"Maxillary Growth Paterrn in Israeli Cleft Affected Patients"

Objectives: The impact of congenital cleft lip and/or palate on craniofacial morphology has been extensively studied. Our aim is to define craniofacial morphology of cleft affected patients among the Israeli population. Material and Methods: Pretreatment lateral cephalographs of 195 Israeli patients from the Orthodontic and Craniofacial Department of the Rambam Health Care Campus and Technion, Haifa, Israel, were examined. 163 of these patients (67 female and 96 male) exhibited one of the following types of clefts: (1) Unilateral cleft lip and palate (88 patients); (2) Bilateral cleft lip and palate (32 patients); (3) Cleft palate (43 patients). The remaining patients (19 females and 13 males), who did not suffer from cleft, served as controls. Each lateral cephalograph was traced and analyzed by plotting different skeletal landmark points according to McNamarra, Steiner and Ricketts' analysis. Results: Conventional measures such as SNA, ANB, Co-A and Co-Gn Co-A were found to be irrelevant for assessing the retruded position of the maxilla in cleft affected patients. Anatomical aberration in the normal position of point A due to alveolar cleft malformation and abnormal incisor eruption patterns is common. However, the distance between the upper first molar and the pterygomaxillary fissure, which indicates the space available for eruption of the upper second molar, was found to be significantly different in cleft affected patients, of all cleft types in the various age groups (younger and older than 9 years old), compared to normal controls. Conclusion: Due to these findings we suggest that the distance between the upper first molar and the pterygomaxillary fissure is an indicative measure in diagnosing sagittal maxillary growth pattern and discrepancy. 4-15-2011-->