Three-dimensional development of the palate in bilateral orofacial cleft newborns 1 year after early neonatal cheiloplasty: Classic and geometric morphometric evaluation Lenka Jaklov  a a, * , Ji  rí Borský b , Michal Jurov  cík c , Eva Hoffmannov  a a , Milo  s  Cerný d , J  an Dupej a, e , Jana Velemínsk  a a a Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Vini cn a 7, 128 43, Prague 2, Czech Republic b Department of Otorhinolaryngology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 00, Prague 5, Czech Republic c ENT, Clinic of the 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84,150 00, Prague 5, Czech Republic d Department of Neonatology with NICU, Obstetrics and Gynecology Clinic, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 00, Prague 5, Czech Republic e Department of Software and Computer Science Education, Faculty of Mathematics and Physics, Charles University, Malostransk eN am estí 25, 118 00, Prague 1, Czech Republic article info Article history: Paper received 10 July 2019 Accepted 24 February 2020 Available online xxx Keywords: Bilateral cleft lip and palate Neonatal cheiloplasty Palate development Geometric morphometry Classic morphometry Dental arch abstract Objectives: The aim of this study was to assess palatal growth in newborns with complete bilateral cleft lip and palate (cBCLP) and bilateral cleft lip and palate with tissue bridges (BCLP þ B) 1 year after early neonatal cheiloplasty (ENC). Material and methods: The methodology was based on classic and morphometric analysis of dental models of newborns with cBCLP or BCLP þ B. These analyses included metric analysis, coherent point drift-dense correspondence analysis, superprojection methods, and multivariate statistics. Dental casts were observed in two age categories, which were compared with each other. The first cast was obtained from each patient before ENC (T0, 5 ± 5 days) and the second one prior to palatoplasty (T1, 12 ± 6 months). Results: Fifty-two dental models obtained from 26 newborns with cBCLP and BCLP þ B were evaluated. The results showed that over the 12-month period, alveolar clefts were narrowed in both cleft types due to anterior growth combined with the formative effect of suturing. This was confirmed by decreases in the dimensions of the right (T0 9.93 ± 2.80 mm, T1 6.64 ± 2.43 mm; p  0.003) and left (T0 10.71 ± 4.13 mm, T1 6.69 ± 4.29 mm; p  0.003) alveolar clefts in cBCLP patients. Similar reductions in alveolar cleft widths occurred on the left side (T0 11.69 ± 4.75 mm, T1 4.34 ± 2.97 mm; p  0.001) of BCLP þ B patients, while on the right side, which was connected by a combined tissue bridge, there was non-significant narrowing of the alveolar cleft (T0 1.61 ± 1.34 mm, T1 1.04 ± 0.70 mm; p ¼ 0.120). The ENC did not restrict posterior palatal growth, meaning that intertuberosity width was extended in cBCLP (T0 32.80 ± 3.15 mm, T1 35.86 ± 2.80 mm; p  0.001) and in BCLP þ B neonates (T0 34.01 ± 2.15 mm, T1 36.21 ± 2.14 mm; p  0.004). Width and length measurements in the observed groups showed growth tendencies equivalent to those in noncleft or LOP patients. Palatal variability was greater in neonatal cBCLP, but was reduced during the monitored period, approximating that for BCLP þ B. Regions with the most notable palatal growth were located primarily at the premaxilla and at the anterior and partially posterior ends of the maxillary segments. Conclusion: Early neonatal cheiloplasty had no negative effect on palatal growth in any direction. There was no reduction in the length or width of the palate during the first year of life, nor was there narrowing of the dentoalveolar arch. The formative effect of the operated lip on the anterior part of the palate was confirmed. This, in combination with the favorable growth, lead to closure of the alveolar cleft. © 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved. * Corresponding author. E-mail address: jaklovale@natur.cuni.cz (L. Jaklov a). Contents lists available at ScienceDirect Journal of Cranio-Maxillo-Facial Surgery journal homepage: www.jcmfs.com https://doi.org/10.1016/j.jcms.2020.02.019 1010-5182/© 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved. Journal of Cranio-Maxillo-Facial Surgery xxx (xxxx) xxx Please cite this article as: Jaklov a L et al., Three-dimensional development of the palate in bilateral orofacial cleft newborns 1 year after early neonatal cheiloplasty: Classic and geometric morphometric evaluation, Journal of Cranio-Maxillo-Facial Surgery, https://doi.org/10.1016/ j.jcms.2020.02.019