الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
this study was carried to evaluate the potential of CBCT for qualitative and quantitative
assessment of defects and deformities of a sample of 20 patients with surgically repaired
complete UCLP, ranging in age from 8 to 12 years divided into two groups (13 boys and 7 girls).
These patients were selected from the outpatient clinic of the Orthodontic Department and Cleft-Care
Clinic affiliated to the Oral and Maxillofacial Surgery Department- Faculty of Dentistry- Ain Shams
University.
All subjects were non-syndromic, medically free, with no previous orthodontic or maxillary
orthopedic treatment and do not have any extracted permanent teeth. They were selected prior to
performing alveolar cleft grafting.
For every patient, CBCT scan was taken. Skeletal, dental and soft tissue characteristics and
dental arch parameters were assessed for each subject using various views obtained from the CBCT
scan. For lateral cephalometric analysis, the images obtained from the CBCT scan were analyzed
using (Onyx Ceph®) orthodontic digitizing software program. Postero-anterior and axial views
analyses for assessment of asymmetry were done directly using i-CATVisionTM V1.8 software of the
CBCT machine.
Moreover, incidence of congenitally missing permanent teeth in relation to the side and site
of the bony defect was investigated using the panoramic views. Furthermore, Huddart/Bodenham
scoring for assessment of the surgical outcomes as well as Angle’s classification of malocclusion
were assessed using the implant screen.
The collected data were tabulated and statistically analyzed using PASW Statistics 18.0®
(Predictive Analytics SoftWare) for Windows.
The obtained results of the current study led to the following conclusions:
1. CBCT is an excellent technology for quantifying and analyzing surface and deep defects and
deformities in patients with CLP.
2. Patients with UCLP were found to have smaller cranial base angle, shorter anterior cranial
base length, retruded and shorter maxilla, smaller mandible, impaired maxillary-mandibular
jaw relation with prevalence of skeletal class III, retroclined upper and lower incisors with
increased interincisal angle, retrusive upper lip and protrusive lower lip compared with noncleft
children.
3. Three-dimensional assessment of asymmetry revealed:
Nasal asymmetry on the bony level as well as the soft tissue level. There was a significant
asymmetry of the nasal cavity in both the horizontal and vertical planes. The bony alar
base showed significant sagittal and transverse depression on the cleft side. The lower
half of the nasal septum was deviated towards the cleft side while both the ANS and the
nasal tip were deviated towards the noncleft side.
Three-dimensional collapse of the maxillary dentoalveolar complex on the cleft side.
Reduction of molar point measurements on the cleft side in the vertical plane indicating
canting of the occlusal plane.
Direct correlation between nasal cavity, maxillary dentoalveolus and molar point
asymmetry in the horizontal plane indicating horizontal collapse of the whole cleft side.
Reduction in the transverse position of malare point on the cleft side indicating collapse
of the malar prominence on the cleft side.
Similar transverse dimension of both sides of the maxillary sinuses but the total anteroposterior
length was smaller on the cleft side.
Mandibular asymmetry was not statistically significant in both the horizontal and vertical
planes.
4. There was a prevalence of left-sided cleft in the studied sample. The permanent maxillary
lateral incisor was found to occur more often on the distal side of the cleft. The maxillary
lateral incisor was the most prevalent missing permanent tooth, followed by maxillary second
premolar. There was a significant association between the side of the cleft and the side of
missing teeth.
5. The mean modified Huddart/Bodenham score for the studied group of UCLP patients
indicates a constricted maxillary dental arch.
6. There was a predominance of class III malocclusion, followed by class I then class II. Only
one case was not classified because the first molars were not erupted yet.
7. In the current study only small sex differences were found. Boys showed significantly lower
mean values for the maxillary measurements than in girls, indicating that boys with UCLP
had a more disturbed maxillary growth than do the girls. Skeletal class III malocclusion was
more significant in boys than in girls. No significant difference in the degree of asymmetry
between boys and girls was found except for the total antero-posterior length of the maxillary
sinus which was smaller in the boys.
8. The study revealed a major defect in the documentation of the previously performed
surgeries of lip and palate repair, which is important to study the effect of the variables of
timing, number of surgeries and surgical technique on the dentocraniofacial morphology of
patients with CLP.