Craniofacial morphology of children with complete unilateral cleft lip and palate following labioplasty and palatoplasty

• Main Authors: Sigit Handoko Utomo, Krisnawati Krisnawati, Benny M. Soegiharto
• Format: Article
• Language: English
• Published: Universitas Airlangga 2012-06-01
• Series: Dental Journal: Majalah Kedokteran Gigi
• Subjects: Cephalometrics; complete unilateral cleft lip and palate; craniofacial morphology; Sefalometri; celah bibir dan langit-langit unilateral komplit; morfologi kraniofasial
• Online Access: http://e-journal.unair.ac.id/index.php/MKG/article/view/833
• ISSN: 1978-3728; 2442-9740

<p><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Background: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>A complete unilateral cleft lip and palate generally results in asymmetry of the midface. The lack of continuity in </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>the perilabial musculature through the midline contributes to a malpositioning of the underlying osseus structures which are often </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>underdeveloped. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Purpose: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>The purpose of this study was to determine whether there are differences in the craniofacial morphology </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>among children with complete unilateral cleft lip and palate following labioplasty and palatoplasty as compared with children without </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>cleft lip and palate at the same pubertal age. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Methods: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>A series of 14 consecutively treated subjects with complete unilateral cleft lip </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>and palate following labioplasty and palatoplasty were compared with 14 pubertal stage-matched controls with normal craniofacial </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>structure. Pubertal stage was determined with cervical vertebral maturation (CVM) method improved by Baccetti et al, 2002. Lateral </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>cephalograms were used for comparison. An unpaired t-test was run for 14 subjects with complete unilateral cleft lip and palate and 14 </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>normal subjects. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Results: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>There were significant cephalometric differences in anterior cranial base length (p = .002), cranial base length </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>(p = .001), maxillary length (p = .000), mandibular length (p = .000), mandibular ramus height (p = .000), mandibular body length </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>(p = .002), and upper anterior face height (p = .004). There was no significant cephalometric difference in posterior cranial base length </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>(p = .051), lower anterior face height (p = .206), posterior face height (p = .865), growth pattern/ facial type (p = .202). </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Conclusion: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>There were craniofacial morphology differences between children with complete unilateral cleft lip and palate post labioplasty and </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>palatoplasty and children without cleft lip and palate at the age of pubertal. Children with complete unilateral cleft lip and palate post </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>labioplasty and palatoplasty had shorter length of the anterior cranial base, cranial base, maxilla, mandible, mandibular ramus height, </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>mandibular body, and upper anterior face height as compared with children without cleft lip and palate at the age of pubertal.</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Latar belakang: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Celah bibir dan langit-langit unilateral komplit umumnya menghasilkan asimetri wajah bagian tengah. </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Berkurangnya kontinuitas otot di sekitar bibir yang melewati garis tengah wajah mengakibatkan malposisi struktur tulang di bawahnya </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>yang seringkali kurang berkembang. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Tujuan: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Tujuan penelitian ini adalah untuk menentukan apakah terdapat perbedaan morfologi </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>kraniofasial anak dengan celah bibir dan langit-langit unilateral komplit pasca labioplasti dan palatoplasti dibandingkan anak tanpa </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>celah bibir dan langit-langit pada usia pubertal. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Metode Penelitian: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Sejumlah subyek penelitian berupa 14 orang anak penderita </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>celah bibir dan langit-langit pasca labioplasti dan palatoplasti dibandingkan dengan 14 orang anak yang normal pada masa pubertal </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>yang sama. Masa pubertal ditentukan menggunakan metode cervical vertebral maturation (CVM) yang dikembangkan oleh Baccetti </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>dkk, 2002. Dilakukan perbandingan hasil pengukuran sefalogram lateral dari kedua kelompok. Uji-t tidak berpasangan dilakukan </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>untuk mengetahui perbedaan gambaran kraniofasial antara kelompok anak dengan celah bibir dan langit-langit unilateral komplit </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>pasca labioplasti dan palatoplasti dan kelompok anak normal. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Hasil: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Terdapat perbedaan bermakna pada panjang basis kranium </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>anterior (p = .002), panjang keseluruhan basis kranium (p = .001), panjang maksila (p = .000), panjang mandibula (p = .000), tinggi </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>ramus mandibula (p = .000), panjang badan mandibula (p = .002), tinggi wajah anterior atas (p = .004). Tidak terdapat perbedaan </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>bermakna pada panjang basis kranium posterior (p = .051), tinggi wajah anterior bawah (p = .206), tinggi wajah posterior (p = </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>.865), pola pertumbuhan/tipe wajah (p = .202). </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Kesimpulan: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Terdapat perbedaan morfologi kraniofasial antara anak dengan celah </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>bibir dan langit-langit unilateral komplit pasca labioplasti dan palatoplasti dibandingkan anak tanpa celah bibir dan langit-langit</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span> <span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>pada masa pubertal. Anak dengan celah bibir dan langit-langit unilateral komplit pasca labioplasti dan palatoplasti memiliki panjang </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>basis kranium anterior, panjang keseluruhan basis kranium, panjang maksila, panjang mandibula, tinggi ramus mandibula, panjang </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>badan mandibula, dan tinggi wajah anterior atas yang lebih pendek dibandingkan anak tanpa celah bibir dan langit-langit pada masa </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>pubertal.</em></span></span></span></span><br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;" /></span></span></span></span></span></span></span></span></span></p>