Sumardi Sariesendy, Kuijpers-Jagtman Anne Marie, Latief Benny S, Wellens Hans L L, Fudalej Piotr S
Department of Orthodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
Clin Oral Investig. 2025 Mar 31;29(4):218. doi: 10.1007/s00784-025-06296-3.
To quantify craniofacial variation, integration, and modularity in untreated adults with orofacial clefts who had not undergone surgery, as well as in unaffected controls.
Fourteen cephalometric landmarks depicting the skull base, maxilla, and mandible were identified on lateral cephalograms of 295 adult Proto-Malayid individuals. The sample included 243 individuals with unoperated clefts-179 with complete unilateral cleft lip and alveolus (UCLA, mean age 23.7 years) and 66 with complete unilateral cleft lip, alveolus, and palate (UCLAP, mean age 24.5 years)-and 50 unaffected controls (NORM, mean age 21.2 years). Geometric morphometrics were used to analyze craniofacial shape variability, integration, and modularity. Principal component analysis (PCA) was used to assess shape variability, while canonical variates analysis (CVA) was used to evaluate group differences by calculating Mahalanobis and Procrustes distances. Integration and modularity were tested for five scenarios: (1) skull base vs. maxilla vs. mandible, (2) skull base with maxilla vs. mandible, (3) skull base with mandible vs. maxilla, (4) skull base vs. maxilla with mandible, and (5) anterior vs. posterior modules. The RV coefficient and covariance ratio were used to assess covariation strength.
The first 6 principal components (PC1-PC6) explained 72% of the total shape variability, with vertical shape variation and sagittal relationships being the primary sources of variability. Craniofacial shape varied significantly among the groups, with the largest Mahalanobis and Procrustes distances observed between the NORM and UCLAP groups (p < 0.001), and the smallest between the UCLA and UCLAP groups (p < 0.001). Modularity and integration patterns differed between cleft-affected individuals and controls; Those with clefts had anterior and posterior modules separated by the pterygomaxillary plane, while controls showed distinct modules for the skull base, maxilla, and mandible or combined skull base-mandible and maxilla.
Unoperated unilateral UCLA and UCLAP affect craniofacial integration and modularity.
These insights highlight the importance of individualized treatment approaches that consider congenital craniofacial organization, potentially improving long-term functional and aesthetic outcomes.
量化未经手术治疗的口面部裂隙成年患者以及未受影响的对照者的颅面变异、整合和模块化情况。
在295名成年原马来裔个体的头颅侧位片上确定了14个描绘颅底、上颌骨和下颌骨的头影测量标志点。样本包括243名未接受手术的裂隙患者——179名单侧完全性唇腭裂患者（UCLA，平均年龄23.7岁）和66名单侧完全性唇腭裂患者（UCLAP，平均年龄24.5岁）——以及50名未受影响的对照者（NORM，平均年龄21.2岁）。采用几何形态测量学分析颅面形状的变异性、整合性和模块化情况。主成分分析（PCA）用于评估形状变异性……此处省略部分重复内容……结论：未经手术治疗的单侧UCLA和UCLAP会影响颅面整合和模块化。
这些见解凸显了考虑先天性颅面结构的个体化治疗方法的重要性，这可能会改善长期的功能和美学效果。
