bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differentiation between Cleft Lip with or without Cleft Palate and Isolated Cleft Palate Using Parental Cephalometric Parameters
Authors: Mossey Peter A. , Mccoll John H. , Stirrups David R. 
Published: October 2018

Objective The purpose of this study was to identify and compare lateral cephalometric measurements in noncleft parents of children with cleft palate (CP) and cleft lip (CL), and cleft lip and palate (CLP). The hypothesis was that discriminant analysis would enable identification of morphometric features that predispose to orofacial clefting and that differ for CP, CL, and CLP and are unevenly distributed within parental pairs. Design This was a prospective, parametric analysis. Setting The study was conducted by the Department of Dental Health, University of Dundee, and the Department of Statistics, University of Glasgow, Scotland. Subjects From a completely ascertained sample of 286 children with cleft lip and/or palate born in the West of Scotland between January 1, 1980, and December 31, 1984, a sample of 83 parents of children with nonsyndromic clefts volunteered for lateral cephalometric examination. Methods Thirty-seven cranial and 99 facial landmarks were identified and 37 linear, angular, and area parameters were used to describe the craniofacial skeleton. Analysis of variance was used for a three-way comparison of CL/CLP/CP, and stepwise discriminant analysis was used to determine which variables discriminate best between cleft lip with or without cleft palate [CL(P)] and isolated cleft palate (CP) parents. Results There were no significant differences whatsoever in the craniofacial morphology between the parents of children with CL and CLP, but differences were found between the CL(P) and CP groups. The most significant of these were in mandibular length, ramus length, mandibular area, and cranial area. Mandibular ramus length alone discriminated between the two groups in 71.4% of CP and in 62.5% of CL(P) cases, while separate analysis of fathers and mothers showed that ramus length and cranial height together reliably distinguish between mothers in 75% of CP and 80% of CL(P) cases. Conclusions Previous studies suggests that unaffected parents with nonsyndromic children with cleft lip and/or palate have differences in their craniofacial morphology when compared to the general population. This study indicates that these morphologic features differ for CP and CL(P).
Effects of Vitamin B6 on Beta-Aminoproprionitrile–Induced Palatal Cleft Formation in the Rat
Authors: Jacobsson Catharina , Granström Gösta 
Published: October 2018

Objective This study was conducted to evaluate the effects of β-aminoproprionitrile and vitamin B6 on palatal clefting. Method In four groups of pregnant Sprague-Dawley rats, β-aminoproprionitrile (BAPN; 600 mg/kg b.w.) was given by gavage on embryonal day 15, 7 hours to induce palatal clefts. Vitamin B6 (10 mg/kg b.w., IM) was given twice on embryonal day 14, 7 hours and on day 15, 7 hours. The possibility that the food's content of vitamin B6 affected the results was also tested. Palatal cleft formation was divided Into four different grades, ranging from no cleft formation to total cleft formation. Results/conclusion It was found that BAPN induces cleft palate in rat fetuses and that this defect can be prevented both in number and severity by administration of vitamin B6 before and simultaneously with BAPN.
Comparison of the Reliability of Craniofacial Anatomic Landmarks Based on Cephalometric Radiographs and Three-Dimensional CT Scans
Authors: Kragskov Jens , Bosch Carles , Gyldensted Carsten , Sindet-Pedersen Steen 
Published: October 2018

Objective Conventional cephalometry is an inexpensive and well-established method for evaluating patients with dentofacial deformities. However, patients with major deformities, and in particular asymmetric cases are difficult to evaluate by conventional cephalometry. Both two- and three-dimensional computed tomography (CT) have been proposed to alleviate some of these difficulties. Only a few studies using metallic markers have indicated 3-D CT to be a useful diagnostic method, whereas no studies have evaluated the reliability of the anatomic cephalometric points used in 3-D CT. The aim of our study therefore was to compare the reliability of anatomic cephalometric points from conventional cephalograms and 3-D CT. Methods Nine human dry skulls were CT scanned. In addition standard lateral and frontal cephalograms were obtained. The CT scans were 3-D image reconstructed, and the cephalometric points were recorded as x, y, and z co-ordinates by two investigators. Computerized cephalometrics were performed on the lateral and frontal cephalograms. Intra- and interindividual variations were calculated for each method and tested for statistical significance. Results Lateral cephalogram measures were more reliable than 3-D CT, with interobserver variations less than 1 mm for most points compared to about 2 mm for 3-D CT. Lateral cephalometrics also showed significantly less interobserver variation for six variables. This was, however, less obvious when 3-D CT was compared to frontal cephalograms. Frontal cephalometrics showed significantly less interobserver variation for three of the investigated variables. Conclusions For standard lateral and frontal cephalometric points, there is no evidence that 3-D CT is more reliable than the conventional cephalometric methods in normal skull, and the benefit of 3-D CT cephalometric is indicated to be in the severe asymmetric craniofacial syndrome patients, as conventional cephalometrics is known to be inferior in these cases.
Effect of Septal Perforations on Measures of Nasal Resistance
Authors: Guyette Thomas W. , Smith Bonnie E. 
Published: October 2018

Objective The purpose of this investigation was to determine the effect of septal perforations on posterior and anterior rhinomanometric measures of nasal resistance In an analog model. Design The data were analyzed using a repeated-measures ANOVA. Nasal resistance was the dependent variable, while type of rhinomanometry, septal perforation size, and position of resistance (proximal vs. distal) were nominal scale independent variables. Participants The analog model used in this study was similar to that described by Warren and Devereux (1966), except that the nasal cavities of the model were modified to create septal perforations. Outcome Measures The main dependent measure was nasal resistance. Results An important finding of this investigation was that septal perforations resulted in large differences (> 3 cm H2O/L/sec) between posterior and anterior nasal resistance values in the bilateral proximal resistor condition. Conclusions Anterior rhinomanometry may underestimate true nasal resistance when a septal perforation Is present, because the septal perforation prevents accurate measurement of nasopharyngeal pressure. Posterior rhinomanometric measures should accurately reflect nasal resistance despite septal perforations, because the perforation does not invalidate the estimate of nasopharyngeal pressure.
Congenital Bony Syngnathia: A Proposed Classification
Authors: Dawson Kenneth H. , Gruss Joseph S. , Myall Robert W.T. 
Published: October 2018

Objective Congenital bony syngnathia is an extremely rare condition characterized by bony fusion of the jaws. Five new cases are described and the existent literature is reviewed. A classification system is proposed and treatment recommendations based on this classification are presented.
Early Maxillary Orthopedics in a Child with an Oblique Facial Cleft
Authors: Stellzig Angelika , Basdra Efthimia K. , Mühling Jochen , Komposch Gerda 
Published: October 2018

Objective Oblique facial clefts are extremely rare. In view of their variabilty, surgical treatment cannot be standardized. To date, early maxillary orthopedics in the treatment of oblique facial clefts have not been reported. The case described here presents a newborn child with a Tessier 3 cleft. Because of the enormous width of the alveolar cleft, a narrowing of the segments was regarded as prerequisite for definitive lip closure. To bring the segments together, an actively working plate with a forward pull was designed. Conclusion After a period of 4 weeks, proper alignment and proximity of the segments were achieved, so that definitive lip closure and plastic reconstruction of the remaining soft tissue defect could be easier performed.
Freeman-Sheldon Syndrome: Case Management from Age 6 to 16 Years
Authors: Ohyama Kimie , Susami Takafumi , Kato Yoshiyuki , Amano Hiromi , Kuroda Takayuki 
Published: October 2018

Objective This is the first description of long-term follow-up of a case of Freeman-Sheldon syndrome. Microstomia was treated with a mouth expander for 2 to 3 hours per day before active orthodontic treatment. Separate impressions were necessary in each quadrant of both upper and lower jaws because of limited mouth opening. Conclusion Orthodontic treatment improved the patient's Class II malocclusion, which was accompanied by crowding and a deep bite.
Velopharyngeal Incompetence as the Presenting Symptom of Malignant Brainstem Tumor
Authors: Lefaivre Jean-François , Cohen Steven R. , Riski John E. , Burstein Fernando D. 
Published: October 2018

Objective When a patient presents with velopharyngeal incompetence (VPI) without an obvious structural or neurologic cause, the clinician is faced with a diagnostic challenge. We present an 11-year-old male with a long history of VPI who had been referred to our institution for evaluation and treatment. Results Detailed clinical examination and work-up revealed a malignant brain-stem tumor. The presenting symptoms of breathiness associated with VPI had been overlooked by several different clinicians in the past. The patient successfully underwent a sphincter pharyngoplasty. Conclusions A careful neurologic examination with special attention to the cranial nerves is necessary to identify subtle neurologic deficits and avoid delay in diagnosis. Differential diagnosis of neurogenic VPI is discussed.
Maternal Cigarette Smoking and Oral Clefts: A Meta-analysis
Authors: Wyszynski Diego F. , Duffy David L. , Beaty Terri H. 
Published: October 2018

Objective A meta-analysis was performed to estimate the association between maternal cigarette smoking and the risk of having a child with a nonsyndromic oral cleft (NSOC). Design Studies published from 1966 through 1996 were retrieved using MEDLINE, Current Contents, bibliographies, and other sources. MEDLINE and Current Contents search terms included “oral clefts,” “cigarette smoking,” “birth defects,” and “congenital malformations.” Cohort and case-control studies that enrolled oral cleft patients [cleft lip with or without cleft palate (CL/P), cleft palate (CP), or both] and controls, and presented information on maternal cigarette exposure during pregnancy were included in the analysis. Descriptive and outcome data from each study were independently abstracted by two authors. Results The overall odds ratio of the 11 studies satisfying criteria was 1.29 [95% confidence interval (CI), 1.18 to 1.42] for CL/P and 1.32 (95% CI: 1.10 to 1.62) for CP, Indicating a small increased risk of having a child with either a CL/P or a CP for mothers who smoke during the first trimester of the pregnancy. Conclusions These analyses suggest a small but statistically significant association between maternal cigarette smoking during the first trimester of gestation and increased risk of having a child with a CL/P or CP.
Embryologic Features of Term Fetuses and Newborns in CL/Fr Mice with Special Reference to Cyanosis
Authors: Kadowaki Shingo , Sakamoto Michiko , Kamiishi Hiroshi , Tanimura Takashi 
Published: October 2018

Objective The objective of this study was to clarify the embryologic features of CL/Fr mice in relation to cyanosis. Method Orofacial examinations were conducted on 18-day-old term fetuses and newborns. Except for open eyelids in a few cases, all of the external abnormalities in this strain were cleft lip and/or palate (CLP). Results The CLP incidence in term fetuses was 28.4%. The body and placental weights were not different between CLP(+) and CLP(-) fetuses. Several types of CLP were found; the most frequent was bilateral complete CLP (60%) followed by left complete (16%). Bilateral complete CL, which is the most severe CL type, was associated with poorly developed secondary palate and wide cleft. In newborns, 39.4% of CLP(+) mice showed cyanosis, where no CLP(-) mice had such signs. The body weight of cyanotic mice with CLP was significantly lighter than that of noncyanotic mice with CLP. Cyanotic mice had severe types of CLP and unelevated palatal shelves. Conclusion We suggest that mechanical airway obstruction may be one of the causes of cyanosis in newborn CL/Fr mice.
Development of Infants and Toddlers with Clefts from Birth to Three Years of Age
Authors: Neiman Gary S. , Savage Hallie E. 
Published: October 2018

Objective The purpose of this study was to use caregiver report measures to describe the developmental status of infants and toddlers with clefts. Method Developmental assessment data were obtained on 186 infants and toddlers with cleft lip (n = 48), cleft palate (n = 46), and cleft lip/palate (n = 92) at one of the following age categories: 5 months (n = 47), 13 months (n = 46), 25 months (n = 47), and 36 months (n = 46). Developmental assessment measures used were the Kent Infant Developmental Scale and the Minnesota Child Development Inventory, both caregiver reports. Data were analyzed in separate 2-between ANOVAs (age x cleft type) for each developmental domain according to developmental assessment measure. Further, results were examined relative to the normative sample. Results The ANOVA results indicated that at 5 months, lower motor and self-help developmental quotients (DQs) were evident compared to the 13-month-old level. When compared to the normative sample, the 5-month-old infants exhibited ‘at-risk/delayed’ development on the motor, self-help, and cognitive domains, and as reflected on their full-scale scores, depending on the cleft type. Infants at 13 and 25 months were within normal limits in all developmental domains, with the exception of the 13-month-old infants with cleft palate, who demonstrate ‘at-risk’ development in the motor domain. At 36 months of age, all toddlers demonstrated significantly lower developmental performance in the fine motor, gross motor, and expressive language domain compared to the 25-month-old toddlers. Toddlers with cleft palate exhibit ‘at-risk/delayed’ development in the expressive language domain at 36 months. Conclusion Data are discussed relative to the events surrounding team management of clefts, Including surgery, middle-ear problems, and feeding difficulty.
Satisfaction with Facial Appearance among Subjects Affected by a Cleft
Authors: Thomas Peter T. , Turner Sarah R. , Rumsey Nicky , Dowell Tom , Sandy Jonathan R. 
Published: October 2018

Objective This study examined the satisfaction of patients with clefting and their parents with facial appearance and how this alters with age. The relationship between satisfaction with appearance and psychosocial functioning was also examined. Design Prospective Setting Subjects were recruited for the study from nine hospital-based clinics. Patients, Participants All subjects had some type of cleft and were 10, 15, or 20 years of age. In all, 111 subjects with clefting and 62 parents were included. Main Outcome Measures Facial appearance was rated on a subjective ordinal scale of 1 to 7; psychosocial adjustment was measured with the Childhood Experience Questionnaire. Results Self-satisfaction with appearance among the 10- and 15-year-old subjects correlated with their psychosocial adjustment (p = .027). The 20-year-old subjects were, on average, significantly more satisfied with their appearance than the 10- and 15-year-olds (p = .009 and p = .012, respectively). However, some 20-year-old subjects remained greatly dissatisfied with aspects of their facial appearance. Subjects with visible anomalies were significantly more dissatisfied with their appearance than subjects with invisible anomalies (p = .035). The 15-year-old subjects were identified as being significantly more dissatisfied with appearance than their parents (p = .005). Conclusions Subjects affected by a cleft with visible Impairments are more dissatisfied with their facial appearance than are subjects with invisible impairments. Satisfaction with facial appearance among 10- and 15-year-old subjects with a cleft may be associated with their self-reported levels of psychosocial functioning. Measuring self-satisfaction with appearance may help to identify subjects at risk from adjustment problems.
Mandibular and Maxillary Asymmetry in Individuals with Unilateral Cleft Lip and Palate
Authors: Laspos Christodoulos P. , Kyrkanides Stephanos , Tallents Ross H. , Moss Mark E. , Subtelny J. Daniel 
Published: October 2018

Objective This study was conducted to evaluate the degree of maxillary and mandibular asymmetry in the verticle and transverse planes seen in posteroanterior cephalometric radiographs relative to chronologic age in postoperative complete UCLP patients compared to controls. Method Mandibular and nasomaxillary asymmetry was retrospectively studied in complete unilateral cleft lip and palate (UCLP) and noncleft individuals (controls) by means of posteroanterior cephalometric analysis. All the UCLP patients available (total 40) and randomly selected noncleft controls (total 142) were Included in the study. The UCLP patients had undergone lip and palate reconstruction in Strong Memorial Hospital, University of Rochester, Rochester, New York, and orthodontic treatment in the Department of Orthodontics, Eastman Dental Center, Rochester, New York. The controls were selected based on the age that treatment was initiated and were treated in the department for various malocclusions; none had undergone maxillary expansion or surgical treatment. The asymmetry assessed on mixed longitudinal records of the patients with UCLP was analyzed relative to three chronologic age groups and compared to the controls. In addition, mandibular asymmetry was correlated to maxillary asymmetry in UCLP individuals to investigate possible growth patterns between the two jaws. Results Mandibular asymmetry in UCLP individuals was found to increase with growth and time and peaked at post-pubertal growth-spurt stages. The cleft subjects were more asymmetric than controls in all stages of growth. Mandibular asymmetry followed the affected maxilla closely, indicating a parallel growth pattern of the jaws. Conclusion The unilateral cleft lip and palate patients manifested asymmetry of the mandible. This asymmetry develops in a parallel pattern with the affected maxilla, suggesting that early evaluation and treatment of the anomalies in the nasomaxillary skeleton as well as in the mandible is necessary when treating unilateral cleft lip and palate individuals.
The Jaw Index: New Guide Defining Micrognathia in Newborns
Authors: Van Der Haven Ibo , Mulder J. Wiebe , Van Der Wal Karel G.H. , Hage J. Joris , De Lange-De Klerk Elly S.M. , Haumann Th. J. 
Published: October 2018

Objective Newborns with glossoptosis due to micrognathia can suffer from life-threatening respiratory distress and severe feeding difficulties. These characteristic features are found in newborns with Pierre Robin sequence. In the relevant literature, no concensus concerning diagnosis for these childern can be found. A guide defining micrognathia can be helpful in the diagnosis of glossoptosis and possible airway obstruction. Method The jaw index is obtained in newborns by measuring three facial dimensions. In a series of 100 healthy neonates the standard measures were defined. Results The average jaw index in children with Pierre Robin sequence differs significantly from the reference group and was found to be over 3.6 times the normal value. Conclusions Micrognathia can be defined with the Jaw index.
Robin Sequence: Obstructive Sleep Apnea following Pharyngeal Flap
Authors: Abramson David L. , Marrinan Eileen M. , Mulliken John B. 
Published: October 2018

Objective We reviewed 24 children with Robin sequence who underwent cleft palate repair. Method All patients were 5 years of age or older at the time of review, allowing for accurate assessment of speech in relation to velopharyngeal function. All infants had palatal closure between 9 and 14 months of age, either V-Y repair (n = 16) or von Langenbeck repair (n = 8). Results Only 1 of 16 children who had V-Y repair had borderline velopharyngeal dysfunction (VPD). For reasons that are unclear, in the von Langenbeck repair group, six of eight children had VPD, and four of six underwent pharyngeal flap. Three additional patients with nonsyndromic Robin sequence had palatoplasty and subsequent pharyngeal flap. Six of the combined total of seven children with nonsyndromic Robin sequence developed obstructive sleep apnea and required flap take-down. Conclusion Since conventional pharyngeal flap for VPD in nonsyndromic Robin sequence children resulted in a high incidence of obstructive sleep apnea, alternative management should be considered: modification of the standard pharyngeal flap, palatal lengthening (V-Y or double-opposing Z-plasty), or construction of a speech bulb.
Relationship between Lower-Lip Fistulae and Cleft Lip and/or Palate in Van der Woude Syndrome
Authors: Onofre Mirian Aparecida , Brosco Heli Benedito , Taga Rumio 
Published: October 2018

Objective This study was conducted to evaluate the relationship between fistulae of the lower lip and cleft lip and/or palate in patients with Van der Woude syndrome. Methods The medical records of 11,000 patients with cleft lip and/or palate registered at the Cleft Lip-Palate Research and Rehabilitation Hospital, University of São Paulo, Bauru were reviewed. Of these patients, 133 (1.2%) presented with Van der Woude syndrome. Results Of the 133 patients, 88 (66.2%) exhibited full clefts, 22 (16.5%) only cleft lip, and 23 (17.3%) only cleft palate. The lower-lip fistulae observed in these 133 patients were bilateral symmetric in 66 (49.7%), bilateral asymmetric in 42 (31.6%), microform In 19 (14.3%), median in 5 (3.8%), and unilateral in 1 (0.7%). Conclusion This population sample appears to exhibit the previously published tendency for bilateral, unilateral, or mixed-type congenital fistulae to be associated with cleft lip with or without cleft palate, while so-called microforms or conic elevations are almost exclusively associated with cleft palate.
Location of Alveolar Clefts Relative to the Incisive Fissure
Authors: Lisson Jörg A. , Kjær Inger 
Published: October 2018

Objective: The purpose of this study was to investigate, in a normal human fetal sample, the development of the anterior area of the palate. Emphasis has been placed on the bilateral epithelial fusion lines between the soft-tissue palatal shelves and the premaxillary mucosa, and on the relationship between these fusion lines and the locations of the incisive fissures and of the tooth buds. The goal was to evaluate how the location of clefts in cleft lip and palate (CLP) patients interferes with tooth buds that are often affected in clefting. Design: Nineteen maxillas of human fetuses underwent histologic examination after serial horizontal sectioning. Superimpositions of tracings from photographs of the histologic sections yielded information on the maxillary morphology at different levels. Results: After elevation and fusion of the soft-tissue palatal shelves, the palatal fusions were Y-shaped. During subsequent osseous palate development, including formation of the incisive fissure and intermaxillary suture, the Y-shaped epithelial fusions disintegrated. The locations of the anterior arms of the epithelial Y and of the incisive fissure did not coincide. Conclusions: The incisive fissure is likely not the location of clefts in CLP. The location of anterior palatal clefting in CLP patients follows the original course of the epitheilal fusion between the palatal shelves and the premaxillary mucosa found in the region of the lateral incisors.