The Relationship Between Dental Agenesis and Maxillary Hypoplasia in Patients With Cleft Lip and Palate

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lindsay E. Janes ◽  
Mohamed Bazina ◽  
Sherif S. Morcos ◽  
Angelica Ukaigwe ◽  
Manish Valiathan ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillary Hypoplasia ◽  
The Relationship

Skeletal and Dental Correction and Stability Following LeFort I Advancement in Patients With Cleft Lip and Palate With Mild, Moderate, and Severe Maxillary Hypoplasia

2021 ◽  
pp. 105566562199610
Author(s):  
Buddhathida Wangsrimongkol ◽  
Roberto L. Flores ◽  
David A. Staffenberg ◽  
Eduardo D. Rodriguez ◽  
Pradip. R. Shetye
Keyword(s):  
Retrospective Study ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Inclusion Criteria ◽  
Maxillary Hypoplasia ◽  
Main Outcome Measure ◽  
Lateral Cephalograms

Objective: This study evaluates skeletal and dental outcomes of LeFort I advancement surgery in patients with cleft lip and palate (CLP) with varying degrees of maxillary skeletal hypoplasia. Design: Retrospective study. Method: Lateral cephalograms were digitized at preoperative (T1), immediately postoperative (T2), and 1-year follow-up (T3) and compared to untreated unaffected controls. Based on the severity of cleft maxillary hypoplasia, the sample was divided into 3 groups using Wits analysis: mild: ≤0 to ≥−5 mm; moderate: <−5 to >−10 mm; and severe: ≤−10 mm. Participants: Fifty-one patients with nonsyndromic CLP with hypoplastic maxilla who met inclusion criteria. Intervention: LeFort I advancement. Main Outcome Measure: Skeletal and dental stability post-LeFort I surgery at a 1-year follow-up. Results: At T2, LeFort I surgery produced an average correction of maxillary hypoplasia by 6.4 ± 0.6, 8.1 ± 0.4, and 10.7 ± 0.8 mm in the mild, moderate, and severe groups, respectively. There was a mean relapse of 1 to 1.5 mm observed in all groups. At T3, no statistically significant differences were observed between the surgical groups and controls at angle Sella, Nasion, A point (SNA), A point, Nasion, B point (ANB), and overjet outcome measures. Conclusions: LeFort I advancement produces a stable correction in mild, moderate, and severe skeletal maxillary hypoplasia. Overcorrection is recommended in all patients with CLP to compensate for the expected postsurgical skeletal relapse.

The Relationship Between Maxillary Growth and Speech in Children With a Unilateral Cleft Lip and Palate at 5 Years of Age

2021 ◽  
pp. 105566562110106
Author(s):  
Matthew Fell ◽  
Jibby Medina ◽  
Kate Fitzsimons ◽  
Miriam Seifert ◽  
Anne Roberts ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Poor Growth ◽  
History Of ◽  
Dental Models ◽  
Maxillary Growth ◽  
Growth Scores ◽  
Outcomes For Children ◽  
The Relationship ◽  
Normal Speech

Objective: This study sought to investigate the association between maxillary growth and speech outcomes for children with a repaired unilateral cleft lip and palate (UCLP) at 5 years of age. Participants: In all, 521 children (180 females and 341 males) with a nonsyndromic complete UCLP, born between 2007 and 2012 in England, Wales, and Northern Ireland were included in this study. Outcome Measures: Maxillary growth was analyzed using dental models scored by the 5-Year-Olds’ index, and perceptual speech analyses were scored by the Cleft Audit Protocol for Speech – Augmented rating. Results: Forty-one percent of the children achieved good maxillary growth (scores 1 and 2 on 5-Year-Old’ index). Fifty percent of the children achieved normal speech (achieving UK speech standard 1). Maxillary growth was not found to have an impact on speech outcome when described by the 3 UK National Cleft Lip and Palate Speech Audit Outcome Standards. Analysis according to individual speech parameters showed dentalizations to be less prevalent in children with good maxillary growth compared to fair and poor growth ( P = .001). The remaining speech parameters within resonance, nasal airflow, and articulation categories were not significantly associated with maxillary growth. Conclusion: The findings from this study suggest that children with a history of complete UCLP, who have poor maxillary growth, are not at a higher risk of having major speech errors compared to children with good or fair maxillary growth at 5 years of age.

scholarly journals Cleft Maxillary Hypoplasia

2021 ◽  
pp. 1675-1702
Author(s):  
Philip Mathew ◽  
Mustafa. K ◽  
Paul Mathai
Keyword(s):  
Treatment Planning ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Clinical Problem ◽  
Congenital Defect ◽  
Individualized Treatment ◽  
Maxillary Hypoplasia ◽  
Surgical Interventions ◽  
Detailed Evaluation

AbstractCleft lip and palate patients are born with a challenging deformity that requires multiple surgical interventions in order to reach functional and esthetic harmony. Mid face deficiency in cleft patients is a challenging clinical problem very often encountered in the management of this congenital defect. Cleft maxillary hypoplasia can be attributed to the inherited traits, acquired traits and Induced traits. CLP patients usually present with symptoms varying from malocclusion, retrusion of midface, and a narrow hard palate. A detailed evaluation and individualized treatment planning is of utmost importance in dealing with these patients. Treatment involves the contribution from both the orthodontist and the craniofacial team. The goals for the treatment for cleft maxillary hypoplasia are improvement of aesthetic deficits as well as correction of malocclusion.

Perceptual Evaluation of Speech and Velopharyngeal Function in Children with and without Cleft Palate and the Relationship to Nasal Airflow Patterns

2002 ◽  
Vol 39 (4) ◽  
pp. 409-424 ◽  
Author(s):  
Hans Dotevall ◽  
Anette Lohmander-Agerskov ◽  
Hasse Ejnell ◽  
Björn Bake
Keyword(s):  
Cleft Palate ◽  
Sensitivity And Specificity ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Strong Association ◽  
Airflow Rate ◽  
Nasal Airflow ◽  
Perceptual Evaluation ◽  
Velopharyngeal Function ◽  
The Relationship

Objectives The aim was to study the relationship between perceptual evaluation of speech variables related to velopharyngeal function and the pattern of nasal airflow during the velopharyngeal closing phase in speech in children with and without cleft palate. Participants Fourteen children with cleft lip and palate or cleft palate only and 15 controls aged 7 and 10 years. All were native Swedish speakers. Method Three experienced listeners performed a blinded perceptual speech evaluation. Nasal airflow was transduced with a pneumotachograph attached to a nasal mask. The duration from peak to 5% nasal airflow, maximum flow declination rate, and nasal airflow at selected points in time during the transition from nasal to stop consonants in bilabial and velar articulatory positions in sentences were estimated. The analysis was focused on the perceptual ratings of “velopharyngeal function” and “hypernasality.” Results A strong association was found between ratings of “velopharyngeal function” and “hypernasality” and the pattern of nasal airflow during the bilabial nasal-to-stop combination /mp/. Both the sensitivity and specificity were 1.00 for the bilabial temporal airflow measure in relation to ratings of “velopharyngeal function.” The nasal airflow rate during /p/ in /mp/ had a sensitivity of 1.00 and specificity of 0.92 to 0.96 in relation to ratings of “hypernasality.” Conclusion Assessment of the nasal airflow dynamics during the velopharyngeal closing phase in speech presents quantitative, objective data that appear to distinguish between perceptually normal and deviant velopharyngeal function with high sensitivity and specificity.

Conversational Skills of Children with Cleft Lip and Palate: A Replication and Extension

2006 ◽  
Vol 43 (2) ◽  
pp. 179-188 ◽  
Author(s):  
Melissa S. Frederickson ◽  
Kathy L. Chapman ◽  
Mary Hardin-Jones
Keyword(s):  
Speech Production ◽  
Cleft Lip ◽  
Significant Positive Correlation ◽  
Cleft Lip And Palate ◽  
Individual Child ◽  
Language Performance ◽  
Positive Correlation ◽  
Conversational Skills ◽  
Conversational Interactions ◽  
The Relationship

Objective To replicate and to extend a previous study examining the conversational skills of children with cleft lip and palate. Participants Thirty-four children (33 to 44 months) participated: 17 children with cleft lip and palate and 17 noncleft children. Methods The children were observed during an interaction with caregivers in their homes. Samples of caregiver-child interactions were coded as assertive or responsive, for type of conversational act, and for discourse level categories. Profiles of conversational activity were determined for each child based on the coding. Correlations were performed to examine the relationship between assertiveness and speech variables (articulation and resonance) for the children with cleft lip and palate. Results Group comparisons revealed that the children with cleft lip and palate produced fewer assertive utterances, were less likely to respond adequately to comments by caregivers, and produced more topic maintaining and fewer topic extending utterances than did their noncleft peers during conversational interactions. Examination of individual child data indicated that 35% of the children with cleft lip and palate exhibited conversational profiles characterized by either low assertiveness or low responsiveness. Finally, a significant positive correlation was noted between conversational assertiveness and speech production skills. Conclusion These findings suggested that the children with cleft lip and palate were less conversationally assertive than their noncleft peers. Further, there appeared to be a relationship between speech production skills and conversational skills, suggesting that poor speech may be impacting language performance for these children.

Can Occlusal Evaluation of Children with Unilateral Cleft Lip and Palate Help Determine Future Maxillofacial Morphology?

2014 ◽  
Vol 51 (6) ◽  
pp. 696-706 ◽  
Author(s):  
Akira Suzuki ◽  
Masaaki Sasaguri ◽  
Kenji Hiura ◽  
Atsushi Yasunaga ◽  
Takeshi Mitsuyasu ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rank Order ◽  
University Hospital ◽  
Dental Arch ◽  
Prospective Longitudinal Study ◽  
Lateral Cephalograms ◽  
Prospective Longitudinal ◽  
The Relationship ◽  
Dental Cast

Objective To investigate the change in occlusal evaluations from the 5-year-olds' index to the Goslon Yardstick and to compare the relationship between the evaluations and maxillofacial growth in patients with complete unilateral cleft lip and palate (UCLP). Design A prospective longitudinal study. Subjects The sample consisted of 85 patients with complete UCLP who underwent surgery from 1969 to 1994 and were treated at the Kyushu University Hospital in Fukuoka, Japan. Subjects had two serial dental casts performed at the ages of 5 and 10 years. Furthermore, each patient had lateral cephalographs taken at the age of 5 years, 76 of 85 subjects had films taken at the age of 10 years, and 54 subjects also had lateral cephalograms taken after the age of 15 years. Methods Every dental cast was evaluated by the 5-year-olds' index and the Goslon Yardstick, respectively. The lateral cephalographs were traced and digitized, and angular dimensions were calculated. Outcomes were compared using Spearman's rank-order correlation analysis and the Kruskal-Wallis analysis. Results and Conclusion Dental arch relationships were evaluated and rated as 2.96 in the 5-year-olds' index and 2.85 in the Goslon Yardstick, respectively. Both groupings showed a significant relationship, and they showed no change in 36 out of 85 subjects (42.3%), significant improvement in 30 (35.3%), and deterioration in 19 (22.3%). Two occlusal groupings and maxillofacial morphology on the cephalographs indicated that the grouping reflected the anteroposterior position of the mandible. Moreover, both groupings showed some relation to previous maxillofacial growth, but they did not show any relationship with future growth. The Goslon Yardstick may not predict maxillofacial morphology in adulthood.

Evaluation of Lefort I Osteotomy Line and Pterygomaxillary Junction Region in Patients With Cleft Lip and Palate

2020 ◽  
pp. 105566562096957
Author(s):  
Bahadır Sancar ◽  
Şuayip Burak Duman
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Le Fort I Osteotomy ◽  
Maxillary Hypoplasia ◽  
Le Fort ◽  
Osteotomy Line ◽  
Le Fort I ◽  
Pterygomaxillary Junction

Objective: This study aimed to evaluate the Le Fort I osteotomy line and pterygomaxillary junction via cone-beam computed tomography in individuals with cleft lip and palate (CLP). Design: Retrospective study. Patients and Methods: The study included individuals older than 16 years with CLP, who were scheduled for repositioning of the maxilla by Le Fort I osteotomy, and those with class III malocclusion with maxillary hypoplasia, who were scheduled for Le Fort I osteotomy. The measurements made in the area of the cleft of individuals with CLP were compared with both the side with no cleft and those with class III malocclusion with maxillary hypoplasia. A total of 11 measurements were made on the axial section parallel to the Frankfurt Horizontal plane, corresponding to the lower 1/5 of the distance between the infraorbital foramen and the anterior nasal spine. Results: There were significant differences both in the comparisons made between the individuals with CLP and those without CLP in terms of the canal-anterior alveolar crest (G) and sinus-anterior alveolar crest (L) measurements ( P < .05). The mean measurement values showed that the measurement results were higher in individuals with CLP in general. Conclusion: In conclusion, we believe that there might be difficulties both in osteotomy and down fracture stages during Le Fort I osteotomies performed in individuals with CLP.

Association Between Nonsyndromic Cleft Lip and Palate and 2 Polymorphic Loci: A Meta-Analysis

2020 ◽  
pp. 105566562096268
Author(s):  
Yusi Wang ◽  
Xueyuan Jia ◽  
Yuandong Qiao ◽  
Lidan Xu ◽  
Xuelong Zhang ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Cleft Lip ◽  
Methylenetetrahydrofolate Reductase ◽  
Cleft Lip And Palate ◽  
Meta Analysis ◽  
Craniofacial Development ◽  
Asian Group ◽  
Potential Association ◽  
Increased Risk ◽  
The Relationship

Objectives: The relationship between Noggin ( NOG) and methylenetetrahydrofolate reductase and nonsyndromic cleft lip and palate (NSCLP) has been reported participate in craniofacial development but need further evidence. To indicate the susceptibility between the 2 genes and NSCLP, rs227731 and rs1801131 polymorphisms were included in the present research. This research may provide some genetic clues for disease detection and surveillance. Design: Seventeen studies including 4023 cases and 5691 controls were provided for meta-analysis, and odds ratio (OR) with 95% CI were obtained to estimate NSCLP risk. Results: Our analysis suggested potential association of rs227731C on increasing the risk of NSCLP in the Caucasian group and total group but not Asian group under all models: allele (OR = 1.45, 95% CI = 1.21-1.75, P < .0001), homozygote (OR = 2.03, 95% CI = 1.42-2.90, P < .0001), heterozygote (OR = 1.44, 95% CI = 1.19-1.73, P = .0001), dominant (OR = 1.61, 95% CI = 1.27-2.04, P < .0001), and recessive models (OR = 1.63, 95% CI = 1.25-2.12, P = .0003). Besides, increased risk is related to rs1801131 in Asian group under 3 models: allele (OR = 1.24, 95% CI = 1.06-1.44, P = .006), heterozygote (OR = 1.24, 95% CI = 1.02-1.52, P = .03), and dominant models (OR = 1.29, 95% CI = 1.06-1.56, P = .009). Conclusions: Our analysis indicates polymorphisms rs227731 and rs1801131 are associated with NSCLP, with predominance of different ethnic group and deepen understanding of NSCLP.

Sign in / Sign up

Export Citation Format

Share Document