Effects of labial adhesion on maxillary arch dimensions and nasolabial esthetics in cleft lip and palate: a systematic review

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

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Three-Dimensional Printing in Cleft Care: A Systematic Review

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211013175 ◽

2021 ◽

pp. 105566562110131

Author(s):

Farrukh R. Virani ◽

Evan C. Chua ◽

Mary Roz Timbang ◽

Tsung-yen Hsieh ◽

Craig W. Senders

Keyword(s):

Systematic Review ◽

3D Printing ◽

Clinical Outcomes ◽

Outcome Measures ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Secondary Outcome ◽

Exclusion Criteria ◽

3 Dimensional ◽

Dimensional Printing

Objective: To determine the current applications of 3-dimensional (3D) printing in the care of patients with cleft lip and palate. We also reviewed 3D printing limitations, financial analysis, and future implications. Design: Retrospective systematic review. Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used by 3 independent reviewers. Articles were identified from Cochrane library, Ovid Medline, and Embase. Search terms included 3D printing, 3 dimensional printing, additive manufacturing, rapid prototyping, cleft lip, and cleft palate. Exclusion criteria included articles not in English, animal studies, reviews without original data, oral presentations, abstracts, opinion pieces, and articles without relevance to 3D printing or cleft lip and palate. Main Outcome Measures: Primary outcome measure was the purpose of 3D printing in the care of patients with cleft lip and palate. Secondary outcome measures were cost analysis and clinical outcomes. Results: Eight-four articles were identified, and 39 met inclusion/exclusion criteria. Eleven studies used 3D printing models for nasoalveolar molding. Patient-specific implants were developed via 3D printing in 6 articles. Surgical planning was conducted via 3D printing in 8 studies. Eight articles utilized 3D printing for anatomic models/educational purposes. 3-Dimensional printed models were used for surgical simulation/training in 6 articles. Bioprinting was utilized in 4 studies. Secondary outcome of cost was addressed in 8 articles. Conclusion: 3-Dimensional printing for the care of patients with cleft lip and palate has several applications. Potential advantages of utilizing this technology are demonstrated; however, literature is largely descriptive in nature with few clinical outcome measures. Future direction should be aimed at standardized reporting to include clinical outcomes, cost, material, printing method, and results.

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Parental response to the feeding behavior problems in children with cleft lip and palate: A systematic review

Special Care in Dentistry ◽

10.1111/scd.12604 ◽

2021 ◽

Author(s):

Sukeshana Srivastav ◽

Isha Duggal ◽

Ritu Duggal ◽

Nitesh Tewari ◽

Prabhat Kumar Chaudhari ◽

...

Keyword(s):

Systematic Review ◽

Behavior Problems ◽

Feeding Behavior ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Parental Response

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An Investigation of 3D Maxillary Arch Morphometry of Children With Unilateral Cleft Lip and Palate

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000007366 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Sanjida Haque ◽

Mohd Fadhli Khamis ◽

Mohammad Khursheed Alam ◽

Wan Muhamad Amir Wan Ahmad

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Maxillary Arch

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Quantitative 3D Maxillary Arch Evaluation of Two Different Infant Managements for Unilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569(2000)037<0562:qmaeot>2.0.co;2 ◽

2000 ◽

Vol 37 (6) ◽

pp. 562-570 ◽

Cited By ~ 9

Author(s):

Chandra N. Prasad ◽

Jeffrey L. Marsh ◽

Ross E. Long, Jr. ◽

Miroslav Galic ◽

Donald V. Huebener ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Maxillary Arch

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Longitudinal Study on the Changes of Maxillary Arch Dimensions in Japanese Children with Cleft Lip and/or Palate: Infancy to 4 Years of Age

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1995_032_0149_lsotco_2.3.co_2 ◽

1995 ◽

Vol 32 (2) ◽

pp. 149-155 ◽

Cited By ~ 16

Author(s):

Yasuo Honda ◽

Akira Suzuki ◽

Masamichi Ohishi ◽

Hideo Tashiro

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Lateral Displacement ◽

Growth Patterns ◽

Posterior Displacement ◽

Arch Width ◽

Dental Hospital ◽

Growth Changes ◽

Isolated Cleft Palate ◽

Maxillary Arch

The focus of this study was an analysis of maxillary arch growth changes prior to the time of cheiloplasty up to 4 years of age. Serial dental casts were obtained and measured in 95 children with cleft lip and palate, or both: 7 unilateral cleft lip and alveolus (CLA), 52 unilateral cleft lip and palate (UCLP), 24 bilateral cleft lip and palate (BCLP), and 12 isolated cleft palate (CP). The children were treated at the Kyushu University Dental Hospital. The results are as follows: (1) Prior to cheiloplasty, the maxillary buccal segments in the subjects with cleft lip and palate showed lateral displacement. The premaxilla in BCLP subjects was protruded. (2) Cheiloplasty influenced maxillary anterior arch width, but not posterior width. The operation caused posterior displacement of the premaxilla in BCLP subjects. (3) Palatoplasty affected the growth of the maxillary arch in the transverse and anteroposterior dimensions. (4) A variety of growth patterns observed in the patients (e.g., increasing or decreasing of the maxillary arch dimensions) suggests that maxillary arch dimensions were affected not only by surgery, but also by other individual factors such as genetic facial pattern and severity of the cleft.

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Early Orthopaedic Treatment of Unilateral Cleft Lip and Palate

British Journal of Orthodontics ◽

10.1179/bjo.5.3.119 ◽

1978 ◽

Vol 5 (3) ◽

pp. 119-132 ◽

Cited By ~ 26

Author(s):

W. C. Shaw

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Cleft ◽

Orthopaedic Treatment ◽

Partial Data ◽

Alveolar Tissue ◽

Maxillary Arch

Serial frontal and lateral cephalometric radiographs with implants and study models of 31 infants' who received orthopaedic treatment for unilateral cleft lip and palate, were analysed with an electronic XY reader. Partial data for 50 normal infants and 10 isolated palatal cleft patients were included to allow certain comparisons. The records at birth indicate that the size of the alveolar cleft in unilateral cleft cases is governed mainly by the degree of transverse segmental separation which is present and only to a lesser extent by deficiency of alveolar tissue, except in a minority of cases. It is clear that in the early months of life, the divided maxillary arch can be made to assume near normal dimensions by inward rotation of the anterior ends of the segments, at the alveolar and basal level, around axes in the tuberosity regions. Appositional growth of the cleft margins makes little contribution to the reduction in cleft size. The significance of the findings is discussed.

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Three-Dimensional Comparison between the Palatal Forms in Complete Unilateral Cleft Lip and Palate with and without Hotz Plate from Cheiloplasty to Palatoplasty

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1996_033_0312_tdcbtp_2.3.co_2 ◽

1996 ◽

Vol 33 (4) ◽

pp. 312-317 ◽

Cited By ~ 15

Author(s):

Katsuaki Mishima ◽

Toshio Sugahara ◽

Yoshihide Mori ◽

Masayoshi Sakuda

Keyword(s):

Nasal Cavity ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Alveolar Ridge ◽

Maxillary Arch ◽

Alveolar Arch

The palatal forms in 20 infants with a complete unilateral cleft lip, and palate (12 with a Hotz plate and 8 without, selected at random) were studied from birth until 18 months of age. Using techniques developed previously, the degree of curvature In the palate and the magnitude of migration of the maxillary segments were measured three-dimensionally. Furthermore, using a newly developed method to approximate a set of the points on the alveolar ridge to a circle in a plane, the form of the alveolar arch was evaluated. Results from the group with a Hotz plate revealed that the plate possesses four effects not seen in the group without a Hotz plate. The size of the palate was larger, and the sagittal gap between the two segments of the maxilla was smaller. These results suggest that the appliance could stimulate the growth of the segments and could prevent collapse of the maxillary arch from the force of lip closure. Third, the steepness of the segments toward the nasal cavity was smaller, possibly occurring because the appliance prevents tongue intrusion into the cleft. Fourth, the magnitude of migration of the lesser segment toward the cleft edge of the major segment was larger. This result suggests that the appliance could guide the growth of the maxillary segments to narrow the cleft width until 18 months of age.

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