PREDICTING THE DEVELOPMENT OF JAWS
IN PATIENTS WITH COMPLETE UNILATERAL
CLEFT OF THE LIP AND PALATE
Velemínská J.1, Šmahel Z.1, Müllerová Ž.2
1Department of Anthropology and Human Genetics, Charles University, Faculty of Natural Sciences, Prague, 2Department of Cleft Defects, Stomatology Clinic, Charles University Hospital Královské Vinohrady, Prague, Czech Republic |
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Summary:
The main objective of this study was to find a predictive multivariate model of jaw development in patients with the
most frequent cleft malformation, i.e. complete unilateral cleft lip and palate (UCLP). The prediction is urgently needed
from the clinical aspect. It will be possible to detect early adversely developing patients upon whom intensive
care and adequate orthodontic treatment could be devoted in good time.
The study is based on a long-term cephalometric follow-up of lateral X-rays of 48 boys with UCLP during puberty.
Using multivariate methods we investigated the relationship of 75 craniofacial characteristics of size, shape and
position during the time interval from 10 to 15 years of age. As the prediction of the development of the jaws in patients
with clefts is very complicated, we have attempted to find a reliable predictive system. Sagittal intermaxillary
relations can be predicted most accurately in the investigated group by means of the angular dimension Ss-N-Sm
(A-N-B angle). We suggest using in clinical practice trinomial equations, the coefficient of determination of which
varies round 0.80, and thus the position of the variables can be explained with sufficient accuracy (the coefficient
of determination 0.64 is considered in orthodontics a value of predictive significance). The proposed predictive
technique was successfully tested in a group of 12 patients with the same diagnosis and therapy.
Key words:
X-ray cephalometry, longitudinal study, complete unilateral cleft lip and palate, jaw relations,
puberty, multiple regression, prediction
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