Facial esthetics in children with unilateral cleft lip and palate 3 years after alveolar bonegrafting combined with rhinoplasty between 2 and 4 years of age

Offert, B; Janiszewska-Olszowska, J; Dudkiewicz, Z; Brudnicki, A; Katsaros, Christos; Fudalej, Piotr (2013). Facial esthetics in children with unilateral cleft lip and palate 3 years after alveolar bonegrafting combined with rhinoplasty between 2 and 4 years of age. Orthodontics & craniofacial research, 16(1), pp. 36-43. Wiley 10.1111/ocr.12002

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OBJECTIVES

To evaluate facial esthetics in patients with unilateral cleft lip and palate (UCLP) after alveolar bone grafting combined with rhinoplasty between 2 and 4 years of age.

DESIGN

Retrospective case-control study.

SETTING

The Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland.

MATERIAL AND METHODS

Photographs of full faces and cropped images of five nasolabial components: nasal deviation, nasal form, nasal profile, vermillion border, and inferior view were assessed by 5 professional and 14 layraters in 29 children (23 boys and 6 girls; mean age = 5.3 years, SD 0.5; Early-grafted group) and 30 children (20 boys and 10 girls; mean age = 5.5 years, SD 1.0; Non-grafted group) with complete unilateral cleft lip and palate repaired with a one-stage closure. The groups differed regarding the timing of alveolar bone grafting: in the Early-grafted group, alveolar bone grafting in combination with rhinoplasty (ABG-R) was performed between 2 and 4 years of age (mean age = 2.3 years; SD 0.6); in the Non-grafted group, the alveolar defect was grafted after 9 years of age. No primary nose correction was carried out in any group. To rate esthetics, a modified five-grade esthetic index of Asher-McDade was used, where grade 1 means the most esthetic and grade 5 - the least esthetic outcome.

RESULTS

Esthetics of full faces and of all nasolabial elements in the Early-grafted group was significantly better than in Non-grafted group. The scores in the Early-grafted group ranged from 2.30 to 2.66 points, whereas in the Non-grafted group ranged from 2.66 to 3.17 points. All intergroup differences were statistically significant (p < 0.05).

CONCLUSIONS

Three years post-operatively, early alveolar bone grafting combined with rhinoplasty is favorable for facial esthetics in children with UCLP, but a longer follow-up is needed to assess whether the improvement was permanent.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > School of Dental Medicine > Department of Orthodontics
UniBE Contributor:	Katsaros, Christos, Fudalej, Piotr
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1601-6343
Publisher:	Wiley
Language:	English
Submitter:	Eveline Carmen Schuler
Date Deposited:	17 Feb 2014 12:11
Last Modified:	05 Dec 2022 14:27
Publisher DOI:	10.1111/ocr.12002
PubMed ID:	23311658
URI:	https://boris.unibe.ch/id/eprint/40118