bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deformations of the Midfacial Complex in Twins with Orofacial Clefts
Authors: Singh G. D. , Kutcipal Elizabeth , McNamara James A. 
Published: October 2018

Objective To investigate the craniofacial morphology in twins with cleft lip and/or palate (OFC) and localize differences, compared with noncleft (NC) twins. Design Retrospective study. Setting School of Dentistry, University of Michigan. Sample Posteroanterior cephalographs of 32 pairs of dizygotic, concordant, like-sexed twins. The NC group consisted of 20 pairs of noncleft twins. The cleft twin (CT) group consisted of 12 pairs of concordant twins (both exhibited OFC). Main Outcome Measures Changes in linear distances, differences in form difference matrices, and visualization of deformations of thin-plate spline (TPS) transformation grids. Results Linear analysis indicated significant reductions in interorbital distance (≈12%; p < .01) and reduced maxillary heights (≈27%; p < .001) in CTs. Euclidean distance matrix analysis strongly supported these findings, confirmed that the form matrices were significantly different (p < .05), and indicated relative decreases in internasal width (≈12%) and maxillary base width (≈10%). The TPS analysis produced a transformation grid that showed superoinferior compression, suggesting that OFC is associated with a downward displacement of the nasomaxillary complex as well as distortion in the region of the maxillary base. Conclusions Twins with orofacial clefts differ from their unaffected counterparts by a midfacial skeletal morphology characterized by decreases in interorbital and internasal widths and relatively shorter maxillary basal heights and widths. Although most of these differences appear to be due to compression and regionalized deformation, the resultant inferior displacement of the medial region of the midface concomitant with horizontal widening in the presumptive palatal region may be a development model associated with OFC.
Posteroanterior Cephalometric Analysis of the Parental Craniofacial Morphology in Orofacial Clefting
Authors: McIntyre G. T. , Mossey P. A. 
Published: October 2018

Objective To evaluate the parental craniofacial morphology in orofacial clefting (OFC). Design Case-control posteroanterior cephalometric study. Setting The Department of Orthodontics, University of Dundee Dental School, Scotland, United Kingdom. Participants Ninety-two parents from a completely ascertained sample of 286 Scottish babies with nonsyndromic OFC and 43 comparison group volunteers from the University of Dundee Dental School. Main Outcome Measures A conventional cephalometric analysis was used to measure linear distances and their ratios, angles, and areas. Two-sample Student's t tests and a discriminant analysis were applied to the data, and the clinically important statistically significant variables were identified using an accepted protocol. Results Sixty-four linear distances, 10 ratios, 52 angles, and 7 areas statistically significantly differed between the parental and comparison groups (p < .01). Of these, 62 linear distances (22%), 9 ratios (45%), 41 angles (41%), and 6 areas (24%) were clinically important. Asymmetry was a feature of the results. Canonical variates analysis correctly classified 91.3% of the parental group and 90.6% of the comparison group using a series of 36 variables. Conclusions The parental craniofacial morphology in OFC differs significantly from the noncleft population. A larger superolateral face and smaller central midface and, in particular, a clinically significantly smaller maxillary width, in conjunction with skeletal asymmetry, characterize the parents of Scottish children with OFC. These features may be of morphogenetic importance in the etiopathogenesis of OFC in this ethnic group.
Shprintzen-Goldberg Syndrome: Case Report
Authors: Topouzelis N. , Markovitsi E. , Antoniades K. 
Published: October 2018

Objective The Shprintzen-Goldberg syndrome is an extremely rare syndrome with a characteristic face. This is one of a group of disorders characterized by craniosynostosis and marfanoid features. The aim of this study was to present a new sporadic case of the syndrome and describe in detail the findings at the maxillofacial region.
Mandibular Distraction Osteogenesis Using an Intraoral Device and Bite Plate for a Case of Hemifacial Microsomia
Authors: Takashima Mariko , Kitai Noriyuki , Mori Yoshihide , Murakami Shumei , Kreiborg Sven , Takada Kenji 
Published: October 2018

Objective To present orthodontic treatment combined with mandibular distraction osteogenesis using an intraoral device and a bite plate in a patient with hemifacial microsomia, severe facial asymmetry, and unilateral mandibular hypoplasia. Patient An 8-year-old girl exhibited mandibular deviation resulting from hypoplasia of the mandibular condyle and ramus on the left side. The patient was treated with an intraoral device for mandibular distraction osteogenesis, bite plate, and hybrid-type functional appliance. Facial asymmetry was improved, and the mandibular ramus was elongated in an anterior and primarily posterior direction with slightly posterior and superior displacement of the proximal segment. Postdistraction treatment results have been stable for 1 year. At the 1-year follow-up, the volume of the lateral and medial pterygoid muscles on the left side had increased. The condyle and disc on the right temporomandibular joint moved well and in harmony at open mouth position, and a rotational movement of the left temporomandibular joint was observed.
The Impact of Cleft Type on Early Vocal Development in Babies with Cleft Palate
Authors: Hardin-Jones Mary , Chapman Kathy L. , Schulte Julie 
Published: October 2018

Objective The purpose of the present investigation was to examine the impact of cleft type on early sound development in children with cleft palate (with or without cleft lip). Participants The participants included 53 babies with unrepaired cleft palate aged 8 to 10 months. Thirty-five babies had cleft lip and palate (CLP) and 18 had cleft palate only (CPO). Main Outcome Measures Spontaneous vocalizations of the CLP and CPO groups were compared to determine whether differences were evident in canonical babbling, size of consonant inventory as well as place and manner of consonant production, and frequency of vocalization. Results Student's t tests revealed no significant differences between the groups in canonical babbling, size of consonant inventory, place and manner of consonant production, or frequency of vocalization. However, there was a trend for babies in the CPO group to produce fewer compensatory stop consonants and more anterior place features. In addition, a larger percentage of children in the CPO group had entered the canonical babbling stage at the time of this study. Conclusions In general, the findings of this study suggested that cleft type does not appear to play a significant role in early consonant development for babies with cleft palate. Additional study using a larger CPO group is recommended to further investigate the trend toward better performance noted in this group.
Early Neuromotor Behavior in Craniosynostotic Rabbits
Authors: Mitchell Ronal L. , Barbano Timothy E. , Losken H. Wolfgang , Siegel Michael I. , Mooney Mark P. 
Published: October 2018

Objective Clinical studies have shown both abnormal and normal mental and psychomotor development in patients with craniosynostosis. However, a number of confounding variables make study comparisons difficult. For these reasons, the present study describes early neuromotor development in an homogeneous rabbit model of craniosynostosis. Design Fifty-three newborn New Zealand white rabbit kits were used: 13 were wild-type, normal control rabbits; 23 had delayed-onset coronal suture synostosis (onset is approximately 57 to 74 days post conception); and 17 had early-onset coronal suture synostosis (onset is approximately 21 to 25 days post conception). All rabbits were observed individually and blindly in an open field, daily for 2 minutes, from birth through the first 14 days of life. The first day of emergence of 10 different mature behaviors and developmental events (in developmental order of appearance: falling, righting, cliff avoidance, first sign of fur, body elevation, head elevation, circling, dragging, eye opening, and hopping) was recorded for each kit. Daily activity levels (grid crossing), and body weights were also recorded. Results Significant group (p < .05) differences were observed in 9 of 11 measures. Both synostosed groups had significantly (p < .05) accelerated onset of behavior in 8 of 9 measures, compared with wild-type controls. The early-onset synostosis group had significantly (p < .05) accelerated onset in five of eight measures, compared with wild-type controls, and three of eight measures, compared with the delayed-onset synostosis group. Conclusions Synostotic rabbits showed precocious neuromotor development possibly through frontal lobe constrictions and altered brain activity from increased intracranial pressure, although primary genetic effects cannot be ruled out.
Cephalometric Assessment of the Posterior Airway Space in Patients with Cleft Palate after Palatoplasty
Authors: Rose Edmund , Thissen Ulrike , Otten Jörg-Elard , Jonas Irmtrud 
Published: October 2018

Objective Upper airway obstruction and mouth breathing influence facial growth and development, which may result in breathing disorders while asleep. The purpose of the present investigation was to analyze cephalometric alterations between patients with cleft palate and a noncleft control group in an obstructive sleep disordered breathing-specific tracing. Setting The study was conducted in the cleft palate clinic of a university hospital. Participants Fifty-three subjects with a mean age of 12.3 ± 3.7 years (range 6.3 to 17.2 years). The cohort included 33 subjects (13 females, 20 males; mean age 12.1 ± 3.8 years, mean body mass index 17.5 ± 2.9 kg/m2) with surgical closure of a unilateral or bilateral cleft palate and a matched control of noncleft participants. None of the subjects suffered from sleep disordered breathing syndrome. Results Compared with the controls, patients with cleft palate had a significant narrow anterior-posterior dimension of the pharynx at the level of the maxillary plane and the narrowest width, a more downward hyoid position, and a longer uvula. Conclusions Patients with cleft palate appear to present pharyngeal and craniofacial distinctive features that characterize patients with obstructive sleep disordered breathing and differ from those of a noncleft control.
Treatment of Scars with Er:YAG Laser in Patients with Cleft Lip: A Preliminary Report
Authors: Francesco Nocini Pier , D'Agostino Antonio , Trevisiol Lorenzo , Bertossi Dario 
Published: October 2018

Objective Although one goal in cleft lip surgery is to avoid serious scarring, residual scars are often observed after primary surgery. The goal of this preliminary report was to present the standardized application of laser technology to reduce the appearance of residual scars. Design Ten patients with scarring after unilateral and bilateral cleft lip surgery were treated with a Dual Mode erbium yttrium-aluminum-garnet laser. This laser was recently introduced and had been used only for cosmetic applications, skin resurfacing, and correction of acne scars. Results An improvement in the clinical appearance of the laser-treated scars was observed after the first treatment, with continued improvement after the second laser session. The clinically observed improvements were corroborated by the patients’ reports concerning satisfaction with the result. Conclusions The combined mechanisms of ablation/coagulation and shrinking of the skin caused by the laser, in addition to observed patient satisfaction and low risk associated with the procedure, suggest that this treatment approach can be effective in the correction of residual scarring in patients with cleft lip.
An Appraisal of Three Methods of Rating Facial Deformity in Patients with Repaired Complete Unilateral Cleft Lip and Palate
Authors: Al-Omari I. , Millett D. T. , Ayoub A. , Bock M. , Ray A. , Dunaway D. , Crampin L. 
Published: October 2018

Objectives To evaluate the reliability of clinical assessment, two-dimensional color transparencies and three-dimensional imaging for evaluating the residual facial deformity in patients with repaired complete unilateral cleft lip and palate (UCLP) and compare the ratings of facial deformity made by health care professionals with those made by lay assessors. Patients and Participant Thirty-one randomly selected subjects aged 10 to 30 years with repaired complete UCLP. Five professionals and five laypersons evaluated each subject's residual cleft-related facial deformity using clinical assessment, two-dimensional color transparencies, and three-dimensional images. Main Outcome Measures The facial deformity of the full face, lip, nose, and midface were scored using a 5-point ordinal scale on two occasions with a 1-month interval. Intra- and interexaminer agreements were calculated from weighted kappa statistics. Bootstrap permutation tests were used to detect any differences in agreement. Results Assessment of facial deformity showed good reproducibility across the three assessment media (κ = 0.42 to 0.83, SE 0.08). Clinical assessment among lay assessors, however, was poor to moderate (κ = 0.16 to 0.58, SE 0.07). For all assessors, there was no difference in the two nonclinical media relative to the standard clinical assessment for assessments of the full face (p = .377). For assessments of the lip or nose, transparency scores were in greater agreement with the clinical scores than were the three-dimensional assessment scores (p = .017 and .011, respectively). For rating the midface, the three-dimensional scores were in greater agreement with the clinical scores than were the color transparencies scores (p = .047). Conclusions In comparison with lay assessors, clinical assessment among professionals was more reproducible. This was not so for nonclinical media. The equivalence of using the color transparencies and three-dimensional media relative to the clinical assessment depends on the region of the face being considered.
Experimental Tooth Movement into Bone Induced by Recombinant Human Bone Morphogenetic Protein-2
Authors: Kawamoto Tatsuo , Motohashi Nobuyoshi , Kitamura Atsushi , Baba Yoshiyuki , Suzuki Shoichi , Kuroda Takayuki 
Published: October 2018

Objective The development of biomaterials for secondary bone grafting to the alveolar cleft, recombinant human morphogenetic protein-2 (rhBMP-2) may have great potential to promote osseous regeneration. The purpose of this study was to investigate the osteoinductive activity of low-dose rhBMP-2 (10 μg/100 μL) and the biological response of newly generated bone to orthodontic stimulation, compared with previous results using high-dose rhBMP-2 (40 μg/100 μL). Method After extraction of the maxillary first premolars, bone defects were surgically created in eight adult beagle dogs using a 5-mm-diameter trepan bar. The rhBMP-2 with a PLGA/gelatin sponge complex (PGS) made of gelatin and polylactic acid polyglycolic acid copolymer was immediately implanted. The osteoinductive activity of rhBMP-2 and tooth movement into the newly generated bone was evaluated based on histological and morphometric examination. Results Dramatic histological and morphometric differences were found in the time course of bone remodeling between low- and high-dose rhBMP-2. The onset of bone remodeling occurred significantly earlier in low-dose rhBMP-2. During experimental tooth movement, in contrast to high-dose rhBMP-2, with which root resorption occurred, only partial cementum resorption occurred on the pressure side with low-dose rhBMP-2. Conclusion These results indicated that the proper dosage of rhBMP-2 should be determined for successful clinical application.
Three-Dimensional Morphology of the Palate in Subjects with Isolated Cleft Palate at the Stage of Permanent Dentition
Authors: Šmahel Zbynek , Trefný Pavel , Formánek Pavel , Müllerová Živa , Peterka Miroslav 
Published: October 2018

Objective Three-dimensional analysis of palate size and shape in patients with isolated cleft palate at the stage of permanent dentition. Design Cross-sectional study using Fourier transform profilometry. Subjects Twenty-nine randomly selected dental casts of approximately 15-year-old boys with isolated cleft palate and 28 dental casts of normal boys of the same age. Interventions All patients were operated on by the same method (pushback and pharyngeal flap surgery) at a mean age of 4.5 years. Main Outcome Measures Data on the palate height in 210 defined locations (pixels). Results The palate in isolated clefts is narrower throughout its whole extent and lower from the level of the first premolars. The difference, as compared with controls, increases in a posterior direction. At the level of the first molars, palatal height is reduced by one-quarter, the area of the transversal section by more than one-third. The shaping of the palate vault is, on average, symmetrical with a marked interindividual variability. Palatal height does not depend on the width of the dentoalveolar arch, and the height of the primary palate is not reduced. Conclusion The smaller width and reduced height from the level of the first premolars posteriorly confirm the substantially reduced space available for the tongue in patients with isolated cleft palate. Deviations are on the average symmetrical, and the anterior part of the palate is not shallower.
The Relationship between the Characteristics of Speech and Velopharyngeal Gap Size
Authors: Kummer Ann W. , Briggs Marianne , Lee Linda 
Published: October 2018

Objective The purpose of this study was to examine the relationship between perceptual characteristics of hypernasality, nasal emission and nasal rustle, and size of the velopharyngeal gap. Design A retrospective medical chart review. Setting Cincinnati Children's Hospital Medical Center. Subjects Subjects were patients of the Craniofacial Anomaly Team. All were between ages 3 and 12 years and diagnosed with velopharyngeal dysfunction secondary to cleft palate ± cleft lip. A total of 173 charts were reviewed. Outcome Measures Speech characteristics were assessed perceptually by an experienced speech-language pathologist. Following that assessment, velopharyngeal closure was evaluated using videofluoroscopy, nasopharyngoscopy, or both. Results Based on the perceptual ratings alone, 21 subjects were diagnosed with nasal rustle only, 27 had hypernasality with nasal rustle, 89 had hypernasality with nasal emission without nasal rustle, and 36 had hypernasality with no audible nasal emission. An ordinal logit regression was conducted and showed that moderate and severe hypernasality contributed significantly to the prediction of a large gap size; nasal rustle contributed significantly to prediction of a small gap size. Perceptual characteristics of speech correctly predicted gap size for 121 of the 173 subjects (70%). Conclusions This investigation revealed that some information regarding velopharyngeal gap size may be predicted from the speech assessment alone. Confidence in the prediction is strongest if the patient has nasal rustle, suggesting a small gap, or if the patient has moderate to severe hypernasality, which is more commonly associated with a large opening.
Use of a Perceptual Evaluation Instrument to Assess the Effects of Infant Orthopedics on the Speech of Toddlers with Cleft Lip and Palate
Authors: Konst Emmy M. , Rietveld Toni , Peters Herman F.M. , Weersink-Braks Hanny 
Published: October 2018

Objective To investigate the effects of infant orthopedics (IO) administered in the first year of life on the speech characteristics of 2.5-year-old children with complete unilateral cleft lip and palate (UCLP) using a perceptual evaluation instrument with equal-appearing interval (EAI) scales. Design In a prospective randomized clinical trial (Dutchcleft), two groups of children with complete UCLP were followed longitudinally. One group received IO based on a modified Zurich approach (IO group), and the other group did not (non-IO group). The appliance was used until soft palate closure at age 12 months. Hard palate closure is delayed until 9 years of age. Participants Three groups of 2.5-year-old toddlers participated in this investigation: 10 IO, 10 non-IO, and 8 noncleft controls matched for age and socioeconomic status. Method Five trained listeners assessed the children's speech in a blinded perceptual rating procedure. They judged 13 specific speech characteristics and indicated their total impression of speech on EAI scales. Results The reliability and consistency of 11 of the rating scales was good. The intelligibility rating scale was the single speech characteristic that distinguished the IO group from the non-IO group; the IO group was judged to be superior. The cleft groups differed from the noncleft group on 9 of the 11 scales. Conclusions Evaluation of speech by means of the present newly developed perceptual rating instrument showed that the IO group obtained significantly higher ratings for intelligibility than the non-IO group. The groups did not differ regarding any of the other speech aspects.
Development of the Orohypopharyngeal Cavity in Normal Infants and Young Children
Authors: Rommel N. , Bellon E. , Hermans R. , Smet M. , De Meyer A-M. , Feenstra L. , Dejaeger E. , Veereman-Wauters G. 
Published: October 2018

Objective To study the growth of the oropharynx and hypopharynx in infants and young children by measuring the lengths of the segments between nasopharyngeal valve and tongue base, tongue base and arytenoids, and arytenoids and upper esophageal sphincter. These measurements will be used as references for developing manofluoroscopy to study deglutition in infants and young children. Patients and Methods Twenty-three children (14 boys, 9 girls) between birth and 4 years of age were prospectively studied. All children had near normal growth parameters and were free of medical illnesses or other major medical conditions that are known to influence the pharyngeal cavity. Lateral videofluoroscopy was used to assess the pharyngeal structures during breathing. All images were digitally recorded and analyzed using a computer program designed specifically for this study. Results and Conclusions Statistically significant correlations were found between the age or height of the patient and the distance from velopharyngeal valve to tongue base and the distance from tongue base to arytenoids, showing a linear increase of the length of the oro- and hypopharynx with age and patient height. There was no significant difference in the pharyngeal distances between boys and girls. On the basis of these results, a linear regression comparison could be established to define the length of each pharyngeal segment for any age until 4 years and for the 50th percentile of height.
Congenital Common Cavity Deformity of Frontal, Ethmoid, and Sphenoid Sinuses
Authors: Tasar Mustafa , Yetiser Sertac , Saglam Mutlu , Tasar Aysın 
Published: October 2018

Objective To present a 17-year-old adolescent patient with lost right eye visual field and intermittent headache since the age of 14 years. The cranium was prominent at the right frontal region. The patient had no history of head trauma or infection and his past medical story was unremarkable. His mental status was normal. Computed tomography scanning revealed an abnormal occurrence of a common cavity deformity of the frontal, ethmoid, and sphenoid sinuses. No other lesions or deformities were present. Such common cavity deformity of these paranasal sinuses has not previously been reported in the English literature.