A longitudinal study of morphological craniofacial patterns via P-A x-ray headfilms in cleft patients from birth to six years of age.

652 P-A X-ray headfilms of 51 unilateral cleft lip and palat, UCLP; 27 bilateral cleft lip and palate, BCLP; and 62 isolated cleft palate, CP were studied longitudinally at 0-3 months, 4-6 months, and annually from 1:0-6:0 years. Breadth change, height change, and growth direction of nine paired landmarks were investigated by means of the rectangular coordinate system with right to left zygomatico-frontal suture (Zf) point line as the X-axis and the perpendicular line to this X-axis at the mid-point between the right and left Zf points as the X-axis. Major findings were: (1) Study of Sphenoid body, interorbital, bizygomatico-frontal suture, and bizygomatic arch breadths showed that BCLP had a significantly broader face than either UCLP or CP. An apparent tendency to hypertelorism still remained at 6:0 in this group while UCLP and CP groups were both close to the Bolton Standards. (2) Nasal and maxillary bredths of BCLP and UCLP were significantly wider during the first year than in CP, but they showed only a slight growth change after the age of one year, compared to constant growth in CP. (3) All marked structural differences disappeared by 6:0 suggesting the effects of lip and/or palate surgery. (4) A slight cross-bite was found in UCLP and BCLP, but there was no such cross-bite in CP. (5) The effect of clefting was seen in mandibular dimensions where the bigonial notch was slightly broader than in non-cleft averages. (6) Upper facial height occlusal height, and posterior total facial height in each cleft group seemed to be larger than the Standard, though both maxillary height and gonial notch height approximated the Standard by 6:0 (7) From 0:3-6:0, there was no noteworthy difference among the cleft groups in either growth direction or facial symmetry of upper face and mandible. It was only in the mid-facial and dental areas that notable characteristics peculiar to the type of cleft were found. The landmarks of nasal aperture, maxilla, and dental arch showed a slight medial displacement on the affected side, although the degree and amount depended on the cleft-type.