Bone Regeneration and Periosteoplasty: A 250-Year-Long History

2009 ◽  
Vol 46 (6) ◽  
pp. 621-628 ◽  
Author(s):  
Davide Lazzeri ◽  
Gian Luca Gatti ◽  
Gianfranco Romeo ◽  
Bruno Balmelli ◽  
Alessandro Massei
Keyword(s):  
Bone Regeneration ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Options ◽  
Surgical Approaches ◽  
New Bone Formation ◽  
Optimal Care ◽  
Bone Surgery ◽  
Scientific World ◽  
Maxillary Cleft

Background: Since antiquity, many attempts have been carried out and a number of theories proposed to explain the process that leads to bone regeneration. Through manifold experiments, several authors tried to understand and subsequently to control the physiological events that enable bone healing. Between the 18th and 19th centuries something changed. Although the scientific world was initially skeptical, a new idea emerged in the field of bone surgery. It principally concerned the necessity to perform amputations and resections leaving intact the periosteum to obtain new bone formation. Materials and Methods: With this article we emphasize the contribution of many authors in the development of knowledge about the osteogenic properties of the periosteum. In particular we focus on the experiences of unknown Italian authors Michele Troja and Bernardino Larghi, consider well-recognized scientific personalities such as Leopold Ollier and Bernhard von Langenbeck, and reach a milestone of plastic surgery with Tord Skoog and his description of periosteoplasty. Conclusion: Various surgical approaches have been proposed to provide optimal care for patients with cleft lip and palate disorders. Among several treatment options, periosteoplasty is one of the choices to correct maxillary clefts. Highlighting difficulties and successes of many authors in demonstrating osteogenic properties of periosteum, this paper describes how periosteoplasty performed in maxillary cleft restoration capitalizes on what has been discovered during a 250-year-long history.

Management of Speech and Swallowing Disorders in Children with Oral Clefts

2019 ◽  
Author(s):  
Ravi K. Garg ◽  
Delora L Mount
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Treatment Options ◽  
Posterior Pharyngeal Wall ◽  
Diagnostic Tools ◽  
Pharyngeal Wall ◽  
Pharyngeal Flap ◽  
Sphincter Pharyngoplasty

Cleft lip and palate are common congenital anomalies with significant implications for feeding, swallowing, and speech. If a cleft palate goes unrepaired, a child will have difficulty distinguishing nasal and oral sounds. Even following cleft palate repair, approximately 20 to 30% of nonsyndromic children have persistent hypernasal speech. This often occurs due to velopharyngeal dysfunction (VPD), a term describing failure of the soft palate and pharyngeal walls to seal the nasopharynx from the oropharynx during oral consonant production. The gold standard for diagnosis is perceptual examination by a trained speech pathologist, although additional diagnostic tools such as nasendoscopy are often used. Treatment options for VPD range from speech therapy to revision palatoplasty, sphincter pharyngoplasty, pharyngeal flap, and pharyngeal wall augmentation. Palatal prosthetics may also be considered for children who are not surgical candidates. Further research is needed to improve selection of diagnostic and treatment interventions and optimize speech outcomes for children with a history of oral cleft. This review contains 1 figure, 3 videos, and 58 references.  Key words: Cleft lip and palate, hypernasal resonance, levator veli palatine, nasal emission, nasendoscopy, palatoplasty, pharyngeal flap, posterior pharyngeal wall augmentation, sphincter pharyngoplasty, velopharyngeal dysfunction

scholarly journals Comparing Plastic Surgery and Otolaryngology Management in Cleft Care: An Analysis of 4,999 Cases

2017 ◽  
Vol 10 (4) ◽  
pp. 271-277 ◽  
Author(s):  
Kevin T. Jubbal ◽  
Dmitry Zavlin ◽  
Shola Olorunnipa ◽  
Anthony Echo ◽  
Edward P. Buchanan ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The United States ◽  
Surgical Approaches ◽  
Nasal Reconstruction ◽  
Improvement Program ◽  
Primary Specialty ◽  
Significant Difference ◽  
Procedure Type

Care for patients with cleft lip and palate is best managed by a craniofacial team consisting of a variety of specialists, including surgeons, who are generally plastic surgeons or otolaryngologists trained in the United States. The goal of this study was to compare the surgical approaches and management algorithms of cleft lip, cleft palate, and nasal reconstruction between plastic surgeons and otolaryngologists. We performed a retrospective analysis of the American College of Surgeons’ National Surgical Quality Improvement Program Pediatric database between 2012 and 2014 to identify patients undergoing primary repair of cleft lip, cleft palate, and associated rhinoplasty. Two cohorts based on primary specialty, plastic surgeons and otolaryngologists, were compared in relation to patient characteristics, 30-day postoperative outcomes, procedure type, and intraoperative variables. Plastic surgeons performed the majority of surgical repairs, with 85.5% ( n = 1,472) of cleft lip, 79.3% ( n = 2,179) of cleft palate, and 87.9% ( n = 465) of rhinoplasty procedures. There was no difference in the age of primary cleft lip repair or rhinoplasty. However, plastic surgeons performed primary cleft palate repair earlier than otolaryngologists ( p = 0.03). Procedure type varied between the specialties. In rhinoplasty, otolaryngologists were more likely to use septal or ear cartilage, whereas plastic surgeons preferred rib cartilage. Results were similar, with no statistically significant difference in terms of mortality, reoperation, readmission, or complications. Significant variation exists in the treatment of cleft lip and palate based on specialty service with regard to procedure timing and type. However, short-term rates of mortality, wound occurrence, reoperation, readmission, and surgical or medical complications remain similar.

scholarly journals Bone Regeneration in Artificial Jaw Cleft by Use of Carbonated Hydroxyapatite Particles and Mesenchymal Stem Cells Derived from Iliac Bone

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Motoko Yoshioka ◽  
Kotaro Tanimoto ◽  
Yuki Tanne ◽  
Keisuke Sumi ◽  
Tetsuya Awada ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Regeneration ◽  
Bone Defect ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Iliac Bone ◽  
Invasive Technique ◽  
Carbonated Hydroxyapatite ◽  
X Ray ◽  
Experimental Side

Objectives of the Study. Cleft lip and palate (CLP) is a prevalent congenital anomaly in the orofacial region. Autogenous iliac bone grafting has been frequently employed for the closure of bone defects at the jaw cleft site. Since the related surgical procedures are quite invasive for patients, it is of great importance to develop a new less invasive technique. The aim of this study was to examine bone regeneration with mesenchyme stem cells (MSCs) for the treatment of bone defect in artificially created jaw cleft in dogs.Materials and Methods. A bone defect was prepared bilaterally in the upper incisor regions of beagle dogs. MSCs derived from iliac bone marrow were cultured and transplanted with carbonated hydroxyapatite (CAP) particles into the bone defect area. The bone regeneration was evaluated by standardized occlusal X-ray examination and histological observation.Results. Six months after the transplantation, perfect closure of the jaw cleft was achieved on the experimental side. The X-ray and histological examination revealed that the regenerated bone on the experimental side was almost equivalent to the original bone adjoining the jaw cleft.Conclusion. It was suggested that the application of MSCs with CAP particles can become a new treatment modality for bone regeneration for CLP patients.

Guided bone regeneration to repair an alveolar bone defect in a girl whose cleft lip and palate had been repaired

2005 ◽  
Vol 43 (5) ◽  
pp. 420-422 ◽  
Author(s):  
Toshitsugu Kawata ◽  
Miho Yuki ◽  
Yoshihiro Miyamoto ◽  
Tadashi Fujita ◽  
Masato Kaku ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Bone Defect ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Guided Bone Regeneration ◽  
Alveolar Bone Defect

Maxillary Anterior Tooth Size and Arch Dimensions in Unilateral Cleft Lip and Palate

2008 ◽  
Vol 45 (6) ◽  
pp. 639-646 ◽  
Author(s):  
Benjamin R. K. Lewis ◽  
Melanie R. Stern ◽  
Derrick R. Willmot
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Univariate Analysis ◽  
Chord Length ◽  
Control Group ◽  
Study Group ◽  
Image Analysis System ◽  
Anterior Teeth ◽  
Maxillary Incisors ◽  
Maxillary Cleft

Objective: To investigate differences in size of the maxillary permanent anterior teeth and arch dimensions between individuals with repaired unilateral cleft lip and palate (UCLP) and a matched control group representing the general population. Design: Retrospective study cast review. Participants: Study casts of 30 subjects due to commence orthodontic treatment following an alveolar bone graft (ABG) were collected from the Cleft Lip and Palate Units in South Yorkshire. Thirty control subjects were collected from a previously validated control group of white individuals in South Yorkshire. Main Outcome Measures: Casts were analyzed with an image analysis system to measure the dimensions of the maxillary permanent anterior teeth, incisor chord lengths, and the intercanine and intermolar widths. The results were analyzed statistically using paired t-tests and two-way univariate analysis of variance (ANOVA). Results: The mesiodistal widths of maxillary anterior teeth in the study group were smaller than the noncleft control group (p < .01). The dimensions of the cleft side maxillary incisors and incisor chord length were smaller (p < .05 and p < .01 respectively) compared with the noncleft side. The study group maxillary cleft side incisor chord length and maxillary intercanine width were narrower than the control group (p < .0001). Conclusions: (1) Anterior teeth are smaller mesiodistally in individuals with UCLP. (2) Maxillary incisors are smaller on the cleft side than the noncleft side. (3) UCLP subjects had smaller maxillary cleft side incisor chord lengths and intercanine widths than the control group despite pre-ABG expansion.

scholarly journals Fixed prosthetic treatment in patients with cleft lip and palate

2017 ◽  
Vol 74 (2) ◽  
pp. 189-192
Author(s):  
Jagoda Bajevska ◽  
Jana Bajevska ◽  
Biljana Bajevska-Stefanovska
Keyword(s):  
Case Report ◽  
Oral Health ◽  
Oral Cavity ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Options ◽  
Term Outcome ◽  
Long Term Outcome ◽  
And Function

Introduction. The prosthetic treatment of patients with cleft palate includes various treatment options such as fixed partial dentures, removable partial prosthesis, etc. The type of prosthetic appliance is determined by the oral health of each individual and the circumstances. We presented three adult patients with the cleft lip and palate subjected to prosthetic treatment. Case report. From the possible prosthetic solutions according to the conditions in the oral cavity and the circumstances, fixed partial dentures veneered with composite or ceramic were chosen. A proper relationship between the teeth was reached with the fixed partial dentures, and function established, the phonetics improved and satisfying aesthetics effect accomplished improving the profile appearance of the patient?s face. Plastic surgery of the nose was performed after that. Conclusion. Multidisclipinary treatment is necessary for favourable long-term outcome in cleft lip and palate patients.

scholarly journals Factors Associated With Psychological Adjustment in Adults With Cleft Lip and/or Palate: Findings From a National Survey in the United Kingdom

2021 ◽  
pp. 105566562110284
Author(s):  
Bruna Costa ◽  
Kenny Ardouin ◽  
Nicola Marie Stock
Keyword(s):  
Psychological Adjustment ◽  
Cleft Lip ◽  
Family Cohesion ◽  
Cleft Lip And Palate ◽  
Treatment Options ◽  
Body Esteem ◽  
The Body ◽  
Life Orientation Test ◽  
Life Orientation ◽  
Factors Associated

Objectives: Research has identified adults born with cleft lip and/or palate (CL/P) to be at risk of poorer psychological outcomes compared to the general population. This study investigated factors that may contribute to positive and negative adjustment in adults born with CL/P. Design: A survey was designed and distributed by the Cleft Lip and Palate Association in collaboration with (University). There were 207 eligible responses (95% completed online) received between July and October 2018. Dependent variables included the Body Esteem Scale for Adolescents and Adults, Harter’s Self Perception Profile for Adults (Global Self-Worth, Social Competence, and Intimacy subscales), the Fear of Negative Appearance Evaluation Scale, and the Revised Adult Attachment Scale. Independent variables were the Revised Life Orientation Test, biodemographic data, and self-reported single-item questions. Results: Factors associated with positive adjustment included reports of a happy childhood, talking about CL/P with family, close friendships, comfort in public spaces, satisfaction with appearance, and a positive life orientation. Psychological distress was associated with a desire for further surgery to improve appearance and/or function. Conclusions: Several factors were identified that may influence psychological adjustment in adults with CL/P. Throughout childhood, family-centered practice to support family cohesion and an open dialogue about CL/P is indicated, as is support for young people to develop social confidence. For adults returning to the cleft service, treatment options for appearance and/or functional concerns should be explored, with access to psychological support when indicated. Interventions to increase optimism, resilience, and self-acceptance may also be warranted throughout the life span.

Bone Regeneration in a Canine Model of Artificial Jaw Cleft Using Bone Marrow–Derived Mesenchymal Stem Cells and Carbonate Hydroxyapatite Carrier

2019 ◽  
Vol 57 (2) ◽  
pp. 208-217
Author(s):  
Takaharu Abe ◽  
Keisuke Sumi ◽  
Ryo Kunimatsu ◽  
Nanae Oki ◽  
Yuji Tsuka ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Survival Rate ◽  
Bone Regeneration ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Canine Model ◽  
Beagle Dogs ◽  
Carbonate Hydroxyapatite

Objective: Cleft lip and palate (CLP) is a common anomaly of the orofacial region. Mesenchymal stem cell (MSC) transplantation has been a focus of regenerative medicine, and its application to the repair of bone defects in patients with CLP is highly anticipated. This study investigated the potential for using MSCs to regenerate bone in a jaw cleft as well as the survival of transplanted MSCs using a canine model of CLP. Design: Mesenchymal stem cells collected from the bone marrow of beagle dogs were transplanted along with carbonate hydroxyapatite into jaw clefts in beagle dogs. Mesenchymal stem cells labeled with fluorescent silica nanoparticles were also transplanted, and a histological analysis was performed 3 months later to evaluate MSC survival. Results: Carbonate hydroxyapatite regeneration into bone was enhanced by cotransplantation of MSCs. The survival rate of MSCs transplanted after 3 months was 5.7%. Conclusions: Transplanted MSCs promote bone regeneration, although their survival rate is low.

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