• 대한치과교정학회지
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• 제22권3호
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• pp.657-673
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• 1992

Orthodontic treatment of cleft patients is difficult as the growth is different from that of normal ones. So it is very important to know the characteristic features of the craniofacial morphology and growth pattern in unilateral cleft lip and palate patients. The materials for this study consisted of 55 normal males and 50 unilateral cleft lip and palate ones who received cheiloplasty and palatoplasty previously. The cleft subjects were divided into 4 groups according to their ages kto find out the growth pattern of hard and soft tissue, and to compare the features with those of normal ones. Each cephalogram analysed by McNamara method and others. The obtained results were as follows 1. In the unilateral cleft lip and palate subjects, forward growth of the maxilla was smaller than that of normal ones from 9 years old. So the maxilla was retruded. The maxillary incisors were severely retruded in all age groups. 2. The mandibular overall length and its anteroposterior position did not show any significant differences between two groups. But the height of ramus was very short and the mandible had vertical growth tendency to compensate for undergrowth of the maxilla in cleft subjects after 12 years of age. 3. Horizontal growth of the soft tissue in middle face was smaller than that of any other facial region from 9 years old. The vertical growth rate of upper lip was decreased as growing old. 4. In cleft subjects, the upper and lower facial component angle and the facial convexity angle were large. So their facial profile changed to straight or concave as growing old.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.55.1-55.7
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• 2019

Background: Transverse facial clefts are Tessier's number 7 facial cleft among numbers 1-15 in Tessier's classification of craniofacial malformations, which varies from a simple widening oral commissure to a complete fissure extending towards the external ear. Case presentation: In a patient with a transverse facial cleft, to functionally arrange the orbicularis oris muscle and form the oral commissure naturally, we performed a surgical procedure including orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty. Conclusion: We achieved good results functionally and esthetically by orbicularis oris muscle reconstruction and cheiloplasty with Z-plasty. The surgical modality of our anatomical repair and 3 months follow-up results are presented.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.5.1-5.5
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• 2019

Background: The present study aimed to determine whether laypeople and professionals rate the facial appearance of individuals with repaired complete unilateral or bilateral cleft lip and palate (UCLP, BCLP) similarly based on viewing full facial images. Methods: The study followed a cross-sectional analytical design where five young patients aged 10 to 14 years, who had completed all stages of their unilateral or bilateral cleft lip and palate treatment (bilateral: three, unilateral: two), were evaluated by two groups. The assessment was done by laypeople and 97 qualified professionals (33 orthodontists, 32 plastic surgeons, and 32 oral and maxillofacial surgeons). Professionals were not involved in any stage of the patients' treatment. Results: The facial appearance assessment of the professional groups on different facial aesthetics was significantly lower than that of laypeople, and they had higher perceived need for further treatment. On the other hand, laypeople had higher aesthetic ratings and lower perceived need for further treatment. Differences were also observed between the assessments of the professional groups. Participants who had lower aesthetic assessments of the repair tended to report a higher influence of cleft lip and palate on social activities and professional life. Conclusion: Differences in perception exist between healthcare professionals and laypeople. The discrepancies between the professional groups could be attributed to different treatment modalities and protocols.

• 대한치과교정학회지
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• 제12권2호
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• pp.165-176
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• 1982

A cephalometric radiographic cross sectional comparative study was undertaken to investigate craniofacial growth in cleft lip and palate individuals. The material for this study consisted of 43 subjects with operated cleft lip and palate.(29 males, 14 females). The range of age was from 6 years to 12 years. The roentgenocephalometric values of cleft individuals were compared with values of normal individuals reported by Lee. The following conclusions were obtained; 1) The pattern of cranial base of the cleft subjects was almost the same as that previously reported for the normal individuals. 2) Anterio-posterior length of the mandible did not show any significant difference but in the cleft subjects, that of the males was larger than that of the females. 3) The maxilla of the cleft subjects was very retruded and showed very concave profile. 4) Gonial angle of the cleft subjects was very high, especially in the female clefts. 5) The height of ramus was very poor in the cleft subjects. 6) The facial length was almost the same, but the facial depth of the cleft subjects was smaller than that of the normal individuals. 7) Maxillary and mandibular incisors were severely retroclined. 8) The range of values in the cleft subjects was very variable and the female clefts showed more distured growth than the male clefts.

• 대한구순구개열학회지
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• 제4권2호
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• pp.9-18
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• 2001

구순구개열은 악안면 영역의 선천기형 중 발생빈도가 가장 높으며 출생시부터 성장완료 시기까지 일관된 치료계획에 의한 종합적 진료체계가 필수적이다. 구순구개열의 개선을 위한 구개부 및 입숭? 조기 봉합 후의 반흔조직의 형성은 치열궁 협착 뿐 아니라 상악골 열성장에 의한 중안모의 함몰을 야기하며 이러한 상악골의 열성장 경향은 연령이 증가할수록 점진적으로 증가하는 성향을 보인다. 따라서, 성장잠재력을 이용한 조기의 악정형치료는 구순구개열 환자에서 반드시 필요하며, 적절한 치료 결과를 얻어내기 위하여 환자의 전후방 골격 형태 뿐 아니라, 성장 방향에 대한 고려가 필요하다. 그러나 혼합치열기의 악정형치료는 좋은 결과를 얻었다 하더라도 높은 재발 성향 및 잔여성장에 의한 악골관계의 변화가 예상되므로 장기간의 보정이 필수적이며 성장에 대한 지속적 평가가 이루어져야 할 것이다.

• 대한치과의사협회지
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• 제55권12호
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• pp.862-869
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• 2017

Cleft lip and palate is the most common teratologic condition of oromaxillofacial units, probably associated with genetic and environmental causes. The goal of cleft surgery is to optimize facial esthetics and stomatognathic function while minimizing growth disturbances from surgical intervention. In this article, the author suggests the recent surgical strategies that minimize cleft nasal deformity and midfacial skeletal constriction. From the author's surgical experiences and literature reviews, only considerate surgeries would achieve functional improvement and facial esthetics in patients with cleft lip and palate.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.22.1-22.2
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• 2019

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.75-80
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• 2011

Deformities related with cleft lip are not only limited to the cleft site but also extended to all around the nasolabial region. Facial development is composed of several complex processes as the formation, migration, coalescence and interaction of separate fields. When there is a cleft event, it means there are general problems of those processes. As a result facial elements should have displacement, deformation and functional hypotrophy. These also affect the mucocutaneous structures, which result in the typical deformities of cleft lip. Traditional surgical methods are not sufficient of the correction of functional impairments in the cleft lip. Accordingly, there are relatively high possibilities of occurring secondary deformities. The Delaire's method focuses on repair of functional impairment of the cleft. Consequently, it can maintain the initial good surgical result and avoid the unnecessary incision scar. And this method can minimize secondary nasal deformities which can reduce the risk of additional nasal correction. Therefore authors introduce this advantageous the Delaire technique cheliolplasty which it can be widely used for the cleft lip correction in Korea.

• Archives of Plastic Surgery
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• 제35권3호
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• pp.303-308
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• 2008

Purpose: The purpose of this study is to develop three-dimensional computerized anthropometry(3DCA) and to compare its reliability and accuracy 3DCA with manual anthropometry(MA) for measurement of lips and nasal deformities in unilateral cleft lips and palate(UCLP) patients. Methods: Samples were consisted of six UCLP patients whose facial plaster models were available immediately before and 3 months after the cleft lip surgery. MA of the facial plaster models was carried out using an electronic caliper. In 3DCA, three-dimensional auto-measuring program was used to digitize landmarks and to measure three-dimensional virtual facial models (3DVFM), which was generated with a laser scanner and 3D virtual modeling program. Intraclass correlation coefficients(ICC) were calculated to evaluate reliability and reproducibility of the variables in both methods, and Wilcoxon's signed rank test was done to investigate the difference in values of the same variables of facial models of each patient between two methods. Results: All ICC values were higher than 0.8, so both methods could be considered reliable. Although most variables showed statistical differences between two methods(p<0.05), differences between mean values were very small and could be considered not significant in clinical situation. Conclusion: In clinical situation, 3DCA can be an objective, reliable and accurate tool for evaluation of lips and nasal deformities in the cleft patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.20.1-20.6
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• 2016

Background: Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. Case presentation: A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. Conclusions: The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.