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Three-Dimensional Assessment of Facial Development in Children With Unilateral Cleft Lip With and Without Alveolar Cleft

Krimmel, Michael MD, DMD*; Kluba, Susanne MD, DMD*; Breidt, Martin; Bacher, Margit DDS; Müller-Hagedorn, Silvia MD, DDS; Dietz, Klaus PhD§; Bülthoff, Heinrich PhD; Reinert, Siegmar MD, DMD*

Journal of Craniofacial Surgery: January 2013 - Volume 24 - Issue 1 - p 313–316
doi: 10.1097/SCS.0b013e318275ed60
Original Articles

Children with cleft lip or cleft lip and alveolus represent a minor group in the cleft population. The aim of this study was to analyze the faces of these children. In a prospective, cross-sectional study, 344 healthy children and 30 children with cleft lip or cleft lip and alveolus were scanned three-dimensionally at the age of 0 to 6 years. Twenty-one standard anthropometric landmarks were identified, and the images were superimposed. Growth curves for normal facial development were calculated. The facial morphology of cleft children was compared with that of unaffected children.

Facial morphology and growth in the transverse direction of the examined patients appeared broadened in all levels. Especially the nasal landmarks indicated a widening of the nose. The landmarks ac l, sbal l, sbal r, c l, sn l, and ls l differed significantly from unaffected children. In the sagittal and vertical dimensions, there was no significant difference compared with unaffected children.

Our study demonstrates that surgical and orthodontic treatment can restore the vertical and sagittal dimensions of the face in children with cleft lip with and without alveolar clefts; however, the transverse dimension—especially the nose—remains too broad.

From the *Department of Oral and Maxillofacial Surgery, University Hospital Tübingen; †Max Planck Institute for Biological Cybernetics; ‡Department of Orthodontics, University Hospital Tübingen; and §Department of Medical Biometry, University of Tübingen, Tübingen, Germany.

Received June 14, 2012.

Accepted for publication September 20, 2012.

Address correspondence and reprint requests to Michael Krimmel, MD, DMD, PhD, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Osianderstr. 2-8, D-72076 Tübingen, Germany; E-mail:

Drs. Krimmel and Kluba contributed equally to this work.

The authors report no conflicts of interest.

© 2013 Mutaz B. Habal, MD