Assessment of Orthodontic Burden of Care in Patients With Unilateral Complete Cleft Lip and Palate

2017 ◽  
Vol 55 (1) ◽  
pp. 74-78 ◽  
Author(s):  
Thamara Frascarelli Alberconi ◽  
Gabriela Leticia Clavisio Siqueira ◽  
Renata Sathler ◽  
Katherine A. Kelly ◽  
Daniela G. Garib
Keyword(s):  
Surgical Procedures ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sao Paulo ◽  
São Paulo ◽  
Craniofacial Anomalies ◽  
Burden Of Care ◽  
Intergroup Comparison ◽  
The Mean

Objective: To assess the orthodontic burden of care of patients from a Brazilian rehabilitation center (Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo [HRAC-USP]). Design: Retrospective. Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo. Interventions: One hundred files of unilateral complete cleft lip and palate patients who had consecutively finished orthodontic rehabilitation at HRAC-USP were evaluated from January 2011 to January 2013. The duration of orthodontic treatment, number of visits, kilometers traveled, number of appliances and surgical procedures performed were recorded. The sample was divided into 2 subgroups according to severity the interarch relation (Goslon Yardstick score) at the beginning of orthodontic treatment. Mann-Whitney test was applied for intergroup comparison ( P < .05). Results: For the total sample (n = 100), the mean time of orthodontic treatment was 140.2 months, the mean number of orthodontic appointments was 61.8, the mean number of appliances was 10, the mean number of surgical procedures was 6.2, and the mean distance traveled to attend the center for orthodontic appointments was 38,978.5 km. The subgroup with the most severe malocclusion (Goslon yardsticks scores 4 and 5) showed a longer orthodontic treatment length, greater number of surgical procedures, and longer distance traveled than those presenting Goslon yardstick scores 1, 2, and 3. Conclusion: Patients with greater severity of the initial malocclusion experienced a higher burden of care than patients with less severity of the initial malocclusion. To reduce the burden of care, research and efforts should focus on minimizing maxillary growth deficiency related to primary surgery.

Chronology and Sequence of Eruption of the Permanent Teeth in Patients with Complete Unilateral Cleft Lip and Palate

2004 ◽  
Vol 41 (6) ◽  
pp. 642-645 ◽  
Author(s):  
Cleide Felíciode Carvalho Carrara ◽  
JoséEduardode Oliveira Lima ◽  
Carlos Eduardo Carrara ◽  
Bernardo Gonzalez Vono
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sao Paulo ◽  
Lateral Incisor ◽  
Permanent Teeth ◽  
São Paulo ◽  
Craniofacial Anomalies ◽  
Cross Sectional ◽  
Maxillary Lateral Incisor ◽  
Mandibular Teeth

Objective To establish the chronology and sequence of eruption of the permanent teeth in subjects with complete unilateral cleft lip and palate. Design Cross-sectional. Data on children presenting complete cleft lip and palate were evaluated. Setting The study was carried out at the Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, Sao Paulo, Brazil. Sample The sample comprised 477 patients with complete unilateral cleft lip and palate, aged 5 to 14 years. Of these patients, 166 were girls and 311 were boys. Results The girls presented, for all maxillary and mandibular teeth, a smaller mean age of eruption than the boys. The maxillary lateral incisor and cuspid adjacent to the cleft presented significantly higher mean ages of eruption than their homologous teeth on the noncleft side.

Prevalence of Palatal and Alveolar Cysts in Babies with Cleft Lip and Palate

2004 ◽  
Vol 41 (5) ◽  
pp. 490-493 ◽  
Author(s):  
Karina Mirela Ribeiro Pinto Alves ◽  
Virginia Peixoto ◽  
Márcia Ribeiro Gomide ◽  
Cleide Felíciode Carvalho Carrara ◽  
Beatriz Costa
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sao Paulo ◽  
São Paulo ◽  
Craniofacial Anomalies ◽  
Cross Sectional ◽  
Significant Difference ◽  
Different Types ◽  
Low Prevalence ◽  
Posterior Area

Objective To evaluate the prevalence of palatal and alveolar cysts in babies with cleft lip and/or palate. Design Cross-sectional. Setting Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP), Bauru, São Paulo, Brazil. Participants Two hundred ninety-one Caucasian babies divided into four groups according to the type of cleft: cleft lip with or without cleft alveolus (70), complete unilateral cleft lip and palate (112), complete bilateral cleft lip and palate (56), and cleft palate (53). Results A low prevalence of palatal and alveolar cysts was observed among patients with the four different types of clefts, with no statistically significant difference between genders. The maxilla and the anterior area of the mouth were more affected than the mandible and the posterior area. Conclusions The low prevalence of palatal and alveolar cysts in the four groups of babies with clefts included in this study may have been due to the high mean age of the sample.

Difference in the Prevalence of Enamel Alterations Affecting Central Incisors of Children with Complete Unilateral Cleft Lip and Palate

2005 ◽  
Vol 42 (4) ◽  
pp. 392-395 ◽  
Author(s):  
Suzana Papile Maciel ◽  
Beatriz Costa ◽  
Marcia Ribeiro Gomide
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sao Paulo ◽  
Permanent Dentition ◽  
Permanent Teeth ◽  
Homogeneous Distribution ◽  
São Paulo ◽  
Craniofacial Anomalies ◽  
Cross Sectional ◽  
Enamel Defects

Objective To evaluate the prevalence of enamel alterations affecting the deciduous and permanent central maxillary incisors of children with complete unilateral cleft lip and palate and to verify their characteristics. Design Cross-sectional. Setting Hospital for Rehabilitation of Craniofacial Anomalies–University of São Paulo, Bauru, São Paulo, Brazil. Patients A sample of 90 patients attending the Hospital for Rehabilitation of Craniofacial Anomalies, presenting with complete cleft lip and palate, of both genders, ages 2 to 11 years old. Methodology The buccal surfaces of the maxillary central incisors of patients were analyzed for observation of the presence of enamel defects, their type, number, and location. The prevalence of defects was compared between deciduous and permanent teeth and between the incisors at the cleft and noncleft sides. Results There was a higher frequency of defects among incisors on the cleft side for both deciduous and permanent dentitions compared with the noncleft side (p < .05); the permanent central incisor was more frequently affected than the deciduous. Evaluation of the types of defects for both incisors in both dentitions demonstrated a homogeneous distribution, except for a lower proportion of yellow opacity in the permanent dentition on the cleft side. In general, the most affected area in all dentitions was the incisal third. Conclusion The prevalence of enamel alterations affecting incisors adjacent to the cleft was higher than for incisors on the noncleft side. This difference also was present in the permanent dentition.

Prevalence of Intranasal Ectopic Teeth in Children with Complete Unilateral and Bilateral Cleft Lip and Palate

2000 ◽  
Vol 37 (3) ◽  
pp. 271-273 ◽  
Author(s):  
Alexandra Sárzyla Medeiros ◽  
Marcia Ribeiro Gomide ◽  
Beatriz Costa ◽  
Cleide Felicio De Carvalho Carrara ◽  
Lucimara Teixeira Das Neves
Keyword(s):  
Retrospective Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sao Paulo ◽  
São Paulo ◽  
Craniofacial Anomalies ◽  
Ectopic Eruption ◽  
Bilateral Cleft Lip ◽  
Males And Females

Objective The objective of this study was to determine the prevalence of ectopic eruption of intranasal teeth. Design This was a retrospective study, where records of children with repaired cleft lip and palate were analyzed. Setting The study was conducted at a large craniofacial center, the Hospital for Rehabilitation of Craniofacial Anomalies, USP, Bauru, São Paulo, Brazil. Subjects The sample consisted of 815 records from patients with bilateral cleft lip and palate (BCLP) and 1495 records from patients with unilateral cleft lip and palate (UCLP). The age of the subjects was 5 to 10 years old and the groups included both males and females. Results The results showed that 0.61% of the children with BCLP and 0.40% of those with UCLP had an intranasal tooth. The prevalence of an intranasal tooth for the whole group was 0.48%, and it appeared to be more common in females.

Dental Development of the Permanent Lateral Incisor in Patients with Incomplete and Complete Unilateral Cleft Lip

2005 ◽  
Vol 42 (5) ◽  
pp. 517-520 ◽  
Author(s):  
Nádia Rodrigues Pioto ◽  
Beatriz Costa ◽  
Marcia Ribeiro Gomide
Keyword(s):  
Root Development ◽  
Cleft Lip ◽  
Development Stage ◽  
Sao Paulo ◽  
Lateral Incisor ◽  
São Paulo ◽  
Craniofacial Anomalies ◽  
Mean Delay ◽  
The Mean

Objective This study aimed to evaluate a possible delay in root development of the permanent lateral incisor on the cleft side compared with its contralateral tooth in patients with incomplete and complete unilateral cleft lip. Design Retrospective. Setting Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, São Paulo, Brazil. Patients A sample of 95 panoramic radiographs of patients with incomplete and complete unilateral cleft was obtained from the files of HRAC/USP. The patients were both boys and girls of various races, aged 5 to 11 years, and did not have any syndrome or associated congenital malformation. The sample was divided into three groups according to the severity of the cleft lip. Main Outcome Measure Radiographs were analyzed to compare root development stage of the lateral incisor on the cleft side with the noncleft side according to the classification of Nolla. Results The mean delay in root development of the permanent lateral incisor on the cleft side ranged from 0.5 to 1.6 scores for all three groups investigated. Conclusions Root development of the permanent lateral incisor on the cleft side was delayed compared with the noncleft side.

Prevalence of Upper Cervical Vertebrae Anomalies in Patients with Cleft Lip and/or Palate and Noncleft Patients

2009 ◽  
Vol 46 (5) ◽  
pp. 481-486 ◽  
Author(s):  
Marta Cunha Lima ◽  
Eduardo Jacomino Franco ◽  
Guilherme Janson ◽  
Izabel Maria Marchi Carvalho ◽  
Carlos Ferreira Santos ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cervical Vertebrae ◽  
Sao Paulo ◽  
Posterior Arch ◽  
São Paulo ◽  
Craniofacial Anomalies ◽  
Lateral Cephalograms ◽  
Significant Difference ◽  
Upper Cervical ◽  
School Of Dentistry

Objectives: To investigate the prevalence of upper cervical vertebrae anomalies in patients with isolated cleft lip, isolated cleft palate, and complete cleft lip and palate, as well as to compare the prevalence of these anomalies between groups, between genders, and with noncleft patients. Design: Retrospective cross-sectional study of randomly selected patients. Setting: Radiology Section, Hospital for Rehabilitation of Craniofacial Anomalies and Department of Orthodontics, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. Participants: The sample comprised 300 lateral cephalograms of cleft patients, aged 12 to 13 years, of both genders, from the files of the Hospital for Rehabilitation of Craniofacial Anomalies–University of São Paulo and 300 lateral cephalograms from noncleft patients of the Department of Orthodontics, Bauru School of Dentistry. Cephalograms of patients with syndromes were not included. Method: Radiographs were interpreted on a film viewer by a single examiner; the profiles of vertebrae were traced on acetate paper, and cervical vertebrae anomalies were registered and categorized into posterior arch deficiencies, fusion, and association of both. Main Outcome Measures: Statistical comparison of groups using the chi-square test. Results: In the cleft group, 38.67% of the patients had cervical vertebrae anomalies. Of those in the noncleft sample, 31% showed anomalies of the cervical spine. This difference was statistically significant. There was no statistically significant difference when the types of clefts were compared with each other or when both genders were compared in both samples. Conclusions: This study confirms the association between clefts and cervical anomalies. Additional research on this topic is necessary.

Respiratory Polysomnographic Findings in Patients Treated Primarily for Unilateral Cleft Lip and Palate

2017 ◽  
Vol 55 (2) ◽  
pp. 287-291 ◽  
Author(s):  
Davi Sandes Sobral ◽  
Gustavo Juliane Faller ◽  
Marcus Vinícius Martins Collares
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sleep Apnea Syndrome ◽  
Mixed Dentition ◽  
Apnea Hypopnea Index ◽  
Craniofacial Anomalies ◽  
Obstructive Sleep ◽  
The Mean ◽  
Airway Abnormalities ◽  
Craniofacial Abnormality

Cleft lip and palate (CLP) is the most common congenital craniofacial abnormality. Obstructive sleep apnea syndrome (OSAS) is a highly prevalent but underdiagnosed disease and is frequently associated with craniofacial anomalies. There are few studies describing the sleep breathing pattern of children with CLP. This study sought to characterize the respiratory profile of 23 children with unilateral cleft lip and palate, aged 7-12 years, who had undergone cleft lip and nasal repair at age 3-4 months and palatoplasty at 12-15 months, with a particular focus on evaluating the presence of OSAS in children with CLP. Polysomnography was performed and findings were analyzed descriptively. We found a mean and median for apnea/hypopnea index (AHI) of 1.11/h (SD = 0.78) and 0.9/h, respectively. The mean obstructive apnea index (OAI) was 0.27/h (SD = 0.38) and the median, 0.1/h. Nearly 30% of patients had an AHI above 1.4 events/h. There was no significant oxyhemoglobin desaturation in the study group. In this group, the prevalence of OSAS was higher than in noncleft populations when compared to the normality values adopted. This sample of patients with unilateral cleft lip and palate exhibited an increased prevalence of OSAS during the mixed dentition stage. Although the results showed that OSAS was mild, we advise closer observation of these patients. Polysomnography is recommended for the assessment of children with airway abnormalities, to individualize the extent of treatment.

Patient-Perceived Barriers to Accessing Cleft Care at a Tertiary Referral Center in São Paulo, Brazil

2018 ◽  
Vol 56 (5) ◽  
pp. 639-645 ◽  
Author(s):  
Ananda Ise ◽  
Camila Menezes ◽  
Joao Batista Neto ◽  
Saurab Saluja ◽  
Julia R. Amundson ◽  
...  
Keyword(s):  
Access To Care ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sao Paulo ◽  
Perceived Barriers ◽  
Treatment Result ◽  
São Paulo ◽  
Orofacial Clefts ◽  
Middle Income ◽  
Referral Center

Background: In low- and middle-income countries, poor access to care can result in delayed surgical repair of orofacial clefts leading to poor functional outcomes. Even in Brazil, an upper middle-income country with free comprehensive cleft care, delayed repair of orofacial clefts commonly occurs. This study aims to assess patient-perceived barriers to cleft care at a referral center in São Paulo. Methods: A 29-item questionnaire assessing the barriers to care was administered to 101 consecutive patients (or their guardians) undergoing orofacial cleft surgery in the Plastic Surgery Department in Hospital das Clínicas, in São Paulo, Brazil, between February 2016 and January 2017. Results: A total of 54.4% of patients had their first surgery beyond the recommended time frame of 6 months for a cleft lip or cleft lip and palate and 18 months for a cleft palate. There was a greater proportion of isolated cleft palates in the delayed group (66.7% vs 33.3%). Almost all patients had a timely diagnosis, but delays occurred from diagnosis to repair. The mean number of barriers reported for each patient was 3.8. The most frequently cited barriers related to lack of access to care include (1) lack of hospitals available to perform the surgery (54%) and (2) lack of availability of doctors (51%). Conclusion: Delays from diagnosis to treatment result in patients receiving delayed primary repairs. The commonest patient-perceived barriers are related to a lack of access to cleft care, which may represent a lack of awareness of available services.

Does Unilateral Cleft Lip and Palate Affect the Maxillary Sinus Volume?

2017 ◽  
Vol 55 (2) ◽  
pp. 168-172 ◽  
Author(s):  
Omer Demirtas ◽  
Fahrettin Kalabalik ◽  
Asim Dane ◽  
Ali Murat Aktan ◽  
Ertugrul Ciftci ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Maxillary Sinus Volume ◽  
Intergroup Comparison ◽  
Significant Difference ◽  
The Mean ◽  
And Gender ◽  
The Right

Objective: The purposes of this study were to evaluate and compare the maxillary sinus volume (MSV) of patients with a unilateral cleft lip and palate (UCLP) between the cleft side and noncleft side and between adolescent patients with UCLP and a control (noncleft) group using cone beam computed tomography (CBCT). Methods: CBCT images of 44 UCLP patients (29 males and 15 females, with a mean [SD] age of 13.5 [5.0] years) and 44 (22 males and 22 females, with a mean [SD] age 14.9 [4.2] years) age- and sex-matched controls were evaluated in this study. Each maxillary sinus was assessed 3-dimensionally, segmented, and its volume was calculated. Results: There were no statistically significant differences between the age and gender distributions of the groups. There was a statistically significant difference in the MSVs of the cleft (10996.78±3522.89 mm3) versus the noncleft side (10382.3±3416.2 mm3; P < .05)] but no significant difference between the MSVs of the right and left sides ( P > .05). In the intergroup comparison, the mean MSVs of the UCLP patients (10701.52±3369.33 mm3) were significantly smaller than those of the control group (16054.08 ± 5293.96 mm3; P < .001). Conclusions: The MSVs of the UCLP patients showed a statistically significant decrease compared to those of the controls ( P < .001). There was also a significant difference in the MSVs of the cleft and noncleft sides of the UCLP patients ( P < .05).

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