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Cleft Lip

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341. Alveolar Bone Grafting With rhBMP2 may Benefit Patients Undergoing Surgical Correction of Cleft Lip/Palate

Alveolar Bone Grafting With rhBMP2 may Benefit Patients Undergoing Surgical Correction of Cleft Lip/Palate UTCAT2158, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Alveolar Bone Grafting With rhBMP2 May Benefit Patients Undergoing Surgical Correction of Cleft Lip/Palate Clinical Question In Cleft lip/palate patients with alveolar clefting, does the use of rhBMP2 for secondary grafting provide as good or better (...) outcomes compared to autogenous grafting from the iliac crest? Clinical Bottom Line The use of rhBMP-2 could be a promising alternative to autogenous iliac crest grafting for secondary bone alveolar cleft grafts in children with cleft lip/palate. (See Comments on the CAT below) 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) Dickinson/2008 Adolescents with alveolar clefting Randomized Controlled Trial Key

2011 UTHSCSA Dental School CAT Library

342. No Current Evidence to Suggest That Teeth Closer To A Surgically Corrected Cleft Lip And Palate Are At Increased Risk For Periodontitis

No Current Evidence to Suggest That Teeth Closer To A Surgically Corrected Cleft Lip And Palate Are At Increased Risk For Periodontitis UTCAT2147, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title No Current Evidence to Suggest That Teeth Closer To A Surgically Corrected Cleft Lip And Palate Are At Increased Risk For Periodontitis Clinical Question Do teeth in close approximation of a surgically corrected cleft palate (...) have a higher risk of periodontitis than other teeth in a patient’s mouth? Clinical Bottom Line The cleft areas do not present a higher prevalence or severity of periodontal pockets and clinical attachment loss than the other areas of their mouth. 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) de Almeida/2009 400 Patients with complete cleft lip and palate Cross-Sectional Key results Comparison

2011 UTHSCSA Dental School CAT Library

343. Distraction osteogenesis or orthognathic surgery for hypoplastic maxilla in cleft lip and palate

Distraction osteogenesis or orthognathic surgery for hypoplastic maxilla in cleft lip and palate Distraction osteogenesis or orthognathic surgery for hypoplastic maxilla in cleft lip and palate - National Elf Service Search National Elf Service Search National Elf Service » » » » Distraction osteogenesis or orthognathic surgery for hypoplastic maxilla in cleft lip and palate Oct 11 2016 Posted by Cleft lip and palate (CLP) is a common birth defect with a global prevalence of between 1 in 5-700 (...) osteogenesis compared to orthognathic surgery for the treatment of hypoplastic maxilla in people with cleft lip and palate. Method Searches were conducted in the Cochrane Oral Health’s Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS, ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry databases with no language restrictions. Randomised controlled trials (RCTs) comparing maxillary distraction osteogenesis

2016 The Dental Elf

344. Infraorbital nerve block for postoperative pain following cleft lip repair in children

Infraorbital nerve block for postoperative pain following cleft lip repair in children Infraorbital nerve block for postop pain following cleft lip repair Search National Elf Service Search National Elf Service » » » » Infraorbital nerve block for postoperative pain following cleft lip repair in children Apr 22 2016 Posted by Cleft lip is one of the most common craniofacial birth defects and requires early correction. It can be carried out during the neonatal period or earlier although timing (...) depends on the type and severity of the deformity, the child’s health and other factors. Pain postoperatively can be a problem and result in psychological, cardiorespiratory, and metabolic issues. The aim of this Cochrane Review was to assess the effects of infraorbital nerve block for postoperative pain following cleft lip repair in children. Methods Searches were conducted in the Cochrane Central Register of Controlled Trials (CENTRAL) , Medline, Embase, LILACS, the metaRegister of Controlled Trials

2016 The Dental Elf

345. Massively Increased Caries Susceptibility in an Irf6 Cleft Lip/Palate Model. (Abstract)

Massively Increased Caries Susceptibility in an Irf6 Cleft Lip/Palate Model. Patients with cleft lip/palate (CLP) have been reported, in some studies, to exhibit an increased prevalence of caries, although the underlying cause for this increase is unknown. In genetically defined mouse models, studies of postnatal sequelae associated with CLP have been hampered by neonatal lethality. Using a conditional targeting approach, we ablated the major CLP gene Irf6 only in the late embryonic oral (...) epithelium ( Irf6 cKO), bypassing the role of the gene in lip and palate morphogenesis and thus ensuring survival to adulthood. We report that Irf6 cKO mice present with 1) dysplastic salivary glands due to disruptions of epithelial junctional complexes, likely secondary to elevated activation of RHO GTPases, and 2) increased salivary cell proliferation. These changes result in significantly reduced saliva flow rate and buffering capacity and increased mucus acidity. A marked decrease in expression

2016 Journal of Dental Research

346. Alveolar Bone Grafting and Cleft Lip and Palate: A Review. (Abstract)

Alveolar Bone Grafting and Cleft Lip and Palate: A Review. Alveolar bone grafting in the mixed dentition stage is an accepted step in the management of cleft alveoli, providing maxillary arch support for dentition and mastication. Points of contention regarding best practices remain, including specific timing, perioperative orthodontic management, bone harvest and substitutes, pain management, and outcomes evaluations. SCOPUS and MEDLINE were searched for articles about alveolar bone grafting

2016 Plastic and reconstructive surgery

347. Cone-beam computed tomography-synthesized cephalometric study of operated unilateral cleft lip and palate and noncleft children with Class III skeletal relationship. (Abstract)

Cone-beam computed tomography-synthesized cephalometric study of operated unilateral cleft lip and palate and noncleft children with Class III skeletal relationship. Our objective was to compare the craniofacial hard and soft tissue characteristics between children with operated unilateral cleft lip and palate (UCLP) and children with noncleft lip and palate (non-CLP) with a Class III skeletal relationship.The study sample consisted of 30 subjects (18 boys, 12 girls; mean age, 10.21 years

2016 American journal of orthodontics and dentofacial orthopedics

348. The Changing Nasolabial Dimensions following Repair of Unilateral Cleft Lip: An Anthropometric Study in Late Childhood. (Abstract)

The Changing Nasolabial Dimensions following Repair of Unilateral Cleft Lip: An Anthropometric Study in Late Childhood. Repair of unilateral cleft lip and nasal deformity in three dimensions requires anticipation of changes in the fourth dimension that can be determined by periodic and objective assessment.Fifty patients with unilateral cleft lip with or without cleft palate underwent primary repair from 1999 to 2004 and were followed through 2014. Anthropometry was performed immediately (...) times of follow-up measurements. Transverse labial width at the cutaneous-vermilion border remained shorter on the cleft side, but this difference decreased in the second period.Understanding how nasolabial features change with growth is critical to crafting the initial repair of unilateral cleft lip and nasal deformity.Therapeutic, IV.

2016 Plastic and reconstructive surgery

349. MSX1 gene polymorphisms in Mexican patients with non-syndromic cleft lip/palate. (Abstract)

MSX1 gene polymorphisms in Mexican patients with non-syndromic cleft lip/palate. Non-syndromic cleft lip/palate malformation (CL/P) is one of the most common birth defects in humans and has a complex etiology involving genetic and environmental factors. Mutations in the MSX1 gene are critical during craniofacial development. The purpose of this study was to investigate the contribution of MSX1 gene polymorphisms to the risk of developing CL/P in a sample of Mexican patients.The sample consisted

2016 International Journal of Pediatric Otorhinolaryngology

350. Palatal growth in complete unilateral cleft lip and palate patients following neonatal cheiloplasty: Classic and geometric morphometric assessment. (Abstract)

Palatal growth in complete unilateral cleft lip and palate patients following neonatal cheiloplasty: Classic and geometric morphometric assessment. A new method of early neonatal cheiloplasty has recently been employed on patients having complete unilateral cleft lip and palate (cUCLP). We aimed to investigate (1) their detailed palatal morphology before surgery and growth during the 10 months after neonatal cheiloplasty, (2) the growth of eight dimensions of the maxilla in these patients, (3

2016 International Journal of Pediatric Otorhinolaryngology

351. Crowdsourcing as a Novel Method to Evaluate Aesthetic Outcomes of Treatment for Unilateral Cleft Lip. (Abstract)

Crowdsourcing as a Novel Method to Evaluate Aesthetic Outcomes of Treatment for Unilateral Cleft Lip. Lack of convenient and reliable methods to grade aesthetic outcomes limits the ability to study results and optimize treatment of unilateral cleft lip. Crowdsourcing methods solicit contributions from a large group to achieve a greater task. The authors hypothesized that crowdsourcing could be used to reliably grade aesthetic outcomes of unilateral cleft lip.Fifty deidentified photographs of 8 (...) - to 10-year-old subjects (46 with unilateral cleft lip and four controls) were assembled. Outcomes were assessed using multiple pairwise comparisons that produced a rank order (Elo rank) of nasal appearance and, on a separate survey, by Asher-McDade ratings. Both surveys were repeated to assess reliability. A group of expert surgeons repeated the same tasks on a smaller subset of photographs.The authors obtained 2500 and 1900 anonymous, layperson evaluations by means of crowdsourcing on each Elo rank

2016 Plastic and reconstructive surgery

352. The Feasibility and Validity of PROMIS: A Novel Measure of Quality of Life among Children with Cleft Lip and Palate. (Abstract)

The Feasibility and Validity of PROMIS: A Novel Measure of Quality of Life among Children with Cleft Lip and Palate. Health-related quality of life is inconsistently captured among children with cleft lip and palate. The Patient-Reported Outcomes Measurement Information System (PROMIS) captures health-related quality of life, with the added benefit of comparability across clinical conditions. In this study, the authors define the validity and feasibility of PROMIS among children (...) with clefts.Children with cleft lip and palate who were at least 5 years old and able to complete instruments independently were eligible for inclusion (n = 93). Children completed PROMIS anxiety, depression, and peer relationship item banks as short forms or computerized adaptive tests. Participants also completed the Pediatric Quality of Life Inventory. Construct validity was measured by Spearman correlations between PROMIS and the Pediatric Quality of Life Inventory controlling for race, sex, age, and income

2016 Plastic and reconstructive surgery

353. Dentoskeletal outcomes of a rapid maxillary expander with differential opening in patients with bilateral cleft lip and palate: A prospective clinical trial. Full Text available with Trip Pro

Dentoskeletal outcomes of a rapid maxillary expander with differential opening in patients with bilateral cleft lip and palate: A prospective clinical trial. The purpose of this 2-arm parallel study was to evaluate the dentoskeletal effects of rapid maxillary expansion with differential opening (EDO) compared with the hyrax expander in patients with complete bilateral cleft lip and palate.A sample of patients with complete bilateral cleft lip and palate was prospectively and consecutively (...) recruited. Eligibility criteria included participants in the mixed dentition with lip and palate repair performed during early childhood and maxillary arch constriction with a need for maxillary expansion before the alveolar bone graft procedure. The participants were consecutively divided into 2 study groups. The experimental and control groups comprised patients treated with rapid maxillary expansion using EDO and the hyrax expander, respectively. Cone-beam computed tomography examinations and digital

2016 American journal of orthodontics and dentofacial orthopedics Controlled trial quality: uncertain

354. Parent satisfaction with primary repair of paediatric cleft lip in Southwest China. (Abstract)

Parent satisfaction with primary repair of paediatric cleft lip in Southwest China. The purpose of this study was to investigate the key factors in relation to parent satisfaction with the primary repair of paediatric cleft lip. One hundred and ninety-five children born with cleft lip and/or palate aged between 3 months and 1 year were recruited, along with their caregivers. All patients underwent primary cleft lip repair, and a telephone interview was held with their main caregivers at 3 (...) months postoperative. The level of satisfaction with each item included in a simplified Cleft Evaluation Profile was ascertained and recorded. Patient clinical data were obtained from the medical records. One hundred and thirty-eight (71%) parents reported satisfaction with the general outcome of surgery. Parents were satisfied with the appearance of the lip and profile of the face, but were dissatisfied with the appearance of the nose and teeth. Mothers of patients showed lower satisfaction levels

2016 International Journal of Oral and Maxillofacial Surgery

355. Estimate of Unmet Need for Cleft Lip and/or Palate Surgery in India. Full Text available with Trip Pro

Estimate of Unmet Need for Cleft Lip and/or Palate Surgery in India. The unmet need for cleft lip and/or palate (CL/P) care in India is significant. However, estimates required for CL/P care program planning are lacking.To estimate the unmet need for CL/P surgery in India at the state level.To determine the proportion of individuals with CL/P who presented for care in India, data were used from patients who received care at Operation Smile programs in 12 low- and middle-income countries from (...) June 1, 2013, to May 31, 2014. The resulting model describes the prevalent unmet need for cleft surgery in India by state and includes patients older than the surgery target ages of 1 and 2 years for cleft lip and cleft palate repair, respectively. Next, the total number of unrepaired CL/P cases in each state was estimated using state-level economic and health system indicators.Prevalent unmet need for CL/P repair.In the 28 states with available data, an estimated 72 637 cases of unrepaired CL/P

2016 JAMA facial plastic surgery

356. GAND classification and volumetric assessment of unilateral cleft lip and palate malformations using cone beam computed tomography. (Abstract)

GAND classification and volumetric assessment of unilateral cleft lip and palate malformations using cone beam computed tomography. The aim of this study was to propose a classification for unilateral cleft lip and palate (UCLP) malformations based on cone beam computed tomography (CBCT) images, as well as to estimate the amount of bone necessary for grafting, and to evaluate the relationship of this volume with scores obtained using the classification. CBCT images of 33 subjects with UCLP were (...) . The intra-observer reproducibility of the classification ranged from 0.29 to 0.92 and the inter-observer agreement ranged from 0.29 to 0.91. There were no statistically significant values when evaluating the association of the volume with the classification (P>0.05). The GAND classification is a novel system that allows the quick estimation of the extent and complexity of the cleft. It is not possible to estimate the amount of bone needed for alveolar bone grafting based on the classification

2016 International Journal of Oral and Maxillofacial Surgery

357. Effects of maxillary protraction therapy on the pharyngeal airway in patients with repaired unilateral cleft lip and palate: A 3-dimensional computed tomographic study. (Abstract)

Effects of maxillary protraction therapy on the pharyngeal airway in patients with repaired unilateral cleft lip and palate: A 3-dimensional computed tomographic study. The purposes of this study were to assess the effects of maxillary protraction therapy on the pharyngeal airways in patients with repaired unilateral cleft lip and palate (UCLP) 3 dimensionally.Eighteen patients with repaired UCLP and anterior crossbite (ages, 10.4 ± 1.3 years) were enrolled in the study group. Hyrax appliances

2016 American journal of orthodontics and dentofacial orthopedics

358. Analysis of the maxillary dental arch after rapid maxillary expansion in patients with unilateral complete cleft lip and palate. Full Text available with Trip Pro

Analysis of the maxillary dental arch after rapid maxillary expansion in patients with unilateral complete cleft lip and palate. Although rapid maxillary expansion has been extensively studied in noncleft patients, scarce evidence of maxillary effects is found for patients with oral clefts. Our objective was to evaluate the dentoalveolar effects of rapid maxillary expansion in children with unilateral complete cleft lip and palate compared with noncleft patients.The experimental group included (...) 25 patients with unilateral complete cleft lip and palate and posterior crossbite (9 girls, 16 boys; mean age, 10.6 years). The control group comprised 27 noncleft patients with posterior crossbite (14 boys, 13 girls; mean age, 9.1 years). The experimental group had lip and palate repairs at 3 and 12 months of age, respectively, and maxillary expansion was indicated before a secondary alveolar bone graft. Digital dental models were obtained immediately before expansion and 6 months after

2016 American journal of orthodontics and dentofacial orthopedics

359. The Essential Anatomical Subunit Approximation Unilateral Cleft Lip Repair. (Abstract)

The Essential Anatomical Subunit Approximation Unilateral Cleft Lip Repair. The anatomical subunit approximation cleft lip repair advantageously achieves a balanced lip contour, with the line of repair hidden along seams of aesthetic subunits. Dr. David Fisher's original description of the repair reflects the considerable thought that went into the evolution of his design. As his technique has gained acceptance in the intervening 10 years, the authors note several key principles embodied (...) in it that represent a shift in the cleft lip repair paradigm. The authors believe understanding these principles is important to mastery of the anatomical subunit technique, and facilitate its teaching. First, design a plan that adheres to anatomical subunits and perform measurements precisely. Second, identify and adequately release each cleft tissue layer from the lip and nose to enable restoration of balance. Third, drive surgical approximation through inset of the lateral muscle into the superiorly backcut

2016 Plastic and reconstructive surgery

360. Full Spectrum of Postnatal Tooth Phenotypes in a Novel Irf6 Cleft Lip Model. Full Text available with Trip Pro

Full Spectrum of Postnatal Tooth Phenotypes in a Novel Irf6 Cleft Lip Model. Clefting of the lip, with or without palatal involvement (CLP), is associated with a higher incidence of developmental tooth abnormalities, including hypodontia and supernumerary teeth, aberrant crown and root morphologies, and enamel defects, although the underlying mechanistic link is poorly understood. As most CLP genes are expressed throughout the oral epithelium, the authors hypothesized that the expression of CLP

2016 Journal of Dental Research

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