[Presurgical orthopedic treatment of children with unilateral cleft lip and palate with a sequential splints method: indications and long-term results]. / Predoperatsionnoe ortopedicheskoe lechenie detei s odnostoronnei rasshchelinoi guby, al'veolyarnogo otrostka i neba s ispol'zovaniem korrektsionnykh kapp: pokazaniya k primeneniyu, otdalennye rezul'taty lecheniya.

OBJECTIVES: To justify the use of the Sequential Splints Method of presurgical orthopedic treatment for children with unilateral cleft lip and palate depending on extent of initial deformation and to estimate long-term results. MATERIALS AND METHODS: The method was applied in 17 unilateral cleft lip and palate infants who received treatment at the age from 4 days to 3 months. There was a control group of 28 cleft lip and palate patients operated with no early orthodontics. Average age in both groups at the time of research was 3.8±0.9 years. Comparative assessment was conducted before the beginning of the post-operative orthodontic treatment for the following parameters: residual width of the alveolar process cleft, presence of lateral incisor's bud, the extent of the nose deformation on the cleft side. RESULTS: It was found that residual width of the alveolar process cleft was, on average, 5.95 mm in the main group and 12.6 mm in the control group. The percentage of the lateral incisor adentia was 28% in the main group and 66% in the control group. The mean score of alar nose deformation was 3.9 and 3.1 points, correspondingly. CONCLUSION: According to obtained results patients who did not receive the presurgical orthopedic treatment were more likely to have residual deformations and larger residual width of the alveolar process cleft. There was higher risk of teeth germs loss in the control group. The Sequential Splints Method of presurgical orthopedic treatment is recommended as a necessary part of the treatment for the unilateral cleft lip and palate.

The role of external aetiological factors in dental anomalies in non-syndromic cleft lip and palate patients.

AIM: The hypothesis tested was whether proper tooth development in cleft lip and palate (CLP) patients is affected by early orthopaedic treatment (EOT), primary surgical interventions and palatal defects after primary palatoplasty. METHODS: The prospective study groups comprised 369 CLP children (aged 11.0 ± 4.5 years) and 500 healthy children (aged 11.1 ± 3.8 years) aged > 6 years without any diseases associated with increased risk of dental anomalies. Patients were examined clinically and radiologically. Primary treatment details and outcomes were extracted from the hospital records registry and analysed to evaluate the role of possible external aetiological factors in dental abnormalities. RESULTS: Selective tooth aplasia was the commonest dental abnormality with upper lateral incisors missing in 33.9% of CLP patients and 3.4% of controls. Central incisor agenesis was restricted to early primary periosteoplasty cases. Lateral incisor aplasia on the cleft side was significantly associated with palatal defect (P = 0.0003) and primary lip surgery type (P = 0.008). The prevalence of developmental enamel defects (DEDs) correlated with primary surgical procedure (P = 0.002), palatal defect and lack of EOT (P = 0.03 and 0.04, respectively). CONCLUSIONS: Surgical trauma during early primary periosteoplasty, reduced blood supply associated with palatal defects and absence of EOT significantly increase the prevalence of frontal tooth anomalies. The prevalence of dental abnormalities in CLP patients depends on treatment protocol.

[Resorbable vs nonresorbable fixation in alveolar bone grafting in unilateral cleft lip and palate patients]. / Otsenka éffektivnosti rezorbiruemoi i nerezorbiruemoi fiksatsii transplantata pri kostnoi plastike verkhnei cheliusti u detei s odnostoronnei rasshchelinoi guby i neba.

The aim of the study was to evaluate the resorbable vs nonresorbable fixation efficiency in bone grafting for unilateral cleft lip and palate (UCLP) patients. Thirty eight UCLP patients aged from 7 to 17 years (mean 11.5±3.1 years) were divided in two groups with different types of cortical graft fixation: group 1 ─ titanium screws (22 patients), group 2 ─ resorbable pins (16 patients). The Bergland and Chelsea scales were used to evaluate the outcomes 8 months after surgery. Additional authors' original scales were introduced: bone volume scale and pyriform rim restoration scale. The Bergland and Chelsea scales have shown good results in groups 1 and 2 in 91 and 81% of cases, satisfactory in 4.5 and 19% of cases, respectively. Upon the bone volume scale good results were achieved in groups 1 and 2 in 64 and in 75% of cases, satisfactory results - in 18 and 19% of cases, respectively. Upon the pyriform rim restoration scale good results achieved in 59 and 88% of cases, respectively. We also took into consideration the influence of age, diagnosis, post-op complications. No statistically significant difference between groups was found, with neither age nor diagnosis showing any influence. Only postsurgical complications and the stability of the orthodontic design seem to be important for good bone formation after alveolar bone grafting.

[Modern approach to early orthopedic treatment in cleft lip and palate children].

The aim of the study was to enhance the quality of early orthopedic treatment in cleft lip and palate (CLP) children. Thirty-six infants aged 1 to 6 months were included in the study. The new method of early CLP orthopedic treatment using set of consecutive splints showed some advantages in compare with existing methods for alveolar bone deformity correction. The elaborated technology for CAD/CAM splints fabrication allows precise positioning of maxillary fragments thus improving overall outcome and making it more predictable.

[Effectiveness and safety of replacement treatment with the growth hormone drug Saizen in a new formulation].

The purpose of the study was to evaluate the efficacy of growth hormone (GH) drug Saizen in a new formulation (lyophilizate for the preparation of solution for injections as 8-mg vials in combination with bacteriostatic solvent in cartridges) in children with GH deficiency and to determine whether a Van.Click syringe-pen was handy for injection of Saizen in the new formulation. Thirty children (7 girb and 23 boys) were treated for 6 months. Ten patients had isolated GT deficiency; 18 patients had multiple adenohypophyseal hormonal deficiency; de Morsiau's syndrome was observed in 2 patients. The dose of the test drug was 0.033 mg/kg/day. During 6-month treatment, Slzen showed a good growth-stimulating effect: the mean growth rate was 11.15±0.71 cm/year; there was a 2-3-fold increase in the baseline low levels of insulin-like growth factor (ILGF-1) and ILGF-CB-3. Over 6 months of treatment, there was a significant decrease in the sum of 4 measured fat folds, which suggests a reduction in the body's adipose tissue. Significant changes were observed in biochemical parameters during the performed therapy: the decrease in the levels of total cholesterol and low-density lipoproteins, which suggests the antiatherogenic effect of GH therapy on lipid metabolism; a significant increase in the level of calcium and phosphorus, the activity of alkaline phosphatase, which is 3.5 times greater than the normal values, which indicate the acceleration of bone metabolic processes. According to the evaluation made, there were no unfavorable phenomena or significant deviation from the normal laboratory parameters, including glucose values. By and large, Sizen tolerance may be regarded as good and its treatment is safe. The use of the autoinjector for GH administration is handy and atraumatic to patients.