Evaluation and Comparison of the Maxillary Palatal Volume of the Unilateral Cleft Lip and Palate Cases Treated with and without Presurgical Naso-Alveolar Molding as Compared to the Non-Cleft Children – A 3D DVT Study

BACKGROUND Cleft individuals have a significant altered growth of the craniofacial structures since birth. The treatments available for infants are mostly associated with controversies regarding timing of initiation, types & timing in surgery, grafting etc. Maxilla is affected in all three dimensions; due to surgery alone or in conjugation with the infant orthopaedics, intrinsic growth retardation or combination of all. Considering the current conflict over the use of pre-surgical nasoalveolar molding (PNAM) and to evaluate the efficacy of PNAM technique, this postdoctoral research was done to compare the maxillary palatal volume in unilateral cleft lip and palate (UCLP) cases treated with and without PNAM as compared to non-cleft individuals. METHODS This is an observational cross-sectional study. The palate alveolar volume was assessed and analysed using 3D-DVT angiography machine. RESULTS There was significant difference between cleft group and non-cleft individuals. The cases treated with PNAM had lesser palatal volume. CONCLUSIONS Restrictive effect on maxilla was evident in PNAM cases, but this altered growth could also be an amalgamation of numerous factors like surgery, infant orthopaedics, and intrinsic growth. Therefore, judicious use, current concepts, and biomechanics of PNAM is the need of an hour. KEY WORDS Maxillary Palatal Volume, Unilateral Cleft Cases, Presurgical Naso-Alveolar Molding, 3D-DVT

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Nasal Obstruction in Children With Cleft Lip and Palate: Results of a Cross-Sectional Study Utilizing the NOSE Scale

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665618772400 ◽

2018 ◽

Vol 56 (2) ◽

pp. 177-186 ◽

Cited By ~ 2

Author(s):

Rosaline S. Zhang ◽

Lawrence O. Lin ◽

Ian C. Hoppe ◽

Oksana A. Jackson ◽

David W. Low ◽

...

Keyword(s):

Nasal Obstruction ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Symptom Evaluation ◽

Significant Difference ◽

History Of ◽

Nasoalveolar Molding

Objective: To characterize the epidemiology and risk factors for nasal obstruction among subjects with cleft lip and/or cleft palate (CL/P) utilizing the well-validated Nasal Obstruction Symptom Evaluation (NOSE) survey. Design: Retrospective cross-sectional study. Setting: Cleft Lip and Palate Program, Children’s Hospital of Philadelphia. Patients, Subjects: One thousand twenty-eight surveys obtained from 456 subjects (mean age: 10.10 (4.48) years) with CL/P evaluated between January 2015 and August 2017 with at least 1 completed NOSE survey. Interventions: Nasal Obstruction Symptom Evaluation surveys completed at each annual visit. Main Outcome Measures: Composite NOSE and individual symptom scores. Results: Sixty-seven percent of subjects had nasal obstruction at some point during the study period, with 49% reporting nasal obstruction at latest follow-up. subjects aged 14 years and older reported the most severe symptoms ( P = .002). Subjects with cleft lip and alveolus (CL+A) and unilateral cleft lip and palate (CLP) reported more severe nasal blockage than other phenotypes ( P = .021). subjects with a history of either posterior pharyngeal flap (PPF) or sphincter pharyngoplasty (SP) had significantly higher NOSE scores than subjects with no history of speech surgery ( P = .006). There was no significant difference ( P > .050) in NOSE scores with regard to history of primary tip rhinoplasty, nasal stent use, or nasoalveolar molding. Conclusions: There are more severe nasal obstructive symptoms among subjects older than 14 years of age, with CL+A or unilateral CLP, and with a history of PPF or SP. Future studies utilizing the NOSE are needed to evaluate and address this prevalent morbidity in the CLP population.

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Development of cleft children’s permanent canines

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-86372019000253520 ◽

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.

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

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665617726532 ◽

2017 ◽

Vol 55 (2) ◽

pp. 220-225 ◽

Cited By ~ 5

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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Cross-Sectional Study of the Length of the Nasal Bone in Cleft Lip and Palate Subjects

The Cleft Palate-Craniofacial Journal ◽

10.1597/04-001.1 ◽

2005 ◽

Vol 42 (4) ◽

pp. 417-422 ◽

Cited By ~ 16

Author(s):

Bo Werner Nielsen ◽

Kirsten Mølsted ◽

Lene Theil Skovgaard ◽

Inger KjæR

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Nasal Bone ◽

Cross Sectional Study ◽

Cross Sectional ◽

Male Adult ◽

Female Ratio ◽

Bone Length ◽

Significant Difference ◽

Nasal Bone Length

Objective The purpose of this study was to analyze the human nasal bone length in newborns and male adults with cleft lip (CL), cleft palate (CP), and unilateral cleft lip and palate (UCLP) and to compare the results to previous findings in prenatal material. Design This study was a radiographic profile cephalometric cross-sectional analysis. Subjects and Methods Profile radiographs from 60 newborns with a male-to-female ratio of 1:1 in each group (20 CL, 20 CP, and 20 UCLP) and 60 male adults (20 CL, 20 CP, and 20 UCLP) were randomly selected among radiographs, taken for optimizing the treatment planning. The nasal bone lengths (n-na) were measured with a digital caliper on the profile radiographs. To compare the nasal bone lengths in the different cleft groups, Student's t tests at a significant level at 5% were performed. Results Nasal bone length was significantly shorter in male adult patients with CL compared with patients with CP. Furthermore, the nasal bone length was significantly shorter in newborns with CL (2 months) compared to newborns with UCLP (2 months). A borderline significance was seen in the comparison of patients with CL and UCLP in male adults. There was no significant difference in the nasal bone length between the patients with CP and UCLP, in either the newborns or the male adults. Conclusions Nasal bone length was significantly shorter in subjects with CL compared with subjects in whom the palate was clefted. The results show that the clefted lip in CL is associated with a subjacent skeletal deviation in the upper midface.

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Assessment of Patients’ Level of Satisfaction with Cleft Treatment Using the Cleft Evaluation Profile

The Cleft Palate-Craniofacial Journal ◽

10.1597/05-151 ◽

2007 ◽

Vol 44 (3) ◽

pp. 292-303 ◽

Cited By ~ 65

Author(s):

Siti Noor Fazliah Mohd Noor ◽

Sabri Musa

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Cross Sectional Study ◽

Interview Schedule ◽

Cross Sectional ◽

Individual Interviews ◽

Self Confidence ◽

Level Of Satisfaction ◽

Significant Difference ◽

Satisfaction With Treatment

Objectives: Determination of the psychosocial status and assessment of the level of satisfaction in Malaysian cleft palate patients and their parents. Design: Cross-sectional study. Participants and Methods: Sixty cleft lip and palate patients (12 to 17 years of age) from Hospital Universiti Sains Malaysia and their parents were selected. The questionnaires used were the Child Interview Schedule, the Parents Interview Schedule, and the Cleft Evaluation Profile (CEP), administered via individual interviews. Results: Patients were teased because of their clefts and felt their self-confidence was affected by the cleft condition. They were frequently teased about cleft-related features such as speech, teeth, and lip appearance. Parents also reported that their children were being teased because of their clefts and that their children's self-confidence was affected by the clefts. Both showed a significant level of satisfaction with the treatment provided by the cleft team. There was no significant difference between the responses of the patients and their parents. The features that were found to be most important for the patients and their parents, in decreasing order of priority, were teeth, nose, lips, and speech. Conclusions: Cleft lip and/or palate patients were teased because of their clefts, and it affected their self-confidence. The Cleft Evaluation Profile is a reliable and useful tool to assess patients’ level of satisfaction with treatment received for cleft lip and/or palate and can identify the types of cleft-related features that are most important for the patients.

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Knowledge and Attitude Among Various Dental Specialities Regarding Nasoalveolar Molding Procedure in Cleft Patients—A Cross-Sectional Study

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211017404 ◽

2021 ◽

pp. 105566562110174

Author(s):

Divya Doddamani ◽

Saraswathi V. Naik ◽

Archana P. Betur ◽

Sugandhan Suriyan ◽

Basappa Nadig

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Orthopedic Procedure ◽

Dental Practitioners ◽

Significant Difference ◽

Knowledge And Attitude ◽

The Aesthetic ◽

Nasoalveolar Molding

Background: Nasoalveolar molding (NAM) is a presurgical orthopedic procedure, mainly focusing upon the aesthetic outcome of the treatment goal by reducing the number of reconstructive surgeries performed later for the purpose of esthetics. It was reported a very small proportion of pediatric dentists are providing presurgical intervention and the practice of NAM still side stepping among various dental practitioners. Objectives: The study was aimed to assess the knowledge and attitude among various dental specialties regarding NAM procedure in cleft patients. Materials and Methods: A questionnaire-based cross-sectional survey was carried out among 180 dental professionals (pedodontists, orthodontists, prosthodontists, oral surgeons). A total of 180 questionnaires were prepared, out of which 98 were filled through direct personal interview and 82 were circulated via Google forms. Results were analyzed using chi-square test, Mann-Whitney U test, and Kruskal-Wallis test. Results: There was statistically significant difference in the cumulative knowledge scores between specialty with P < .001; 99% of the participants think one should opt for NAM before cleft lip and palate surgery and 39% participants prefer pedodontists to carry out NAM procedure. Conclusion: Dental specialists in India have a positive attitude toward presurgical orthopedics. Majority of them agreed that there is great improvement in the aesthetic outcomes of surgeries after NAM intervention.

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A cross sectional study on mothers’ insight of feeding babies with cleft lip and palate in Hyderabad city, Telangana

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20200957 ◽

2020 ◽

Vol 7 (3) ◽

pp. 1012

Author(s):

Sravya Turlapati ◽

Parthasarathi Reddy ◽

Prathibha Polasani ◽

Irram Abbas Hameed ◽

Monica Mocherla ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Cross Sectional Study ◽

Sectional Study ◽

Key Factors ◽

Maternal Bonding ◽

Cross Sectional ◽

Care And Support ◽

Significant Difference ◽

Self Administered Questionnaire

Background: Feeding infants with cleft lip and palate is one of the most challenging and worrying events in a mother’s life. When the baby fails to thrive, the mother becomes anxious as the effort goes futile which may inhibit maternal bonding with the child leading to other consequences. Hence, our aim was to assess the attitudes of mothers towards feeding their babies with cleft lip and palate.Methods: A cross sectional study was conducted among mothers of children with cleft lip and palate at a cleft center in Hyderabad city. The mothers were interviewed using a self-administered questionnaire on a 3-point Likert scale. The collected data were subjected to statistical analysis using SPSS version 22.Results: A total of 96 mothers participated in the study. Among them a majority of them bottle fed their baby (85%). Escape of milk through nostrils was reported to be the most common problem faced by the child (30%). The attitudes of mothers were categorized into good (29%), moderate (62.5%) and poor (28%). Also there was a significant difference between the educational qualification, household income and clinical diagnosis with the attitude of mothers.Conclusions: In the present study, a majority of them had moderate attitude. Personal and professional care and support are the key factors influencing the mothers’ attitude.

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Language Sample Analysis in Children With Cleft Lip and Palate

Iranian Rehabilitation Journal ◽

10.32598/irj.19.1.523.5 ◽

2021 ◽

Vol 19 (1) ◽

pp. 23-30

Author(s):

Leila Safarpour ◽

◽

Nahid Jalilevand ◽

Ali Ghorbani ◽

Mahboobeh Rasouli ◽

...

Keyword(s):

Language Production ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Cross Sectional Study ◽

Mean Value ◽

Measurement Tool ◽

Craniofacial Anomalies ◽

Cross Sectional ◽

Significant Difference ◽

Language Sample Analysis

Objectives: Cleft Palate (CP) with or without Cleft Lip (CL/P) are the most common craniofacial birth defects. Cleft Lip and Palate (CLP) can affect children’s communication skills. The present study aimed to evaluate language production skills concerning morphology and syntax (morphosyntactic) in children with CLP. Methods: In the current cross-sectional study, 58 Persian-speaking children (28 children with CLP & 30 children without craniofacial anomalies=non-clefts) participated. Gathering the language samples of the children was conducted using the picture description method. The 50 consecutive intelligible utterances of children were analyzed by the Persian Developmental Sentence Scoring (PDSS), as a clinical morphosyntactic measurement tool. Results: The PDSS total scores of children with CLP were lower than those of the non-clefts children. A significant difference was found between the studied children with CLP and children without craniofacial anomalies in the mean value of PDSS total scores (P=0.0001). Discussion: Children with CLP demonstrate a poor ability for using morphosyntactic elements. Therefore, it should be considered how children with CLP use the grammatical components.

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Maxillary Arch Dimensions in 6-Year-Old Cleft Children in Northern Finland: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147432 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7432

Author(s):

Mirjami Corcoran ◽

Saujanya Karki ◽

Leena Ylikontiola ◽

Riitta Lithovius ◽

George Sándor ◽

...

Keyword(s):

Cleft Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Cross Sectional Study ◽

University Hospital ◽

Cross Sectional ◽

Significant Difference ◽

Student’S T ◽

The Right ◽

Maxillary Arch

The aim was to cross-sectionally examine the maxillary arch dimensions in 6-year-old children with cleft lip and/or palate and to compare them with the initial cleft sizes among patients with cleft palate. The study included 89 patients with clefts treated at the Oulu University Hospital. The subjects were divided into three groups: cleft palate, cleft lip, and cleft lip and palate. Study casts were scanned, and the maxillary arch dimensions were examined using a 3D program (3Shape Orthoanalyzer, Copenhagen, Denmark). The statistical methods Student’s t-test and one-way ANOVA were used to compare the means (SD) between the groups. Spearman’s correlation coefficient was used to determine the correlation between cleft severity and maxillary dimensions. A significant difference was found between different initial cleft sizes in terms of distance between the second deciduous molar and the first incisor on the right side. The intermolar width showed a negative correlation with the initial cleft size. The dimensions were shorter for clefts affecting the palate and largest for clefts affecting only the lip. Larger clefts resulted in a shorter maxilla on the right side. Many dimensions became shorter when the initial cleft was larger. Clefts of the palate resulted in smaller maxillas.

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