J Korean Assoc Oral Maxillofac Surg.  2007 Jun;33(3):238-246.

Abnormal growth pattern of human fetal maxilla with cleft lip and palate

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Kangnung National University, Gangneung, Korea.
  • 2Graduate School of Dentistry, Graduate School of Dentistry, Seoul National University, Seoul, Korea.
  • 3Department of Oral Pathology, College of Dentistry, Kangnung National University, Gangneung, Korea. sklee@kangnung.ac.kr

Abstract

This study is aimed to elucidate the abnormal growth pattern of human fetal maxilla with cleft lip and palate (CLP). Total 71 fetal maxillae with CLP were obtained from aborted human fetuses. They were examined radiologically for the dimensional changes of maxillary trapezoid (MT) formed by maxillary primary growth centers (MxPGC)(Lee et al., 1992). In palatal radiogram of the CLP maxilla, the MT was traced by the anterior and posterior MxPGCs, and the dimensions of anterior and posterior maxillary widths, maxillary length, and MT length (MTL), and MT area were measured for evaluation of the basic growth pattern of the developing maxilla. The growth of anterior and posterior MxPGCs was severely retarded in the prenatal maxillae with CLPs, showing abnormal shape of MT. Cleft lip subjects without cleft palate also showed arrested growth of MT. Unilateral cleft lipalveolar cleft or cleft palate (UCL-AC/CP) and bilateral cleft lip-alveolar cleft or cleft palate (BCL-AC/CP) showed enhanced abnormal MT pattern. The abnormality of MT was most marked in BCL-AC/CP. It was also observed that the craniofacial malformations other than CLPs produced abnormal MT. In conclusion, the MT growth of prenatal CLP maxilla was severely arrested and resulting in abnormal MT shape on the palatal radiogram. BCL-AC/CP showed more protruded nasal septum than other types of CLPs, while UCL-AC/CP showed severe deviation of the protruded nasal septum towards the non-cleft side. Cleft lip only subjects also showed the abnormal growth of MT. These data suggest that the MT is primarily involved in CLPs, and MT shape could be utilized as a sensitive indicator for the analysis of maxillary malformation in different types of CLPs.

Keyword

Cleft lip and palate; Human fetus; Maxilla; Maxillary primary growth center (MxPGC); Maxillary trapezoid (MT)

MeSH Terms

Cleft Lip*
Cleft Palate
Fetus
Humans*
Maxilla*
Nasal Septum
Palate*
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