scholarly journals Assessment of nasopharynx area and level of severity posterior crossbite on children with cleft lips and palate post-palatoplasty

2020 ◽  
Vol 32 (2) ◽  
Author(s):  
Anie Apriani ◽  
Risti Saptarini Primarti ◽  
Alwin Kasim ◽  
Fahmi Oscandar
Keyword(s):  
Cleft Lip ◽  
Soft Tissues ◽  
Cleft Lip And Palate ◽  
Secondary Data ◽  
Normal Children ◽  
Posterior Crossbite ◽  
Cephalometric Radiograph ◽  
Significant Difference ◽  
Lateral Cephalometric Radiograph ◽  
Average Size

Introduction: Many children with post palatoplasty had crossbite posterior. This study was aimed to assess the nasopharynx area and the posterior crossbite severity level of children with cleft lip and palate (CLP) who received palatoplasty treatment compared to normal children. Methods: The study was observational analytic. The research subject was 14 children with CLP post-palatoplasty and 14 normal children. The object of research was 28 study models and secondary data of lateral cephalometric radiograph of children with CLP post palatoplasty and normal children. The measurement of PTM-ad1-Ad2-PTM and PTM-So-Ba-PTM were used to measure the nasopharyngeal area. Study models were assessed to analyse the level of severity of posterior crossbite. Results: The average of the soft tissues (the nasopharynx) area children with CLP post-palatoplasty was 35.02 mm2, which was lower than the normal child (35.73 mm2). Similarly, the average of the hard tissues (the nasopharynx) area children with CLP post-palatoplasty was 301.40 mm2, which was smaller than the normal children (315.54 mm2). Statistical analysis of the nasopharynx area resulted in non-significant difference. All children with CLP post-palatoplasty was suffered from posterior crossbite. The level of severity posterior crossbite, which was categorised as good was 42.9%, poor criteria was 35.7%, moderate criteria was 14.3%, and very good criteria was 7.1%. Conclusion: There is no difference between the average size of the nasopharynx area on children with CLP post-palatoplasty and normal children. The level of severity posterior crossbite after palatoplasty in CLP children mostly included in the good criteria.

scholarly journals Cephalometric evaluation of rapid and slow maxillary expansion in patients with BCLP: Secondary data analysis from a randomized clinical trial

2019 ◽  
Vol 89 (4) ◽  
pp. 583-589 ◽  
Author(s):  
Leonardo Gregório ◽  
Arthur César de Medeiros Alves ◽  
Araci Malagodi de Almeida ◽  
Rodrigo Naveda ◽  
Guilherme Janson ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Secondary Data ◽  
Study Groups ◽  
Maxillary Expansion ◽  
Posterior Crossbite ◽  
Facial Pattern ◽  
Quad Helix

ABSTRACT Objective: To compare the dentoskeletal effects of rapid (RME) and slow (SME) maxillary expansion in patients with bilateral complete cleft lip and palate (BCLP). Materials and Methods: This was a secondary analysis of a previous randomized controlled trial (RCT). Forty-six patients (34 male, 12 female) with BCLP and posterior crossbite (mean age of 9.2 years) were randomly assigned to two study groups. Group RME comprised subjects treated with Haas/Hyrax expander. Group SME included patients treated with quad-helix appliance. Cone-beam computed tomography (CBCT) was performed before expansion (T1) and after appliance removal at the end of a 6-month retention period (T2) for a previous RCT that compared the transverse skeletal effects of RME and SME. CBCT-derived cephalometric images were generated and cephalometric analysis was performed using Dolphin Imaging Software (Chatsworth, Calif). Intergroup comparisons were performed using t tests (P < .05). Results: Baseline forms were similar between groups. No significant differences between RME and SME groups were found. Conclusions: Rapid and slow maxillary expansion produced similar sagittal and vertical changes in patients with BCLP. Both Haas/Hyrax and quad-helix appliances can be used in patients with vertical facial pattern. Clinical relevance: RME and SME can be equally indicated in the treatment of maxillary arch constriction in patients with BCLP.

scholarly journals Correlation of cervical vertebral maturity and teeth calcification stages in children with cleft lip and palate

2019 ◽  
Vol 4 (3) ◽  
pp. 167
Author(s):  
Sandy Pamadya ◽  
Azhari Azhari ◽  
Ria Noerianingsih Firman
Keyword(s):  
Strong Correlation ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rank Correlation ◽  
P Value ◽  
Dental Age ◽  
Cross Sectional ◽  
Cephalometric Radiograph ◽  
Lateral Cephalometric Radiograph ◽  
Cervical Vertebral Maturation

Cleft lip and palate are the most common craniofacial anomalies in Indonesia. Recent publications report that there was delayed skeletal and dental age in cleft lip and palate patients. Panoramic and lateral cephalometric radiograph to evaluate growth and development through skeletal and dental age is still rarely used. The research aimed to determine the correlation between cervical vertebral maturation and teeth calcification stages in children aged 7 to 16 years old with cleft lip and palate in Unpad Dental Hospital. The research design was analytic correlation and the sample was selected using purposive sampling cross-sectional using secondary data panoramic and lateral cephalometric radiograph. The scores of cervical maturation and teeth calcification stages were then analyzed statistically using SPSS version 16. Spearman coefficient of rank correlation test showed strong correlation between cervical vertebral maturation and teeth calcification stages on all teeth, with the highest rs score was secondary molar (0.734) and p value 0.000 The conclusion of this research is that there is a strong correlation between cervical vertebral maturation and teeth calcification stages in children aged 7 to 16 years old with cleft lip and palate.

Comparative Evaluation of the Pharyngeal Airways and Related Soft Tissues of Unilateral and Bilateral Cleft Lip and Palate Patients with the Noncleft Individuals

2017 ◽  
Vol 54 (1) ◽  
pp. 53-59 ◽  
Author(s):  
Isil Aras ◽  
Servet Dogan
Keyword(s):  
Influence Function ◽  
Comparative Evaluation ◽  
Hyoid Bone ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Cleft Lip And Palate ◽  
Pairwise Comparison ◽  
Significant Difference ◽  
Bilateral Cleft Lip ◽  
The Mean

Aim This study is a comparison of pharyngeal airways and associated soft tissues of unilateral and bilateral cleft lip and palate patients with the noncleft individuals. Materials and Methods Twenty-four unilateral cleft lip and palate patients (UCLP), 21 bilateral cleft lip and palate patients (BCLP), and 26 noncleft patients (NC) between ages 15 to 17 were included in the study. Eleven linear, 1 angular, and 1 proportional measurements were carried out on pretreatment lateral cephalometric head films of these individuals. Results The nasopharyngeal depths were markedly reduced in BCLP when compared with the NC (P < .001) and UCLP (P < .01) with a significant difference (P < .01) also among UCLP and NC. Minimum space behind the tongue concerning BCLP and UCLP were significantly lower compared to the NC (P < .001 and P < .01, respectively). In pairwise comparison among the clefts, BCLP showed significant (P < .05) narrowing of this distance. Tongue heights and velar lengths were significantly (P < .001) lower in cleft groups compared to the controls. Similarly, the hyoid bone was positioned in a significantly (P < .01) anterior and inferior direction in cleft patients. Comparison of the mean ratio of velar length to nasopharyngeal depth of the three groups revealed significant (P < .001) inadequacies in cleft patients with significantly (P < .05) more severely reduced values in BCLP. Conclusion Pharyngeal airways and involved soft tissues of cleft patients show serious inadequacies compared to controls, with significant diversities among cleft types pertaining to some of the parameters investigated. It should be kept in mind that these variations can influence function in terms of respiration and phonation.

Orthodontic Pre Grafting Closure of Large Alveolar Bony and Soft Tissue Gaps: A Novel Nonsurgical Protraction of the Lesser Segments in Growing Patients With Cleft Lip and Palate

2021 ◽  
pp. 105566562110076
Author(s):  
Maria Costanza Meazzini ◽  
Noah Cohen ◽  
Valeria Marinella Augusta Battista ◽  
Cristina Incorvati ◽  
Federico Biglioli ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Procedures ◽  
Efficient Method ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Cleft Lip And Palate ◽  
Face Mask ◽  
Younger Patients ◽  
Good Healing

Background: Closure of wide alveolar clefts with large soft tissue gaps and reconstruction of the dentoalveolar defect are challenging for the surgeon. Some authors successfully used interdental segmental distraction, which requires an additional surgical procedure. Objective: This study evaluates the effectiveness of tooth borne devices utilized to orthopedically advance the lesser segments, with a complete approximation of the soft tissue of the alveolar stumps, allowing traditional simultaneous soft tissue closure and bone grafting, and avoiding the need for supplementary surgery. Methods: Eight growing patients, 2 with unilateral complete cleft lip and palate (UCLP) and 6 with bilateral complete cleft lip and palate (BCLP), with large soft tissue and bony alveolar defects prior to bone grafting were prospectively selected. A banded rapid palatal expander (RPE) in BCLP and a modified RPE in UCLP combined with protraction face mask in younger patients or a modified Alt-Ramec in patients older than 12 years were applied. Radiographic and photographic records were available at T0, at the end of protraction (T1) and at least 1 year after bone grafting (T2). Results: Patients with large gaps showed a significant reduction in the bony cleft area and approximation of the soft tissues at T1. All patients received bone grafting with good healing and ossification at T2. Conclusion: In growing patients with UCLP and BCLP with large gaps, presurgical orthodontic protraction seems to be an efficient method to reduce the cleft defect, minimizing the risk of post grafting fistulas, reducing the need for supplementary surgical procedures.

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.

A Quantitative Three-Dimensional Assessment of Abnormal Variations in Facial Soft Tissues of Adult Patients with Cleft Lip and Palate

2003 ◽  
Vol 40 (5) ◽  
pp. 544-549 ◽  
Author(s):  
Virgilio F. Ferrario ◽  
Chiarella Sforza ◽  
Claudia Dellavia ◽  
Gianluca M. Tartaglia ◽  
Davide Sozzi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Z Score ◽  
Soft Tissue Profile ◽  
Variability Index ◽  
The Mean ◽  
Facial Soft Tissues

Objective To supply quantitative information about the facial soft tissues of adult operated patients with cleft lip and palate (CLP). Design, Setting, and Patients The three-dimensional coordinates of soft tissue facial landmarks were obtained using an electromagnetic digitizer in 18 Caucasian patients with CLP (11 males and 7 females aged 19 to 27 years) and 162 healthy controls (73 females and 89 males aged 18 to 30 years). From the landmarks, 15 facial dimensions and two angles were calculated. Data were compared with those collected in healthy individuals by computing z-scores. Two summary anthropometric measurements for quantifying craniofacial variations were assessed in both the patients and reference subjects: the mean z-score (an index of overall facial size), and its SD, called the craniofacial variability index (an index of facial harmony). Results In treated patients with CLP, facial size was somewhat smaller than in normal individuals, but in all occasions the mean z-score fell inside the normal interval (mean ± 2 SD). Almost all patients had a craniofacial variability index larger than the normal interval, indicating a global disharmonious appearance. Overall, in patients pronasale, subnasale, and pogonion were more posterior, the nose was shorter and larger, the face was narrower, and the soft tissue profile and upper lip were flatter than in the reference population. Conclusions The facial soft tissue structures of adult operated patients with CLP differed from those of normal controls of the same age, sex, and ethnic group. In this patient group, surgical corrections of CLP failed to provide a completely harmonious appearance, even if the deviations from the reference were limited. Further analyses of larger groups of patients are needed.

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

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.

The Effect of Presurgical Treatment on Palatal Tissue Area in Unilateral Cleft Lip and Palate Subjects

1977 ◽  
Vol 4 (4) ◽  
pp. 181-185 ◽  
Author(s):  
A. G. Huddart ◽  
J. J. Crabb
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The Other ◽  
Normal Children ◽  
Orthopaedic Treatment ◽  
Tissue Area

The investigation measures the area of palatal tissue at birth and at four months in three groups of subjects: (1) 30 complete unilateral cleft lip and palate cases who received presurgical maxillary orthopaedic treatment; (2) 15 similar cases who did not receive such treatment and were used as controls; (3) 30 normal children with intact palates. The changes occurring in the three groups of cases over the four month period are compared. In particular it was noted that presurgical treatment retarded the growth of palatal tissue. The significance of this in relation to the other findings and presurgical treatment generally is discussed.

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