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Cleft Lip

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221. Evidence-Based Medicine: Secondary Correction of Cleft Lip Nasal Deformity. (PubMed)

Evidence-Based Medicine: Secondary Correction of Cleft Lip Nasal Deformity. After reading this article, the participant should be able to: 1. Understand the components of unilateral and bilateral cleft lip nasal deformity. 2. Assess the deformity. 3. Design a treatment plan for secondary correction of cleft lip nasal deformity. 4. Discuss methods for managing suboptimal outcomes.Correction of cleft lip nasal deformity has been addressed in this Maintenance of Certification/Continuing Medical (...) Education series a number of times-a testament to the complexity of the topic. In this addition to the series, the authors provide a principle-based approach toward management of unilateral and bilateral cleft lip nasal deformity with an emphasis on timing intervention, role for intermediate correction, and methods for cleft rhinoplasty after completion of nasal growth.

2017 Plastic and reconstructive surgery

222. Evidence-Based Medicine: The Bilateral Cleft Lip Repair. (PubMed)

Evidence-Based Medicine: The Bilateral Cleft Lip Repair. After reading this article, the participant should be able to: 1. Understand the epidemiology, abnormal embryology, anatomy, and etiopathogenesis of cleft lip. 2. Be able to classify and describe bilateral cleft lip. 3. Recognize the importance of preoperative management of bilateral cleft lip. 4. Recognize the large breadth of differing management options. 5. Describe key steps and tenets of the surgical repair.This fourth Maintenance (...) of Certification/Continuing Medical Education article on cleft lip focuses on the topic of bilateral cleft lip. Previous articles placed an emphasis on the unilateral cleft lip, velopharyngeal insufficiency, or cleft lip and palate management. The authors focus on summarizing key points from previous articles and describing the importance of preoperative management and surgical repair of the bilateral cleft lip.

2017 Plastic and reconstructive surgery

223. Current and Emerging Treatments for Postsurgical Cleft Lip Scarring: Effectiveness and Mechanisms. (PubMed)

Current and Emerging Treatments for Postsurgical Cleft Lip Scarring: Effectiveness and Mechanisms. Cleft lip with or without cleft palate is the most common congenital malformation of the head and the third-most common birth defect. Surgical repair of the lip is the only treatment and is usually performed during the first year of life. Hypertrophic scar (HTS) formation is a frequent postoperative complication that impairs soft tissue form, function, or movement. Multiple lip revision operations

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2017 Journal of Dental Research

224. Dentition Patterns in Different Unilateral Cleft Lip Subphenotypes. (PubMed)

Dentition Patterns in Different Unilateral Cleft Lip Subphenotypes. Oral clefts play an essential role in disturbed odontogenesis of the deciduous and permanent dentition, yet little is known about this relationship. We investigated, within the categories cleft lip with or without alveolus (CL ± A) and cleft lip, alveolus and palate (CLAP), whether different CL subphenotypes based on morphological severity of the cleft show different dentition patterns and whether a more detailed subdivision (...) of the incomplete CL has clinical relevance. In this retrospective study, 345 children with nonsyndromic unilateral CL ± A and CLAP from the Dutch Association for Cleft Palate and Craniofacial Anomalies (NVSCA) registry were included to assess the association between the CL subphenotypes and lateral incisor patterns. Five different deciduous and permanent patterns of the lateral incisor were distinguished: located in normal position (pattern z/Z), in the anterior segment (pattern x/X) or in the posterior

2017 Journal of Dental Research

225. Disrupted IRF6-NME1/2 Complexes as a Cause of Cleft Lip/Palate. (PubMed)

Disrupted IRF6-NME1/2 Complexes as a Cause of Cleft Lip/Palate. Mutations and common polymorphisms in interferon regulatory factor 6 ( IRF6) are associated with both syndromic and nonsyndromic forms of cleft lip/palate (CLP). To date, much of the focus on this transcription factor has been on identifying its direct targets and the gene regulatory network in which it operates. Notably, however, IRF6 is found predominantly in the cytoplasm, with its import into the nucleus tightly regulated like (...) in patients with CLP (NME1 R18Q in an IRF6 and GRHL3 mutation-negative patient with van der Woude syndrome and NME2 G71V in a patient with nonsyndromic CLP). Both variants disrupted the ability of the respective proteins to interact with IRF6. The data presented suggest an important role for cytoplasmic IRF6 in regulating the availability or localization of the NME1/2 complex and thus the dynamic behavior of epithelia during lip/palate development.

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2017 Journal of Dental Research

226. Direct Anthropometry of Repaired Bilateral Complete Cleft Lip: A Long-Term Assessment. (PubMed)

Direct Anthropometry of Repaired Bilateral Complete Cleft Lip: A Long-Term Assessment. Repair of bilateral complete cleft lip requires more than following a design in a textbook. The operative strategy should incorporate knowledge of anticipated nasolabial changes with growth.Direct nasolabial anthropometry was recorded in 174 children with bilateral complete cleft lip before and immediately after primary repair. Serial measurements were taken in 66 Caucasian patients between the ages of 6 (...) of 174 patients (18 percent), usually performed in late childhood or adolescence.Serial anthropometry documented postoperative changes in nasolabial dimensions compared to normal growth curves. Repair of bilateral complete cleft lip requires primary correction of nasal and labial features based on their differential growth, with special attention to nasal width, philtral height and proportions, and size of the median tubercle.Therapeutic, IV.

2017 Plastic and reconstructive surgery

227. Assessment of complete unilateral cleft lip and palate treatment outcome using EUROCRAN index and associated factors. (PubMed)

Assessment of complete unilateral cleft lip and palate treatment outcome using EUROCRAN index and associated factors. Assessment of treatment outcome is the only non-invasive approach to identify the effects of cleft lip and palate repair and modify management accordingly. Here the aim is to assess the outcome of complete unilateral cleft lip and palate (CUCLP) patients using EUROCRAN index and to check whether there are any factors associated with the treatment outcome.It is a retrospective (...) cross sectional study. Dental models were collected from archives of two cleft referral centers in Pakistan. Five blinded examiners scored 101 models twice at two week interval. The primary outcome was mean EUROCRAN scores based on dental arch relationships and palatal surface morphology.A mean(SD) score of 2.72 (0.76) and 2.20 (0.73) was determined based on dental arch relationships and palatal surface morphology, respectively. According to the final logistic regression model, modified Millard

2017 International Journal of Pediatric Otorhinolaryngology

228. A Comparative Analysis of Recombinant Human Bone Morphogenetic Protein-2 with a Demineralized Bone Matrix versus Iliac Crest Bone Graft for Secondary Alveolar Bone Grafts in Patients with Cleft Lip and Palate: Review of 501 Cases. (PubMed)

A Comparative Analysis of Recombinant Human Bone Morphogenetic Protein-2 with a Demineralized Bone Matrix versus Iliac Crest Bone Graft for Secondary Alveolar Bone Grafts in Patients with Cleft Lip and Palate: Review of 501 Cases. Alveolar cleft reconstruction using iliac crest bone graft is considered standard of care for children with complete cleft lip and palate at the time of mixed dentition. Harvesting bone may result in donor-site morbidity and additional operating time and length (...) of hospitalization. Recombinant human bone morphogenetic protein (rhBMP)-2 with a demineralized bone matrix is an alternative bone source for alveolar cleft reconstruction. The authors investigated the outcomes of rhBMP-2/demineralized bone matrix versus iliac crest bone graft for alveolar cleft reconstruction by reviewing postoperative surgical complications and cleft closure.A retrospective chart review was conducted for 258 rhBMP-2/demineralized bone matrix procedures (mean follow-up, 2.9 years) and 243 iliac

2017 Plastic and reconstructive surgery

229. The effect of various factors on the dental arch relationship in non-syndromic unilateral cleft lip and palate children assessed by new approach: a retrospective study. (PubMed)

The effect of various factors on the dental arch relationship in non-syndromic unilateral cleft lip and palate children assessed by new approach: a retrospective study. Cleft lip and palate (CLP) is one of the most common birth defects. Multiple factors are believed to be responsible for an unfavorable dental arch relationship in CLP. Facial growth (maxillary) retardation, which results in class III malocclusion, is the primary challenge that CLP patients face. Phenotype factors and postnatal (...) treatment factors influence treatment outcomes in unilateral cleft lip and palate (UCLP) children, which has led to a great diversity in protocols and surgical techniques by various cleft groups worldwide. The aim of this study was to illustrate the dental arch relationship (DAR) and palatal morphology (PM) of UCLP in Bangladeshi children and to explore the various factors that are responsible for poor DAR and PM.Dental models of 84 subjects were taken before orthodontic treatment and alveolar bone

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2017 BMC Pediatrics

230. Hearing thresholds and ventilation tube treatment in children with unilateral cleft lip and palate. (PubMed)

Hearing thresholds and ventilation tube treatment in children with unilateral cleft lip and palate. Children with cleft lip and palate have a high prevalence of otitis media with effusion (OME) which is often associated with a fluctuating, conductive hearing loss in the low and mid-frequencies and a risk for permanent hearing loss in the higher frequencies. Although common, there is no consensus on the treatment of OME with ventilation tubes. The aim of this study is to document if the risk (...) for permanent hearing loss and acquired cholesteatoma increases due to treatment with ventilation tubes (VT treatments) during childhood in a group of children with cleft lip and palate.A retrospective medical chart review of 33 children (25 boys and 8 girls) born with unilateral cleft lip and palate (UCLP) was completed. Audiological data (results of hearing sensitivity tests, the total number of hearing tests, and number of VT treatments) were extracted from medical records from when the children were 4-7

2017 International Journal of Pediatric Otorhinolaryngology

231. [Timing of alveolar bone graft and sequences of canine eruption in cases of cleft lip and palate: a systematic review]. (PubMed)

[Timing of alveolar bone graft and sequences of canine eruption in cases of cleft lip and palate: a systematic review]. The alveolar bone graft (ABG) is an important phase in the surgical treatment of cleft lip and palate (CLP). The purpose of alveolar bone grafting is to eliminate oronasal fistulas, restore the continuity of the maxilla and provide optimal periodontal support for spontaneous eruption of permanent canines adjacent to the cleft. The purpose of this systematic review (...) was to determine the ideal timing of the ABG that would achieve these goals.Databases consulted were MEDLINE, Embase et EBSCOhost, using keywords present in the MeSH: [cleft lip and palate] and [alveolar bone graft] and [tooth eruption]. Selection criteria included retrospective studies, prospective studies and meta-analyzes dating from January 2005, with available full text.Among 105 references, 9 articles met our selection criteria. ABG carried out before or just after the eruption of permanent canines

2017 L' Orthodontie francaise

232. ACSS2 gene variant associated with cleft lip and palate in two independent Hispanic populations. (PubMed)

ACSS2 gene variant associated with cleft lip and palate in two independent Hispanic populations. A candidate variant (p.Val496Ala) of the ACSS2 gene (T > C missense, rs59088485 variant at chr20: bp37 33509608) was previously found to consistently segregate with nonsyndromic cleft lip and/or palate (NSCLP) in three Honduran families. Objectives of this study were 1) to investigate the frequency of this ACSS2 variant in Honduran unrelated NSCLP patients and unrelated unaffected controls and 2

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2017 Laryngoscope

233. The Prevalence of Congenital Heart Disease in Nonsyndromic Cleft Lip and/or Palate: A Systematic Review of the Literature. (PubMed)

The Prevalence of Congenital Heart Disease in Nonsyndromic Cleft Lip and/or Palate: A Systematic Review of the Literature. Life-threatening anomalies, such as congenital heart disease (CHD) must be identified in patients with cleft lip and/or palate (CL/P) to minimize perioperative risk. Nevertheless, screening practices vary highly among cleft teams and programs, and little is known about the prevalence and clinical significance of CHD in nonsyndromic CL/P patients. Through a systematic (...) literature review, this study examines the demographics and severity of CHD in the nonsyndromic CL/P population. The implications of concomitant CHD in providing safe and comprehensive cleft care both in the United States and abroad are discussed.A systematic review of PubMed literature from 1980 to September 2015 was performed following PRISMA guidelines. Studies describing rates of CHD and severity of lesions specifically in nonsyndromic and all CL/P patients were included. Analysis of cumulative data

2017 Annals of plastic surgery

234. Predictive validity of the GOSLON Yardstick index in patients with unilateral cleft lip and palate: A systematic review. (PubMed)

Predictive validity of the GOSLON Yardstick index in patients with unilateral cleft lip and palate: A systematic review. Among the various indices developed for measuring the results of treatment in patients born with unilateral cleft lip and palate (UCLP), the GOSLON Yardstick index is the most widely used to assess the efficacy of treatment and treatment outcomes, which in UCLP cases are closely linked to jaw growth. The aim of this study was to conduct a systematic review to validate

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2017 PloS one

235. Maxillofacial growth and speech outcome after one-stage or two-stage palatoplasty in unilateral cleft lip and palate. A systematic review. (PubMed)

Maxillofacial growth and speech outcome after one-stage or two-stage palatoplasty in unilateral cleft lip and palate. A systematic review. The number of surgical procedures to repair a cleft palate may play a role in the outcome for maxillofacial growth and speech. The aim of this systematic review was to investigate the relationship between the number of surgical procedures performed to repair the cleft palate and maxillofacial growth, speech and fistula formation in non-syndromic patients (...) with unilateral cleft lip and palate.An electronic search was performed in PubMed/old MEDLINE, the Cochrane Library, EMBASE, Scopus and CINAHL databases for publications between 1960 and December 2015. Publications before 1950-journals of plastic and maxillofacial surgery-were hand searched. Additional hand searches were performed on studies mentioned in the reference lists of relevant articles. Search terms included unilateral, cleft lip and/or palate and palatoplasty. Two reviewers assessed eligibility

2017 Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery

236. Longitudinal Photogrammetric Analysis of the Columellar-Labial Angle following Primary Repair of Bilateral Cleft Lip and Nasal Deformity. (PubMed)

Longitudinal Photogrammetric Analysis of the Columellar-Labial Angle following Primary Repair of Bilateral Cleft Lip and Nasal Deformity. The changing nasolabial dimensions after repair of bilateral cleft lip and nasal deformity can be documented by anthropometry; however, the columellar-labial angle is rarely measured.This is a study of white patients who had synchronous repair of bilateral cleft lip performed by one surgeon (J.B.M.). The columellar-labial angle was measured on lateral (...) photographs with the subject in neutral head position. Average values for columellar-labial angle at two or more time points were analyzed with a general estimating equation and cubic modeling. Values for complete and incomplete bilateral cleft lips were compared to each other and to Farkas' norms. Direct anthropometric measurements of intraoperative columellar length were compared to the postoperative columellar-labial angle using Pearson correlation analysis.Eighty-five patients were studied (64

2017 Plastic and reconstructive surgery

237. An anatomical subunit-based outcome assessment scale for bilateral cleft lip and palate. (PubMed)

An anatomical subunit-based outcome assessment scale for bilateral cleft lip and palate. As there is currently no internationally accepted outcome measurement tool available for complete bilateral cleft lip and palate (CBCLP), the goal of this prospective study was to develop a numerical evaluation scale that allows reliable scoring of this cleft deformity. Our cohort comprised 121 Indian subjects with CBCLP who underwent surgical repair (mean age at time of surgery 6.53 months) using (...) a modified Millard technique. A panel of three professionals evaluated each subject's outcome of bilateral cleft lip repair 6 months postoperatively on two-dimensional (2D) full-face photographs in the frontal view and worm's eye view. A simple two-point rating system was applied to separately analyse a total of 12 components of lip, nose, and scar. The results and mean scores for the analysed anatomical areas were 2.2±1.01 (max=3) for nose, 5.4±1.54 (max=8) for lip, and 1.9±1.3 (max=3) for scar

2017 International Journal of Oral and Maxillofacial Surgery

238. A Comparative Analysis of rhBMP-2/DBM vs. ICBG for Secondary Alveolar Bone Grafts in Patients with Cleft Lip and Palate: Review of 501 Cases. (PubMed)

A Comparative Analysis of rhBMP-2/DBM vs. ICBG for Secondary Alveolar Bone Grafts in Patients with Cleft Lip and Palate: Review of 501 Cases.

2017 Plastic and reconstructive surgery

239. Gingival esthetics and oral health-related quality of life in patients with cleft lip and palate. (PubMed)

Gingival esthetics and oral health-related quality of life in patients with cleft lip and palate. While the oral health-related quality of life (OHRQoL) is known to be reduced in patients with cleft lip and palate (CLP), its inter-dependency with the soft tissue characteristics of the CLP area remains unclear. This study aimed to evaluate the soft tissue characteristics in the treated cleft area in order to investigate whether gingival esthetics correlate with OHRQoL. Thirty-six patients (...) with unilateral or bilateral CLP (46 cleft areas) were investigated after secondary/tertiary alveolar bone grafting and orthodontic/prosthetic implant treatment using an adapted score to rate gingival esthetics (clinical esthetic score, CES). The patient's OHRQoL was determined using the German short version of the Oral Health Impact Profile questionnaire (OHIP-G14). The results showed a significantly better rating in patients with their own teeth in situ (12.05±1.10) than in patients with implants (6.95±4.78

2017 International Journal of Oral and Maxillofacial Surgery

240. Towards Microsurgical Correction of Cleft Lip Ex Utero via Restoration of Craniofacial Developmental Programs. (PubMed)

Towards Microsurgical Correction of Cleft Lip Ex Utero via Restoration of Craniofacial Developmental Programs. Cleft lip with or without cleft palate is present in approximately one in 500 to 700 live births, representing the most common congenital craniofacial anomaly. Previously, the authors developed a unique murine model with compound Pbx deficiency that exhibits fully penetrant cleft lip with or without cleft palate. To investigate the possibility of tissue repair at an early gestational (...) at the midface lambdoidal junction. Embryos were cultured in a 37°C modified whole-embryo culture system.Targeted release of Wnt9b resulted in augmented Wnt expression at the lambdoidal junction. Microsurgical implantation of Wnt9b-soaked microspheres resulted in cleft correction in 27.1 percent of the Pbx-deficient embryos. The difference in the ratio of the areas of clefting between implanted and nonimplanted embryos was significant (p < 0.05).Ex utero correction of cleft lip with or without cleft palate

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2017 Plastic and reconstructive surgery

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