Tsuji Kyoko, Haruyama Naoto, Nomura Shunsuke, Murata Naohisa, Yoshizaki Keigo, Mitsuyasu Takeshi, Nakano Hiroyuki, Nakamura Seiji, Mori Yoshihide, Takahashi Ichiro
Section of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan.
Section of Oral and Maxillofacial Oncology, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan.
PeerJ. 2021 Apr 20;9:e11297. doi: 10.7717/peerj.11297. eCollection 2021.
Myriad maxillo-mandibular occlusal relationships are observed in patients with isolated cleft palate (ICP), unlike in patients with other cleft types, such as cleft lip and palate.
This study aimed to categorise the characteristics of craniofacial morphology in patients with ICP, and investigate the clinical factors affecting these categorised morphological characteristics.
Thirty-six girls with ICP (age (mean ± SD): 5.36 ± 0.36 years) underwent cephalometric measurement. Their craniofacial morphology was categorised using cluster analysis. Profilograms were created and superimposed onto the standard Japanese profilograms to visualise the morphological characteristics of each group (cluster). The mean values and variations in the linear and angular measurements of each group were compared with the Japanese standards and statistically analysed using Dunnett's test after the analysis of variance. Fisher's exact test was used to analyse the differences between the cleft types (cleft in the hard and/or soft palate) and skills of the operating surgeons in the groups.
Cluster analysis of craniofacial morphologies in patients with ICP resulted in the formation of three categories: the first cluster exhibited a relatively harmonious anteroposterior relationship between the maxilla and the mandible (22.2%); the second cluster exhibited crossbite owing to a significantly smaller maxilla (33.3%); and the third cluster exhibited a smaller mandible with posterior rotation showing skeletal class II malocclusion (44.4%). Differences in cleft types and surgeons were not associated with the distribution of patients in each cluster.
Patients with ICP exhibited characteristic morphological patterns, such as bimaxillary retrusion or severe mandibular retrusion, besides the anterior crossbite frequently found in patients with cleft lip and palate . Understanding the typical morphological characteristics could enable better diagnostic categorisation of patients with ICP, which may eventually improve orthodontic treatment planning.
与唇腭裂等其他类型腭裂的患者不同，孤立性腭裂（ICP）患者存在多种上下颌咬合关系。
本研究旨在对ICP患者的颅面形态特征进行分类，并调查影响这些分类形态特征的临床因素。
对36名ICP女童（年龄[均值±标准差]：5.36±0.36岁）进行了头影测量。使用聚类分析对她们的颅面形态进行分类。创建侧貌图并叠加到标准日本侧貌图上，以直观显示每组（聚类）的形态特征。将每组的线性和角度测量的均值及变异与日本标准进行比较，并在方差分析后使用Dunnett检验进行统计学分析。采用Fisher精确检验分析各组腭裂类型（硬腭和/或软腭腭裂）与手术医生技能之间的差异。
对ICP患者的颅面形态进行聚类分析，形成了三类：第一类聚类显示上颌与下颌之间存在相对协调的前后关系（22.2%）；第二类聚类由于上颌明显较小而出现反咬合（33.3%）；第三类聚类显示下颌较小且向后旋转，表现为骨性II类错牙合（44.4%）。腭裂类型和手术医生的差异与各聚类中患者的分布无关。
除了唇腭裂患者常见的前牙反咬合外，ICP患者还表现出特征性的形态模式，如双颌后缩或严重下颌后缩。了解典型的形态特征有助于对ICP患者进行更好的诊断分类，最终可能改善正畸治疗计划。
