bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of TGFβ2 on Collagen Synthesis in Cultured Normal and Wounded Fetal Mouse Palates
Authors: Thompson Sue Ann , Canady John W. , Coberly Dana M. , Sandra Alexander , Lee Chun Mee , Pang Judy C. 
Published: October 2018

Objective: It has been demonstrated in a number of models that fetal wounds heal with little or no scar. Since collagen is an integral part of the extracellular matrix in adult scar formation, we studied the synthesis and localization of collagen in an in vitro mouse palate model for fetal wound healing. Methods: Palates, dissected from fetal mice at 15, 16, and 17 days of gestation and from newborn mice, were cultured in medium containing serum (for 8 hours); this was followed by culture in serum-free medium (for 12 hours). One-half of the samples from each age group were wounded in the midline. All samples were placed in serum-free medium containing 20 μCl/mL 3H-proline for 8 hours. In addition, palates from 15-day gestation and from newborn mice were also incubated with transforming growth factor TGFβ2 (10 ng/mL). Palates were washed with saline, homogenized, and radioactivity was counted. Proline uptake was calculated for each sample as counts per milligram of protein and was subjected to statistical analysis (three-way analysis of variance). Samples of the homogenate were subjected to sodium dodecyl sulfate-gel electrophoresis and Western blotting in order to determine the types of collagen that were synthesized. Immunohistochemical localization of collagen types I, III, and VI was carried out on paraffin-embedded samples from each group. Results: There were no significant differences in proline uptake between wounded mouse palates and nonwounded mouse palates at any age, and there was no histological evidence of regeneration of the palate at the site of the wound. Proline uptake was significantly greater in untreated wounded palates at 15 days’ gestation than it was in newborns. After treatment with TGFβ2, proline uptake was significantly greater in both wounded and nonwounded palates in the newborn group and had no effect on collagen synthesis in palates from 15-day gestation animals. Collagen types I and III were localized in histological specimens using immunohistochemistry and on nitrocellulose using Western blotting. No type VI collagen was demonstrated by Western blotting, but it was localized around blood vessels and on basement membranes using immunohistochemistry. Conclusion: Treatment with TGFβ2 significantly increased collagen synthesis, as assessed by 3H-proline uptake, in cultured palates from newborn mice as compared with palates from untreated newborn mice and from both treated and untreated palates of 15-day gestation mice. These data suggest a differential response to TGFβ2 by mouse palates as a function of fetal development.
Children's Attitudes toward Interacting with Peers with Different Craniofacial Anomalies
Authors: Reed Julie , Robathan Magali , Hockenhull Anna , Rostill Helen , Perrett David , Lees Andie 
Published: October 2018

Objective: This study was designed to evaluate children's understanding of different craniofacial anomalies and their willingness to interact with children with such anomalies. Design: This was a between-measures design in which children were randomly allocated to one of three groups. Each group viewed one of three pairs of computer-generated images (nondistinctive, cleft lip, or misshapen nose) of similar-aged children. Setting: Participants were recruited from two city elementary schools and were interviewed at their schools. Participants: A total of 100 children (aged 7 to 10 years) entered the study, and complete sets of data were obtained for each child. As the majority of the children were white (n = 92), the nonwhite children (n = 8) were excluded from the data analyses. Main Outcome Measures: Participants were asked a number of questions to ascertain their thoughts about the image, and measures were then taken of each child's willingness to interact with the stimulus child. Results: There were no significant differences between the three groups. Boys were significantly more willing to interact with the stimulus images than were girls, and there was a nonsignificant trend for girls to be more likely to spontaneously mention the craniofacial anomaly. Participants gave varied explanations for the condition's causation. Conclusions: Boys and girls differed in their willingness to interact with unfamiliar peers with and without facial distinctions. Various explanations were given to explain causality of the anomaly. Findings lend some support to the proposal that high “background attractiveness” can overshadow the impact of a craniofacial anomaly.
Callus Distraction of the Midface in the Severely Atrophied Maxilla—A Case Report
Authors: Hierl Thomas , Hemprich Alexander 
Published: October 2018

Objective: This report introduces the possibilities of callus distraction in the extremely atrophied, edentulous midface in a cleft lip and palate patient. Intervention: After a subtotal Le Fort II osteotomy, tension wires were fixed to the zygomatic buttresses and frontal sinus walls by way of titanium mini-plates and mesh and connected to a rigid external distractor. Then distraction of the whole midface (1 mm/d) was performed. Results: Even in severe atrophy a distraction of the maxilla of 20 mm was possible. Stability has been shown for more than 5 months. Conclusions: Rigid external midfacial distraction may be used in difficult cases for the correction of sagittal discrepancies where conventional orthognatic surgery is likely to be insufficient. Further investigations will concentrate on the long-term outcome.
The Presurgical Status of the Alveolar Cleft and Success of Secondary Bone Grafting
Authors: Aurouze Catherine , Moller Karlind T. , Bevis Richard R. , Rehm Kelly , Rudney Joel 
Published: October 2018

Objective The primary purpose of this study was to evaluate presurgical status of the alveolar cleft site and success of secondary alveolar bone grafting. Design Thirty patient records were retrospectively reviewed. Patients selected for inclusion had isolated cleft of at least the primary palate. Patients with additional anomalies were not selected. The study population consisted of 15 female sites and 16 male cleft sites. There were two bilateral cleft lip and palate (CLP) patients and 28 unilateral CLP patients. The age at the time of the secondary alveolar bone grafting ranged from 7 years to 14 years, 4 months. Setting The study was conducted at the Cleft Palate Clinic at the University of Minnesota, School of Dentistry. Method Presurgical radiographs taken at least 1 month prior to the secondary bone grafting and postsurgical radiographs taken at least 6 months after bone surgery were measured. Measurements included size of the cleft defect and bone support for distal and mesial teeth adjacent to the cleft. Evaluation of success was determined on the basis of postsurgical measurements of satisfactory, intermediate, and unsatisfactory outcomes. Results and Conclusion The size of the cleft defect was not correlated with the success rate of the secondary alveolar bone grafting. If the amount of distal bone support for the mesial tooth was the same as those in a periodontally healthy individual, a satisfactory outcome was 5.8 times more likely. If the amount of mesial bone support for the distal tooth was the same as those in a periodontally healthy individual, the satisfactory outcome was 3.8 times more likely. Although not a primary purpose of the study, it was found that in this study population, if the patient was female, a satisfactory outcome was 3.8 times more likely.
A New Technique for the Quantitative Analysis of Cranial Suture Biology
Authors: Sherick Daniel G. , Buchman Steven R. , Goulet Robert W. , Goldstein Steven A. 
Published: October 2018

Objective Our objective was to assess the ability of the microcomputed tomography scanner to correctly image normal and synostosed cranial sutures at the ultrastructural level. Design and Methods Two specimens of coronal sutures were collected from operative specimens. After appropriate preparation, histological sections were obtained and stained with toluene blue for evaluation. Representative histological sections were compared to microcomputed tomography slices. Results and Conclusions With microcomputed tomography, we successfully imaged one normal and one synostosed human coronal suture and performed a quantitative analysis of these specimens. Microcomputed tomography scanning was found to be a highly accurate imaging device for the evaluation of cranial suture development. Microcomputed tomography offers three-dimensional imaging at the microscopic level and allows for rapid quantitative analysis of bone architecture, including several measurements unavailable through histologic analysis. We believe that microcomputed tomography can play an important role in imaging and in the quantitative analysis of the stereology of bone microarchitecture. Among its advantages, microcomputed tomography is able to image many more slices than are obtainable through histology, and the method is not prone to human error. Microcomputed tomography slices are generated without destruction of the specimen and without loss or corruption of reproducible data. Structure-oriented slices from microcomputed tomography together with cellular-oriented sections from histology are complementary in the overall quantitative analysis of cranial sutures.
The Basis for Presurgical Orthopedic Treatment of Infants with Unilateral Complete Cleft Lip and Palate
Authors: Koželj Vesna 
Published: October 2018

Objective The purpose of this study was to describe the posttreatment morphology of the upper part of the oral cavity of complete unilateral cleft lip and palate (UCLP) patients and to compare it to noncleft contemporaries. Patients were treated according to a protocol designed to keep a proper resting posture of the oral cavity. Design Retrospective study on dental casts. Setting The study was performed at a maxillofacial center serving a population of 2 million inhabitants. Data for noncleft subjects are the result of a longitudinal study at the same institution. Patients Twenty-one Caucasian UCLP patients (13 males, 8 females) aged 5 to 9 years with no other congenital anomalies and no postoperative orthodontic treatment. Interventions Each patient received 5 to 6 months of preoperative orthopedics with a passive plate and external nonelastic strapping with definitive lip repair at age 5 to 7 months, soft palate repair at 11 to 15 months, and hard palate repair with mucoperiosteal closure of the alveolus at 30 to 36 months. Each patient was compared to the mean values obtained from a longitudinal study of a group of 25 healthy noncleft children of the same ethnic group (11 males, 14 females). Results Analysis of dental casts indicated that 16 patients had a width, depth, and length of the alveolar arch in the range of the mean normal values minus two standard deviations. Their analyzed palates were flatter than normal. Six of 21 children had too small an alveolar arch for their ages, and they did not acquire a correct posture of the oral cavity. Conclusion The results indicate that the upper part of the oral cavity of UCLP patients can reach the dimensions of noncleft contemporaries despite surgery.
Genetics of Nonsyndromic Cleft Lip and Palate: A Review of International Studies and Data regarding the Italian Population
Authors: Carinci Francesco , Pezzetti Furio , Scapoli Luca , Martinelli Marcella , Carinci Paolo , Tognon Mauro 
Published: October 2018

The aims of this review are (1) to illustrate current knowledge of the mode of inheritance and the loci involved in the cleft lip and palate and (2) to summarize the results of our investigations, which were carried out in Italy. It is well established that nonsyndromic cleft of the lip with or without the palate (CL±P) and cleft palate only (CPO) are separate entities. Genetic heterogeneity has been observed in CL±P, which involves different chromosome regions, mainly 6p23 (OFC1), 2q13 (OFC2), and 19q13.2 (OFC3), as well as other loci, such as 4q25-4q31.3 and 17q21. Furthermore, an interaction between different genes has been suggested in the oligogenic model. In one case at least, an OFC1 and OFC2 interaction has been demonstrated. The mode of inheritance of CPO is compatible with a recessive single major gene model, while an association with a candidate gene, mapping on the chromosome region 2q13/TGF α, remains to be confirmed.
Histological Evaluation of Autogenous Iliac Particulate Cancellous Bone and Marrow Grafted to Alveolar Clefts—A Preliminary Report of Five Young Adult Cases
Authors: Iino Mitsuyoshi , Ishii Hiroaki , Sato Junichi , Seto Kanichi 
Published: October 2018

Objective We histologically evaluated iliac particulate cancellous bone and marrow (PCBM) grafted to alveolar clefts in five young adults with cleft lip and palate. Patients and Methods Five young adults with cleft lip and palate underwent secondary alveolar bone grafting. The mean age of the patients was 21.2 years (range = 17 to 27 years). Bone specimens were taken from the graft site 5 to 10 months after the surgery simultaneously with implant fixture placement (two cases), vestibuloplasty (two cases), and rebone grafting (one case). These five bone specimens were prepared and stained with hematoxylin and eosin and examined microscopically. Result One specimen, taken 5 months after surgery, showed immature trabecular bone partially lined by osteoblasts. The remaining four specimens showed well-mineralized trabeculae and fatty change in the marrow space. Conclusion In young adult cases, PCBM remodeled after grafting and became mature bone about 5 to 6 months after the surgery.
Laryngeal Airway Resistance in Cleft Palate Children with Complete and Incomplete Velopharyngeal Closure
Authors: Guyette Thomas W. , Sanchez Anita J. , Smith Bonnie E. 
Published: October 2018

Objective This study investigated the effect of velopharyngeal insufficiency on aerodynamic measures of laryngeal function in children with cleft palate. Design Data were analyzed using analysis of covariance. The independent variable was velopharyngeal closure, and the dependent variables were laryngeal resistance, laryngeal airflow, and transglottal pressure. Age and gender were covariates. Setting The data were collected at The Craniofacial Center, University of Illinois, a tertiary health care center located in Chicago. Patients Thirty-six children with cleft palate were recruited from among the patients at The Craniofacial Center. Ten children with velopharyngeal areas > 5 mm2 during oral speech were placed in the incomplete closure group, while 26 children with areas < 1 mm2 were placed in the complete closure group. Outcome Measures The three dependent variables (transglottal pressure, transglottal airflow, and laryngeal resistance) were measured. Results Laryngeal resistance and transglottal pressure were significantly higher, and transglottal airflow was significantly lower in the group with complete closure. Conclusions In summary, cleft palate patients with complete velopharyngeal closure exhibited higher laryngeal resistances than those with incomplete closure.
Facial Growth in a Cleft Palate Patient Treated with the Herbst Appliance: A Long-Term Profile Roentgenographic and Roentgen Stereometric Analysis of Profile Changes and Displacement of the Jaws
Authors: Sarnäs Karl-Victor , Rune Bodil , Åberg Magnus 
Published: October 2018

Objective To monitor facial development in a patient with cleft palate who was treated with the Herbst appliance. Monitoring was in terms of changes in the skeletal profile and growth in the circummaxillary sutures and temporomandibular joints (TMJs). Design Prospective profile roentgenography (between the ages of 6 and 20 years) and roentgen stereometric analysis (between the ages of 8 and 19 years). Setting Center for Craniofacial Anomalies and Department of Plastic and Reconstructive Surgery, Malmö University Hospital, Malmö, Sweden. Patient Boy with cleft of the soft and posterior part of the hard palate and marked facial convexity. Interventions Surgical repair of the soft palate at age 9 months, velopharyngeal flap at age 8 years, and insertion of implants under general anesthesia and treatment with the Herbst appliance at age 11 years. Roentgen examinations were performed in connection with continued clinical evaluations and treatment. Main outcome Measures Profile roentgenograms were traced and measured by one of the authors using conventional point-based analysis. Stereo roentgenograms were digitized by the Department of Orthopedic Surgery, Malmö University Hospital. Results The direction of profile changes was partly discordant with the direction of articular growth in the circummaxillary sutures and TMJs. The successful treatment result was accomplished by a temporary influence on sagittal growth direction in the circummaxillary sutures and on rotational growth direction in the TMJs, combined with a favorable natural remodeling and articular growth pattern. Conclusions The mode of growth by which treatment aims were reached was partly unexpected, i.e., discordant with the generally accepted principal concept that treatment with the Herbst appliance positions the mandible forward.
Quantitative Analysis of the Velopharyngeal Sphincter Function during Speech
Authors: Poppelreuter Sabine , Engelke Wilfried , Bruns Thomas 
Published: October 2018

Objective This study reports a new concept for quantitative analysis of velopharyngeal function using electromagnetic articulography and simultaneous transoral video endoscopy. Participants The velopharyngeal closure mechanism was studied in 16 healthy German subjects during production of the vowel-consonant-vowel sequences /afa/ and /apa/. Design Velar movements in the sagittal and vertical direction were measured by electromagnetic articulography (EMA) while video endoscopy was used for recording in the sagittal and transverse directions. Main outcome Measure A transverse sagittal quotient (TSQ) was defined after the measurement of sagittal and transverse diameters of the velopharyngeal port (VPP) in the video-endoscopic pictures on the basis of a frame-by-frame analysis. Results The sphincter morphology was objectively determined with the TSQ base value. A terminal sphincter deformation (TSD) for closure phases of articulatory movement was revealed by a qualitative shape analysis of the TSQ curves. Conclusions The assessment of the TSQ of velopharyngeal port diameters and the TSD in the terminal closure period lead to a new dynamic interpretation of velopharyngeal closure patterns.
Role of the Superior Pharyngeal Constrictor Muscle in Forced Breathing in Dogs
Authors: Yaman Zekai , Kogo Mikihiko , Senoo Hitomi , Iida Seiji , Ishii Shoichirou , Matsuya Tokuzo 
Published: October 2018

Objective Respiratory-related electromyographic (EMG) activity of the superior pharyngeal constrictor (SPC) muscle was analyzed during the early stage of forced breathing. Design Four adult dogs anesthetized with sodium pentobarbital were used. In the first part of the study, oral and nasal breathing tubes were placed into the respective cavities, and a tracheotomy tube was placed in the second part of the study. Two conditions, the presence (oral-nasal tube breathing) and absence (tracheotomy breathing) of airflow in the upper airway, were achieved in each dog. Following quiet breathing, animals were connected to a closed breathing system, first by an oral-nasal tube and then by a tracheotomy tube. We proposed to induce a forced breathing condition mechanically by using this system for 1 minute. We increased resistance to airflow during forced breathing by means of connecting tubes and a bag. Our aim was not to produce chemical drive but to produce a forced respiration by increasing the resistance to airflow. Tidal volume, breathing frequency, minute volume, chest wall movement, and EMG activity of the SPC muscle were measured and analyzed. Results During quiet breathing through an oral-nasal or tracheotomy tube, low-amplitude EMG activity of the SPC muscle corresponding to the expiratory cycle of the respiration was observed. In both study conditions, phasic expiratory EMG activity increased immediately after the advent of the breathing from the closed system. Tidal volumes and frequencies also increased rapidly during forced breathing. Conclusions An increase in the resistance to airflow increased the activity of the SPC muscle. This augmented respiratory activity probably assists the patency of the upper airway. The augmented respiratory activity was independent of the local reflex pathways. Respiratory-related activity of the SPC muscle may help dilate and stiffen the pharyngeal airway, promoting airway patency.
Gastroesophageal Reflux in Pierre Robin Sequence—Early Surgical Treatment
Authors: Dudkiewicz Zofia , Sekuła Ewa , Nielepiec-Jałosińska Anna 
Published: October 2018

Objective To assess the prevalence of gastroesophageal reflux (GER) in patients with Pierre Robin sequence and to assess whether early palatoplasty with subperiosteal release of the floor of the mouth eliminates upper respiratory tract infections and gastroesophageal reflux. Methods In the period from 1993 to 1997, 24 children with Pierre Robin sequence were treated. Because GER is known to occur in patients with this syndrome, we screened for GER in each child for whom an early palatoplasty was to be performed at 3 months of age. In 21 cases, the presence of GER was confirmed. Within the past 2 years, palatoplasty has been combined with subperiosteal release of the floor of the mouth (SRFM). Prompt clinical improvement and shortened hospital stays have resulted. Results and Conclusions Follow-up studies performed several months after the surgery showed no evidence of GER. The authors conclude that an early closure of the impaired palatopharyngeal ring and the elimination of the mechanism that causes the posterior rotation of the tongue can reduce the need for such surgical procedures as glossopexy, gastrostomy, tracheostomy, and Nissen's fundoplication.
Intrasphenoidal Migration of a Premaxillary Kirschner Wire
Authors: KayikçOǧlu Aycan , Karamüsel Sebat , Mavili Emin , Erk Yücel , Benli Kemal 
Published: October 2018

Objective The use of Kirschner wire for the fixation of premaxilla is a well-known method in bilateral cleft lip surgery. We report a case in which the Kirschner wire of the premaxillary fixation had migrated intrasphenoidally. Results and Conclusions The foreign body was accidentally discovered during a cephalometric analysis and was taken out surgically through an upper lip sulcus incision. Although the wire remained asymptomatic for 10 years, it constituted a potential danger for intracranial migration.
The State of the Art in Cleft Palate Surgery
Authors: Larossa Don 
Published: October 2018

Overview This update focuses on current practices and controversies in surgical repair of the hard and soft palate posterior to the alveolus. Our current understanding of the advantages and disadvantages of presurgical active and passive manipulation of the hard palate shelves including the use of periosteoplasty is reviewed. The evolution of the multiple methods of repair of the hard and soft palate is given in a historical context along with a discussion of the concerns about timing of palate repair.