Longitudinal craniofacial growth patterns in patients with orofacial clefts: geometric morphometrics.

OBJECTIVE To demonstrate craniofacial developmental patterns in repaired cleft lip and cleft palate (CLP). DESIGN Retrospective, longitudinal. SETTING Center for Craniofacial Disorders, San Juan, Puerto Rico. SAMPLE Males aged 9 to 17 years: 13 noncleft (NC) Class I occlusion (NCC1); 13 NC Class III malocclusion (NCC3); 12 CLP Class I occlusion (CLPC1); and 15 CLP Class III malocclusion (CLPC3). MAIN OUTCOME MEASURES Form changes (ages 10, 13, and 16 years), using finite-element scaling analysis. RESULTS NCC1, 10 to 13 interval: 30% size increase in upper midface (p <.05), mental region (p <.01), mandibular body (p <.05); 13 to 16 interval: 10% to 35% size increase in bimaxillary region and ramus (p <.01). NCC3, 10 to 13 interval: 10% to 40% size increase in posterior cranial base, upper midface, and mandible (p <.05); 13 to 16 interval: 10% to 30% size increase in bimaxillary region (p <.01), especially ramus. CLPC1, 10 to 13 interval: 10% to 15% size increase in posterior cranial base (p <.01), midface (p <.05), and mandibular ramus (p <.05); 13 to 16 interval: 8% to 20% size increase in upper midface (p <.01), lower midface (p <.05), and mandible (p <.05). CLPC3, 10 to 13 interval: no significant changes; 13 to 16 interval: upper midface and cranial base show nonsignificant size decreases, but ramus showed size increase. CONCLUSIONS Noncleft and CLP Class 1 occlusion groups show similar craniofacial growth patterns. Noncleft Class III groups show excessive cranial and mandibular growth. Class III malocclusion in CLP patients is associated with clinically deficient craniomaxillary growth. Growth guidance may be indicated in children with CLP with unfavorable craniofacial growth patterns.