bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Alveolar Cleft Bone Grafting—State of the Art
Authors: Eppley Barry L. , Sadove A. Michael 
Published: October 2018

Overview Bone grafting of the alveolus is an essential step in the reconstruction of the orofacial cleft deformity. Secondary grafting with iliac marrow consistently produces trabecular bone to unify the maxilla and provide odontogenic support. It requires preoperative maxillary alignment, well designed mucoperiosteal flaps, and good oral hygiene to be optimally successful. Its high success rate currently makes it the preferred approach at most centers. Primary grafting with rib results in a unified maxilla, eliminates the oronasal fistula, and does not adversely affect midfacial growth. It assists in preventing maxillary segmental collapse, particularly in the bilateral cleft patient. Whether it can produce enough alveolar bone to support long-term odontogenic needs awaits further clinical documentation in the limited numbers of centers that routinely perform this procedure.
A Method of “Unilateral Operation” for Early Repair of Unilateral Complete Cleft Palate. Preliminary Report
Authors: Song Ruyao , Song Yeguang , Liu Cunming , Ma Haihuan , Zhao Yu , Zhao Ru , Fang Zhen 
Published: October 2018

Objective This article describes a method of “unilateral operation” and the preliminary results of a group of patients with unilateral complete cleft palate undergoing the operation at early age. Design The “unilateral operation” consists of four relaxation maneuvers. After all of the four maneuvers have been performed on the deformed side of an unilateral complete cleft palate, the deformed side can be moved posteriorly and medially to contact with the normal side. Then the cleft can be closed without tension. Results From 1995 to 1998, 19 cases of unilateral complete cleft palate were repaired with this method at 5–12 months of age. Postoperatively, there were no deaths nor dehiscences. Under the care and guidance of an experienced speech pathologist, 15 of 17 of these children have normal vocal quality at 1–2 years of age. Conclusions The “unilateral operation” is a rational, adequate, and safe method for early repair of unilateral complete cleft palate. It's design addresses four principles. First, operating only on the deformed side of a unilateral complete cleft palate leaves the normal side unperturbed. Second, complete relaxation of the deformed side is achieved before closing the cleft. Third, in comparison with conventional procedures, which operate on both sides of the palate, this method has the advantage of less surgical trauma, less blood loss, and shorter time of operation. Fourth, all of these advantages are beneficial to early cleft palate repair, which is an important factor in achieving good speech.
A Comparison of the Effects of Veau-Wardill-Kilner Palatoplasty and Furlow Double-Opposing Z-Plasty Operations on Eustachian Tube Function
Authors: Güneren Ethem , Özsoy Zafer , Ulay Mithat , Eryilmaz Erhan , Özkul Haluk , Geary Philip Michael 
Published: October 2018

Objective The purpose of this study was to compare the effects of Veau-Wardill-Kilner (VWK) two-flap palatoplasty and Furlow double-opposing Z-plasty operations on eustachian tube (ET) opening in patients with cleft palate (CP). Design Twenty-six patients underwent CP repair between 1993 and 1997. VWK and Furlow operations were used in 13 patients each. All patients were examined by the otorhinolaryngologist before and after the operations; mean follow-up time was 27.3 months. Secretory otitis media (SOM), as identified by tympanograms, was the comparison criterion used. Results The prevalence of SOM was 69% (n = 18) in all CP patients pre-operatively. Among those with preoperative SOM, we did not find any statistically significant difference in the frequency of postoperative SOM between the two techniques. Conclusion This study suggests that there is no difference in postoperative ET function between patients undergoing either VWK or Furlow operations, in spite of the differences in muscle positioning in these operations. We discuss the implications of this finding in relation to surgical anatomy and histology of the soft palate muscles.
Prevalence of Intranasal Ectopic Teeth in Children with Complete Unilateral and Bilateral Cleft Lip and Palate
Authors: Medeiros Alexandra Sárzyla , Gomide Marcia Ribeiro , Costa Beatriz , De Carvalho Carrara Cleide Felicio , Neves Lucimara Teixeira Das 
Published: October 2018

Objective The objective of this study was to determine the prevalence of ectopic eruption of intranasal teeth. Design This was a retrospective study, where records of children with repaired cleft lip and palate were analyzed. Setting The study was conducted at a large craniofacial center, the Hospital for Rehabilitation of Craniofacial Anomalies, USP, Bauru, São Paulo, Brazil. Subjects The sample consisted of 815 records from patients with bilateral cleft lip and palate (BCLP) and 1495 records from patients with unilateral cleft lip and palate (UCLP). The age of the subjects was 5 to 10 years old and the groups included both males and females. Results The results showed that 0.61% of the children with BCLP and 0.40% of those with UCLP had an intranasal tooth. The prevalence of an intranasal tooth for the whole group was 0.48%, and it appeared to be more common in females.
Comparative Study between Children with and without Cleft Lip and Cleft Palate, Part 1: Cephalometric Analysis
Authors: Zúñiga Claudia , Miralles Rodolfo , Carvajal Raúl , Ravera María José , Contreras Paula , Cavada Gabriel 
Published: October 2018

Objective This study was conducted to compare craniofacial relationships, position, and curvature of the cervical spine between children with cleft lip and cleft palate who had been operated on and children without clefts. Method This study was performed in 28 children with mixed dentition. They were divided into two groups. The study group included 14 children with unilateral operated cleft lip and cleft palate, ranging in age from 6 to 12 years, who clinically presented with a short upper lip, abnormal lip seal, and inhibition of sagittal development of the midface that was radiographically assessed. The control group included 14 children without clefts, ranging in age from 8 to 11 years. All of them had normal lip seal, nasal breathing, and a clinically normal body posture. Design A lateral craniocervical radiograph in a self-balanced natural head position in an erect posture, and without using a head holder, was taken for each child of both groups, with the mandible in maximum intercuspation and lips in habitual posture. The true vertical was marked on all the films. Specific angular and linear dimensions were used to assess the craniocervical relationships, as were the position of the cervical spine, its curvature, or both. Results and Conclusions The study group presented a significant increase in the extension of the head on the neck, forward position of the cervical spine, and a decrease in the curvature of the cervical spine in comparison with the children without clefts. These results are more relevant considering that the study group also presented higher significant values of lower facial height than children without clefts.
Orthodontic Treatment for a Patient with Pierre-Robin Sequence Complicated by Juvenile Periodontitis
Authors: Okada Kinya , Yamashiro Takashi , Tenshin Satoru , Takano-Yamamoto Teruko 
Published: October 2018

Objective To arrest the advancement of periodontitis. Patient A 17-year-old boy diagnosed with Pierre-Robin sequence at birth exhibited localized juvenile periodontitis. Severe bone loss and mobile teeth were localized in the incisors and molars, which were irregularly positioned, possibly associated with a residual scar from palatoplasty for a soft palate cleft at an early age. Conclusion Combined orthodontic-periodontic-prosthodontic treatment arrested the advancement of the periodontitis and established a stable occlusion.
Speech and Language Issues in the Cleft Palate Population: The State of the Art
Authors: Kuehn David P. , Moller Karlind T. 
Published: October 2018

Objective State-of-the-art activity demands a look back, a look around, and, importantly, a look into the new millennium. The area of speech and language has been an integral part of cleft palate care from the very beginning. This article reviews the development and progression of our knowledge base over the last several decades in the areas of speech; language; anatomy and physiology of the velopharynx; assessment of velopharyngeal function; and treatment, both behavioral and physical, for velopharyngeal problems. Method The clear focus is on the cleft palate condition. However, much of what is reviewed applies to persons with other craniofacial disorders and with other underlying causes of velopharyngeal impairment. A major challenge in the next several years is to sort through speech disorders that have a clear anatomic underpinning, and thus are more amenable to physical management, versus those that may be treated successfully using behavioral approaches. Speech professionals must do a better job of finding and applying ways of treating individuals with less severe velopharyngeal impairment, thus avoiding the need for physical management in these persons or ignoring the speech problem altogether. Conclusion Early and aggressive management for speech and language disorders should be conducted. For most individuals born with cleft conditions, a realistic goal should be normal speech and language usage by the time the child reaches the school-age years.
Standardization of 3-D CT Measurements for Length and Angles by Matrix Transformation in the 3-D Coordinate System
Authors: Kitaura Hideki , Yonetsu Koichi , Kitamori Hideki , Kobayashi Kazuhide , Nakamura Takashi 
Published: October 2018

Objective We attempted to establish a new 3-D cephalometry with helical computed tomography (CT) by introducing the matrix transformation of the 3D coordinate system. Subjects and Methods Three-dimensional cephalometric landmarks on the craniofacial bones were expressed as 3-D vectors originating from the center of the sella. These vectors were standardized by the matrix transformation so that the midsagittal plane and cranial base line coincided with the XZ plane and X axis of the 3-D coordinate system, respectively. We also applied this new method to trace the normal growth of the craniofacial bones in 44 patients with head and neck cancer (age range, 5 to 26 years; 19 women and 25 men). Results The accuracy for length measurements was less than 3% of standard error of means with a slice thickness of 1 or 3 mm for 28 out of the 29 length measurements recorded. The precision errors by repeated measurements were 0.8% to 1.0% coefficients of variation for intra- and interobserver variability. Standardization of 3-D vectors representing the cephalometric landmarks allowed us to assess successfully the age-related transition of these landmarks of the patients' craniofacial bones. Conclusion A new assessment method for 3-D CT cephalometry has been developed by standardizing cephalometric landmarks using a matrix transformation of the 3-D coordinate system. This new assessment method may offer potential in planning plastic and reconstructive surgery.
Linkage Analysis of Candidate Regions in Swedish Nonsyndromic Cleft Lip with or without Cleft Palate Families
Authors: Wong Fung Ki , Hagberg Catharina , Karsten Agneta , Larson Ola , Gustavsson Maria , Huggare Jan , Larsson Catharina , Teh Bin Tean , Linder-Aronson Sten 
Published: October 2018

Objective To analyze linkage of five candidate regions for nonsyndromic cleft lip with or without palate (CLP) on chromosome 2p13, 4q, 6p23, and 19q13; in addition chromosome 1q32, the locus for van der Woude syndrome, on Swedish CLP families. Design Three to five linked microsatellite markers were selected from each candidate region. Polymerase chain reaction (PCR) with fluorescent-labeled microsatellite markers was performed on DNA samples from the participating families. Electrophoresis of the PCR products was performed on a laser-fluorescent DNA sequencer. The genotype data were analyzed with multipoint linkage analysis. Modes of inheritance tested included two autosomal dominant, an autosomal recessive, and a nonparametric model. Multipoint logarithm of odds (LOD) scores were also calculated by assuming genetic heterogeneity. Participants Nineteen Swedish multigenerational families with at least two first-degree relatives affected with CLP. Greater than 50% of the families studied show vertical transmission of the clefting phenotype and both inter- and intrafamilial variability were noted. Results Cumulative multipoint LOD scores for the whole group of families calculated under autosomal dominant modes of inheritance were negative in all regions and less than −2 except chromosome 6p23. LOD scores calculated under recessive inheritance and the nonparametric model were inconclusive. There was no significant evidence of genetic heterogeneity among the sample group. Conclusions The group of Swedish CLP families did not demonstrate significant linkage to any of the five candidate regions examined. This might suggest a new but yet unknown CLP locus or loci in this family group. However, because linkage could not be excluded in some individual families, they should still be tested with candidate genes from these regions.
The Relationship between Temporal Aspects of Oral-Nasal Balance and Classification of Velopharyngeal Status in Speakers with Cleft Palate
Authors: Jones David L. 
Published: October 2018

Objective The purpose of this investigation was to determine whether temporal patterns of oral-nasal balance differentiate speakers with cleft palate who exhibit adequate and inadequate velopharyngeal function. Design The Nasal Accelerometric Vibrational Index (NAVI) was used to measure the time course and amplitude of oral-nasal balance during the productions of syllables, words, and sentences. The measures obtained include mean amplitude, time integral (area under the curve), absolute duration, relative duration, rise time, and fall time. Participants The subjects for this study were 20 children with repaired cleft palates with or without cleft lip. Ten children (aged 5 through 18 years) were assigned to the velopharyngeal competence (VPC) group (normal oral-nasal resonance, no nasal emission of air). Ten children (aged 3 through 19) were assigned to the velopharyngeal insufficiency (VPI) group (hypernasal speech, velopharyngeal gap observed via nasal endoscopy). Results Both mean amplitude and time integral of NAVI were greater in the VPI group than in the VPC group (p < .01). Absolute duration and relative duration of the NAVI signal were greater in the VPI group (p < .01). NAVI rise time was shorter in the VPI group (p < .01), and NAVI fall time was longer in the VPI group (p < .01). The amplitude measures contributed the most to discrimination of speaker group, but the durational measures become increasingly influential as a function of a speech task. Conclusions Although amplitude of nasalization may have the strongest perceptual salience in classification of velopharyngeal status, the temporal component may exert greater influence during more complex speech tasks.
Facial Growth in Adulthood after Primary Periosteoplasty or Primary Bone Grafting in UCLP
Authors: Sameshima Glenn T. , Šmahel Zbyněk 
Published: October 2018

Objective The primary research aim of this study was to compare long-term differences in craniofacial morphology at adulthood between two groups of unilateral cleft lip and palate (UCLP) patients: one operated by primary periosteoplasty and the other by primary bone grafting. Design The two groups were followed longitudinally at 5-year intervals; this study examined the 15- to 20-year age range. Setting University hospital/center located in Prague, Bohemia, Czech Republic. Patients 17 men with primary bone grafting, 29 men with primary periosteoplasty. Interventions Primary bone grafting or periosteoplasty. Methods Serial cephalometric radiographs. Main outcome Measures Conventional cephalometric and finite element measures. Results The mandibular symphysis was larger in the bone-grafted group. The periosteoplasty group displayed a more horizontal growth of the mandible with less rotation than the bone-grafted group. There were no other significant differences. Conclusions We conclude that the original outcomes differences observed in childhood and adolescence were masked by skeletal and dental compensations in adulthood. These observations can be attributed to both natural growth and clinical intervention.
Vascular Endothelial Growth Pattern of Endochondral Bone Graft in the Presence of Demineralized Intramembranous Bone Matrix—Quantitative Analysis
Authors: Chow K.M.C. , Rabie A.B.M. 
Published: October 2018

Objective To determine the timely ingrowth of new blood vessels of composite endochondral (EC) bone and demineralized bone matrix (DBM) prepared from intramembranous (IM) origin (EC-DBMIM) and to compare it with EC bone graft alone. Design Thirty-two rabbits with 32 critical-size (10 × 5 mm), full-thickness bony defects in rabbit parietal bone were divided into two groups: composite EC-DBMIM group—mplanted with compositeautogenousEC bone and DBMIM; EC bone group—mplanted whEC bone alone. Two rabbitsfrom each group were sacrificed 1, 2, 3, 4, 5, 6, 7, and 14 days after grafting. Neovascularization was assessed by immunohistochemical staining with antihuman angiogenesisrelated endothelial cell antibodies (EN 7/44). Quantitative analysis of neovascularization, represented by percentage area of positive immunohistochemical staining, was performed on 320 sections of the experimental groups by a computer-assisted image analyzer. Results Positive immunohistochemical staining was first identified on day 2 post grafting for the composite EC-DBMIM group in comparison with day 4 in the EC bone graft group. The composite EC-DBMIM bone graft group showed earlier and almost 100% more neovascularization when compared with the EC bone graft group. Conclusion DBMIM enhances healing and integration of EC bone graft by enhancing vascularization as well as increasing the amount of new blood vessels formed. In clinical cases in which EC autogenous bone is used to graft a large defect such as in cleft palate and craniofacial surgery, DBMIM should allow better integration and healing of the EC bone graft to the host bone.
An Investigation of the Dentition of Parents of Children with Cleft Lip and Palate
Authors: Haria S. , Noar J.H. , Sanders R. 
Published: October 2018

Objective The aim of this investigation was to identify whether any dental features in parents of children with cleft lip and palate can be useful as predictors of clefting. Methods The dentition of 28 pairs of parents of children with complete unilateral (17) and bilateral (11) cleft lip and palate and 21 pairs of parents of noncleft children were evaluated. Clinical and radiographic examinations were carried out to identify abnormalities of tooth number and morphology. Study cast assessment was undertaken to evaluate incisor relationship, overjet, over-bite, intercanine widths, and mesiodistal widths of individual teeth, and these data were subjected to statistical analysis. Results The prevalence of abnormalities of tooth number in parents of cleft children was similar to those reported elsewhere for general populations. In parents of children with unilateral clefts, there was no tooth-size asymmetry between teeth on the side corresponding to the child's cleft and noncleft sides, respectively. No differences were found in tooth widths and intercanine widths between parents of children with unilateral clefts and parents of children with bilateral clefts. The incisor relationship, overjet, overbite, and intercanine widths were found not to differ statistically between the parents of cleft children and parents of noncleft children. Conclusions No predictors of clefting could be identified in the dentition of parents of children with cleft lip and palate.
Evaluation of Primary Dentition in Cleft Lip and Palate Children with and without Natal/Neonatal Teeth
Authors: Cabete Haline Farha , Gomide Marcia Ribeiro , Costa Beatriz 
Published: October 2018

Objective Natal/neonatal teeth are very common in children with complete unilateral and bilateral cleft lip and palate. The extraction of these teeth is the usual treatment in the Hospital for Rehabilitation of Craniofacial Anomalies. The objective of this study was to verify whether these teeth could be of the normal complement or whether they were supernumerary. Design The primary dentition of children with cleft lip and palate with and without natal/neonatal teeth was compared at the Hospital for Rehabilitation of Craniofacial Anomalies. Subjects The sample consisted of 55 children with complete unilateral and bilateral cleft lip and palate with natal/neonatal teeth and 54 without. Results No positive association between these groups and missing lateral incisor or supernumerary or complete dentition was found. Conclusion The extraction of the natal/neonatal teeth did not alter the final complement of primary teeth, and these teeth could be the lateral incisor or supernumerary.
Double Tongue, Intraoral Anomalies, and Cleft Palate—Case Reports and a Discussion of Developmental Pathology
Authors: Britto J.A. , Ragoowansi R.H. , Sommerlad B.C. 
Published: October 2018

Objective Isolated cleft palate is the most common presentation of the non-syndromic cleft lip/palate combinations and is multifactorial in etiology. We report two cases of children with clefts of the secondary palate coexistent with double tongue and in either case mandibular epulis or superiorly displaced salivary gland. Results and Discussion In each case, the palatal cleft correlated anatomically with the intraoral space–occupying lesion. The ratio of tongue volume to intraoral volume during palatogenesis is discussed with reference to the pathogenesis of cleft palate. These clinical cases propose the model of a unifying sequence of developmental events whereby deformation of palatal shelf elevation results in secondary palatal clefting.
A Possible Otological Complication Due to Maxillary Expansion in a Cleft Lip and Palate Patient
Authors: Aizenbud Dror , Hefer Tsila , Rachmiel Adi , Figueroa Alvaro A. , Joachims Henry Z. , Laufer Dov 
Published: October 2018

Objective We present a possible negative side effect of a sudden onset of secretory otitis media in a 12-year-old boy with unilateral cleft lip and palate who underwent maxillary expansion. The secretory otitis media caused a temporary hearing loss developed during the activation of the expander appliance. The possible causes for this complication are discussed. Conclusions Clinicians should be aware of the possible association between maxillary expansion and secretory otitis media.
Treacher Collins Syndrome: Current Evaluation, Treatment, and Future Directions
Authors: Posnick Jeffrey C. , Ruiz Ramon L. 
Published: October 2018

Objective Treacher Collins syndrome (TCS) is an inherited disorder in which there are bilateral symmetric anomalies of the structures within the first and second branchial arches. In general, there is complete penetrance and variable expressivity of the trait. The craniofacial rehabilitation of a child with TCS is tailored to the extent of the deformities involved: the orbitozygomatic region, the maxillomandibular region, the nose, facial soft tissues, and external and middle ear structures. Conclusion This article reviews the range of clinical features and specific dysmorphology observed in TCS. Functional and aesthetic objectives are discussed, and a comprehensive staged reconstructive approach is outlined, which may be used as a roadmap for treatment planning.