DIFFERENTIATION BETWEEN CLEFT-LIP WITH OR WITHOUT CLEFT-PALATE AND ISOLATED CLEFT-PALATE USING PARENTAL CEPHALOMETRIC PARAMETERS

Objective: The purpose of this study was to identify and compare later al cephalometric measurements in noncleft parents of children with cle ft palate (CP) and cleft lip (CL), and cleft lip and palate (CLP). The hypothesis was that discriminant analysis would enable identification of morphometric features that predispose to orofacial clefting and th at differ for CP, CL, and CLP and are unevenly distributed within pare ntal pairs. Design: This was a prospective, parametric analysis. Setti ng: The study was conducted by the Department of Dental Health, Univer sity of Dundee, and the Department of Statistics, University of Glasgo w, Scotland. Subjects: From a completely ascertained sample of 286 chi ldren with cleft lip and/or palate born in the West of Scotland betwee n January 1, 1980, and December 31, 1984, a sample of 83 parents of ch ildren with nonsyndromic clefts volunteered for lateral cephalometric examination. Methods: Thirty-seven cranial and 99 facial landmarks wer e identified and 37 linear, angular, and area parameters were used to describe the craniofacial skeleton. Analysis of variance was used for a three-way comparison of CL/CLP/CP, and stepwise discriminant analysi s was used to determine which variables discriminate best between clef t lip with or without cleft palate [CL(P)] and isolated cleft palate ( CP) parents. Results: There were no significant differences whatsoever in the craniofacial morphology between the parents of children with C L and CLP, but differences were found between the CL(P) and CP groups. The most significant of these were in mandibular length, ramus length , mandibular area, and cranial area. Mandibular ramus length alone dis criminated between the two groups in 71.4% of CP and in 62.5% of CL(P) cases, while separate analysis of fathers and mothers showed that ram us length and cranial height together reliably distinguish between mot hers in 75% of CP and 80% of CL(P) cases. Conclusions: Previous studie s suggests that unaffected parents with nonsyndromic children with cle ft lip and/or palate have differences in their craniofacial morphology when compared to the general population. This study indicates that th ese morphologic features differ for CP and CL(P).