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Cleft Lip

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201. Treatment outcomes of pre-surgical infant orthopedics in patients with non-syndromic cleft lip and/or palate: A systematic review and meta-analysis of randomized controlled trials. (PubMed)

Treatment outcomes of pre-surgical infant orthopedics in patients with non-syndromic cleft lip and/or palate: A systematic review and meta-analysis of randomized controlled trials. Non-syndromic clefts lip and/or palate (CL/P) defects may have manifold significant and detrimental consequences for the affected individuals and their family environment. Although the use of pre-surgical infant orthopedics (PSIO) was introduced as a means to improve management and treatment outcomes, there still (...) of the available evidence was assessed with the Grades of Recommendation, Assessment, Development and Evaluation approach.Finally 20 papers (3 unique trials) were identified, involving a total of 118 patients with unilateral complete CL/P and 16 with cleft of the soft and at least two thirds of the hard palate. Eight publications were considered as being of low, four of unclear and eight of high risk of bias. In general, the investigated appliances did not present significant effects when compared to each

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2017 PloS one

202. Assessment of complete unilateral cleft lip and palate patients: Determination of factors effecting dental arch relationships. (PubMed)

Assessment of complete unilateral cleft lip and palate patients: Determination of factors effecting dental arch relationships. The purpose of the current study was to assess the treatment outcome of non-syndromic patients having complete unilateral cleft lip and palate (CUCLP) by using GOSLON index and to determine any association of pre and/or postnatal factors with the treatment outcome.One hundred and one sets of dental models of patients having CUCLP were assessed in this retrospective

2017 International Journal of Pediatric Otorhinolaryngology

203. Skoog Primary Periosteoplasty versus Secondary Alveolar Bone Grafting in Unilateral Cleft Lip and Alveolus: Long-Term Effects on Alveolar Bone Formation and Maxillary Growth. (PubMed)

Skoog Primary Periosteoplasty versus Secondary Alveolar Bone Grafting in Unilateral Cleft Lip and Alveolus: Long-Term Effects on Alveolar Bone Formation and Maxillary Growth. Clefts involving the alveolus are treated using one of two strategies: primary periosteoplasty at the time of lip repair or secondary alveolar bone grafting at mixed dentition. Most teams favor secondary alveolar bone grafting because of its high success rate, and concerns have been raised that primary periosteoplasty may (...) interfere with maxillary growth. However, primary periosteoplasty may obviate the need for future bone grafting and is still practiced in some centers. Few studies compare the long-term outcomes of these two strategies.Fifty-seven consecutive patients born with unilateral cleft lip and alveolus were studied retrospectively. All patients underwent primary lip repair using Skoog's method; 28 patients underwent primary periosteoplasty at the time of lip repair and the remaining 29 underwent secondary

2017 Plastic and reconstructive surgery

204. The prevalence and factors associated with malnutrition among infants with cleft palate and/or lip at a hospital in Uganda: a cross-sectional study. (PubMed)

The prevalence and factors associated with malnutrition among infants with cleft palate and/or lip at a hospital in Uganda: a cross-sectional study. To determine the prevalence and factors associated with malnutrition among infants with Cleft palate and/or cleft lip (CP+/-L) at Comprehensive Rehabilitation for Uganda Hospital (CoRSU) in Uganda.This was a cross-sectional study done on infants with CP+/-L and their caretakers admitted between November 2013 and October 2014 at CoRSU hospital which

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2017 BMC Pediatrics

205. Preoperative Alveolar Segment Position as a Predictor of Successful Gingivoperiosteoplasty in Patients with Unilateral Cleft Lip and Palate. (PubMed)

Preoperative Alveolar Segment Position as a Predictor of Successful Gingivoperiosteoplasty in Patients with Unilateral Cleft Lip and Palate. Gingivoperiosteoplasty can avoid secondary alveolar bone grafting in up to 60 percent of patients with a cleft. However, preoperative predictors of success have not been characterized. This study reports on the preoperative alveolar segment position most favorable for successful gingivoperiosteoplasty.The authors performed a single-institution (...) , retrospective review of patients with a unilateral cleft who underwent nasoalveolar molding. Alveolar segment morphology was directly measured from maxillary dental models created before and after nasoalveolar molding. Statistical analysis was performed to identify parameters associated with the decision to perform gingivoperiosteoplasty and its success, defined as the absence of an eventual need for alveolar bone grafting.Fifty patients with a unilateral cleft who received nasoalveolar molding therapy were

2017 Plastic and reconstructive surgery

206. Objective Assessment of the Unilateral Cleft Lip Nasal Deformity Using 3D Stereophotogrammetry: Severity and Outcome. (PubMed)

Objective Assessment of the Unilateral Cleft Lip Nasal Deformity Using 3D Stereophotogrammetry: Severity and Outcome. Optimization of care to correct the unilateral cleft lip nasal deformity is hampered by lack of objective measures to quantify preoperative severity and outcome. The purpose of this study was to develop a consensus standard of nasal appearance using three-dimensional stereophotogrammetry; determine whether anthropometric measurements could be used to quantify severity (...) and outcome; and determine whether preoperative severity predicts postoperative outcome.The authors collected facial three-dimensional images of 100 subjects in three groups: 45 infants before cleft lip repair; the same 45 infants after cleft lip repair; and 45 children aged 8 to 10 years with previous repairs. Five additional age-matched unaffected control subjects were included in each group. Seven expert surgeons ranked images in each group according to nasal appearance. The rank sum score was used

2017 Plastic and reconstructive surgery

207. Evaluation of dehiscence and fenestration in adolescents affected by bilateral cleft lip and palate using cone-beam computed tomography. (PubMed)

Evaluation of dehiscence and fenestration in adolescents affected by bilateral cleft lip and palate using cone-beam computed tomography. We evaluated the dehiscence and fenestration presence in maxillary and mandibular anterior teeth of patients affected by bilateral cleft lip and palate (BCLP) and compared the findings with a well-matched control group of noncleft patients using cone-beam computed tomography.Cone-beam computed tomography images of 51 patients were divided into 2 groups (group

2017 American journal of orthodontics and dentofacial orthopedics

208. "Camouflaging Cleft Lip Scar Using Follicular Unit Extraction Hair Transplantation Combined With Autologous Fat Grafting." (PubMed)

"Camouflaging Cleft Lip Scar Using Follicular Unit Extraction Hair Transplantation Combined With Autologous Fat Grafting." The scar that occurs after cleft lip surgery poses a serious cosmetic problem. One of the methods used to solve this problem in adult male patients is hair transplantation. However, satisfactory results with this method cannot always be achieved because of possible graft loss. The corrective feature of fat grafting has been reported in many studies. The authors' aim (...) with this report is to share their results with hair transplantation combined with fat grafting in patients with cleft lip.This study included 20 patients who had both a scar and alopecia in the cleft lip area. The patients underwent fat grafting from the periumbilical region by means of miniature liposuction harvesting cannulas. Three months after fat injection, hair transplantation was performed with hair from the submental area and scalp using the folliculate unit extraction technique. Patients were

2017 Plastic and reconstructive surgery

209. A Comparative Study of the Aesthetic Outcome of Two Techniques for Unilateral Complete Cleft Lip Repair. (PubMed)

A Comparative Study of the Aesthetic Outcome of Two Techniques for Unilateral Complete Cleft Lip Repair. Cleft lip repair aims to create symmetric nasolabial morphology with minimal scarring. Poor aesthetic outcomes may have damaging psychosocial implications. Determining the optimal method of recreating lip symmetry is a major goal of applied cleft clinical research. This study aims to determine whether subjective assessment could differentiate aesthetic outcome between two surgeons who use (...) two different surgical techniques for unilateral cleft lip repair.Surgeon A uses a modified rotation-advancement technique incorporating a supra-white roll flap and Noordhoff-style vermilion flap. Surgeon B uses an upper and lower triangle technique. Neither surgeon used presurgical orthopedics. Five-year postoperative frontal photographs (cropped according to the Asher-McDade aesthetic index) were analyzed by a panel of 40 blinded surgical and lay reviewers using a five-point Likert scale

2017 Plastic and reconstructive surgery

210. Changes in maxillofacial morphology and velopharyngeal function with two-stage maxillary distraction-mandibular setback surgery in patients with cleft lip and palate. (PubMed)

Changes in maxillofacial morphology and velopharyngeal function with two-stage maxillary distraction-mandibular setback surgery in patients with cleft lip and palate. Maxillary distraction is increasingly used for the correction of severe maxillary retrusion in patients with cleft lip and palate. However, control of the maxillary movement is difficult, and the need to wear visible distractors for a long period of time causes psychosocial problems. A two-stage surgical approach consisting (...) of maxillary distraction and mandibular setback was developed to overcome these problems. In this study, changes in maxillofacial morphology and velopharyngeal function were examined in 22 patients with cleft lip and palate who underwent this two-stage approach. Lateral cephalograms taken just before the first surgery, immediately after the second surgery, and at completion of the active post-surgical orthodontic treatment were used to examine maxillofacial morphology. Velopharyngeal function was evaluated

2017 International Journal of Oral and Maxillofacial Surgery

211. Early Placement of Ventilation Tubes in Infants with Cleft Lip and Palate: A Systematic Review. (PubMed)

Early Placement of Ventilation Tubes in Infants with Cleft Lip and Palate: A Systematic Review. Objective Studies have shown that the majority of cleft lip and palate (CLP) children have middle ear fluid present at the time of lip repair (3-4 months). Despite hearing loss, the majority of children do not undergo ventilation tube treatment if required until the time of palate repair (9-12 months). We aimed to examine the effectiveness and potential complications of early ventilation tube (...) placement prior to palatoplasty in infants with cleft lip and palate. Data Sources Medline (1946-2015), Embase (1980-2015), and EBM Reviews (Cochrane Central Register of Controlled). Review Methods Data sources were searched for publications that described the results of early ventilation tube placement in children with CLP prior to cleft palate repair. Two independent reviewers appraised the selected studies. Results Of 226 studies identified, 6 studies met the inclusion criteria. Early ventilation

2017 Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

212. The Smile Index Part 1: A Large-Scale Study of Phenotypic Norms for Pre- and Post-Operative Unilateral Cleft Lip. (PubMed)

The Smile Index Part 1: A Large-Scale Study of Phenotypic Norms for Pre- and Post-Operative Unilateral Cleft Lip. Unilateral cleft lip has a spectrum of disease morphology, but severity classifications are difficult given the absence of accessible, objective assessment tools or reference data. The authors characterize the spectrum of cleft morphology before and after surgical repair for a large, multi-ethnic population using easily identifiable facial landmarks collected through a novel smart (...) symmetry improved significantly from preoperatively to postoperatively for the following measurements: columellar angle (65 ± 17 degrees to 87 ± 8 degrees), nostril width ratio (1.7 ± 0.68 to 1.0 ± 0.22), philtral height ratio (0.8 ± 0.14 to 1.0 ± 0.14), and lip length ratio (0.9 ± 0.26 to 1.0 ± 0.11) (p < 0.001). Surgeon and layperson rankings showed high inter-rater reliability (r = 0.64, p < 0.001). Preoperatively, multivariate regression showed that cleft width ratio, nostril width ratio

2017 Plastic and reconstructive surgery

213. The electrical activity of the masticatory muscles in children with cleft lip and palate. (PubMed)

The electrical activity of the masticatory muscles in children with cleft lip and palate. Information regarding masticatory muscle function in children with cleft lip and palate (CLP) is limited. As a consequence, research on masticatory muscle activity in cleft subjects is needed.To assess masticatory muscle activity in children surgically treated for CLP as well as identify the possible factors associated with this activity.The sample comprised 82 children with mixed dentition and Class I (...) occlusions (25 children with unilateral CLP and 57 subjects with no cleft abnormalities). A DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany) was used to take electromyographical (EMG) recordings of the temporal and masseter muscles both in the mandibular rest position and during maximum voluntary contraction (MVC).Patients with clefts showed a significant increase in temporal muscle activity at rest compared with the controls. The presence of clefts and unilateral posterior crossbites are factors

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2017 International Journal of Paediatric Dentistry

214. Quantitative assessment of the learning curve for cleft lip repair using LC-CUSUM. (PubMed)

Quantitative assessment of the learning curve for cleft lip repair using LC-CUSUM. The first step in cleft lip repair is the precise positioning of anatomical landmarks and tracing of the incisions on the patient's lip at the beginning of the procedure. The aim of this study was to evaluate progress made in learning cleft lip repair tracing using a quantitative assessment of learning curves: LC-CUSUM (learning curve - cumulative sum). Eight surgical residents were enrolled and asked to trace (...) lip repair incisions on five cases of unilateral left cleft lip over 5 consecutive weeks. Results were compared to a reference tracing based on the positioning of nine anatomical landmarks and assessed using LC-CUSUM. Competence was defined as the accurate positioning of the nine landmarks (less than 1.4mm deviation from the reference positions, with an accepted 15% failure rate). After five tracing sessions, competence was not achieved evenly for all trainees, or for all landmarks, underlining

2017 International Journal of Oral and Maxillofacial Surgery

215. Bone-anchored maxillary protraction therapy in patients with unilateral complete cleft lip and palate: 3-dimensional assessment of maxillary effects. (PubMed)

Bone-anchored maxillary protraction therapy in patients with unilateral complete cleft lip and palate: 3-dimensional assessment of maxillary effects. The aim of this study was to 3-dimensionally assess the treatment outcomes of bone-anchored maxillary protraction (BAMP) in patients with unilateral cleft lip and palate.The cleft group comprised 24 patients with unilateral cleft lip and palate and Class III malocclusion with mean initial and final ages of 11.8 and 13.2 years, respectively (...) side.BAMP caused similar amounts of maxillary protraction in patients with and without unilateral cleft lip and palatem with discrete differences between the cleft side and the noncleft side.Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

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2017 American journal of orthodontics and dentofacial orthopedics

216. Three-dimensional evaluation of the airway spaces in patients with and without cleft lip and palate: A digital volume tomographic study. (PubMed)

Three-dimensional evaluation of the airway spaces in patients with and without cleft lip and palate: A digital volume tomographic study. Patients with cleft lip and palate (CLP) suffer from several esthetic and functional challenges. Comprehensive treatment of these patients involves orthognathic surgery that may lead to velopharyngeal insufficiency or reduction in lower airway. Several cases of airway insufficiency, velopharyngeal incompetence, snoring, hypopnea, and obstructive sleep apnea

2017 American journal of orthodontics and dentofacial orthopedics

217. A New Method for Reconstruction of Vermilion Deficiency in Cleft Lip Deformity: The Bi-Winged Myomucosa Switch Flap. (PubMed)

A New Method for Reconstruction of Vermilion Deficiency in Cleft Lip Deformity: The Bi-Winged Myomucosa Switch Flap. This study reviewed the method of using the bi-winged myomucosa switch flap for correction of secondary cleft lip deformity in patients with vermilion mucosa deficiency, lack of the central tubercle, and disproportionate lip projection, obviating the conventional Abbe flap when the prolabium has acceptable philtrum and Cupid's bow definition.The technique was applied to adult (...) patients with secondary vermilion deficiency after primary bilateral cleft lip repair. The flap consisted of the transverse vermilion mucosa and the superior part of the orbicularis oris muscle from the lower lip. It was elevated, leaving a central cuff of muscle and mucosa tissue for blood supply, and tapered down bilaterally. The flap was transposed cephalically and inset to the deficient upper vermilion. Division of the pedicle was performed 2 weeks later. The preoperative and postoperative

2017 Plastic and reconstructive surgery

218. Anthropometric and aesthetic outcomes for the nasolabial region in 101 consecutive African children with unilateral cleft lip one year after repair using the anatomical subunit approximation technique. (PubMed)

Anthropometric and aesthetic outcomes for the nasolabial region in 101 consecutive African children with unilateral cleft lip one year after repair using the anatomical subunit approximation technique. One hundred and one patients with complete or incomplete cleft lip underwent the anatomical subunit approximation technique for repair. The patients were followed up prospectively for 1year. The objective of this study was to determine the outcomes for the nasolabial area through anthropometric (...) measurements and assessment of the Asher-McDade Aesthetic Index and Steffensen's criteria at 1year after surgery. Six assessors (three cleft surgeons and three non-surgeon medical professionals) examined cropped images; reliability was assessed using Cronbach's alpha. The difference in lip length between the healthy and operated sides was 0.61mm and the difference in nostril diameter was 0.37mm (differences not significant). The average scar width was 2.78±1.35mm. Hypertrophic scars were observed in 9.9

2017 International Journal of Oral and Maxillofacial Surgery

219. A cone beam computed tomographic evaluation of the size of the sella turcica in patients with cleft lip and palate. (PubMed)

A cone beam computed tomographic evaluation of the size of the sella turcica in patients with cleft lip and palate. Changes in the size of the sella turcica are frequently related to pathologies and syndromes. The aim of this was to compare the sella turcica dimensions in patients with unilateral and bilateral cleft lip and palate and non-cleft subjects.Cone beam computed tomography (CBCT) images of three groups consisted of 20 patients with unilateral cleft lip and palate; 20 patients (...) with bilateral cleft lip and palate and a control group consisting of 20 non-cleft subjects were the research population in this pilot study. The sella turcica linear dimensions in terms of length, depth and diameter were measured for all subjects. One-way ANOVA test was used to determine any significant differences among the three groups for the measured parameters.The length, depth and diameter of sella turcica were found to be significantly smaller in the unilateral and bilateral groups compared

2017 Journal of Orthodontics

220. Three-dimensional printed haptic model from a prenatal surface-rendered oropalatal sonographic view: a new tool in the surgical planning of cleft lip/palate. (PubMed)

Three-dimensional printed haptic model from a prenatal surface-rendered oropalatal sonographic view: a new tool in the surgical planning of cleft lip/palate. Three-dimensional (3D) ultrasound has significantly improved prenatal screening and perinatal care in the area of cleft lip/palate and other deformities, providing essential preoperative information to the surgical team. However, current 3D reconstruction modalities are limited primarily to display on a two-dimensional surface. In contrast (...) , a 3D printed haptic model allows both the surgeon and the parents to develop a better understanding of the anatomy and the surgical procedure through the ability to interact directly with the printed model. The production of a 3D printed haptic model of cleft lip and palate obtained from a surface-rendered oropalatal sonographic view is presented here. The development of this 3D printed haptic model will allow the surgical team to perform preoperative planning with a highly accurate medical model

2017 International Journal of Oral and Maxillofacial Surgery

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