended more towards the left side of the face than the right side. Moreover, the skeletal component was greater in the vertical direction than the transverse direction. In the transverse direction, it was shown that the left side of the face was larger than the right side. In addition, dental asymmetry was more commonly observed in the midline of the mandibular teeth than the maxillary teeth.