Palatal and Alveolar Tissue Deficiency in Infants With Complete Unilateral Cleft Lip and Palate

2017 ◽  
Vol 55 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Katy A. Bednar ◽  
David S. Briss ◽  
Mohamed S. Bamashmous ◽  
Barry H. Grayson ◽  
Pradip R. Shetye
Keyword(s):  
Surface Area ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Plan ◽  
Specific Treatment ◽  
Patient Specific ◽  
Alveolar Ridge ◽  
Surface Areas ◽  
Significant Difference ◽  
Alveolar Tissue

Objective: To investigate intrinsic palatal and alveolar tissue deficiency in patients with unilateral cleft lip and palate (UCLP) as compared to age-matched individuals without UCLP using surface area measurements on 3D scans of plaster casts. Methods: 22 maxillary casts of infants with UCLP from the Wyss Department of Plastic Surgery of NYU Langone Medical Center and 37 maxillary casts from infants without clefts from Sillman’s longitudinal study were scanned by Ortho Insight 3D by Motion View Software, LLC (Chattanooga, TN) and measured using Checkpoint software (Stratovan, Davis, CA). The palatal and alveolar surface areas of each cast were measured. The most superior point of the alveolar ridge in front of the incisive papilla and the most superior point of each maxillary tuberosity were connected by a line that ran along the highest part of the alveolar ridge. This line was used to set boundaries for the palatal surface area measurements. The surface areas of greater and lesser segments were measured independently on UCLP casts. A total palatal surface area for the UCLP sample including width of the cleft gap was also measured. Results: There was a statistically significant difference in surface area ( P > .001) when we compared the UCLP area of the cleft segments alone with the non-cleft sample. There was a positive correlation (determine the statistical significance) between the surface area of the cleft segments and cleft gap. In addition, there was a statistically significant difference between UCLP plus cleft area and the non-cleft samples in surface area ( P < .0001). Conclusion: An intrinsic palatal and alveolar tissue deficiency exists in patients born with UCLP. The amount of tissue deficiency for a patient with UCLP should be considered when developing and executing a patient-specific treatment plan.

scholarly journals The Validation of an Innovative Method for 3D Capture and Analysis of the Nasolabial Region in Cleft Cases

2020 ◽  
Vol 58 (1) ◽  
pp. 98-104
Author(s):  
Ashraf Ayoub ◽  
Adil Khan ◽  
Ali Aldhanhani ◽  
Hashim Alnaser ◽  
Kurt Naudi ◽  
...  
Keyword(s):  
Surface Area ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Strong Correlations ◽  
Upper Lip ◽  
3D Images ◽  
3 Dimensional ◽  
Significant Difference ◽  
Reliable Source ◽  
3D Capture

Objective: To validate a newly developed method for capturing 3-dimensional (3D) images of the nasolabial region for assessing upper lip scarring and asymmetry in surgically managed unilateral cleft lip and palate (UCLP) cases. Design: Validation study, single cohort. Materials and Methods: Eighteen surgically managed UCLP cases were recruited, the nasolabial region of each face was scanned using an intraoral scanner (IOS) to produce 3D images. The images were manually segmented to allow the calculation of surface area of the scar and upper lip asymmetry. Five professionals and 5 lay assessors subjectively evaluated the same images and graded the upper lip scarring and asymmetry at 2 separate occasions. The relationship between the subjective and objective assessments was evaluated. Results: Moderate correlation was found between subjective and objective evaluations of the upper lip scarring and total asymmetry. The captured 3D images were of good quality for the objective measurements of lip asymmetry and residual scarring. Moderate to strong correlations were detected between the 2 panels (T ranging between 0.5 and 0.9) with no significant difference ( P > .05) in the mean score of the subjectively evaluated parameters. Conclusion: The IOS is a useful tool for the capture of the nasolabial morphology. The captured 3D images are a reliable source for measuring lip asymmetry and scar surface area. The method has sufficient validity for routine clinical use and for objective outcome measures of the surgical repair of cleft lip.

scholarly journals Analysis of Soft Tissue Cephalometry in Skeletal Class I with Post Operation Unilateral and Bilateral CLP

2019 ◽  
Vol 1 (2) ◽  
pp. 66
Author(s):  
Ardan Fitrianto ◽  
Thalca Hamid ◽  
Ida Bagus Narmada
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Plan ◽  
Class I ◽  
Congenital Defects ◽  
Cephalometric Analysis ◽  
Skeletal Class ◽  
Significant Difference ◽  
Line Angle

Background: Facial appearance is an important diagnostic criterion that must be considered in orthodontics treatment plan. Orthodontics treatment is one of the dental treatments to prevent or correct tooth position abnormalities so that optimal function can be achieved including occlusion, proportional arrangement of the teeth and facial profile, as well as the harmony of facial profiles. Common facial abnormality cases include cleft lip and palate. Cleft lip and palate are caused by congenital defects and environmental factors. Purpose: The study was aimed to determine post-operative soft tissue cephalometric analysis of skeletal class I with post-operative of unilateral and bilateral CLP. Methods: This was a descriptive observational study. The subjects were secondary data from radiographic cephalometry obtained from the CLP Center Premier Hospital Surabaya and Universitas Airlangga Dental Hospital. Result: There was a significant difference in line angle parameters in both groups with a significant value of 0.002 (p <0.05). There were also significant differences in the Li-H line parameters in both groups with a significant value of 0.000 (p <0.05). There were H line angle and Li-H line differences in soft tissue cephalometric analysis between skeletal class I group with post-operative unilateral and bilateral CLP group. Conclusion: There was no difference in soft tissue cephalometric analysis between the post-operative of unilateral CLP and bilateral CLP on all parameters.

Evaluation of a Three-Dimensional Stereophotogrammetric Method to Identify and Measure the Palatal Surface Area in Children with Unilateral Cleft Lip and Palate

2016 ◽  
Vol 53 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Marcio De Menezes ◽  
Ana Maria Cerón-Zapata ◽  
Ana Maria López-Palacio ◽  
Andrea Mapelli ◽  
Luca Pisoni ◽  
...  
Keyword(s):  
Surface Area ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional

scholarly journals Effects of rapid maxillary expansion in cleft patients resulting from the use of two different expanders

2016 ◽  
Vol 21 (6) ◽  
pp. 82-90 ◽  
Author(s):  
Daniel Santos Fonseca Figueiredo ◽  
Lucas Cardinal ◽  
Flávia Uchôa Costa Bartolomeo ◽  
Juan Martin Palomo ◽  
Martinho Campolina Rebello Horta ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rapid Maxillary Expansion ◽  
Cone Beam ◽  
Tomographic Image ◽  
Maxillary Expansion ◽  
Downward Movement ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Maxillary Region

ABSTRACT Objective: The aim of this study was to evaluate the skeletal and dental effects of rapid maxillary expansion (RME) in cleft patients using two types of expanders. Methods: Twenty unilateral cleft lip and palate patients were randomly divided into two groups, according to the type of expander used: (I) modified Hyrax and (II) inverted Mini-Hyrax. A pretreatment cone-beam computed tomographic image (T0) was taken as part of the initial orthodontic records and three months after RME, for bone graft planning (T1). Results: In general, there was no significant difference among groups (p > 0.05). Both showed a significant transverse maxillary expansion (p < 0.05) and no significant forward and/or downward movement of the maxilla (p > 0.05). There was greater dental crown than apical expansion. Maxillary posterior expansion tended to be larger than anterior opening (p < 0.05). Cleft and non-cleft sides were symmetrically expanded and there was no difference in dental tipping between both sides (p > 0.05). Conclusions: The appliances tested are effective in the transverse expansion of the maxilla. However, these appliances should be better indicated to cleft cases also presenting posterior transverse discrepancy, since there was greater expansion in the posterior maxillary region than in the anterior one.

scholarly journals MOLECULAR GENETIC STUDY OF THE IMPACT OF SNP C677T OF THE GENE MTHFR IN THE DEVELOPMENT OF CONGENITAL ISOLATED CLEFT LIP AND PALATE

2018 ◽  
Vol 25 (5) ◽  
pp. 104-110
Author(s):  
V. S. Uchaeva ◽  
Yu. A. Vasiliev ◽  
A. S. Gracheva ◽  
O. V. Gulenko ◽  
I. G. Udina
Keyword(s):  
Genetic Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Population Genetic Study ◽  
Molecular Genetic Study ◽  
Increased Risk ◽  
Significant Difference ◽  
Congenital Cleft ◽  
The Impact

Aim. This research was designed to conduct an associative population genetic study for the consideration of the impact of SNP C677T of the gene MTHFR in the congenital maxillofacial developmental anomalies (CMDA): congenital cleft lip (CCL), congenital cleft palate (CCP), congenital cleft lip and palate (CCLP) in the Krasnodar territory. The aim of the study is to establish the associations between SNP C677T of the gene MTHFR and the development of congenital cleft lip and/ or palate.Materials and methods. In this research, the peculiarities of distribution of SNP C667T of the gene MTHFR in children with congenital cleft lip and/or palate (n=223) and their mothers (n=78) in comparison with the control group (n=124) were studied in the Krasnodar territory. The genetic demographic questionnaires were gathered for children with CMDA, the information about diagnosis was obtained from the medical records. The biological samples, including blood or scrapings of oral mucosa, were collected from children with the pathology and their mothers. The DNA was extracted from the samples by the standard method. The study of the peculiarities of distribution of alleles of SNP C677T of the gene MTHFR was performed by PCR-PFLP with endonuclease Hinf I or by tetra-primer ARMS-PCR method in children with CCL, CCP, CCLP, their mothers and the control group. Statistical processing of the obtained data was performed by the algorithms of the “Statistica” program.Results. While comparing the profiles of frequencies of SNP C677T in children with CCL, CCP and CCLP with the control group, there were identified no significant differences in the frequency of this SNP and no peculiarities of genotypes distribution. There was identified a significant difference in the peculiarities of genotypes distribution with the control group (G=19,5232, d.f.=1, p<0,001) as well as united genotypes (С/C и С/T) in accordance to T/T (G=10,4657, d.f.=1; p<0,001) and united genotypes (C/T и T/T) in accordance to C/C (G=15,1896, d.f.=1, p<0,001) for the mothers of children with CCL, CCP and CCLP.Conclusion. As a result of the study, we established the association of SNP C677T of the MTHFR gene with the development of congenital cleft lip and/or palate: mothers’ T/T genotype is associated with the increased risk of giving birth to a child with CCL, CCP and CCLP (in comparison with mothers with C/C+C/T genotype): odds ratio [OR]=16,63, 95% CI: 3,86-71,71; p=0,0003 and also for mothers with genotypes (C/T+T/T) in comparison with mothers with genotypes C/C: OR=3,22, CI:1,71-6,08; p=0,0002. The amount of risk is not significant in children with CMDA for T/T genotype. So it is possible to make a conclusion about the impact of C677T of the gene MTHFR in the development of CCL, CCP and CCLP only in mother’s genotype. 

scholarly journals ASSESSMENT OF PRESURGICAL NASOALVEOLAR MOULDING (PNAM) IN UNILATERAL CLEFT LIP AND PALATE

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Santosh Kumar
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Intervention Group ◽  
Control Group ◽  
Width Ratio ◽  
Long Term Effects ◽  
Important Indicator ◽  
Medical College ◽  
Significant Difference ◽  
Nasoalveolar Molding

Background: Midface symmetry is an important indicator of success of complete unilateral cleft lip and palate (CUCLP) treatment. There is little literature on the long-term effects of Presurgical Nasoalveolar Molding (PNAM) on Midface symmetry in children treated for CUCLP. Material and Methods: This case-control study was carried out in the Department of Burn and Plastic Surgery at Government Medical College and Hospital, Bettiah, Bihar, India from may 2018 to Dec 2019. Complete unilateral CL+P patients had basilar and frontal photographs at two time points: (1) initial (2) postsurgical. 30 nasal molding patients and 20 control patients were included. Presurgical nasal molding was performed prior to primary lip repair in intervention group. No nasal molding was performed in control group. Results: A statistically significant difference was found for postsurgical nostril height-width ratio (P< .05). No other statistically significant differences were found. Conclusion: Nasal molding and surgery resulted in more symmetrical nostril height-width ratios than surgery alone. Alar groove ratios were not statistically significantly different between groups perhaps because application of nasal molding was not early enough; postsurgical nasal splints were not utilized; overcorrection was not performed for nasal molding

Early Orthopaedic Treatment of Unilateral Cleft Lip and Palate

1978 ◽  
Vol 5 (3) ◽  
pp. 119-132 ◽  
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.

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

1996 ◽  
Vol 33 (4) ◽  
pp. 312-317 ◽  
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.

Growth Rate of the Vomer in Normal and Cleft Lip and Palate Human Fetal Specimens

1992 ◽  
Vol 29 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Kyle R. Kimes ◽  
Mark P. Mooney ◽  
Michael I. Siegel ◽  
John S. Todhunter
Keyword(s):  
Growth Rate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Growth Curves ◽  
Reconstruction Technique ◽  
Linear Component ◽  
Volumetric Growth ◽  
Significant Difference ◽  
Postmenstrual Age

The present study, part of an ongoing investigation of normal and dysmorphic development of the human fetal oronasal capsule, examined the rate of growth of the vomer. For comparative purposes, 29 human fetal specimens (20 “normal” and 9 cleft lip and palate [CLP]) were celloidin embedded, sectioned, stained with hematoxylin and eosin, and serially digitized. The specimens ranged from 8 to 21 weeks in postmenstrual age. The application of a well-documented three-dimensional reconstruction technique provided quantification of several aspects of the vomer. CLP vomer length and volume were growing at a faster rate In the 8 to 21 week age range. Growth curves were produced by plotting length and volume against postmenstrual age and a significant difference was noted between the slopes (growth rate) of the linear component of the normal and CLP growth curves for vomer length (p < .001) and volume (p < .001). This study tested the hypothesis of a more rapidly growing 8 to 21 week CLP vomer and observed that the growth trends of the CLP vomer are similar to those of the CLP nasal septum, which also was found to possess a significantly larger (p < .001) volumetric growth rate throughout the course of the vomer. Comparative findings suggest that a pathogenetic correlate of CLP is the rapid enlargement of the midline structures of the oral and nasal capsules.

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