• 대한치과교정학회지
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• 제41권6호
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• pp.431-439
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• 2011

Objective: To determine whether there is any difference between the cleft and non-cleft sides of the mandible in unilateral cleft lip and palate (UCLP) patients, or the right and left sides in control patients; and to determine if there is any difference between the mandibular asymmetry of UCLP patients and that of control patients. Methods: We examined cone-beam computed tomography (CBCT) scans of 15 patients with UCLP and 15 age- and gender-matched control patients. We evaluated 8 linear, 3 surface, and 3 volumetric measurements and compared the cleft/non-cleft sides of UCLP patients and the right/left sides of controls. Results: There were no statistically significant gender differences in any linear, surface, or volumetric measurement. The single significant side-to-side difference in UCLP patients was a longer coronoid unit on the cleft side than on the non-cleft side ($p$ = 0.046). Body volume was significantly lower in the UCLP group than in the control group ($p$ = 0.008). Conclusions: In general, UCLP patients have symmetrical mandibles, although the coronoid unit length is significantly longer on the cleft side than on the non-cleft side. UCLP patients and controls differed only in body volume.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권4호
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• pp.430-435
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• 2000

Cleft lip and palate is one of the congenital anomalies which need comprehensive and multidisciplinary treatment plan because 1) oral cavity is an important organ with masticatory function as a start of digestive tract, 2) anatomic symmetry and balance is esthetically important in midfacial area, and 3) it is also important to prevent psycho-social problems by adequate restoration of normal facial appearance. There are many different protocols in the treatment of cleft lip and palate, but our department has adopted and modified the $Z{\"{u}}rich$ protocol, as published in the Journal of Korean Cleft Lip and Palate Association in 1998. The first challenge is feeding. Type of feeding aid ranges from simple obturators to active orthopedic appliances. In our department we use passive-type plate made up of soft and hard acrylic resin which permits normal maxillary growth. We use Millard's method to restore normal appearance and function of unilateral complete cleft lip. In consideration of both maxillary growth and phonetic problems, we first close soft palate at 18 months of age and delay the hard palate palatoplasty until 4 to 5 years of age. When soft palate is closed, posterior third of the hard palate is intentionally not denuded to allow normal maxillary growth. In hard palate palatoplasty the mucoperiosteum of affected site is not mobilized to permit residual growth of the maxilla. We have treated a patient with unilateral complete cleft lip and palate by Ajou protocol, which is a kind of modified $Z{\"{u}}rich$ protocol. It is as follows: Infantile orthopedics with passive-type plate such as Hotz plate, cheiloplasty with Millard's rotation-advancement flap, and two stage palatoplasty. It is followed by orthodontic treatment and secondary osteoplasty to augment cleft alveolus, orthognathic surgery, and finally rehabilitation with conventional prosthodontic treatment or implant installation. The result was good up to now, but we are later to investigate the final result with longitudinal follow-up study according to master plan by Ajou protocol.