Final Posttreatment Occlusion in Patients With Unilateral Cleft Lip and Palate.

OBJECTIVE: To evaluate final posttreatment occlusion in patients with complete unilateral cleft lip and palate (cUCLP) by comparing (1) 3 treatment centers, (2) males and females, (3) cleft and noncleft sides, (4) right- and left-sided clefts, and (5) orthodontic treatment with/without orthognathic surgery (OS). DESIGN: Retrospective cohort study. PATIENTS: Blinded posttreatment dental casts of 56 patients (19.4 ± 1.4 years) with cUCLP from 3 centers in Switzerland. MAIN OUTCOME MEASURE: Occlusal assessment using the modified Huddart/Bodenham (MHB) index. RESULTS: Our sample comprised 35 males and 21 females, 46 with left- and 10 with right-sided clefts, of which 32 had undergone OS. The final posttreatment occlusion showed a median MHB score of 0 (interquartile range: -1.0 to 2.0) in the total sample and did not seem to depend on treatment center, sex, or OS. The MHB scores for the anterior buccal and the buccal segments were more negative on the cleft than on the noncleft side (P = .002 and P = .006, respectively). When the cleft was on the left side, the MHB score tended to be more positive in the labial (P = .046) and anterior buccal segments (P = .034). CONCLUSIONS: This study shows a very satisfactory final posttreatment occlusion in patients with cUCLP. The more constricted buccal occlusion on the cleft side emphasizes the attention that should be given in correcting the more medially positioned lesser maxillary segment. The influence of cleft-sidedness should be analyzed further on a sample including more patients with right-sided clefts.

Dentofacial and upper airway characteristics of mild and severe class II division 1 subjects.

The aim of this retrospective, cross-sectional study was to assess whether mild and severe Class II division 1 subjects have craniofacial and upper airway characteristics, which relate to the severity of Class II as judged by overjet or ANB angle. The sample consisted of pre-treatment lateral cephalograms and dental casts of 131 males and 115 females (mean age 10.4 ± 1.6). Inclusion criteria were: healthy Caucasian subjects, at least ¾ Class II first molar relationship on both sides and overjet ≥ 4 mm. The cephalograms were traced and digitized. Distances and angular values were computed. Mild and severe Class II was defined by overjet (<10 mm/≥ 10 mm) or by ANB angle (<7 degrees/≥7 degrees). Statistics were performed with two-sample t-test and Pearson's correlation analysis. In the two overjet groups, significant differences were mainly found for incisor inclination while the two ANB groups differed significantly in SNA, WITS, Go-Pg, SpaSpp/MGo, SN/MGo, and Ar-Gn. The shortest airway distance between the soft palate and the posterior pharyngeal wall was significantly correlated to the NS/Ar angle. Statistical analysis revealed several significant correlations. Patients with a large overjet or ANB angle differed significantly from patients with a small overjet or ANB angle mainly in their incisor inclination. In the present sample, the overjet and to some extent also the ANB angle is determined by soft tissue or individual tooth position rather than by skeletal background. In retrognathic patients, a tendency towards smaller airway dimensions was found. However, statistical analysis did not reveal a strong connection between upper airway and dentoskeletal parameters, but a large interindividual variation.