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Open Access Research article

Facial morphometrics of children with non-syndromic orofacial clefts in Tanzania

Mange Manyama1*, Jacinda R Larson2, Denise K Liberton2, Campbell Rolian3, Francis J Smith2, Emmanuel Kimwaga1, Japhet Gilyoma4, Kenneth D Lukowiak5, Richard A Spritz6 and Benedikt Hallgrimsson2

Author Affiliations

1 Department of Anatomy, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania

2 Department of Anatomy and Cell Biology, University of Calgary, Calgary, Canada

3 Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada

4 Department of Surgery, Bugando Medical Centre, Mwanza, Tanzania

5 Department of Physiology and Pharmacology, University of Calgary, Calgary, Canada

6 Human Medical Genetics and Genomics Program, University of Colorado School of Medicine, Aurora, CO, USA

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BMC Oral Health 2014, 14:93  doi:10.1186/1472-6831-14-93

Published: 29 July 2014

Abstract

Background

Orofacial clefts (cleft lip/palate; CL/P) are among the most common congenital anomalies, with prevalence that varies among different ethnic groups. Craniofacial shape differences between individuals with CL/P and healthy controls have been widely reported in non-African populations. Knowledge of craniofacial shape among individuals with non-syndromic CL/P in African populations will provide further understanding of the ethnic and phenotypic variation present in non-syndromic orofacial clefts.

Methods

A descriptive cross-sectional study was carried out at Bugando Medical Centre, Tanzania, comparing individuals with unrepaired non-syndromic CL/P and normal individuals without orofacial clefts. Three-dimensional (3D) facial surfaces were captured using a non-invasive 3D camera. The corresponding 3D coordinates for 26 soft tissue landmarks were used to characterize facial shape. Facial shape variation within and between groups, based on Procrustes superimposed data, was studied using geometric morphometric methods.

Results

Facial shape of children with cleft lip differed significantly from the control group, beyond the cleft itself. The CL/P group exhibited increased nasal and mouth width, increased interorbital distance, and more prognathic premaxillary region. Within the CL/P group, PCA showed that facial shape variation is associated with facial height, nasal cavity width, interorbital distance and midfacial prognathism. The isolated cleft lip (CL) and combined cleft lip and palate (CLP) groups did not differ significantly from one another (Procrustes distance = 0.0416, p = 0.50). Procrustes distance permutation tests within the CL/P group showed a significant shape difference between unilateral clefts and bilateral clefts (Procrustes distance = 0.0728, p = 0.0001). Our findings indicate the morphological variation is similar to those of studies of CL/P patients and their unaffected close relatives in non-African populations.

Conclusion

The mean facial shape in African children with non-syndromic CL/P differs significantly from children without orofacial clefts. The main differences involve interorbital width, facial width and midface prognathism. The axes of facial shape differences we observed are similar to the patterns seen in Caucasian populations, despite apparent differences in cleft prevalence and cleft type distribution. Similar facial morphology in individuals with CL/P in African and Caucasian populations suggests a similar aetiology.