scholarly journals The Difference in Cervical Vertebral Skeletal Maturation between Cleft Lip/Palate and Non-Cleft Lip/Palate Orthodontic Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Waeil Batwa ◽  
Khalid Almoammar ◽  
Aziza Aljohar ◽  
Abdullah Alhussein ◽  
Saad Almujel ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Skeletal Maturity ◽  
Skeletal Maturation ◽  
Growth Spurt ◽  
Male Population ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
Orthodontic Patients ◽  
Saudi Male

Objective. The aim was to evaluate differences in the cervical vertebral skeletal maturity of unilateral cleft lip and palate (UCLP) and non-cleft lip/palate (non-CLP) Saudi male orthodontic patients. Method. This cross-sectional multicenter study took place at the dental school, King Saud University and King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, between October 2014 and September 2015. The records of Saudi male orthodontic patients with UCLP n=69 were collected. Cervical vertebral maturation was assessed using their cephalometric radiographs. The records of 138 age-matched non-CLP Saudi male orthodontic patients served as controls. Results. There was a significant difference in skeletal maturity between the UCLP and non-CLP groups, as evident in the delayed skeletal development among the UCLP participants. Moreover, pubertal growth spurt onset was significantly earlier in the non-cleft participants in comparison with the UCLP participants p=0.009. Conclusions. There is delayed skeletal maturity among the UCLP Saudi male population in comparison with their non-CLP age-matched peers.

Mandibular Asymmetry and Antigonial Notching in Individuals with Unilateral Cleft Lip and Palate

2002 ◽  
Vol 39 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Stephanos Kyrkanides ◽  
Liubov Richter
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Facial Asymmetry ◽  
Skeletal Maturation ◽  
Growth Spurt ◽  
Pubertal Growth Spurt ◽  
Panoramic Radiographs ◽  
Pubertal Growth ◽  
Mandibular Asymmetry ◽  
Orthodontic Patients

Objective To determine whether asymmetric antigonial notching is associated with the development of mandibular and lower facial asymmetry in individuals with unilateral cleft lip and palate (UCLP). Design Retrospective mixed-longitudinal investigation including UCLP and nonaffected orthodontic patients. Participants All (24) available patients with UCLP treated in our clinic with complete longitudinal records, and 72 skeletal maturation matched noncleft orthodontic patients that served as controls. Subject records included hand-wrist, panoramic, frontal, and 45° oblique cephalometric radiographs. Main outcome Measures The development of mandibular asymmetry, measured on oblique cephalometric radiographs, as well as lower facial asymmetry, measured on frontal cephalometric radiographs, was monitored in individuals with UCLP in relation to antigonial notching asymmetry, assessed on panoramic and oblique cephalometric radiographs. Results First, no statistical differences were found in antigonial notching asymmetry between patients with UCLP and noncleft controls. Second, antigonial notching asymmetry, observed on panoramic and oblique cephalometric radiographs, significantly correlated with the attendant development of mandibular and lower facial asymmetry in individuals with UCLP. Third, the development of mandibular and lower facial asymmetry at pubertal and post-pubertal growth spurt stages significantly correlated with antigonial notching asymmetry, measured on panoramic radiographs, at prepubertal and pubertal growth spurt stages, respectively. Conclusions The degree of antigonial notching noted on panoramic radiographs can be used as an early indicator of developing mandibular and lower facial asymmetry in individuals with UCLP.

Asymmetries of the Upper Lip and Nose in Noncleft and Postsurgical Unilateral Cleft Lip and Palate Individuals

1996 ◽  
Vol 33 (4) ◽  
pp. 306-311 ◽  
Author(s):  
Stephanos Kyrkanides ◽  
Ron Bellohusen ◽  
J. Daniel Subtelny
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Skeletal Maturation ◽  
Growth Spurt ◽  
Growth Stages ◽  
Upper Lip ◽  
Significant Difference ◽  
The Difference ◽  
Small Change ◽  
And Control

The purpose of this study was to retrospectively evaluate post-surgical asymmetries of the upper lip and nose in complete unilateral cleft lip and palate individuals using documentation collected over a period of years. Twenty-three complete unilateral cleft lip and palate subjects (UCLP) and 34 noncleft subjects who served as controls and had undergone orthodontic treatment were Included in the study. Nasal asymmetry, deviation of the tip of the nose, and the deviation of the midpoint of the vermilion border of the upper lip were compared to chronologic age and skeletal maturation in cleft subjects and controls. Comparison between cleft and control cases was also assessed. Results indicate that nasal asymmetry peaks at postpubertal growth stages in the control groups, and the difference between UCLP and controls decreases with time and maturation. The deviation of the nasal tip peaks during the pubertal growth spurt for both UCLP and controls, and the difference between UCLP and controls also decreases with time. The deviation of the midpoint of the vermilion border shows relatively small change with time and maturation, and there is no significant difference between UCLP and controls. In general, the facial asymmetries studied were not as great as expected, and the difference between UCLP and controls decreased with time, growth, and maturation.

scholarly journals Physiological maturation stage of cervical vertebrate index in cleft lip/palate and non-cleft lip/palate patients

2019 ◽  
Vol 4 (3) ◽  
pp. 149
Author(s):  
Wenti Komala ◽  
Endah Mardiati ◽  
Eky Soeria Soemantri ◽  
Isnaniah Malik
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cervical Vertebrae ◽  
Maturation Stage ◽  
Lateral Cephalogram ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
Stage Transition ◽  
Maturation Index ◽  
Cervical Vertebral Maturation

Cleft lip and palate is one of the most common congenital anomalies. Cleft lip and palate patients encounter growth problems in lip and palate area, although their overall growth and development remains unknown. Cervical vertebral maturation are indicators of physiological maturation used in interceptive treatment and orthognathic surgery. The present study aims to determine physiological maturation stage of cervical vertebrae maturation index in cleft andnon-cleft patients. Lateral cephalogram of 26 cleft patients and 27 non-cleft patients with a range of chronological age from 8-16 years old were involved. The cervical vertebrae maturation were analyzed in six stages of cervical vertebrae maturation method of Hassel and Farman. Data were analyzed using t-test (p≤ 0.05). The result shows that physiologicalmaturation stage of cervical vertebrae maturation index in cleft and non-cleft patients has no significant difference in stage acceleration (p= 0.38), stage transition (p= 0.41) and deceleration (p= 0.39). Likewise, there is no significant difference in physiological maturation stage of cervical vertebrae maturation index between cleft and non-cleft patients. 

Speech and Hearing Outcomes of the Patients with Cleft Lip and Palate: Comparison between One-Stage Simultaneous and Two-Stage Surgical Repairs

2020 ◽  
Vol 103 (11) ◽  
pp. 1171-1177
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Common Belief ◽  
Two Stage ◽  
Treatment Protocols ◽  
Palatal Fistula ◽  
One Stage ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
Palate Repair

Background: Conventional treatment for cleft lip and palate patients is lip repair at three to four months and then palatal repair at nine to 12 months of age. However, for the patients who delay seeing a doctor especially in a developing area such as Northern Thailand, simultaneous lip and palate repair is performed at 12 to 18 months of age or later, depending on the age at the first visit. It is a common belief that patients with cleft lip and palate will be behind non-cleft patients in early development phonemes because of the open palate. This delay persists until the palate is repaired and on into the postoperative period. This proposition has not been proven with long-term clinical outcomes in one-stage repairs. Objective: To investigate the effects of one-stage repair on speech assessment, hearing, and incidence of palatal fistula. The results were compared with conventional two-stage surgical repairs. Materials and Methods: The present study was designed two groups. Group 1 consisted of 25 children (mean age 11.28±1.93 years) treated with a one-stage repair. Cleft lip, palate, and alveolus were repaired at a single surgical session in the first 18 months of life (mean age at the time of surgery 13.52±4.51 months). Group 2 consisted of 17 children (mean age 11.02±2.23 years) treated in two-stage surgical repairs. Lip repair was performed at a median age of 4.01 months (IQR 3.62 to 5.46), and palate repair was performed at a mean age of 13.54±4.14 months. Both groups underwent cleft lip and palate repairs at the Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University between January 1, 2004 and December 31, 2010. Speech and hearing for all patients were evaluated by experienced ENT doctors. The palatal fistula was evaluated by the same plastic surgeons. Results: One-stage repair showed significant normal articulation and less articulation disorder when compared with two-stage surgical repairs. However, no significant difference was determined for other speech assessments, hearing, and incidence of palatal fistula. Conclusion: Because one-stage repair seems to have a more positive influence on articulation, and both surgical treatment protocols give similar results on speech assessments, hearing, and incidence of palatal fistula, regardless of the timing of the surgery, the one-stage repair is not inferior to conventional two-stage surgical repairs for patients in developing areas. This is due to several important advantages, such as less hospitalization, lower cost, and less chance of nosocomial infection. Keywords: One-stage repair, Speech, Hearing, Palatal fistula, Cleft lip, Palate

scholarly journals Female and Male Differences in Academic Achievement in Individuals With Cleft

2017 ◽  
Vol 55 (2) ◽  
pp. 196-203 ◽  
Author(s):  
Martin Persson ◽  
Magnus Becker ◽  
Amy L. Conrad ◽  
Henry Svensson
Keyword(s):  
Academic Achievement ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Population Based ◽  
Male Population ◽  
Compulsory School ◽  
Female Population ◽  
Grade Point ◽  
Medical Birth Register ◽  
Significant Difference

Objective: The focus of this study was to determine if there is any significant difference in academic achievement for girls and boys with a cleft compared to the general population of Swedish students at graduation from compulsory school. Design: A retrospective population-based study using data obtained from the Swedish Medical Birth Register that was linked to the Swedish School–Grade Register. Participants: Two hundred seventy girls and 241 boys with cleft palate (CP), 222 girls and 429 boys with cleft lip (CL), and 299 girls and 531 boys with cleft lip and palate (CLP) were compared with the compulsory school population comprising 609,397 girls and 640,007 boys. Main Outcome Measures: (1) Odds of receiving the lowest grade and reduced odds in receiving high grades in Mathematics, English, and Swedish. (2) grade point average (GPA). Results: In all 3 subject grades, for boys with cleft there was no difference when compared to the male population. Girls with cleft were similar to their peers with a few exceptions. Girls with CLP had lower Math grades, and girls with CP had lower Math, English, and Swedish grades. Girls with CP and CLP achieved a significantly lower GPA in comparison to the female population and boys with CP and CL achieved lower GPAs in comparison to the male population. Conclusions: This study indicates that educational outcomes for girls with cleft are more negatively affected than for boys with cleft.

Comparison of Microbial Activity Among Infants With or Without Using Presurgical Nasoalveolar Molding Appliance

2020 ◽  
Vol 57 (6) ◽  
pp. 762-769
Author(s):  
Hanieh Hassani ◽  
Jung-Wei Chen ◽  
Wu Zhang ◽  
William Hamra
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Bacterial Count ◽  
Colony Count ◽  
Caries Risk ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
Ph Level ◽  
Nasoalveolar Molding

Purpose: The aim of the current study is as follows: (1) to study whether wearing the presurgical nasoalveolar molding appliance (PNAM) had facilitated the establishment of Streptococcus mutans and Lactobacillus ( LB) and to determine other factors including pH and caries susceptibility associated with wearing the PNAM. Methods: Saliva samples of 61 infants (4.5 ± 2.06 months old) were collected from the following 3 groups: PNAM (n = 23), healthy (n = 30), and cleft lip and palate (CLP) without any treatment (n = 8). Saliva samples were assessed using selective agar to enumerate total LB and S mutans and subjected to adenosine triphosphate (ATP)-driven bioluminescence determinations using a luciferin-based assay system, and pH level was evaluated. One-way analysis of variance with least significant difference post hoc test ( P < .05) and Pearson correlation were used to evaluate S mutans, LB, pH, and ATP levels. Results: A total of 63 patients (30 healthy patients, 23 patients with cleft lip/palate who had PNAM appliance and 8 patients with cleft lip/palate who did not use the appliance) were seen in this study. There is a significant difference in pH ( P = .012), LB Caries Risk Test ( P < .001), LB colony count ( P < .001), S mutans Caries Risk Test ( P < .001), and S mutans colony count ( P < .001) among the 3 groups (PNAM > CLP > healthy). The ATP level was not significantly different among the 3 groups. Conclusion: Higher bacterial count and lower pH were found in the PNAM group. Cleft lip and/or palate patients wearing the PNAM appliance are at higher risk for dental caries.

Functional Analysis of Cleft Lip and Palate Patients with Modified Rakosi Method

2002 ◽  
Vol 39 (1) ◽  
pp. 101-104
Author(s):  
M. Okan Akcam ◽  
Tunç Altiok ◽  
F. Erhan Özdiler
Keyword(s):  
Functional Analysis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mouth Opening ◽  
Class I ◽  
Control Group ◽  
Angle Class ◽  
Significant Difference ◽  
Joint Disorder ◽  
Orthodontic Patients

Objective The aim of this study was to investigate the mandibular functions of patients with cleft lip and palate (CLP) by means of modified Rakosi Functional Analysis and to test whether there was a risk of tendency to temporo-mandibular joint disorder when compared with Angle Class I non-CLP patients. Design Fifteen patients with unilateral CLP with a mean age of 12.2 ± 1.91 years and randomly selected 15 Angle Class I orthodontic patients with a mean age of 10.5 ± 2.01 years as a control group. None of the subjects had complaint of symptoms of temporomandibular joint disorder in their histories. All subjects were evaluated using modified Rakosi Functional Analysis method in accordance with a scoring system of the findings. Main outcome Measures Intra- and extracapsular clinical functional surveys were taken. A Mann-Whitney U test was used to evaluate the differences between the CLP and non-CLP groups. Results and Conclusion There was a significant difference (p < .01) between the distributions of the total scores of the two groups. A significant difference (p < .05) in right lateral movement was also observed between the two groups. However, there were no significant but borderline differences in clicking, crepitus, and maximum mouth opening findings between the two groups. Because these results do not explain the reason for the aforementioned differences, further studies seem essential.

Skeletal Asymmetries of the Nasomaxillary Complex in Noncleft and Postsurgical Unilateral Cleft Lip and Palate Individuals

1995 ◽  
Vol 32 (5) ◽  
pp. 428-433 ◽  
Author(s):  
Stephanos Kyrkanides ◽  
Ron Bellohusen ◽  
J. Daniel Subtelny
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Significant Degree ◽  
Skeletal Maturation ◽  
Growth Spurt ◽  
Pubertal Growth Spurt ◽  
Pubertal Growth ◽  
Anterior Nasal Spine ◽  
And Control ◽  
Skeletal Asymmetry

Asymmetries in the nasomaxillary skeleton are very common in individuals with unilateral cleft lip and palate. The purpose of this study was to retrospectively evaluate postsurgical asymmetries of the nasomaxillary skeleton in unilateral cleft lip and palate patients. Included in this study were 36 complete cleft lip and palate subjects, along with 36 noncleft (control) subjects. Skeletal asymmetry, deviations of the anterior nasal spine, and the premaxillary area were compared by chronologic age and skeletal maturation in cleft subjects and controls. Comparison between cleft and control cases was assessed. Results indicated that skeletal asymmetry in unilateral clefts and controls peaks during the pubertal growth spurt. The anterior nasal spine and nasal septum always tend to deviate toward the noncleft side of the nasal cavity, although individual variation exists. Cleft subjects were found to be more asymmetric than noncleft subjects to a statistically significant degree.

Vertical Facial Skeletal Asymmetry and Occlusal Cant Relationship in Patients With Unilateral Cleft Lip and Palate

2020 ◽  
pp. 105566562097457
Author(s):  
Bengisu Akarsu-Guven ◽  
Ezgi Atik ◽  
Hande Gorucu-Coskuner ◽  
Muge Aksu
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Facial Asymmetry ◽  
Cranial Base ◽  
Control Group ◽  
Lower Face ◽  
Significant Difference ◽  
Angular Measurements ◽  
Cleft Lip Palate

Objective: To evaluate the maxillary and mandibular vertical skeletal asymmetries, and the correlation between these asymmetries and occlusal cant in patients with unilateral cleft lip–palate (UCLP). Methods: Anteroposterior radiographs of 25 patients with UCLP (UCLP group, mean age: 20.98 ± 4.88 years) and 25 subjects without cleft (control group, mean age: 19 ± 2.86 years) were included. Independent samples t test, Mann-Whitney U test and Pearson correlation analysis were performed based on linear and angular measurements. Results: Lower facial horizontal asymmetry did not show statistically significant difference between the UCLP and control groups. However, vertical asymmetry of (a) the lateral cranial base ( P = .014), (b) the nasomaxillary region ( P < .001), (c) the maxillary dentoalveolus ( P = .001), and (d) the lower face ( P = .038) were all found to be significantly greater in UCLP group. The occlusal cant angle was also significantly greater in patients with UCLP compared to the controls ( P = .016). While the occlusal cant angle was found to be correlated with the vertical asymmetry of the occlusal cant ( r = 0.931, P < .001), maxillary cant angle was found to be correlated with the vertical asymmetry of the maxillary dentoalveolus ( r = 0.655, P < .001). Conclusions: There was no correlation between the occlusal cant and the vertical and horizontal skeletal asymmetries. Vertical asymmetries of the lower face and the medial cranial base were negatively correlated with the horizontal lower facial asymmetry.

scholarly journals A LATERAL CEPHALOGRAPHIC EVALUATION OF ASSOCIATION OF CLEFT LIP AND PALATE WITH CERVICAL VERTEBRAL ANOMALIES

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Shazia Khatoon ◽  
Samir Jain
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Skeletal Maturity ◽  
Vertical Plane ◽  
Growth Spurt ◽  
Poor Correlation ◽  
Posterior Arch ◽  
Dental Patients ◽  
Vertebral Anomalies ◽  
Optimal Illumination

Generally, orthodontic treatment and intervention are timed to take place before or during the peak growth velocity or pubertal growth spurt to achieve favorable effects in correcting sagittal, transverse, and vertical plane disharmonies. Skeletal maturity and growth spurts have been assessed by several methods in the literature, including chronological age, dental development, and sexual maturation characteristics. All of these methods have limitations, such as poor correlation with growth spurt. Hence based on above findings the present study was planned for A Lateral Cephalographic Evaluation of Association of Cleft Lip and Palate with Cervical Vertebral Anomalies. The present study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. In the present study 20 cases of the age from 5 to 20 years suffered from the cleft lip and Palate were enrolled and evaluated with the different parameters. The radiographs were traced for cervical spine from C1- C4 on an acetate paper with 3H pencil under optimal illumination. Cervical vertebral anomalies were recorded and categorized into posterior arch deficiencies and fusion or both. The data generated from the present study concludes that the association between cleft lip and palate and cervical vertebral anomalies indicates that cervical vertebral anomalies may be implicated as the etiology of cleft lip and palate. As oral and maxillofacial radiologists, lateral cephalographs are easily available in records of dental patients and can be used to identify cervical vertebral anomalies. Cervical vertebral anomalies can predispose to further disorders and identification of such anomalies mandates referral to the concerned specialist for appropriate management. Keywords: Cleft Lip and Palate; Cervical Vertebral Anomalies; Dehiscence; Fusion; Lateral Cephalographs, etc.

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