Vertical Facial Skeletal Asymmetry and Occlusal Cant Relationship in Patients With Unilateral Cleft Lip and Palate

2020 ◽  
pp. 105566562097457
Author(s):  
Bengisu Akarsu-Guven ◽  
Ezgi Atik ◽  
Hande Gorucu-Coskuner ◽  
Muge Aksu
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Facial Asymmetry ◽  
Cranial Base ◽  
Control Group ◽  
Lower Face ◽  
Significant Difference ◽  
Angular Measurements ◽  
Cleft Lip Palate

Objective: To evaluate the maxillary and mandibular vertical skeletal asymmetries, and the correlation between these asymmetries and occlusal cant in patients with unilateral cleft lip–palate (UCLP). Methods: Anteroposterior radiographs of 25 patients with UCLP (UCLP group, mean age: 20.98 ± 4.88 years) and 25 subjects without cleft (control group, mean age: 19 ± 2.86 years) were included. Independent samples t test, Mann-Whitney U test and Pearson correlation analysis were performed based on linear and angular measurements. Results: Lower facial horizontal asymmetry did not show statistically significant difference between the UCLP and control groups. However, vertical asymmetry of (a) the lateral cranial base ( P = .014), (b) the nasomaxillary region ( P < .001), (c) the maxillary dentoalveolus ( P = .001), and (d) the lower face ( P = .038) were all found to be significantly greater in UCLP group. The occlusal cant angle was also significantly greater in patients with UCLP compared to the controls ( P = .016). While the occlusal cant angle was found to be correlated with the vertical asymmetry of the occlusal cant ( r = 0.931, P < .001), maxillary cant angle was found to be correlated with the vertical asymmetry of the maxillary dentoalveolus ( r = 0.655, P < .001). Conclusions: There was no correlation between the occlusal cant and the vertical and horizontal skeletal asymmetries. Vertical asymmetries of the lower face and the medial cranial base were negatively correlated with the horizontal lower facial asymmetry.

Comparison of Microbial Activity Among Infants With or Without Using Presurgical Nasoalveolar Molding Appliance

2020 ◽  
Vol 57 (6) ◽  
pp. 762-769
Author(s):  
Hanieh Hassani ◽  
Jung-Wei Chen ◽  
Wu Zhang ◽  
William Hamra
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Bacterial Count ◽  
Colony Count ◽  
Caries Risk ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
Ph Level ◽  
Nasoalveolar Molding

Purpose: The aim of the current study is as follows: (1) to study whether wearing the presurgical nasoalveolar molding appliance (PNAM) had facilitated the establishment of Streptococcus mutans and Lactobacillus ( LB) and to determine other factors including pH and caries susceptibility associated with wearing the PNAM. Methods: Saliva samples of 61 infants (4.5 ± 2.06 months old) were collected from the following 3 groups: PNAM (n = 23), healthy (n = 30), and cleft lip and palate (CLP) without any treatment (n = 8). Saliva samples were assessed using selective agar to enumerate total LB and S mutans and subjected to adenosine triphosphate (ATP)-driven bioluminescence determinations using a luciferin-based assay system, and pH level was evaluated. One-way analysis of variance with least significant difference post hoc test ( P < .05) and Pearson correlation were used to evaluate S mutans, LB, pH, and ATP levels. Results: A total of 63 patients (30 healthy patients, 23 patients with cleft lip/palate who had PNAM appliance and 8 patients with cleft lip/palate who did not use the appliance) were seen in this study. There is a significant difference in pH ( P = .012), LB Caries Risk Test ( P < .001), LB colony count ( P < .001), S mutans Caries Risk Test ( P < .001), and S mutans colony count ( P < .001) among the 3 groups (PNAM > CLP > healthy). The ATP level was not significantly different among the 3 groups. Conclusion: Higher bacterial count and lower pH were found in the PNAM group. Cleft lip and/or palate patients wearing the PNAM appliance are at higher risk for dental caries.

Craniofacial Morphology of Dutch Patients with Bilateral Cleft Lip and Palate and Noncleft Controls at the Age of 15 Years

2008 ◽  
Vol 45 (6) ◽  
pp. 661-666 ◽  
Author(s):  
Geer M. van den Dungen ◽  
Edwin M. Ongkosuwito ◽  
Irene H. A. Aartman ◽  
Birte Prahl-Andersen
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Class Iii ◽  
Cross Sectional ◽  
Significant Difference ◽  
Bilateral Cleft Lip

Objective: Comparison of craniofacial morphology in bilateral cleft lip and palate patients to that of a noncleft control group at the age of 15 years. Design: A cross-sectional study of cephalometric data. Subjects and Methods: Cephalometric records of 41 consecutive patients (32 boys and 9 girls) with nonsyndromic complete bilateral cleft lip and palate born between 1973 and 1987. The patients were treated by the cleft teams of the Erasmus Medical Centre in Rotterdam and the VU University Amsterdam. The control group of normal Dutch subjects was followed in the Nijmegen Growth Study. From this population, mean cephalometric data were used. Differences in cephalometric measurements and other variables were calculated between the bilateral cleft lip and palate group and the control group. Results: Independent-sample t tests indicated that there was a statistically significant difference between the mean of the cephalometric values of the bilateral cleft lip and palate patients and the control group with respect to all cephalometric variables. Pearson correlation coefficients calculated between angle ANB and the number of operators, number of surgical procedures before 15 years of age, and the year of birth were not significant. Conclusions: Bilateral cleft lip and palate patients treated in the Amsterdam and Rotterdam cleft centers differed significantly from the control group in all measurements. A Class III development due to a less forward positioned maxilla was observed. The vertical measurements indicated a more divergent growth pattern in bilateral cleft lip and palate patients (Ans-Me/N-Me, GoGn-SN, and SN-FFH).

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

Cranial Base in Newborns with Complete Cleft Lip and Palate: Radiographic Study

1995 ◽  
Vol 32 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Kirsten Mølsted ◽  
Inger Kjær ◽  
Erik Dahl
Keyword(s):  
Temporal Bone ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Test Group ◽  
Cranial Base ◽  
Sphenoid Bone ◽  
Control Group ◽  
Petrous Portion ◽  
A Minor ◽  
Base Width

In a 1993 study, Mølsted and colleagues found an increased width of the sphenooccipital synchondrosis in newborns with complete clefts of the lip, alveolus, and palate compared with newborns with incomplete clefts. As the spheno-occipital synchondrosis represents remnants of the early chondrocranium that later ossifies and incorporates in the cranial base, it is possible that an inborn alteration, such as a deviant growth of cartilage, or a delayed maturation in the early development of the cartilaginous cranial base, can affect not only the length and the width of the cranial base, but also the petrous portion of the temporal bone and the nasal septum, as these structures also have a cartilaginous origin. The purpose of the present study was to measure the cranial base width, including the width of the maxilla, and to measure the bilateral angulation of the petrous portion of the temporal bone and the sphenoid bone in 3-month-old children with complete clefts and in 3-month-old children with an incomplete cleft of the lip, and to compare the two groups. Fifty-two children with complete clefts (CLP) without associated malformations comprised the test group. Forty-eight children with a minor, incomplete cleft lip (CL) constituted the control group. The results of the comparison showed marked differences between the CLP and CL groups. In the CLP children, the cranial base width and the bilateral angulation of the sphenoid bone increased. An increased angulation was also seen between left and right sides of the pars petrosa. Furthermore, increased maxillary width was found. This confirms that cleft lip and palate is not an isolated malformation localized to the jaws but a malformation, which also involves the cartilaginous cranial base.

scholarly journals Development of cleft children’s permanent canines

2019 ◽  
Vol 67 ◽  
Author(s):  
Manoel Itaguacy Leite NOVAIS JUNIOR ◽  
Manuella Santos Carneiro ALMEIDA ◽  
Camila Helena Machado da COSTA ◽  
Tassia Cristina de Almeida Pinto SARMENTO ◽  
Luis Ferreira de SOUSA FILHO ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Tooth Development ◽  
Cross Sectional Study ◽  
Control Group ◽  
Case Group ◽  
Age Difference ◽  
Cross Sectional ◽  
Panoramic Radiographs ◽  
Significant Difference

ABSTRACT Objective: Evaluating the development of the permanent cuspids in children from Paraíba with cleft lip and palate applying the Nolla and the Demirjian methods. Methods: A cross-sectional study using an inductive approach and applying a comparative statistical procedure and direct documentation research technique. The universe of the study consisted of children assisted at the orthodontic practice of the Brazilian Association of Dentistry - Paraíba Section. The sample comprised 72 pairs of panoramic radiographs of children with and without cleft lip and palate from the same gender and, age difference of up to 30 days, ranging from 5 to 13 years of age. The study has evaluated the development of 576 cuspids. The images were evaluated by three duly calibrated examiners concomitantly, and the calcification stages were determined by a consensus. The stages of the cuspids calcification were evaluated in the panoramic radiographs according to Nolla and Demirjian classifications. Results: The average of the calcification stage of teeth was correspondingly higher in the control group than in the case group, showing a development delay of the cuspid teeth in the cleft lip and palate patients. The lower cuspids were significantly more developed than the upper cuspids (p <0.001). There were no significant differences between the sides. There was early tooth development in females but without significant difference. Conclusion: It was possible to note that patients with cleft lip and palate presented a delay in the development of the permanent cuspids when compared to non-cleft lip and palate patients, thus, reinforcing the importance of the individualization of the orthodontic planning.

Tomographic Pharyngeal Dimensions in Individuals with Unilateral Cleft Lip/Palate and Class III Malocclusion are Reduced When Compared with Controls

2017 ◽  
Vol 54 (5) ◽  
pp. 502-508 ◽  
Author(s):  
Trindade-Suedam Ivy Kiemle ◽  
Freire Lima Thiago ◽  
Dominguez Campos Letícia ◽  
Faria Yaedú Renato Yassutaka ◽  
Filho Hugo Nary ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Cone Beam ◽  
Control Group ◽  
Craniofacial Anomalies ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Cross Sectional ◽  
Cleft Lip Palate

Objective The objective of this study was to three-dimensionally evaluate the pharyngeal dimensions of individuals with complete nonsyndromic unilateral cleft lip and palate (UCLP) using cone beam computed tomography. Design This was a cross-sectional prospective study. Setting The study took place at the Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil. Patients and Participants The control group (CON) consisted of 23 noncleft adults with class III malocclusion, and the cleft group (UCLP) consisted of 22 individuals with UCLP and class III malocclusion. Two subgroups of individuals with class III malocclusion as a result of maxillary retrusion with (UCLP'; n = 19) and without (CON'; n = 8) clefts were also assessed. Interventions Pharyngeal volume, pharyngeal minimal cross-sectional area (CSA), location of CSA, pharyngeal length, sella-nasion-A point angle (SNA), sella-nasion-B point angle (SNB), and A point-nasion-B point angle (ANB), and body mass index were assessed using Dolphin software. Main Outcome Measure The pharyngeal dimensions of UCLP individuals are smaller when compared with controls. Results Mean pharyngeal volume (standard deviation) for the UCLP patients (20.8 [3.9] cm3) and the UCLP’ patients (20.3 [3.9] cm3) were significantly decreased when compared with the CON (28.2 [10.0] cm3) and CON’ patients (29.1 [10.2] cm3), respectively. No differences were found in the pharyngeal minimal CSA, ANB, or pharyngeal length values between groups (CON versus UCLP and CON’ versus UCLP'). CSAs were located mostly at the oropharynx, except in the UCLP’ patients, which were mainly at the hypopharynx. Mean SNA in the UCLP (76.4° [4.6°]) and UCLP’ groups (75.1 [3.1°]) were significantly smaller than those in the CON (82.8° [4.1°]) and CON’ groups (78.6° [1.2°]). SNB values were statistically smaller only for the comparison of CON versus UCLP patients. Conclusion The pharynx of individuals with UCLP and class III malocclusion is volumetrically smaller than that of individuals with class III malocclusion and no clefts.

scholarly journals Physiological maturation stage of cervical vertebrate index in cleft lip/palate and non-cleft lip/palate patients

2019 ◽  
Vol 4 (3) ◽  
pp. 149
Author(s):  
Wenti Komala ◽  
Endah Mardiati ◽  
Eky Soeria Soemantri ◽  
Isnaniah Malik
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cervical Vertebrae ◽  
Maturation Stage ◽  
Lateral Cephalogram ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
Stage Transition ◽  
Maturation Index ◽  
Cervical Vertebral Maturation

Cleft lip and palate is one of the most common congenital anomalies. Cleft lip and palate patients encounter growth problems in lip and palate area, although their overall growth and development remains unknown. Cervical vertebral maturation are indicators of physiological maturation used in interceptive treatment and orthognathic surgery. The present study aims to determine physiological maturation stage of cervical vertebrae maturation index in cleft andnon-cleft patients. Lateral cephalogram of 26 cleft patients and 27 non-cleft patients with a range of chronological age from 8-16 years old were involved. The cervical vertebrae maturation were analyzed in six stages of cervical vertebrae maturation method of Hassel and Farman. Data were analyzed using t-test (p≤ 0.05). The result shows that physiologicalmaturation stage of cervical vertebrae maturation index in cleft and non-cleft patients has no significant difference in stage acceleration (p= 0.38), stage transition (p= 0.41) and deceleration (p= 0.39). Likewise, there is no significant difference in physiological maturation stage of cervical vertebrae maturation index between cleft and non-cleft patients. 

Speech and Hearing Outcomes of the Patients with Cleft Lip and Palate: Comparison between One-Stage Simultaneous and Two-Stage Surgical Repairs

2020 ◽  
Vol 103 (11) ◽  
pp. 1171-1177
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Common Belief ◽  
Two Stage ◽  
Treatment Protocols ◽  
Palatal Fistula ◽  
One Stage ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
Palate Repair

Background: Conventional treatment for cleft lip and palate patients is lip repair at three to four months and then palatal repair at nine to 12 months of age. However, for the patients who delay seeing a doctor especially in a developing area such as Northern Thailand, simultaneous lip and palate repair is performed at 12 to 18 months of age or later, depending on the age at the first visit. It is a common belief that patients with cleft lip and palate will be behind non-cleft patients in early development phonemes because of the open palate. This delay persists until the palate is repaired and on into the postoperative period. This proposition has not been proven with long-term clinical outcomes in one-stage repairs. Objective: To investigate the effects of one-stage repair on speech assessment, hearing, and incidence of palatal fistula. The results were compared with conventional two-stage surgical repairs. Materials and Methods: The present study was designed two groups. Group 1 consisted of 25 children (mean age 11.28±1.93 years) treated with a one-stage repair. Cleft lip, palate, and alveolus were repaired at a single surgical session in the first 18 months of life (mean age at the time of surgery 13.52±4.51 months). Group 2 consisted of 17 children (mean age 11.02±2.23 years) treated in two-stage surgical repairs. Lip repair was performed at a median age of 4.01 months (IQR 3.62 to 5.46), and palate repair was performed at a mean age of 13.54±4.14 months. Both groups underwent cleft lip and palate repairs at the Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University between January 1, 2004 and December 31, 2010. Speech and hearing for all patients were evaluated by experienced ENT doctors. The palatal fistula was evaluated by the same plastic surgeons. Results: One-stage repair showed significant normal articulation and less articulation disorder when compared with two-stage surgical repairs. However, no significant difference was determined for other speech assessments, hearing, and incidence of palatal fistula. Conclusion: Because one-stage repair seems to have a more positive influence on articulation, and both surgical treatment protocols give similar results on speech assessments, hearing, and incidence of palatal fistula, regardless of the timing of the surgery, the one-stage repair is not inferior to conventional two-stage surgical repairs for patients in developing areas. This is due to several important advantages, such as less hospitalization, lower cost, and less chance of nosocomial infection. Keywords: One-stage repair, Speech, Hearing, Palatal fistula, Cleft lip, Palate

3D Assessment of Nasolabial Appearance in Patients With Complete Unilateral Cleft Lip and Palate

2017 ◽  
Vol 55 (2) ◽  
pp. 220-225 ◽  
Author(s):  
Ieva Bagante ◽  
Inta Zepa ◽  
Ilze Akota
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
3 Dimensional ◽  
Significant Difference ◽  
Group A ◽  
Left And Right ◽  
The Difference

Objective: Rhinoplasty in patients with complete unilateral cleft lip and palate (UCLP) is challenging, and the surgical outcome of the nose is complicated to evaluate. The aim of this study was to assess the nasolabial appearance of patients with UCLP compared with a control group. Design: Cross-sectional study. Setting: Riga Cleft Lip and Palate Centre, Latvia. Participants: All consecutive 35 patients born between 1994 and 2004 with nonsyndromic complete UCLP were included. Of 35 patients, 29 came for checkup; the mean age was 14.7 years (range 10-18). In the control group, 35 noncleft participants at 10 years of age were included. Interventions: Nasolabial appearance was evaluated from 3-dimensional images using a 3-dimensional stereo-photogrammetric camera setup (3dMDface System), the results being analysed statistically. Results: In UCLP group, a statistically significant difference between cleft and noncleft side was found only in alar wing length ( P < .05). The difference of nasolabial anthropometric distances in the control group between the left and right side was not significant. The difference between the UCLP group and the control group was significant in all anthropometric distances except the lateral lip length to cupid’s bow. Conclusions: The nasolabial appearance with acceptable symmetry after cleft lip and reconstructive surgery of the nose was achieved. Symmetry of the nasolabial appearance in patients with UCLP differed from those in the control group. The 3D photographs with a proposed set of anthropometric landmarks for evaluation of nasolabial appearance seems to be a convenient, accurate, and noninvasive way to follow and evaluate patients after surgery.

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