Copyright © 2018 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited. Anthropometric Analysis of the Dental Arches of Five- Year-Old Children With Cleft Lip and Palate Gabriela Mendonc ¸a Rando, DDS,  Eloa ´ Cristina Passucci Ambrosio, MSc,  Paula Karine Jorge, MSc,  Danielle Zola Almeida Prado, MSc, y Maiara Miyuki Matsui Falzoni, MSc,  Cleide Felı ´cio Carvalho Carrara, PhD, y Simone Soares, PhD, y Maria Aparecida Andrade Moreira Machado, PhD, y and Thais Marchini Oliveira, PhD y Abstract: This study aimed to analyze the dimensional alterations of the dental arches of 5-year-old children with cleft lip and palate and to compare these dimensions with children without oral clefts. One hundred twenty children were divided into the following groups: unilateral cleft lip (UCL), unilateral cleft lip and palate (UCLP), cleft palate (CP), and control (C). A specific software was used to digitize the dental casts and perform the anthropometric analyses through the measurement of transversal linear intercanine and intermolar distances on the maxilla and mandible. The inter- group comparisons of the maxillary dimensions exhibited that the intercanine distances of groups C and UCL were statistically greater than that of groups UCLP and CP. The intermolar distance was significantly smaller in group UCLP than in the other groups. No statistically significant difference occurred in the mandibular inter- canine and intermolar distance among groups. The analysis of the superposition of the maxillary over the mandibular transversal distances showed statistically significant differences among groups. This study showed that at 5-year old, the children with cleft involving the palate had more maxillary dimensional alterations than those without cleft palate. Key Words: Cleft lip, cleft palate, dental arch, three-dimensional (J Craniofac Surg 2018;29: 1657–1660) P hotography, cephalometry, or dental cast can be used to analyze the effect of primary surgeries on the craniofacial develop- ment. 1–3 At the first phase of the craniofacial growth, the most common method used is the scanning of the dental casts through a specific software. The digitized model enables conducting retro- spective, longitudinal, and multicenter studies 2 comparing different cleft types. 4 The study of the dental arches of 5-year-old children is important to understand the morphological alterations after the primary plastic surgeries and to aid in the preventive and corrective therapies of children with cleft lip and palate (CLP). So, further studies are necessary to give new guidelines on documentation and planning of the rehabilitative treatment of these children. Thus, this study aimed to analyze the dimensional alterations of the dental arches of 5-year- old children with cleft lip and palate and to compare these dimensions with children without oral clefts. METHODS The Institutional Review Board of the Hospital for Rehabilitation of Craniofacial Anomalies, University of Sa ˜o Paulo (HRAC/USP) and Bauru School of Dentistry approved this study regarding ethical aspects (protocol CAAE: 48136215.0.0000.5441). The sample comprised digitized dental casts of 5-year-old children regularly enrolled in the institutions. The children with oral clefts attended the HRAC/USP. The rehabilitation protocol of lip repair was performed by Millard technique around 3 months. Complete palate repair was performed by Von Langenback technique around 12 months. The children without oral clefts attended the Bauru School of Dentistry. These children presented normal occlusion. Inclusion criteria were children born between 2010 and 2012, with complete primary dentition, without deleterious habit and orthodontic and/or orthopedic treatment. Exclusion criteria were presence of associated syndrome or malformation and children with misbehavior. The children were selected according to the HRAC/ USP and Bauru School of Dentistry routines. The models were obtained from the files of both institutions. Sample size was calculated to obtain the minimum number of children to conduct the study. For that purpose, with level of significance of 5%, test power of 80%, standard deviation of the intercanine distance of 2.16 mm 4 , and a minimum difference to be clinically detected of 1.7 mm, the minimum sample size was of 26 children per group. Thus, 120 children were divided into the following groups: control—C; unilateral cleft lip—UCL; unilateral cleft lip and palate—UCLP; and cleft palate—CP (Fig. 1A–D). A laser scanner system (3Shape’s R700 Scanner) coupled to a computer was used to digitize the dental casts. A specific software (3D Software Appliance Designer, 3Shape, Copenhagen, Denmark) provided the anthropometric analyses. On the maxilla and mandi- ble, we measured the following transversal linear distances: inter- canine—the distance between the cusp tips of the primary canines; 5 intermolar—the distance from the point on the middle of the distance between the buccal and palatal cusps of the right primary first molar to the point on the middle of the distance between the buccal and palatal cusps of the left primary first molar. 6 All statistical tests were executed in GraphPad Prism software (Prism 5 for Windows, Version 5.0; GraphPad Software Inc, San Diego, CA), with level of significance of 5%. Shapiro–Wilk test verified the normality of the quantitative variables. The From the  Department of Pediatric Dentistry, Orthodontics and Commu- nity Health, Bauru School of Dentistry; and y Hospital for the Rehabili- tation of Craniofacial Anomalies, University of Sa ˜o Paulo, Bauru, Brazil. Received December 22, 2017. Accepted for publication June 3, 2018. Address correspondence and reprint requests to Thais Marchini Oliveira, PhD, Bauru School of Dentistry, University of Sa ˜o Paulo, Alameda Dr. Octa ´vio Pinheiro Brisolla, 9-75, Bauru, Sa ˜o Paulo 17012-901, Brazil; E-mail: marchini@usp.br Sponsorship: FAPESP process: 2015/26695-0. The authors report no conflicts of interest. Copyright # 2018 by Mutaz B. Habal, MD ISSN: 1049-2275 DOI: 10.1097/SCS.0000000000004806 CLINICAL STUDY The Journal of Craniofacial Surgery  Volume 29, Number 6, September 2018 1657