Objectives: The primary objective was to assess if a correlation exists between CVM and statural height growth velocity. The secondary objective was to assess if a correlation exists between CVM and mandibular growth velocity. Design/Setting: A prospective longitudinal study undertaken at Liverpool University. Subjects: Participants were aged between 8-18 years, of either gender and enrolled from the orthodontic waiting list at Liverpool University Dental Hospital. Methods: Standing height was measured every 6 weeks with subjects barefoot and in natural head position. Lateral cephalograms were taken at the start of treatment, on completing functional appliance therapy and prior to debond. Mandibular growth was assessed using the area of the triangle condylion-gnathion-gonion. Intra- and inter-observer reliability of CVM staging, cephalometric and statural height measurements were assessed using Cohen’s weighted kappa, intra-class correlation coefficient, and Bland and Altman plots respectively. ANOVA was used to test for statistically significant differences between the CVM stages. Results: 108 participants were included for analysis. The peak in statural height growth velocity occurred at CVM stage 3 (P=0.001). The peak in mandibular growth occurred at CVM stage 3, although this was not statistically significant. Conclusions: The findings of this study demonstrate that CVM staging is valid for identifying the pubertal peak in statural height. The peak in mandibular growth as assessed by the triangle Co-Go-Gn occurred at CVM Stage 3, but this was not statistically significant. Ethical approval was granted from Liverpool East Research Ethics Committee on 30th October 2013 with reference number 13/NW/0408 and protocol number UoL000751.

Differential growth was demonstrated between facial features and within some facial features. In particular, the columella, nostrils and philtrum did not grow significantly after surgery, although this would be considered normal in the age group studied. Facial growth in children with UCL and UCLP was independent of the head and body growth. The presence of a cleft of the secondary palate accentuated the amount of soft tissue disruption by the cleft in the lip and nose, but not the pattern of disruption. Primary lip / nose repair had no detrimental effect on the early growth and development of the facial features. Likewise, palate repair had no discernible effect on facial soft tissue growth at age 2 years. Primary lip /nose repair had a beneficial effect on facial morphology in terms of reducing asymmetry and was most successful in the improving philtrum and nasal base symmetry, less successful in improving the nasal rim asymmetry. A possible early beneficial effect of cleft repair remote from the surgery site was noted in the reduction of upper face asymmetry in the first year of life. Residual asymmetry in the facial features did not change by age 2 years, despite increases in size with growth. Facial morphology outcomes for UCL and UCLP children in this study was generally similar at 2 years of age, despite marked differences in pre-operative facial form. However, nasal base asymmetry, upper face asymmetry and residual nostril shape deformity were significantly greater in UCLP children at 2 years of age, than in UCL children. These shape differences were not detectable by measurement of facial dimensions alone.

Background: Changes in clinical management; advances in non-invasive three-dimensional imaging; developments in methods of shape analysis. Aim: To assess three-dimensional dentofacial deformity with a view to early appraisal of primary surgical outcome. Results: Significant differences in upper lip morphology were found between the cleft children and their unaffected peers; nasal asymmetry that became more obvious in function was noted in cleft children; the maxillary dental arches of the children with repaired cleft palate were shallow, short and narrow; and the dental arch, deformity and the facial soft tissue deformity were unrelated. Contributions to the field: It has been shown that deviation from normal could be detected as young as 3 years of age using computerised stereophotogrammetry; preliminary, objective, three-dimensional analysis of facial function has been completed in young children; the accuracy of three-dimensional CT scanning of dentate study models and the time cost of data collection were quantified; and this study has produced a body of three-dimensional data that can test and support analytical advances.