bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental Development and Learning Disorders in Children with Single Suture Craniosynostosis
Authors: Kapp-Simon Kathleen A. 
Published: October 2018

Objective This study examined the global intellectual development and presence/absence of learning disorders in children with nonsyndromic metopic, sagittal, and unilateral coronal synostosis who had early surgery (under 1 year of age), late surgery (over 1 year of age), or no surgery to correct the synos-tosis across three time periods. Design The design was longitudinal. Children were assessed at initial team evaluation, 1 year after surgery or initial evaluation if surgery was not performed, and annually thereafter. Participants Participants included 84 consecutively evaluated patients. Seventy-two children were evaluated at Time 1 (T1), 8 months; 57 at Time 2 (T2), 21 months; and 39 at Time 3 (T3), 50 months. Data on learning disorders or mental retardation were available on 34 children who were school age. Main Outcome Measures The Mental Development Index from the Bayley Scales of Infant Development was the main outcome measure for T1 and T2. The General Cognitive Index from the McCarthy Scales of Children's Abilities was the main outcome measure for T3. Learning disorders were determined from school and clinical records. Results Repeated measures analyses of variance found no statistical differences in the development of children based on diagnosis or surgical status across time. Base rate of mental retardation at T1 was consistent with normative data; however, the incidence of retardation was two to three times the expected rate at T2 and T3. Learning disorders were present in 47% of school-age children who were not retarded. Chi-square analysis showed no significant differences between rates of retardation or learning disorders based on surgical status. Conclusions Most children with nonsyndromic craniosynostosis obtain developmental quotients within the normal range in infancy. Rates of retardation may increase relative to normative expectations as children mature. A high rate of learning disorders was identified. Results are preliminary due to sample size.
Maxillary Arch Dimensions in Bilateral Cleft Lip and Palate from Birth until Four Years of Age in Boys
Authors: Heidbuchel Kiki L.W.M. , Kuijpers-Jagtman Anne M. , Kramer Gem J.C. , Prahl-Andersen Birte 
Published: October 2018

Objective To describe the development of maxillary arch dimensions in children with bilateral cleft lip and palate (BCLP) during the first 4 years of life and to compare it with that in noncleft children. Design This was a retrospective, mixed-longitudinal study. Setting The study was conducted at the Cleft Palate Center of the University Hospital of Nijmegen. Subjects The sample consisted of 26 boys with BCLP who were born between 1976 and 1990 and treated at the University Hospital of Nijmegen. Data for a control group of 34 noncleft boys were collected at the University Hospital of Amsterdam. Method Palatal arch dimensions were digitized on dental casts. A comparison between BCLP and noncleft dimensions was made at fixed time intervals. Results At birth, anterior and posterior arch widths as well as arch depths were significantly larger in children with BCLP. After 7 months (lip closure), anterior arch width and arch depth diminished considerably in the cleft group. After 12 months (palatoplasty), a slight decrease in posterior arch width was observed, and arch depths showed slight catch-up growth. At 4 years of age, anterior arch width was significantly narrower and anterior arch depth was shorter in children with BCLP than in control subjects. Posterior arch width was significantly wider. Conclusions During the first 4 years of life, maxillary arch dimensions in children with BCLP show a unique development that is significantly different from that in noncleft children.
Surgical Repositioning of the Premaxilla in Combination with Two-Stage Alveolar Bone Grafting in Bilateral Cleft Lip and Palate
Authors: Iino Mitsuyoshi , Sasaki Tomokazu , Kochi Shoko , Fukuda Masayuki , Takahashi Tetsu , Yamaguchi Tai 
Published: October 2018

Objective This paper introduces a surgical technique for premaxillary repositioning in combination with two-stage alveolar bone grafting for the correction of the premaxillary deformity of patients with bilateral cleft lip and palate (BCLP). The paper also reports on two patients with BCLP who underwent this surgical management. Surgical Procedure The operation is usually performed when the patient is 8 to 14 years of age. In the first stage of surgery, the side more accessible to the septopremaxillary junction is selected, and an osteotomy of the premaxilla and unilateral alveolar bone grafting are performed. Approximately 4 to 12 months after the first stage of surgery, contralateral alveolar bone grafting is carried out. Conclusion We have found that this surgical procedure is highly effective, because it ensures the blood supply to the premaxilla and minimizes the potential for surgical failure. Moreover, it affords wide exposure of the premaxillary bone surface, facilitating sufficient boney bridging and allowing for orthodontic tooth movement.
Incidence of Secondary Lip Surgeries as a Function of Cleft Type and Severity: One Center's Experience
Authors: Henkel Kai-Olaf , Gundlach Karsten , Saka Basam 
Published: October 2018

Objective This study was conducted to ascertain the frequency of surgeries typically required to adequately repair a cleft lip. Material All operations performed on patients with clefts of the lip (alveolus and palate) from 1968 to 1990 in the Rostock Cleft Center were evaluated. Methods Procedures were classified as primary labioplasties versus secondary revisions. Patients were also classified according to cleft type, the anatomical segment revised, and the reason for lip revision. Two indices were calculated. The revision index related the number of revisions to the number of primary labioplasties. The index of indication related the number of patients with revisions to the number of primary labioplasties. Results During the period of study, 712 primary labioplasties and 771 secondary revisions were performed. The overall revision index was 1.10. The index of indication varied from 0.28 for unilateral complete clefts of the lip to 0.67 for bilateral complete clefts of the lip. Revision of the lip was the most common secondary procedure, followed by nostril and columella revision, and revision of the oral vestibule. Conclusions The incidence of secondary surgery of the repaired cleft lip (index of indication) of about 35% is similar to previously reported data. However, the incidence varies with cleft type and is required more often with bilateral complete clefts of the lip.
Maxillary Dental Development in Complete Unilateral Alveolar Clefts
Authors: Solis Alex , Figueroa Alvaro A. , Cohen Mimis , Polley John W. , Evans Carla A. 
Published: October 2018

Objective This study was conducted to determine whether development of individual maxillary teeth in subjects with complete unilateral alveolar clefts was significantly different from that found in unaffected children. Design Retrospective, mixed longitudinal. Setting Craniofacial Center, university based. Materials and Methods A sample of 179 panoramic radiographs obtained during the mixed dentition from 79 subjects (47 males, 32 females) with complete alveolar clefts was analyzed. After visual evaluation of root development of the permanent maxillary teeth from radiographs, a score from 0 to 5 was assigned utilizing a predefined scoring system. Statistical analyses were performed between the cleft and unaffected reference groups available in the literature. Results The cleft side dentition was found to be significantly delayed in development relative to the noncleft side (p < .05). Compared to the reference group, the cleft side lateral incisor demonstrated a mean difference in development of 1.59 years followed by the canine (1.39 years), the central incisor (0.96 years), the first premolar (0.94), and the second premolar (0.78). Conclusion Teeth directly adjacent to the cleft site were shown to be the most delayed. The lateral incisors and canines were observed to be the most variable when compared to their corresponding antimeres. The information obtained from this study may assist the orthodontist in selecting the appropriate time to initiate orthodontic treatment in order to prepare the permanent dentition prior to alveolar bone grafting.
Effects of Irradiation and Methyl-Triazene on Craniofacial Development in Mouse Embryos: A Semiautomated Morphometric Analysis
Authors: Glineur R. , Van Sint Jan S. , Louryan S. , Philippson C. , De Maertelaer V. , Evrard L. , Rooze M. 
Published: October 2018

Objective The purpose of the present study was a 2D-semiautomated morphometric analysis of craniofacial growth in nuclear magnetic resonance imaged (NMRI) mouse embryos. Methods The NMRI mouse embryos were exposed in utero to either a single dose of 2 Gy X-irradiation on day 9 of gestation (113 embryos) or to 1.5 mg methyl-triazene administered orally to their pregnant mothers on gestational day 10.5 (124 embryos). An additional group of 108 embryos was used as controls. Digitized pictures of embryos from gestational days 14 to 17 were taken in lateral right view using a video system. Landmarks were located and digitized for computerized analysis of growth changes in relation to developmental stages of the face. Results The results revealed that the snout of control embryos lengthens during the developmental period considered. The snout of embryos previously submitted to methyl-triazene displayed micrognathia, and all treated fetuses exhibited macroscopic signs of microcephaly with a reduced mandible. The snouts of irradiated embryos appeared shortened at the 14-day stage and continued to shorten as development proceeded. A shortening of the midface was detected macroscopically in 83% of the cases. Conclusion The results of this morphometric analysis enabled us to trace the developmental progression of the induced dysmorphosis and to assess the differences compared with normal development.
Classic and Occult Submucous Cleft Palates: A Histopathologic Analysis
Authors: Stal Samuel , Hicks M. John 
Published: October 2018

Objective Although classic and occult submucous clefts have been well described with respect to clinical features and endoscopic findings, there is a paucity of information regarding the histologic characteristics of the midline palatal area and its role in the clefting process. This preliminary study describes the histopathologic features of classic and occult submucosal clefts. Design Twenty-eight patients with classic submucous cleft (12 patients) and occult submucous cleft (16 patients) were available for study. Histopathologic evaluation of two biopsies from each patient (muscular uvulae biopsy; levator muscle bundle biopsy) was performed. Results Submucosal fibrosis with relatively dense collagen deposition was noted in both the musculus uvulae and levator muscle bundle biopsy sites. Individual myocytes and myocyte fascicles were entrapped and encased by fibrotic tissue, resulting in disruption of the fascicular organization. Most fascicles were disrupted by intervening dense collagen bands within and interposed between the fascicles. The myocytes had an atrophic or hypoplastic appearance with cross-sectional diameters ranging from 42% to 61% (mean reduction, 53%) less than those expected for myocytes from normal palates. There was fascicular disorganization with intermixing of longitudinally and cross-sectionally oriented myocyte groups. Minor salivary glands were affected as well with increased collagen deposition between and within lobules of salivary gland tissue. Conclusions This histopathologic study indicates that significant fibrosis is present within submucosal cleft regions and is associated with myocyte atrophy or hypoplasia. The relatively dense fibrosis appears to be a well-organized, chronic process and is present in the absence of significant chronic inflammation. In addition, there is myocyte fascicular disorganization with a haphazard arrangement. This disorderly arrangement may imply that there is a failure of resorption of the epithelial/mesenchymal tissue during palatine shelf closure with retention of mesenchymal tissue that contains the insertion of the velopharyngeal musculature apparatus.
Infant TGF-Alpha Genotype, Orofacial Clefts, and Maternal Periconceptional Multivitamin Use
Authors: Shaw Gary M. , Wasserman Cathy R. , Murray Jeffrey C. , Lammer Edward J. 
Published: October 2018

Objective We previously demonstrated a strong association between periconceptional maternal cigarette smoking, infant transforming growth factor–alpha (TGFa) genotype, and risk of orofacial clefts. Because serum folate may be decreased by cigarette smoking and because maternal periconceptional use of multivitamins containing folic acid has been associated with a reduced risk of clefting, we explored whether a potential relation existed between infant TGFa genotype, maternal multivitamin use, and risk of orofacial cleft phenotypes. Design Data were derived from a population-based case–control study of fetuses and live-born infants among a cohort of 1987 to 1989 California births (n = 548,844). Information concerning periconceptional multivitamin use was obtained via telephone interviews with mothers of 731 (84.7% of eligible) orofacial cleft case infants, and of 734 (78.2%) nonmalformed control infants. DNA was obtained from newborn screening bloodspots and genotyped for the Taq1 polymorphism of TGFa. Among infants of interviewed mothers, genotypes were available for 571 (78.1%) case infants and 640 (87.2%) control infants. Setting The study encompassed all hospitals in selected California counties. Main Outcome Measure The main outcome measures were the risks of specific cleft phenotypes among infants with uncommon TGFa genotypes and whose mothers did not use multivitamins periconceptionally. Results Compared with infants homozygous for the common TGFa genotype and whose mothers used multivitamins, increased clefting risks were observed for infants with the A2 genotype (homozygous or heterozygous) and whose mothers did not use multivitamins. Risk estimates were 3.0 (1.4–6.6 [95% confidence interval]) for isolated cleft lip with or without cleft palate (CLP), 2.4 (0.69–11.6) for multiple CLP, 2.6 (0.97–7.7) for isolated cleft palate (CP), 4.2 (1.3–16.2) for multiple CP, and 8.1 (2.6–27.7) for “known-syndrome” clefts. Clefting risks for infants with the A2 genotype and whose mothers used multivitamins were substantially smaller, as were the risks for infants with the A1 genotype whose mothers did not use multivitamins. Conclusion These data provide preliminary evidence for a gene–nutrient interaction in risk of clefting.
A Retrospective Comparison of Craniofacial Form in Northern Irish Children with Unilateral Cleft Lip and Palate
Authors: Leonard Alan G. , Kneafsey Brian , Mckenna Stephen , Johnston Chris D. , Burden Donald J. , Stevenson Mike 
Published: October 2018

Objective This study evaluated the craniofacial form of a sample of Northern Irish children with unilateral cleft lip and palate (UCLP). The quality of the outcomes achieved was compared with the outcomes reported for the six centers involved in the European multicenter study (Mars et al., 1992; Mølsted et al, 1992). Design Retrospective analysis. Patients All children born with complete skeletal UCLP in Northern Ireland during the years 1983 to 1987. Main outcome Measures Cephalometric analysis was used to determine the craniofacial form and soft tissue profile. The quality of the dental arch relationships was independently assessed using the Goslon ranking system. Results The sample comprised 25 children with complete skeletal UCLP who had cephalometric radiographs and study casts recorded at a mean age of 9.4 years (range, 8 to 11 years). Cephalometric analysis revealed no important skeletal differences between the Northern Irish UCLP children and the published results from the six Eurocleft centers. The soft tissue profile of the Northern Irish UCLP children was significantly more convex than the soft tissue profile recorded for center D in the Eurocleft study. The Goslon ranking system revealed that 18 (72%) of the Northern Irish UCLP children had good or satisfactory dental arch relationships. Conclusions No clinically important differences were detected between the mean cephalometric skeletal parameters of the Northern Irish UCLP children and those published for the six cleft centers involved in the Eurocleft study. On average, the Northern Irish UCLP children were found to differ significantly from Eurocleft's center D in their soft tissue facial contour and sagittal lip profile. The quality of the dental arch relationships of the Northern Irish sample was between the best and the less good Eurocleft centers.
Electromyographic Investigation of Masticatory Muscles in Unilateral Cleft Lip and Palate Patients with Anterior Crossbite
Authors: Li Weiran , Lin Jiuxiang , Fu Minkui 
Published: October 2018

Objective To evaluate the characteristics of masticatory muscle activity in operated unilateral cleft lip and palate (UCLP) patients with anterior crossbite compared with normal individuals. Subjects Sixteen male and 13 female Chinese patients with UCLP and anterior crossbite. Fifteen male and 13 female Chinese individuals without cleft abnormalities served as a control group. Design Electromyographic activity of the masseter muscles and anterior temporalis muscles was recorded bilaterally in different mandibular positions using bipolar surface electrodes. Results Compared to noncleft controls, patients with UCLP demonstrated (1) higher activation levels of masseter and temporalis muscles in the rest position, (2) lower potential function of masseter and temporalis, (3) inharmonious activity of the masticatory muscles during mandibular border movement, (4) a higher asymmetry index of the masseter and temporalis muscles, and (5) longer silent periods of the two muscles. Conclusions The function of masticatory muscles is different in patients with UCLP with anterior crossbite. Muscle function should be considered when evaluating cleft patients for orthodontic treatment and orthognathic surgery.
Muscle Fiber Type Distribution in the Normal Human Levator Veli Palatini Muscle
Authors: Moon Jerald B. , Thompson Sue Ann , Jaeckel Elise , Canady John W. 
Published: October 2018

Objective This study examined the muscle fiber type distribution within the normal adult levator veli palatini muscle. Methods Levator veli palatini muscle tissue was harvested from the palates of 12 (seven female, five male) adult noncleft cadavers. Adjacent sections were stained for adenosine triphosphatase at pH 10.4 or 4.2. After mounting, magnifying, and photographing, Type I versus Type II fiber types were differentiated by the intensity of, or by the inhibition of, staining of matched fibers at each pH level. Type I fibers stained light at pH 10.4 and dark at pH 4.2, while Type II fibers stained light at pH 4.2 and dark at pH 10.4. Main outcome Measures The number of fibers counted for each specimen ranged from 60 to 616. The numbers of Type I and Type II stained fibers appearing in each muscle tissue sample were determined and expressed as a percentage of the total number of fibers identified. A few identified fibers could not be labelled as either Type I or Type II. Results The overall proportion of Type I fibers, averaged across all specimens, was 59.8%. Male specimens had 67.4% Type I fibers and 31.8% Type II fibers, while female specimens had 54.4% Type I fibers and 44.4% Type II fibers. Conclusions Observed fiber type distributions were similar to those reported for other articulatory muscles, but differed slightly from previously reported distributions for normal levator veli palatini. The distributions observed in this study provide a baseline against which to relate fiber type data from the levator veli palatini of cleft palates to the functional status of the velopharyngeal mechanism.
Survey of Dentists' Experience with Cleft Palate Children in Chile
Authors: Dabed Cynthia C. , Cauvi Doris L. 
Published: October 2018

Objective This study was designed to study the experience of dentists with children with palatal clefts seeking treatment in Santiago, Chile. Design A 13-item questionnaire was sent to 203 pediatric and general dentists treating children. Of the 141 dentists who voluntarily completed the questionnaire, 118 were selected for this study. These professionals worked in private and public health centers in the Santiago, Chile, metropolitan area. Results and Conclusions The results showed that a majority of dentists had treated a low number (1 to 3) of cleft palate children in the previous years, using a combination of preventive-curative and radical treatments. Although a majority reported that there were no differences in the treatment of the cleft and noncleft children, a majority had problems during the course of treatment. The results suggest the need for more current information about the care of cleft children.
A Comparison of Two Different Bone-Harvesting Techniques for Secondary Alveolar Bone Grafting in Patients with Cleft Lip and Palate
Authors: Mccanny C.M. , Roberts-Harry D.P. 
Published: October 2018

Objective To compare the outcome of the trephine with open hip surgery for alveolar bone grafting in cleft lip and palate surgery. Design The study was retrospective. The radiographs were assessed blindly and on two separate occasions 1 week apart. Setting University Teaching Hospital. Patients, Participants In one group (group A), a trephine was used; in the other (group B), open hip surgery was employed. Group A was comprised of 16 patients (nine with unilateral and seven with bilateral clefts of the lip and palate) and group B, 13 patients (eight unilateral and five bilateral). The prime entry criterion for inclusion in the study was that the canine tooth had erupted into the graft site. Interventions A long cone periapical radiograph was taken of the erupted canine tooth in the graft site. Main Outcome Measure The radiographs were graded from type I to type IV, as described by Bergland et al. (1986a). A comparison was also made of the eruption of the canine, postoperative morbidity, and length of stay in hospital for each group. Results There was no statistically significant difference in the interdental bone height (p = .61, Mann–Whitney U test). In group A, all patients had a satisfactory clinical outcome (type I or II), and in group B, only one patient had an unsatisfactory result (type III). The spontaneous eruption of the canine and the number of nights spent in the hospital were also similar for both groups. However, no patients in group A suffered postoperative complications, whereas three patients in group B reported either a limp or postoperative infection of the hip. Conclusion Both techniques produced satisfactory repair of the bony defect, but the open hip surgery resulted in greater postoperative morbidity.