bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maxillary Growth following Atelocollagen Implantation on Mucoperiosteal Denudation of the Palatal Process in Young Rabbits: Implications for Clinical Cleft Palate Repair
Authors: Fujioka Masaki , Fujii Tohru 
Published: October 2018

Objective: The implantation of atelocollagen matrix on the denuded surface of palatal bone following cleft palate repair has been used because it enhances wound healing. This study was performed to determine whether the beneficial effect of atelocollagen matrix implantation on the prevention of scar tissue contraction also inhibits the scar's interference with the growth of maxillary bone. Method: Fifty New Zealand White rabbits (aged 4 weeks) underwent palatal mucoperiosteal denudation, and atelocollagen matrix was implanted on the left palatal process. The opposite side was left open as a control. Results: Histopathologically, the implantation side exhibited early infiltration of mononuclear cells and fibroblasts, and better growth of connective tissue strands and epithelium. in addition, the formation of rete ridges were seen that were similar to the normal mucosa. The bone of the atelocollagen-implanted side was covered with regenerated periosteum-like layers, but that of the control side was lined by granulation tissue, suggesting the existence of continuous inflammation on the periosteal region. When the animals reached adulthood (aged 24 weeks), the areas of scars and palatal processes, palatal shelf width, molar teeth incline, and bone mineral contents were measured and compared between sides. The atelocollagen-applied scars showed less contraction, the area and width of atelocollagen-implanted palatal processes showed more satisfactory growth, and the dental arch deformity was suppressed in comparison with the control side. Conclusions: Our results suggest that the use of atelocollagen matrix on the denuded bone surface following cleft palate repair decreases the scar's effect on maxillary growth.
Application of Thiamine in Preventing Malformations, Specifically Cleft Alveolus and Palate, during the Intrauterine Development of Rats
Authors: Bienengräber Volker , Fanghänel Jochen , Malek Fathi A. , Kundt Günther 
Published: October 2018

Objective: Animal experiments were conducted to test the reproducibility of previously documented antiteratogenic effects of thiamine on cleft formation in the craniofacial system. Design: Thirteen gravid Wistar rats carrying 98 fetuses were given the hydrazine derivative procarbacine (200 mg/kg BW) on the fourteenth day postconception (PC) to induce malformations, chiefly cleft alveolus and palate (day of determining presence of sperm was called the first day PC). Seven of the treated gravid rats carrying 48 fetuses were additionally given a daily dose of 200 mg/kg thiamine from the thirteenth to the nineteenth day PC. Outcome Measures: A comparative analysis of the fetuses in both experimental groups was conducted externally and, for the skeleton, macroscopically using special staining techniques; the heads were analyzed using successional histologic sections; bodies were examined stereomicroscopically using the razor-blade sectioning technique. Results: In 12 of the 16 parameters evaluated, no statistically significant differences were found between experimental groups. in some cases, we even observed an amplifying effect of thiamine on the development of malformations in the rat strain used in our study. Conclusions: Because several previous authors have repeatedly described treatment with thiamine as one of the sufficient prophylactic measures in slowing the development of viscerocranial malformations, especially cleft afveolus and palate, it is of utmost importance that the timing of treatment and dosage of thiamine be taken into consideration not only in animal experiments but also when applying results to humans.
Elevated Levels of Transforming Growth Factors Beta 2 and Beta 3 in Lambdoid Sutures from Children with Persistent Plagiocephaly
Authors: Lin Kant Y. , Nolen Amber A. , Gampper Thomas J. , Jane John A. , Opperman Lynne A. , Ogle Roy C. 
Published: October 2018

Objective: To analyze the pertinent history and physical findings specific to the subset of patients with a progressive posterior skull deformity, requiring surgery to correct their deformity. Patients: Since the Academy of Pediatrics issued its recommendation on supine positioning of infants to prevent sudden infant death syndrome (SIDS) in 1992, 73 children have presented to the University of Virginia Craniofacial Anomalies Clinic with posterior-skull deformities. The majority were successfully managed with conservative therapy, but in six patients, the deformity was severe and persistent, requiring surgical correction. All six children were older (7.5–12 mo), presenting with more severe morphologic appearances and a higher incidence of associated neurodevelopmental delay. Three had family backgrounds of isolated craniosynostosis. Methods: Characteristics of these patients were examined to determine why they may have differed from those that responded to conservative management. Immunohistochemical staining of their lambdoid sutures was performed. Results: Significantly increased staining for TGF-ß2 and TGF-ß3, potent stimulators of bone cell growth and differentiation, was seen in all ‘affected’ sutures from the flattened side of the skull, compared to unaffected sutures from the protruding side of the skull—a pattern similar to that seen during normal bony obliteration of calvarial sutures. Conclusion: The majority of patients with posterior plagiocephaly associated with positioning responded to conservative management, while a small subset of patients with persistent posterior skull deformation required surgical intervention. A genetic basis for the latter patients’ persistent plagiocephaly, rather than positioning, cannot be ruled out. Genetics, prolonged external pressure against the sutures, or a combination of these factors may lead to permanently raised levels of growth factors in ‘affected’ sutures.
Breast Feeding for Cleft Lip and Palate Patients, Using the Hotz-Type Plate
Authors: Kogo Mikihiko , Okada Gen , Ishii Shouichirou , Shikata Megumi , Iida Seiji , Matsuya Tokuzo 
Published: October 2018

Objective: Oral-cavity feeding movements were analyzed during sucking and used to modify a Hotz-type plate to facilitate sucking in infants with cleft lip and palate. Design: Sucking movements were analyzed using lateral view cine radiography as three adults fed from a bottle. A Hotz-type plate was then modified to better isolate the oral cavity and to occlude the oral airway. The plate was then utilized indirect breast feeding by 10 babies. Outcome Measures: Sucking rate, amount of milk taken, and duration of use of the plate were assessed. Results: Wearing this plate, four babies with cleft lip and palate could suck their mother's breast, drinking about 22 g/trial. Conclusions: Although supplemental bottle feeding was required to provide enough nourishment, this is the first step to reaching ideal breast feeding situation for these patients.
The Lambda Flap for Secondary Cleft Lip Repair
Authors: Tange Ichiro 
Published: October 2018

Objective: A modified Abbe flap of the lambda figure type, designed by the author and used before or after secondary cleft lip repair in 146 consecutive cases since 1990 is described. Design: This series consisted of 71 cases with unilateral deformity and 75 cases with bilateral deformity at adolescent or adult ages. The technical details of this method and representative cases with the results are shown. The philtrum is created by incising the two branches of the lambda flap obliquely at 45 degrees to the skin surface in the lower lip, then matching them in the central recipient bed of the deficient upper lip. Results and Conclusions: The resultant upper lip is not only full and slack, but also attractive with an acute cubic contour of the philtrum. Furthermore, the residual scar at the donor site is concealed in the mentolabial fold.
Self-Perceived Facial Appearance and Psychosocial Adjustment in Preadolescents with Craniofacial Anomalies
Authors: Pope Alice W. , Ward Johanna 
Published: October 2018

Objective: To identify aspects of psychosocial adjustment related to the self-perceived facial appearance of preadolescents with craniofacial abnormalities. Design: Concurrent relationships were evaluated using a within-group correlational design. Participants: Participants were 24 patients, aged 11 to 13, of a major craniofacial center and their parents who were contacted by telephone and agreed to participate. Main Outcome Measures: Self-report and parent-report questionnaires assessing psychosocial adjustment. Results: Self-perceived facial appearance was positively correlated with global self-worth, self-perceived social acceptance, and number of same-sex close friends, and negatively correlated with loneliness, parent-rated social problems, and parental advice/support and concern (all p's < .05 or better). Conclusions: Dissatisfaction with facial appearance was associated with peer relationship problems and low global self-esteem, but not with other aspects of self-concept or other types of adjustment problems.
Mandibular Asymmetry in Noncleft and Unilateral Cleft Lip and Palate Individuals
Authors: Laspos Christodoulos P. , Kyrkanides Stephanos , Tallents Ross H. , Moss Mark E. , Subtelny J. Daniel 
Published: October 2018

Objective: The purpose of this study was to retrospectively investigate mandibular asymmetry in unilateral cleft lip and palate individuals (UCLP) in relation to chronologic age and in relation to lower facial asymmetry. Design: The longitudinal records of 34 UCLP individuals and 142 controls treated in the Department of Orthodontics, Eastman Dental Center, Rochester, NY, were included in the study. Posteroanterior and oblique cephalometric radiographs were analyzed for lower facial asymmetry and mandibular asymmetry, respectively. Mandibular asymmetry in UCLP was analyzed relative to three age groups (6–10, 11–14, and 15 or greater) and compared to controls. Moreover, mandibular asymmetry was analyzed relative to lower facial asymmetry. Results: UCLP individuals showed no significant differences in mandibular asymmetry compared to controls. In addition, no significant correlation was found between mandibular asymmetry and lower facial asymmetry in UCLP. Conclusions: The degree of mandibular asymmetry in UCLP appears not to be the major contributing factor to the lower facial asymmetry noted on these individuals. Possible cranial-base/temporal-region anomalies may be involved in unilateral cleft lip and palate and be responsible of the asymmetry noted in the lower facial skeleton.
Craniofacial Morphology of Conotruncal Anomaly Face Syndrome
Authors: Kitano Ichiko , Park Susam , Kato Kogo , Nitta Naotsugu , Takato Tsuyoshi , Susami Takafumi 
Published: October 2018

Objective and Design: The conotruncal anomaly face syndrome (CTAF) comprises congenital heart disease and dysmorphic face, and is frequently associated with cleft palate or hypernasality. There have been many discussions about the overlap with velocardiofacial syndrome (VCF). The aim of this study was to clarify the craniofacial characteristics of CTAF patients by clinical examination, and photogrammetric and cephalometric analyses, and to clarify the differences compared to published data on VCF. Results: The facial features of CTAF included hypertelorism, small palpebral fissures, upward slanting of palpebral fissures, bloated eye lids, low nasal bridge, small mouth, open mouth at rest, and malformed auricles. Cephalometric features included bialveolar protrusion, small gonial angle, backward rotation of the mandibular ramus, and labial inclination of the maxillary incisors. An acute cranial base angle was also noted. These results differed from those of VCF. There were, however, no obvious pathognomonic findings for the differential diagnosis between CTAF and VCF. Conclusions: Considering these findings, use of CATCH 22, the inclusive classification of cardiac anomalies, cleft palate, and dysmorphic face may be of value for the clinical understanding in these patients.
Comparative Survey of Osteotomized and Nonosteotomized BCLP Patients
Authors: Lisson Jörg A. , Tränkmann Joachim 
Published: October 2018

Objective: At Hannover Medical School, treatment of BCLP patients was revised and updated in 1980. The objective of the present study was to evaluate the differences in treatment outcome between BCLP patients treated after the revised concept including infant orthopedics, and BCLP patients who received osteotomy in addition to surgical and orthodontic treatment during childhood. Patients: Nine of 48 BCLP patients born between 1980 and 1983 received surgical and orthodontic treatment according to the Hannover concept. They were compared to 9 of 68 adolescent and adult patients from Hannover without this protocol, who underwent maxillary osteotomy and consecutive orthodontic treatment. Main Outcome Measures: Comparison of the two groups was made at the end of active orthodontic treatment by cast analysis and lateral cephalometrics to evaluate sagittal, transverse, and vertical changes. Results and Conclusions: No patient treated using the revised protocol showed characteristics of skeletal angle class III at any stage of investigation. No indication for osteotomy was found in this group. All patients with osteotomy had skeletal angle class III resulting from insufficient midfacial growth. Sagittal and vertical skeletal relations were successfully improved by osteotomy.
Sagittal Position of the Left and Right Maxillary Segment in Children with Cleft Lip and Palate
Authors: Ras Frank , van Aalten Laura , Janse Arina , Mobers Shell , Prahl-Andersen Birte 
Published: October 2018

Objective: The purpose of the present study was to investigate left-right differences in the sagittal position of the maxillary segments in children with cleft lip and palate. Method: The sample consisted of children with operated cleft lip or cleft lip and alveolus [CL/CLA (n=16) mean age, 9.3 yr], operated unilateral cleft lip and palate [UCLP (n=27) mean age, 9.1 yr], and operated bilateral cleft lip and palate [ [BCLP(n = 17) mean age, 9.5 yr]. Computed tomography (CT) horizontal slices of the maxilla were obtained and used to determine the sagittal position of the left and right segment of the maxilla in relation to the mandibular rami and the cranial base. Significant effects were analyzed with multivariate analyses of variance (MANOVA). Results and Conclusions: It was concluded that, in contrast to children having CL/CLA or UCLP, children with BCLP showed left-right differences in the sagittal position of the maxillary segments. The segment on the left side was more posteriorly positioned compared to the right side. Because the same results were obtained in relation to the mandibular rami as well as in relation to the cranial base, it can be assumed that the position of these rami are not affected by the different types of oral clefts.
Testing for Interaction between Maternal Smoking and TGFA Genotype among Oral Cleft Cases Born in Maryland 1992–1996
Authors: Beaty Terri H. , Maestri Nancy E. , Hetmanski Jacqueline B. , Wyszynski Diego F. , Vanderkolk Craig A. , Simpson Jennifer C. , McIntosh Iain , Smith E. Anne , Zeiger Joanna S. , Raymond Gerald V. , Panny Susan R. , Tifft Cynthia J. , Lewanda Amy F. , Cristion Connie A. , Wulfsberg Eric A. 
Published: October 2018

Objective: Infants born in Maryland between June 1992 and June 1996 were used in a case-control study of nonsyndromic oral clefts to test for effects of maternal smoking and a polymorphic genetic marker at the transforming growth factor alpha (TGFA) locus, both of which have been reported to be risk factors for these common birth defects. Design and Setting: Cases were infants with an oral cleft ascertained through three comprehensive treatment centers, with additional ascertainment through a registry of birth defects maintained by the Maryland Health Department. Controls were healthy infants. Medical history information on infants and mothers were collected, along with DNA samples Patients, Participants: Among 286 cases contacted (72% ascertainment), there were 192 nonsyndromic isolated oral clefts (106 M; 86 F) available for this case-control study. Main Outcome Measures: The largest group of 149 Caucasian nonsyndromic cases and 86 controls was used to test for association with maternal smoking and genotype at the Taq1 polymorphism in TGFA. Results: While this modest sample had limited statistical power to detect gene-environment interaction, there was a significant marginal Increase In risk of having an oral cleft If the mother smoked (odds ratio = 1.75, 95%CI = 1.01 to 3.02). We could not demonstrate statistical interaction between maternal smoking and TGFA genotype in this study, however, and the observed increase in the C2 allele among cases was not statistically significant. Conclusions: We could not confirm either the reported association between oral clefts and TGFA genotype or its interaction with maternal smoking. However, these data do show an increased risk if the mother smoked during pregnancy, and this effect was greatest among infants with a bilateral cleft and no close family history of clefts.
Formation and Enlargement of the Paranasal Sinuses in Normal and Cleft Lip and Palate Human Fetuses
Authors: Smith Timothy D. , Siegel Michael I. , Mooney Mark P. , Burrows Annie M. , Todhunter John S. 
Published: October 2018

Objective: Comparisons of paranasal sinus morphology between humans with and without cleft lip and palate (CLP) have yielded conflicting opinions regarding size differences. Although postnatal samples have been investigated, no studies have compared paranasal sinus volumes between cleft and noncleft human fetuses. Method: The nasal cavities of 20 ‘normal’ and 9 CLP human fetuses (8–21 weeks’ postmenstrual age) were examined to assess prenatal volumetric changes of the maxillary sinuses, anterior and posterior ethmoidal air cells, and sphenoidal sinuses. Lengths and volumes of right and left maxillary and sphenoidal sinuses were calculated from histologically prepared sections using a computer reconstruction technique, and regression equations were generated to assess the enlargement rates. Results: All paranasal sinuses were found among both normal and CLP specimens in the same locations and in similar age ranges. However, greater shape asymmetry was noted for all sinuses in CLP compared to normal specimens. In the normal sample, results indicated significant (p < .05) correlations between right or left maxillary sinus length (R2 = 0.49, 0.54) and volume (R2 = 0.67, 0.68), and increasing postmenstrual age, but no significant (p > .05) correlations were observed for right or left sphenoidal sinus length or volumes and postmenstrual age. Maxillary sinus length changes were best described by second-order polynomial regression equations, and volume changes were best described by logarithmic equations. When individual right or left sinuses of CLP specimens were compared to the mean of the normal sample, one maxillary sinus was significantly (p < .05) larger, and 9 maxillary sinuses were not significantly (p > .05) different. Sphenoidal sinus lengths and volumes of CLP specimens were within the same range compared to these dimensions for the normal sample. Conclusion: Results on normal specimens indicate that maxillary sinuses exhibit second-trimester length and volume increases, whereas sphenoidal sinuses are more variable. This study suggests a similar timing of sinus formation in normal and CLP fetuses, but shape asymmetries are frequently detected among CLP specimens. In particular, the sphenoidal sinuses may be altered in shape and size by adjacent, hypertrophic cartilaginous structures in CLP fetuses. These results indicate that the maxillary sinuses of CLP fetuses are not deficient in size compared to noncleft fetuses.
Examination of Craniofacial Morphology in 10-Month to 5-Year-Old Children with Cleft Lip and Palate
Authors: Casal Carmen , Rivera Alejandro , Rubio Germán , Sentís-Vilalta Joan , Alonso Alfonso , Gay-Escoda Cosme 
Published: October 2018

Objective: The purpose of this study was to assess craniofacial growth In children from 10 months to 5 years of age with cleft lip and/or palate and to develop a systematic method of cephalometric measurements. Design: A case-control study. Setting: Craniofacial unit of a teaching hospital for children. Patients: A consecutive series of the first 22 patients with cleft lip and/or palate who underwent early reconstructive treatment [isolated cleft lip (CL) 6; isolated cleft palate (CP) 7; unilateral cleft lip and palate (UCLP) 7; and bilateral complete cleft lip and palate (BCLP) 2] (mean age, 27.9 months) and 22 age- and sex-matched noncleft children. Interventions: Lateral cephalometric headfilms of the children were taken using a pediatric cephalostat. Main Outcome Measures: Cephalometric landmarks were measured according to Ricketts cephalometry. Results: As compared with controls, CL patients had a lingual position and inclination of maxillary and mandibular incisors, an increase of interincisal angle and a decrease of incisor overjet, an increase in facial convexity, and a decrease in facial depth and mandible body length. In CP patients, palatal plane inclination and mandible arch were significantly reduced. In UCLP patients, there was a decrease in molar relation and incisor overbite, an increase in interincisal angle, reduced position and inclination of maxillary incisors and inclination of mandibular incisors, an increase in facial convexity, and lower facial height. Conclusions: Based on the absence of midface growth reduction, these short-term results suggest a tendency toward normal maxillomandibular growth.
Effect of Temporary Closure of Oronasal Fistulae on Levator Veli Palatini Muscle Activity
Authors: Tachimura Takashi , Hara Hisanaga , Koh Hideyasu , Wada Takeshi 
Published: October 2018

Objective: The objective of this study was to clarify electromyographically the effects of closing an oronasal fistula on levator muscle activity and oral air pressure in patients with velopharyngeal incompetence and in those with adequate velopharyngeal function. Subjects: Five patients with adequate velopharyngeal function and six patients with velopharyngeal incompetence were studied. All subjects had an oronasal fistula at the anterior third portion of the hard palate in spite of primary palatal closure using palatal push-back operation. Outcome Measures: The smoothed electromyographic activity of the levator veli palatini muscle was measured with the fistula closed with a cotton swab dipped in saline and with the fistula left open. Results: Under the closed fistula condition, oral air pressure was greater than that observed under the open fistula condition irrespective of velopharyngeal function. Levator veli palatini muscle activity was significantly lower in magnitude under the condition of closure than under the open condition in the patients with adequate velopharyngeal function, whereas in those with velopharyngeal incompetence, it was not significantly changed. Conclusions: The results suggest that velopharyngeal function is affected by temporary closure of an oronasal fistula, and that the magnitude of the effect is greater for subjects with adequate velopharyngeal function than for subjects with velopharyngeal incompetence.