Subphenotyping and Classification of Cleft Lip and Alveolus in Adult Unoperated Patients
| Autor: | Antonius J.M. Luijsterburg, Lea Kragt, Benny S. Latief, Edwin M. Ongkosuwito, Costas Lekkas, Anna M. Rozendaal, Christl Vermeij-Keers |
|---|---|
| Přispěvatelé: | Plastic and Reconstructive Surgery and Hand Surgery, Oral and Maxillofacial Surgery |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Adolescent Cephalometry Cleft Lip 03 medical and health sciences 0302 clinical medicine Alveolar Process Humans Medicine Simonart band business.industry 030206 dentistry Anatomy Middle Aged Cleft Palate Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] Phenotype 030104 developmental biology Otorhinolaryngology Indonesia Embryology Female Oral Surgery business |
| Zdroj: | Cleft Palate-Craniofacial Journal, 55(9), 1267-1276. American Cleft Palate Craniofacial Association Cleft Palate-Craniofacial Journal, 55, 1267-1276 Cleft Palate-Craniofacial Journal, 55, 9, pp. 1267-1276 |
| ISSN: | 1545-1569 1055-6656 |
| Popis: | Objective: Previously, a new embryological classification was introduced subdividing oral clefts into fusion and/or differentiation defects. This subdivision was used to classify all subphenotypes of cleft lip with or without alveolus (CL±A). Subsequently, it was investigated whether further morphological grading of incomplete CLs is clinically relevant, and which alveolar part is deficient in fusion/differentiation defects. Design: Observational cohort study. Setting: Three hundred fifty adult unoperated Indonesian cleft patients presented themselves for operation. Cephalograms, dental casts, and intraoral and extraoral photographs—eligible for the present study—were used to determine morphological severity of CL±A. Patients: Patients with unilateral or bilateral clefts of the primary palate only were included. Main Outcome Measures: Clefts were classified—according to developmental mechanisms and timing in embryogenesis—as fusion and/or differentiation defects. Grades of incomplete CLs were related to the severity of alveolar clefts (CAs) and hypoplasia, and permanent dentition was used to investigate which alveolar part is deficient in fusion/differentiation defects. Results: One hundred eight adult patients were included. All subphenotypes—96 unilateral and 12 bilateral clefts—could be classified into differentiation (79%), fusion (17%), fusion-differentiation (2%), or fusion and differentiation (2%) defects. The various grades of incomplete CLs were related to associated CAs and hypoplasia, and all alveolar deformities were located in the premaxillae. Conclusions: This study showed that all CL±A including the Simonart bands can be classified, that further morphological grading of incomplete CLs is clinically relevant, and that the premaxilla forms the deficient part in alveolar deformities. |
| Databáze: | OpenAIRE |
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