A RETROSPECTIVE COMPARISON OF FRONTAL FACIAL DIMENSIONS IN ALVEOLAR-BONE-GRAFTED AND NONGRAFTED UNILATERAL CLEFT-LIP AND PALATE PATIENTS

This retrospective study was undertaken to describe and compare fronta l craniofacial dimensions in alveolar-bone-grafted and nongrafted comp lete unilateral cleft lip and palate (CUCLP) patients and in noncleft subjects with normal occlusions and good facial balance. Clinical data were obtained from the files of the Hospital for Sick Children, Toron to. Patients were eligible for inclusion if they had posteroanterior c ephalograms (PA) taken at adulthood and no congenital anomalies other than CUCLP. A total of 86 adult Caucasian CULCP patients were studied, including 58 who had not received grafts, 28 who had received seconda ry alveolar bone grafts, and, for comparison, 60 noncleft Caucasian ad ults. The PA cephalometric radiographs were traced, digitized, and mea sured. Analysis of variance (ANOVA) was used to test for among-groups differences in the means of the ratios, proportions, and angular measu res. Tukey-Kramer HSD procedure was used to conduct post-hoc pairwise comparisons following significant (p less than or equal to 0.05) F-rat ios from ANOVA. Sexual dimorphism was a common finding, with males dem onstrating greater facial width. Despite primary surgical repairs, the anterior nasal spine in the nongrafted CUCLP patients was deviated to the noncleft side, and the alar base was depressed on the cleft side. The maxillary incisors close to the cleft site were irregularly incli ned, and this irregularity was more severe in the nongrafted CUCLP pat ients. The long-term effects of secondary alveolar bone grafting on tr ansverse craniofacial growth appears to be minimal and limited to the immediate area of the cleft.