Can Occlusal Evaluation Determinate Future Maxillofacial Morphology of Children with Unilateral Cleft Lip and Palate?

• Project/Area Number: 21592598
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Orthodontic/Pediatric dentistry
• Research Institution: Kyushu University
• Principal Investigator: SUZUKI Akira 九州大学, 大学病院, 講師 (20037542)
• Co-Investigator(Kenkyū-buntansha): 竹之下 康治 九州大学, 歯学部, 准教授 (50117157) ; 窪田 泰孝 九州大学, 大学病院, 講師 (60205151) ; 笹栗 正明 九州大学, 大学病院, 准教授 (00225898)
• Co-Investigator(Renkei-kenkyūsha): 笹栗 正明 九州大学, 大学病院, 准助教 (00225898)
• Project Period (FY): 2009 – 2011
• Project Status: Completed (Fiscal Year 2011)
• Budget Amount: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000); Fiscal Year 2011: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2010: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2009: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
• Keywords: 口唇裂口蓋裂患者 / 咬合評価 / 顎顔面形態 / 成長 / Goslon Yardstick / 継年資料 / セファロ分析 / 石膏模型 / 口唇裂口蓋裂 / 顎顔面成長 / 頭部X線規格写真 / 経年的研究 / 歯学 / 臨床 / 顎顔面発育 / Goslon yardstic / 5-year-old index

Research Abstract

Two studies were carried out ;(Study A) Correlation analyses between the occlusal relationship evaluated by the Goslon Yardstick and the maxillofacial growth measured from longitudinal cephalographs taken on 85 subjects with unilateral cleft lip and palate at the ages of five, ten, and over fifteen.(Study B) Comparison of maxillofacial growth patterns from 3-4 months old to fifteen years or older taken on longitudinal cephalographs of 38 male and 46 female CLP subjects among three cleft types ; unilateral cleft lip and alveolus(CLA), unilateral cleft lip and palate(CLP), and isolated cleft palate(CP). The followings were concluded from these two studies
(1) Occlusal evaluation by the Five-year-old index or the Goslon Yardstick is a simple measure to represent maxilla-mandibular relationship, but those measures evaluate the outcome of maxillofacial growth until the time.(2) The occlusal evaluation by the Goslon Yardstick at ten years was similar with the one by the Five-year-old index at five years, furthermore orthodontic treatment has a tendency to make the outcome of occlusal evaluation better.(3) The outcome of occlusal evaluation has a significant relation with the amount and direction of mandibular growth rather than maxillary growth affected by labioplasty and/or palatoplasty in the subjects with unilateral cleft lip and palate.(4) Occlusal outcome evaluated by the Goslon Yardstick at the age of ten had no significant relation with future maxillofacial growth after then until adulthood. This suggests the maxillofacial growth in puberty may be great and determined the matured facial profile in adult. In this study, there were some CLP subjects who had been classified in good groups by the five-year-old index and the Goslon Yardstick, but underwent Orthognathic surgery in adulthood.(5) From the Study B comparing the longitudinal maxillofacial growth among the subjects with CLA, CLP, and CP, both labial and palatal plastic surgeries affected maxillofacial growth, but not mandibular growth. As our surgical procedure for palatal repair was the same one, the modified V-Y push back method, the effects of surgical procedures on maxillofacial growth will be evaluated and compared by the inter-centers study in future.(6) This study suggests that final maxillofacial morphology in adulthood will be determined by the genetic growth potential of the growing CLP children, especially in puberty. We need to evaluate the effects of more factors ; ones by plastic surgeries, genetic background, in order to predict the matured maxillofacial growth of the subjects with cleft lip and/or palate.

Research Products

• [Journal Article] Retrospective Evaluation of Treatment Outcome in Japanese Children with Complete Unilateral Cleft Lip and Palate (2007)
  • Author(s): Suzuki A, Yoshizaki K, Honda Y, Sasaguri M, Kubota Y, Nakamura N, Ohishi M, Oka M, Tashiro H, Katsuki T, Fujino H.
  • Journal Title: Part 1 : 5 Year Olds' Index for Dental Arch Relationships. Cleft Palate-Craniofac J Volume: 44(4) Pages: 434-443
• [Presentation] 口唇裂口蓋裂患者における顎顔面発育の乳幼児期から成人までの経年的変化 (2011)
  • Author(s): 田村直子,笹栗正明,鈴木陽,光安岳志,辻口友美,新井伸作,松村香織,森悦秀,中村誠司
  • Organizer: 第56回日本口腔外科学会総会
  • Place of Presentation: 大阪
• [Presentation] 口唇裂口蓋裂患者における顎顔面発育の乳幼児期から成人までの経年的変化 (2011)
  • Author(s): 田村直子, 笹栗正明, 鈴木陽, 光安岳志, 辻口友美, 新井伸作, 松村香織, 森悦秀, 中村誠司
  • Organizer: 第56回日本口腔外科学会総会
  • Place of Presentation: 大阪市