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Cleft Lip

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1. The Use of Pre-Surgical Nasoalveolar Molding (PNAM) in Unilateral Cleft Lip and Palate Patients Reduces Width of Alveolar Cleft

The Use of Pre-Surgical Nasoalveolar Molding (PNAM) in Unilateral Cleft Lip and Palate Patients Reduces Width of Alveolar Cleft UTCAT3327, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title The Use of Pre-Surgical Nasoalveolar Molding (PNAM) in Unilateral Cleft Lip and Palate Patients Reduces Width of Alveolar Cleft Clinical Question In patients with unilateral cleft lip and palate, does the use of pre-surgical (...) nasoalveolar molding (PNAM) therapy reduce the width of the alveolar cleft? Clinical Bottom Line The use of pre-surgical nasoalveolar molding in unilateral cleft lip and palate patients reduces the alveolar cleft width. This is supported by a randomized controlled trial including 120 patients (60 controls) and a case control study with 30 patients. All patients studied were previously diagnosed with unilateral cleft lip and palate and were shown to have a significant reduction in intersegmental distances

2018 UTHSCSA Dental School CAT Library

2. Cleft lip and palate

Cleft lip and palate Cleft lip and palate - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Cleft lip and palate Last reviewed: February 2019 Last updated: January 2018 Summary Oro-facial clefts are among the most common birth defects. Cleft lip with or without cleft palate is approximately twice as common as isolated cleft palate. The majority of cleft lip deformities are associated with a varying degree of nasal (...) deformity. Oro-facial clefts can occur in isolation or as a component of an identifiable syndrome. The aetiology of cleft lip and palate involves a variety of genetic and environmental factors that result in variable expressions of oro-facial clefting. Comprehensive care involves a multi-disciplinary cleft team with specialists from fields such as facial plastic surgery, genetics, nursing, speech-language pathology, orthodontics, dentistry, oral surgery, audiology, and paediatrics. Definition An oro

2018 BMJ Best Practice

3. Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients. Full Text available with Trip Pro

Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients. Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults (...) of hypoplastic maxilla in people with cleft lip and palate.Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 May 2018), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2018, Issue 4), MEDLINE Ovid (1946 to 15 May 2018), Embase Ovid (1980 to 15 May 2018), and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; from 1982 to 15 May 2018). The US

2018 Cochrane

5. Dentists Treating Cleft Lip and/or Palate Patients Will Need to Consider Anatomical Variations when Delivering Local Anesthetic

Dentists Treating Cleft Lip and/or Palate Patients Will Need to Consider Anatomical Variations when Delivering Local Anesthetic UTCAT3331, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Dentists Treating Cleft Lip and/or Palate Patients Will Need to Consider Anatomical Variations when Delivering Local Anesthetic Clinical Question In cleft lip and palate patients, will altered anesthetic techniques be more effective (...) than standard techniques in achieving adequate pain control? Clinical Bottom Line Low evidence to support minor alterations needed that include first anesthetize away from cleft and then at cleft margins. But similarities include the use of topical anesthetic and the guidance for slow injection. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Trindade-Suedam/2012 2 patients with cleft palate and lip

2018 UTHSCSA Dental School CAT Library

6. To Admit or Not to Admit: That is the Cleft Lip Question. Confirming the Safety of Outpatient Cleft Lip Repair. (Abstract)

To Admit or Not to Admit: That is the Cleft Lip Question. Confirming the Safety of Outpatient Cleft Lip Repair. There is no accepted protocol for inpatient versus ambulatory cleft lip surgery. The aim of this study was to review the safety of outpatient repair and develop guidelines.A retrospective review of patients younger than 2 years undergoing primary cleft lip repair from 2008 to 2015 at six centers was performed. Patients were divided into two groups: predominantly ambulatory (discharged (...) , and other congenital comorbidities had significant impact on admission rates in the predominantly ambulatory group (p < 0.05). Respiratory comorbidities and syndromes were risk factors for readmission if patients presented to the emergency department (p < 0.05).Ambulatory cleft lip repair can be performed safely in most patients with no difference in emergency department visits or readmission. Patients with comorbidities should be admitted for observation.Therapeutic, IV.

2018 Plastic and reconstructive surgery

7. The Difference in Cervical Vertebral Skeletal Maturation between Cleft Lip/Palate and Non-Cleft Lip/Palate Orthodontic Patients Full Text available with Trip Pro

The Difference in Cervical Vertebral Skeletal Maturation between Cleft Lip/Palate and Non-Cleft Lip/Palate Orthodontic Patients 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.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 (...) was significantly earlier in the non-cleft participants in comparison with the UCLP participants (p = 0.009).There is delayed skeletal maturity among the UCLP Saudi male population in comparison with their non-CLP age-matched peers.

2018 BioMed research international

8. Guidelines for Breastfeeding Infants with Cleft Lip, Cleft Palate, or Cleft Lip and Palate

Guidelines for Breastfeeding Infants with Cleft Lip, Cleft Palate, or Cleft Lip and Palate ABM Protocol ABM Clinical Protocol #17: Guidelines for Breastfeeding Infants with Cleft Lip, Cleft Palate, or Cleft Lip and Palate, Revised 2013 Sheena Reilly, 1,2 Julie Reid, 1,3 Jemma Skeat, 2 Petrea Cahir, 1 Christina Mei, 2 Maya Bunik, 4 and the Academy of Breastfeeding Medicine A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical (...) problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breast- feeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. De?nitions W hen a cleft lip(CL) occurs, thelipisnotcontiguous, and when a cleft palate (CP) occurs, there is communi- cation between the oral and nasal cavities. 1 Clefts can range

2013 Academy of Breastfeeding Medicine

9. Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients. Full Text available with Trip Pro

Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients. Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults (...) with a repaired cleft. Conventional orthognathic surgery, such as Le Fort I osteotomy, is often performed for the correction of maxillary hypoplasia. An alternative intervention is distraction osteogenesis, which achieves bone lengthening by gradual mechanical distraction.To provide evidence regarding the effects and long-term results of maxillary distraction osteogenesis compared to orthognathic surgery for the treatment of hypoplastic maxilla in people with cleft lip and palate.We searched the following

2016 Cochrane

10. Combined correction of the nasal tip and upper lip in bilateral cleft lip patients: A novel approach. (Abstract)

Combined correction of the nasal tip and upper lip in bilateral cleft lip patients: A novel approach. Secondary nasal deformity in bilateral cleft lip is one of the great surgical challenges. The problems are an under projected tip, an infra-tip lobule merging with the pro-labium and a short columella. Upper lip vermillion border deformity is a further significant problem. We demonstrate our novel approach to management by classifying patients into 3 groups depending on the status of important (...) features such as the anatomy of the prolabial skin island, length of columella and upper lip width and fullness. We demonstrate that cleft patients with nasal deformity and poor upper lip aesthetics can be managed with a single operation.Crown Copyright © 2019. Published by Elsevier B.V. All rights reserved.

2019 International Journal of Pediatric Otorhinolaryngology

11. Investigation of candidate genes of non-syndromic cleft lip with or without cleft palate, using both case-control and family-based association studies. Full Text available with Trip Pro

Investigation of candidate genes of non-syndromic cleft lip with or without cleft palate, using both case-control and family-based association studies. Non-syndromic cleft of the lip and/or palate (NSCL/P) is one of the most common polygenic diseases. In this study, both case-control and family-based association study were used to confirm whether the Single Nucleotide Polymorphisms (SNPs) were associated with NSCL/P.A total of 37 nuclear families and 189 controls were recruited, whose blood DNA

2019 Medicine

12. Palatal morphology in unilateral cleft lip and palate patients: Association with infant cleft dimensions and timing of hard palate repair. (Abstract)

Palatal morphology in unilateral cleft lip and palate patients: Association with infant cleft dimensions and timing of hard palate repair. To assess the impact of cleft severity and timing of hard palate repair on palatal dimensions in unilateral cleft lip and palate (UCLP) children.Single-centre analysis within a multicenter RCT of primary surgery; 122 UCLP randomized to early hard palate closure (EHPC) at 12 months or delayed hard palate closure (DHPC) at 36 months; 28 frequency-matched (...) with palatal height (P = 0.01).Unilateral cleft lip and palate palates differ from controls in width and height. DHPC may represent an advantage for the transversal dimension, but a disadvantage for palatal height. Infant cleft dimensions partially explain differences in palatal height.© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

2019 Orthodontics & craniofacial research Controlled trial quality: uncertain

13. Exploring Research Priorities of Parents Who Have Children With Down Syndrome, Cleft Lip With or Without Cleft Palate, Congenital Heart Defects, or Spina Bifida Using ConnectEpeople: A Social Media Coproduction Research Study. Full Text available with Trip Pro

Exploring Research Priorities of Parents Who Have Children With Down Syndrome, Cleft Lip With or Without Cleft Palate, Congenital Heart Defects, or Spina Bifida Using ConnectEpeople: A Social Media Coproduction Research Study. Using social media for research purposes is novel and challenging in terms of recruitment, participant knowledge about the research process, and ethical issues. This paper provides insight into the recruitment of European parents of children with specific congenital (...) lip with or without cleft palate, congenital heart defects, and spina bifida.The design was exploratory and descriptive with 3 phases. Phase 1 included the recruitment of RAPs and generation of research questions important to them; phase 2 was a Web-based survey, designed using Qualtrics software, and phase 3 included analysis and ranking of the top 10 research questions using an adapted James Lind Alliance approach. Simple descriptive statistics were used for analysis, and ethical approval

2019 Journal of medical Internet research

14. Assessment of facial asymmetry before and after the surgical repair of cleft lip in unilateral cleft lip and palate cases. Full Text available with Trip Pro

Assessment of facial asymmetry before and after the surgical repair of cleft lip in unilateral cleft lip and palate cases. This study was performed to assess facial asymmetry in patients with unilateral cleft lip and palate (UCLP) before and after primary lip repair. Three-dimensional facial images of 30 UCLP cases (mean age 3.7±0.8months) captured 1-2days before surgery and 4 months after surgery using stereophotogrammetry were analysed. A generic mesh - a mathematical facial mask consisting (...) the non-cleft side. The maximum vertical asymmetry was at the upper lip. The greatest anteroposterior asymmetry was at the alar base and in the paranasal area. The overall facial asymmetry improved markedly after surgery. Residual anteroposterior asymmetry was noted at the alar base, upper lip, and cheek on the cleft slide. In conclusion, dense correspondence analysis provided an insight into the anatomical reasons for the residual dysmorphology following the surgical repair of cleft lip for future

2017 International Journal of Oral and Maxillofacial Surgery

15. Non-syndromic Cleft Lip and Palate Polymorphisms Affect Normal Lip Morphology Full Text available with Trip Pro

Non-syndromic Cleft Lip and Palate Polymorphisms Affect Normal Lip Morphology Non-syndromic cleft lip with or without palate (NSCL/P) is a frequent malformation of the facial region. Genetic variants (SNPs) within nineteen loci have been previously associated with NSCL/P in GWAS studies of European individuals. These common variant SNPs may have subtler effects on the morphology of the lip and face in unaffected individuals. Several studies have investigated the genetic influences on facial (...) morphology using land-marking methods, but these landmarks are sparse in the lip region. The aim of this study is to assess for associations between the nineteen NSCL/P SNPs and normal lip phenotypes, using a detailed categorical scale. Three-dimensional laser scanned facial images were obtained of 4,747 subjects recruited from the Avon Longitudinal Study of Parents and Children (ALSPAC) and genetic data was available for 3,643 of them. A polygenetic risk score (PRS) combining the nineteen NSCL/P SNPs

2018 Frontiers in genetics

16. The Skoog Lip Repair for Unilateral Cleft Lip Deformity: The Uppsala Experience. (Abstract)

The Skoog Lip Repair for Unilateral Cleft Lip Deformity: The Uppsala Experience. The Uppsala Craniofacial Center has been treating patients with unilateral cleft lip deformity using the lip repair technique described by Tord Skoog. The aim of this study was to determine complications after lip surgery and the incidence and indications for lip revisions in all patients born with unilateral cleft lip from 1960 to 2004.All patients who were born from 1960 to 2004 with unilateral cleft lip, cleft (...) lip and alveolus, or cleft lip and palate and underwent lip repair were studied retrospectively. The timing, indication, complications of the primary procedure, and type of secondary surgery were recorded. Kruskal-Wallis and Fisher's exact tests were used, with Bonferroni correction.The study included 443 patients. The total rate of early surgical complications was 6 percent (n = 26). Secondary surgery for short upper lip was performed in 3.8 percent (n = 17), 8.4 percent (n = 37) underwent

2018 Plastic and reconstructive surgery

17. Epidemiology and clinical profile of individuals with cleft lip and palate utilising specialised academic treatment centres in South Africa. Full Text available with Trip Pro

Epidemiology and clinical profile of individuals with cleft lip and palate utilising specialised academic treatment centres in South Africa. The study was conducted to determine the epidemiology and clinical profile of individuals with cleft lip and/or palate (CLP) utilizing specialized academic treatment centres in South Africa's public health sector.The Human Research Ethics Committee of the University of the Witwatersrand in Johannesburg provided ethical approval for the study. We conducted (...) per 1000 live births, with provincial variation of 0.1/1000 to 1.2/1000. The distribution of clefts was: 35.3% cleft palate; 34.6% cleft lip and palate; 19.0% cleft lip and other cleft anomalies at 2%. Of the total number of CLP, 47.5% were male and 52.5% female, and this difference was statistically significant (p<0.001). The majority of clefts occurred on the left for males (35.5%) and palate for females (43.4%), with a male predominance of unilateral cleft lip and palate (53.3%).The study

2019 PLoS ONE

18. Comparison of dental outcomes in patients with nonsyndromic complete unilateral cleft lip and palate who receive secondary alveolar bone grafting before or after emergence of the permanent maxillary canine. (Abstract)

Comparison of dental outcomes in patients with nonsyndromic complete unilateral cleft lip and palate who receive secondary alveolar bone grafting before or after emergence of the permanent maxillary canine. For patients with complete unilateral cleft lip and palate (CUCLP), secondary alveolar bone grafting (SABG) can be performed before or after the emergence of the cleft side permanent canine (pre-CE and post-CE, respectively). The controversy regarding dental outcomes related to the timing (...) of SABG remains unsettled. The objective of this study was to evaluate dental survival and specific dental outcomes of cleft-adjacent teeth in children with CUCLP who received either pre-CE or post-CE SABG.The permanent maxillary canines and the central and lateral incisors of 21 pre-CE and 23 post-CE SABG subjects with nonsyndromic CUCLP and all cleft-related surgeries performed by the same surgeon were analyzed retrospectively. Intraoral radiographs and clinical chart notes were collected at age 7

2020 American journal of orthodontics and dentofacial orthopedics

19. Comparison of motor-phonetic versus phonetic-phonological speech therapy approaches in patients with a cleft (lip and) palate: a study in Uganda. (Abstract)

Comparison of motor-phonetic versus phonetic-phonological speech therapy approaches in patients with a cleft (lip and) palate: a study in Uganda. At present, there is growing interest in combined phonetic-phonological approaches to treat active speech errors in children with a cleft (lip and) palate (CP ± L). Unfortunately, evidence for these type of speech interventions in this population is lacking. Therefore, the present study investigated the effectiveness of speech intervention in Ugandan

2020 International Journal of Pediatric Otorhinolaryngology

20. The conchal butterfly graft in secondary reconstruction of the bilateral cleft lip nasal deformity. (Abstract)

The conchal butterfly graft in secondary reconstruction of the bilateral cleft lip nasal deformity. The bilateral cleft nasal deformity is characterized by a short columella and a broad, flattened nasal tip. Secondary correction is challenging and often complicated by skin envelope scarring and hypoplastic alar cartilages. Adequate and durable tip projection requires a procedure that adequately augments the nasal tip and maximizes tip support. We describe a novel technique for secondary (...) correction of this deformity in the immature pediatric population.The conchal butterfly graft technique utilizes a folded cartilage construct to simultaneously increase tip projection and provide tip support. A retrospective review of 19 consecutive patients with bilateral cleft lip who underwent secondary tip rhinoplasty utilizing our technique over a 7-year period was conducted. Charts were reviewed for age at operation, length of follow-up and secondary revision procedures. Pre- and post-operative

2020 International Journal of Pediatric Otorhinolaryngology

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