Three dimensional analysis of CT image on naso-maxillary complex in cleft lip and palate patients

Abstract

This study was designed to clarify the three dimensional features of naso-maxillary complex in cleft lip and palate (CLP) by using computed tomography (CT) and to examine its change following an upper dental arch expansion. Sequential CT images with 2mm-thickness were obtained for 11 unilateral CLP boys (UCLP), 6 bilateral CLP boys (BCLP) and 4 boys without cleft (non-cleft). Additionally, two serial sets of upper dental cast before and after dental arch expansion coupled with CT images in UCLP were used to evaluate the effect of dental arch expansion on the naso-maxillary complex. UCLP demonstrated a remarkable naso-maxillary deformity characterized by a decreased volume of maxillary sinus in comparison with the non-cleft patients. Both the volume and shape of nasal cavity were significantly different between the cleft and non cleft side. Naso-maxillary morphology of BCLP, however, was similar to that of the non cleft except for the decreased volume of alveolar arch. Comparative study of UCLP and BCLP showed a significant difference in naso-maxillary morphology. There were some significant correlations between the dental arch expansion and change of each naso-maxillary component, suggesting the effect of expansion stress on the naso-maxillary complex in UCLP. However, deformation caused by expansion stress varied, depending on each component of the naso-maxillary complex.