Comparison of Nasopharyngeal Airway Volume in Cleft Lip and Palate Patients With Normal Individuals Using Cone Beam Computed Tomography.

This study aimed to compare nasopharyngeal airway volume in cleft lip and palate patients with normal individuals using Cone Beam Computed Tomography (CBCT). In this cross-sectional study, 40 CBCT scans of 9 to 12-years-old patients were enrolled and divided into 3 groups: normal individuals (n=16), unilateral cleft lip and palate (UCLP, n=14) and bilateral cleft lip and palate patients (BCLP, n=10). Superior and middle pharyngeal airway volumes and nasal width were measured and compared between 3 groups. ANOVA and χ 2 tests were used for statistical comparison. P <0.05 was considered significant. Superior airway volume was not significantly different between the 3 groups ( P =0.36). However, there was a significant difference between the 3 groups regarding middle pharyngeal volume ( P =0.49) and nasal width ( P =0.021). There was not a significant difference in the upper and middle pharyngeal volume and also nasal width between the 2 sexes. Considering different dimensions of evaluation of the pharyngeal airway volume of cleft lip and palate patients, the evaluation of airway volume is essential during orthodontic or orthognathic surgical treatments that expand or protect the maxilla.

Effect of Platelet-rich Plasma on the Clinical Success of Alveolar Grafts in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis.

OBJECTIVES: This study assessed the effect of platelet-rich plasma (PRP) on the clinical success of alveolar grafts in patients with cleft lip and palate. MATERIALS AND METHODS: In this meta-analysis, a search of the literature was conducted in Medline, Scopus, ISI Web of Science, and Cochrane Central Register of Controlled Trials for randomized clinical trials using PRP or platelet-rich fibrin (PRF) along with autogenous bone for alveolar ridge grafts in patients with cleft lip and palate. The methodological quality of the studies was analyzed using Cochrane's risk of the bias assessment tool. The extracted data underwent meta-analysis using the random-effects model. RESULTS: Of a total of 2256 articles retrieved, 12 met the eligibility criteria and were enrolled; out of which 6 did not undergo meta-analysis due to heterogeneous data. The percentage of defects filled by bone graft was 0.648% (95% confidence interval: -0.15 to 1.45), which was not statistically significant ( P =0.115). Subgroup analysis showed no significant difference based on the use of PRF or PRP ( P =0.28), type of cleft (unilateral/bilateral; P =0.56), or type of radiographic modality (3D/2D; P =0.190). Meta-regression analysis showed that the duration of follow-up and the difference in the mean age of patients did not have a significant effect on the results (R=0, I2: high). CONCLUSION: The application of PRP/PRF in combination with autogenous bone graft did not have a significant effect on the percentage of alveolar cleft filled by a bone graft. Future clinical studies are required to further elucidate the effect of PRP in the regeneration of alveolar clefts.

The impact of immediate versus delayed mini-screw placement on alveolar bone preservation and bone density following tooth extraction: evidence from a canine model.

The aim of this study was to evaluate the impact of mini-screw placement on the alveolar ridge using a split-mouth design. Twelve beagles underwent bilateral extraction of their lateral teeth. In the immediate group, a mini-screw was unilaterally placed approximately 3-4 mm below the alveolar crest of the extraction site on the experimental side. The delayed group received mini-screws six weeks after tooth extraction. On average, the dogs were sacrificed after 11 weeks, and the maxillary bones were excised and scanned using cone-beam computed tomography (CBCT). Histopathological examinations were conducted to assess inflammation and bone formation scores. The results showed that in the immediate group, bone height was significantly greater on the intervention side compared to the control side (p < 0.05), whereas there was no significant difference in the delayed group. In both groups, there was a significant increase in bone density around the mini-screws compared to the control sides (p < 0.05). Mini-screw insertion led to a significant enhancement of bone growth in both groups (p < 0.05), with no notable differences between the two groups. The mini-screws did not have any impact on bone inflammation or width. Overall, both immediate and delayed mini-screw placement in the extraction socket positively influenced bone dimensions, density, and histological properties. However, immediate insertion was more effective than delayed placement in preserving vertical bone height, despite delayed insertion resulting in higher bone density.

Age-Dependent Three-Dimensional Evaluation of Circummaxillary Sutures Maturation in Normal Population Using Cone-Beam Computed Tomography: Early Childhood Through Adolescence.

INTRODUCTION: Initiation time of dentofacial orthopedics is as important as the choice of treatment protocol. Morphology and degree of fusion of circummaxillary sutures differ in various populations; hence, the aim of this study was to evaluate the exact age of ossification of the most important maxillary suture using cone-beam computed tomography to find the appropriate age to start orthopedic treatment. METHODS AND MATERIALS: This cross-sectional retrospective study was performed on 517 cone-beam computed tomography images of patients aged 6 to 18 years old. Patients with obvious pathology or fractures were excluded from the study. Two independent observers scored the radiographs. The ossification stage of the zygomatico-maxillary suture (ZMS) was classified into 5 stages and each suture was classified according to age and sex of the patients. Kendall Taub, Kruskal-Wallis, Mann-Whitney U test, and Bayesian analysis were used for statistical analysis. Statistical significance was set at P value < 0.05. RESULTS: In this study, 517 samples consisting of 260 females (50.3%) and 257 males (49.7%) with a mean age of 12.03 ± 3.74 years old were examined. A significant difference did not exist between the 2 sexes regarding the stages of ZMS ossification except for in stage E. The ZMS transitional stage from B to C was found to occur at the age of 11.8 in boys and 12.6 in girls. CONCLUSIONS: According to the transitional age of ZMS maturation from stage B to C, it seems that orthopedic treatments of the maxilla are not much effective after the age of 12. Therefore, the authors should start orthopedic treatment of the maxilla before the age of 12 in both sexes.

Anthropometric Parameters of Nasomaxillary Complex in 2, 4, 6, and 12-Month-Old Children as a Reference for Cleft Lip and Palate Reconstructive Surgery.

ABSTRACT: The purpose of this study was to analyze the morphology of the nasomaxillary complex of Iranian healthy infants of 2, 4, 6, and 12-month-old.In this cross-sectional study, 232 healthy Fars infants of 2, 4, 6, and 12-month-old referred to Mashhad health centers were evaluated. Photographic images were taken from the infants' frontal view at rest position. Anthropometric landmarks including width of the mouth, nose, columella, width and height of the philtrum, and height of the upper lip were measured by Photoshop software.The authors did not find any considerable differences in nasolabial morphology of Fars children between boys and girls, except for columellar width and the width of superior philtrum at all intervals. The mean columellar width decreased with increasing age in both sexes. The width of the lower philtrum decreased from 2 to 4 months in both sexes, but increased from 4 to 6 months. In girls, the mean height of the right and left philtrum and height of the upper lip increased by increasing age from 2 to 4 months. But it consistently reduced from 4 months to 6 and 12-month-old. In boys, the mean height of the right and left philtrum and height of the upper lip decreased from 2 to 4 months. It showed a mild increase from 4 to 6 months, and a relatively large reduction from 6 to 12 months.This study provides useful information for reconstructive surgeries of the nasolabial region in the population studied.

Do Patients With Cleft Lip and Palate Differ From Normal Individuals in Skeletal Maturity?

Orthopedic treatment to improve deficient maxillary growth of cleft lip and palate patients is an important part of treatment. The success of this treatment is strongly dependent on the time of initiation of therapy. There has been a large controversy in the available literature regarding the skeletal age of these patients. The aim of the present study was to compare the skeletal age of cleft lip and palate patients with normal individuals.37 unilateral and 14 bilateral cleft lip and palate patients and 47 healthy individuals participated in this cross-sectional study. The patients were classified into 8 to 10 and 11 to 14-year-old individuals. Cervical vertebral maturational stage of participants was evaluated in the lateral cephalometry. The skeletal age of cleft lip and palate patients was compared with normal controls. Chi-square was used for statistical analysis. There was not a significant difference in the skeletal developmental stage of unilateral and bilateral cleft compared to their normal peers according to their age and sex. Also, significant difference in skeletal maturational stage of cleft lip and palate patients was not found between boys and girls (P = 0.8). Similarly, no significant difference was found in the skeletal age of the 3 studied groups without considering the age and sex of participants (P = 0.5). Regarding the similar skeletal maturational stage of cleft lip and palate patients with normal controls in our study, their maxillofacial orthopedic treatment can be initiated at similar time to normal peers.

Fractional CO2 laser treatment for post-surgical lip scars in cleft lip and palate patients.

Post-surgical scars of cleft lip patients can lead to abnormal lip activity, which causes deficient maxillary growth. The aim of the present study was to assess the effect of laser therapy on the appearance and electrical activity of the upper lip in cleft lip and palate patients. Twelve patients with cleft lip and palate participated in this study. All patients had surgically repaired the cleft lip at the age of about 3-6 months. The lip scars underwent five fractional CO2 laser treatment sessions with a 4-week interval. Improvement of the quality of the skin texture was recorded according to quartile grading scale based on photographs taken before and 1 month after treatment. Patients' satisfaction survey was also recorded using Patient Scar Assessment Questionnaire (PSAQ) before and after laser therapy. Moreover, the EMG activity of the upper lip muscle was measured before and after treatment. According to dermatologists, the improvement of scar appearance ranged from 0.5 to 3, with a mean of 1.29 ± 0.86. Mean scores of the scar appearance (p < 0.001), symptoms (p = 0.003), and scar consciousness (p < 0.001) subscales of the PSAQ questionnaire had significantly increased after treatment. The EMG recording of the upper lip had decreased significantly after laser treatment at rest (p = 0.009) and maximum lip compression (p = 0.007). The fractional CO2 laser is an effective method for treating old scars of the cleft lip with a significant change in the opinion of patients about their scar appearance. Also, the therapy can help to reduce the EMG activity of the upper lip at rest.

Recombinant Human Bone Morphogenic Protein-2 Combined With Autogenous Bone Graft for Reconstruction of Alveolar Cleft.

Recombinant human bone morphogenic proteins (rhBMPs) have been introduced for reconstruction of alveolar defects. The volume of the bone formed at the cleft region may be related to rhBMP-2 dose. Greater side effects have been reported with increased doses of rhBMP-2. The aim of the present study was to assess the bone at the cleft area using low dose of rhBMP-2 combined with autogenous bone graft for reconstruction of the alveolar cleft. Patients with unilateral cleft lip and palate between the 11 to 14 years old were enrolled. After palatal expansion, autogenous graft was placed at the side of cleft in the control group (n = 6). In the BMP group, the rhBMP-2 was injected into the autogenous bone graft at the defect site (n = 5). Cone beam computed tomography (CBCT) images were taken of all patients immediately and 3 months after graft surgery to compare the density, thickness, and height of the bone graft between the 2 groups. Intermolar and interpremolar widths were also measured. The authors found less diminish of density and height of the bone graft 3 months postsurgery in patients with autogenous bone graft combined with rhBMP-2. However, significant difference in the relapse tendency of transverse dimension of the arch or thickness of the bone graft was not observed between the 2 groups. Thus, low dose rhBMP-2 combined with autogenous bone graft can be promising to reach predictable results after alveolar reconstruction in cleft lip and palate patients.

The Impact of Type-D Personality on Oral Health-Related Quality of Life in Cleft Lip and Palate Adolescents.

The purpose of this study was to investigate the oral health-related quality of life and type-D personality in cleft lip/palate (CLP) patients and the relationship between type-D personality and oral health-related quality of life (OHRQoL) in CLP patients. Fifty patients with CLP within age range from 8 to 15 years were chosen and asked to complete both Child Oral Health Impact Profile (COHI) and Type-D scale (DS14) questionnaire. Moreover, the participants of a control group matched with CLP patients were asked to complete the DS14 questionnaire. A significant difference between boys and girls on the subscale "emotional well-being" of COHIP (P = 0.001) and a positive significant correlation between "oral symptoms" and age (P = 0.029) were found among CLP patients. The prevalence of type-D personality was equal between clefts and nonclefts groups. However, there was a significant relationship between type-D personality and OHRQoL in CLP patients regarding mean scores of overall COHIP and its subscales (P < 0.05). This study has shown that the personality type remains unchanged among cleft patients and a meaningful relationship exists between type-D personality and OHRQoL.

Parents' Perceptions of the Oral Health-related Quality of Life of their Autistic Children in Iran.

OBJECTIVES: The aim of this study was to evaluate parents' perception of the oral health-related quality of life (OHRQoL) of autistic children in Iran, and to determine the quality of life of their families in relation to child' oral health status. STUDY DESIGN: 70 families with at least one child with autism, and 70 families with normal children were enrolled. Parents' perceptions of the OHRQoL of children were assessed using pre-validated PedsQL oral health scale questionnaire. PedsQL Family Impact Module questionnaire was also used to evaluate the impact of having an autistic child on the quality of life of their families. Both of the questionnaires were filled by parents. Parents of children with autism spectrum filled a separate questionnaire for the sibling of the autistic child. In the control families, child-reported PedsQL oral health scale questionnaire was also filled by the child himself/herself. Mann-Whitney U-test, and chi-square were used for statistical analysis. RESULTS: There was a significant difference in the mean total score of PedsQL oral health scale questionnaire between autistics and controls. Parents of normal children reported more oral problems (p<0.001). There was not a significant difference in the mean total score of PedsQL Family Impact Module questionnaire between the families of autistics and controls in the last 7 and 30 days. CONCLUSION: According to parents' point of view, oral health-related quality of life of autistic children was better than normal children. However, parents of autistic children had more problems in the social and communication issues.

Delayed Myocardial Infarction Associated With Rituximab Infusion: A Case Report and Literature Review.

To report a case of delayed myocardial infraction after rituximab infusion. A 52-year-old woman with history of refractory idiopathic thrombocytopenic purpura had hypertension, seizure, and mild coronary artery disease and received rituximab; after 24 hours, she returned back with chest pain, nausea, and vomiting. Her electrocardiogram showed a ST-elevation in the II, III, aVF, and aVR lead and ST depression in I and aVL lead; after another complementary test, the myocardial infraction was confirmed. The patient was sent to the intensive care unit, and after 8-day hospitalization, she was discharged. Based on the Naranjo Probability Scale, the likelihood of rituximab-induced acute myocardial infarction in this case was probable. Rituximab is generally well tolerated; however, cardiovascular effects of this drug can be fatal. The side effects usually occur during or a short time after infusion; this case demonstrated that rituximab side effects may occur with delay. This case demonstrates, although a rare phenomenon, myocardial infraction may occur after 24 hours and clinicians should be aware of this fatal effect even after a period of time in patients receiving rituximab, especially in patients with history of coronary artery disease.

Assessment of Depression Prevalence and Its Relation With Interleukin 18 One Year After Renal Transplantation.

Renal transplantation is the treatment of choice for many patients with end-stage renal disease. Because there is little information about depression after kidney transplantation, we investigated frequency and determinant factors of depression and also its association with interleukin (IL)-18. Kidney transplant recipients were investigated between January 2011 and February 2013. Depression was assessed using the Beck Depression Inventory (BDI, BDI-II). We investigated the relationship between 1-year posttransplantation depression and all-cause mortality, acute kidney injury, and serum creatinine 1, 3, and 12 months after transplantation. Furthermore, the association of depression with IL-18 biomarker was recorded 1 year after transplantation. A total of 74 patients (age: 37.06 ± 16.2 years; 59.5% male) were enrolled in this study 1 year after transplantation. Nineteen (25.6%), 2 (2.7%), and 1 (1.3%) of them experienced mild, moderate, and severe depression, respectively. IL-18 biomarker (independent variable) was significantly associated with depression 1 year after transplantation. Our data suggested that IL-18 level increased significantly in renal transplant patients with depression.

Maxillary Protraction With Intermaxillary Elastics to Miniplates Versus Bone-Anchored Face-Mask Therapy in Cleft Lip and Palate Patients.

INTRODUCTION: Cleft lip and palate patients usually have deficient maxilla due to postsurgical scars. The aim this study was to compare the effectiveness of miniplates-anchored face-mask therapy versus intermaxillary elastics to miniplates for maxillary traction in cleft lip and palate patients. METHODS: This clinical trial included 11 prepubertal patients with cleft lip and palate. Initially, a w-arch expander was cemented and activated 3 mm per month to overcorrect the crossbite. Then, the patients were divided into 2 groups: mini-plate-anchored face-mask (n = 5): 2 miniplates were placed in the maxilla and the patients were instructed to wear a face-mask for 12 to 14 hours/per day. Intermaxillary elastics to miniplates (n = 6): 2 miniplates were inserted in the maxilla; 1 on each side and 2 miniplates were placed in the anterior mandible on both sides. Intermaxillary elastics with a force of 250 g per side were attached to the hooks. Cephalometric parameters before treatment (T1) and after achieving positive overjet (T2) were compared between the 2 groups. Fisher exact, paired, and independent t tests were used for statistical comparison. RESULTS: At T1 or T2 there was not a significant difference between the 2 groups in the skeletal, dental, and soft tissue variables. CONCLUSION: According to results of our preliminary study, intermaxillary elastics to miniplates might have a promising effect as an alternative for face mask therapy in maxillary protraction of cleft lip and palate patients.

Comparative evaluation of cranial base and facial morphology of cleft lip and palate patients with normal individuals in cone beam computed tomography.

INTRODUCTION: This study aimed to compare the cranial base and facial morphology of cleft lip and palate (CLP) patients with individuals with no cleft. METHODS: Thirty-two adult individuals including 9 patients without cleft, 14 patients with unilateral CLP, and 9 patients with bilateral CLP participated in the study. The average age of participants was 18.71 ± 2.1 years. Full skull cone-beam computed tomography of all of the participants was taken. Anatomic landmarks were traced in the midsagittal, coronal, and axial planes, and craniofacial height and width-related parameters were compared among the 3 groups. Analysis of variance and Tukey test were used for comparison. P < 0.05 was considered as significant. RESULTS: SNA (P = 0.048), SNB (P = 0.005), S-N-Pog (P = 0.007), N-ANS (P = 0.013), and the distance between the most superior points of the external auditory meatus (P = 0.01) were significantly decreased in bilateral CLP compared with the control group. Similarly, SNB (P = 0.013) and S-N-Pog (P = 0.008) were significantly smaller in unilateral cases compared with the controls. S-N to the palatal plane was significantly increased in both unilateral (P = 0.013) and bilateral (P = 0.00) cases compared with individuals with no cleft. However, S-N to the palatal plane significantly increased in bilateral cases compared with unilateral clefts (P = 0.028). CONCLUSIONS: Based on the results of the current study, adult patients with CLP showed relatively distinctive morphological features in maxillofacial and cranial base regions. It seems that less dysmorphic characteristics are observed in transverse dimensions of the face and basicranium in both types of cleft. On the other hand, lateral cranial base is more affected by CLP compared with the middle basicranium.

Are Mesenchymal Stem Cells Implanted in Lip Defect Capable of Returning Orbicularis Oris Muscle Function?

INTRODUCTION: This study aimed to evaluate the amount of orbicularis oris muscle formation and function after using scaffold-free cells and mesenchymal stem cells scaffold in repaired cleft lip of rats. METHODS: Forty male Wistar rats were used. A triangular cut (7 × 7 × 4  mm) was made on the upper lip of 30 rats and then divided into 3 equal groups. In the first group (control), the defected cuts were closed by routine surgical procedures. The second group consisted of cell scaffold and the third scaffold-free cells (5 × 5 × 3) in the area of the incision.Two months after restoration, muscle electromyography activity was examined alongside 10 normal rats and tissue samples were histologically examined. Data were analyzed statistically by SPSS software and ANOVA and the Kruskal-Wallis test. The significance level was considered at P < 0.05. RESULTS: Electromyography activity in second and third groups was not significantly different from each other and with normal muscle. The control group had, however, higher activity than normal muscle (P < 0.001). The amount of newly formed muscle tissue in the scaffold group had a clear statistical difference with the cell scaffold (P = 0.018) and control group (P < 0.001). Furthermore, the inflammatory reaction showed a significant statistical difference in the control and scaffold group (P = 0.001) and the scaffold and cell-scaffold groups (P = 0.007). There was no significant difference in the number of formed fibroblast cells and collagen tissue in the area between the 3 groups. CONCLUSIONS: The results of this study show that extracellular matrix scaffold can reduce tension in the repaired cleft lip area by increasing muscle formation and decreasing scar tissue contraction, confirming the benefits of this type of scaffold.

Facial soft-tissue morphology of adolescent patients with nonsyndromic bilateral cleft lip and palate.

The purpose of this study was to cephalometrically evaluate the facial soft-tissue characteristics of adolescent patients with bilateral cleft lip and palate (BCLP) and to compare them with a noncleft control group. Lateral cephalometric radiographs obtained from 56 adolescents with nonsyndromic BCLP (29 boys and 27 girls) were analyzed and compared with 67 control subjects (29 boys and 38 girls) who were matched for sex, age, and ethnicity. All patients had been operated on before the age of 2 years for the surgical repair of cleft lip and palate. None had received any orthopedic or orthodontic treatment. Independent-samples t test revealed that patients with BCLP significantly differed from the control group by having a flatter facial profile, thinner and more retruded nasal base, flatter nasal tip (in males), and reduced upper-lip length. Furthermore, thicker lower-lip pit, shallower mentolabial sulcus, and increased inclination angles of the upper and lower lips relative to the horizontal plane were observed in female patients compared with the normal group. The findings of the current study suggested that adolescent patients with BCLP showed several facial soft-tissue deformities when compared with normal individuals with the same age, sex, and ethnic origin. This study provides objective measures that could lead to better treatment planning and prediction of the need for corrective surgeries in patients with BCLP.

Orofacial dysfunction in cleft lip and palate patients using the nordic orofacial test-screening.

INTRODUCTION: The Nordic Orofacial Test-Screening (NOT-S) protocol serves as a widely recognized tool for assessing orofacial dysfunction comprehensively. This study aimed to compare orofacial dysfunction between unilateral (UCLP) and bilateral (BCLP) cleft lip and palate patients using the NOT-S. MATERIALS AND METHODS: This descriptive cross-sectional study enrolled 104 patients, comprising 72 with unilateral cleft lip and palate (UCLP) and 32 with bilateral cleft lip and palate (BCLP) referred to the cleft lip and palate clinic of Mashhad Dental School. Orofacial dysfunction was assessed using the Nordic Orofacial Test-Screening (NOT-S), which includes a structured interview and clinical examinations encompassing 6 domains each. Statistical analysis utilized Mann-Whitney, Fisher's exact, and Chi-square tests, with significance set at P < 0.05. RESULTS: No significant differences were found in structured interview (P = 0.45), clinical examination (P = 0.45), or total NOT-S score (P = 0.11) between the two types of cleft lip and palate. CONCLUSION: Based on NOT-S assessment, patients with unilateral (UCLP) and bilateral (BCLP) cleft lip and palate exhibited comparable orofacial dysfunctions. In the structured interview, the most prevalent issues were identified in the domain of chewing and swallowing for both cleft types. In clinical examination, unilateral cleft lip and palate patients commonly experienced facial problems at rest, while bilateral cleft lip and palate patients frequently encountered challenges with speaking. However, these differences were not statistically significant.

Palm and finger print characteristics in nonfamilial cleft lip and palate patients and their parents.

The aim of this study was to investigate if Iranian individuals with nonfamilial cleft lip and palate (CLP) and their unaffected parents display more dermatoglyphic asymmetry than the normal population.The study group included 55 patients with nonfamilial CLP and their unaffected parents (38 fathers and 47 mothers). The control group included 60 healthy children and their parents (37 fathers and 50 mothers). Total ridge counts of each finger (TRC), atd angles, a-b ridge counts, and finger print pattern types of all participants were recorded. Asymmetry between the right and left hands of each individual was determined. Dissimilarity between pattern types on homologous fingers was compared using chi-square test. Asymmetry of other parameters was statistically analyzed using the Mann-Whitney U test.There were no significant differences between the groups in terms of their asymmetry of atd angle, a-b ridge count, and pattern dissimilarity score. However, significant differences in mean TRC between CLP patients and control children were found for the right ring digit (P = 0.023), right little digit (P = 0.032), and left index digit (P = 0.005). Also, there were significant differences among CLP patients and control children (P = 0.022) as well as unaffected fathers of CLP patients and their control group (P = 0.020) in terms of type of finger print pattern.No enhanced fluctuating asymmetry was found in most of the dermatoglyphic traits in the population studied, which indicated a low degree of developmental instability of the sporadic cases of cleft deformity.

Prevalence of dental anomalies in patients with cleft lip and palate.

The aim of the present study was to investigate the prevalence of dental anomalies in a group of patients with cleft lip and palate (CL/P) in the northeast of Iran. Ninety-one patients referring to the Cleft Lip and Palate Clinic of Mashhad Dental School were enrolled and classified into right CL/P, left CL/P, and bilateral CL/P groups. Photographs, dental casts, and panoramic and periapical radiographs were retrieved, and dental anomalies were recorded. χ test was used to analyze the frequency of dental anomalies according to type of cleft and sex. Missing maxillary lateral incisors was the most frequent dental anomaly, which was slightly higher in the bilateral group (61.1%). There were significantly more cases of missing lateral incisors outside the cleft area in right CL/P (P = 0.015). Peg lateral incisors were observed in 33.3% of bilateral CL/P compared with 28% of right and 23.3% of left unilateral cases. The sample presented rotations of central incisors in the cleft area in 33.3% of bilateral clefts. In unilateral clefts, it occurred more frequently in the right side (48%). Sexual dimorphism appeared only for maxillary central incisor rotation in the cleft area, which showed significantly greater frequency in females (P = 0.025). Transposition of maxillary canine and first premolars was found in 5.5% of bilateral, 8% of right, and 3.3% of left unilateral clefts. The prevalence of dental anomalies in the studied sample seems to be higher than that reported in the normal population. More anomalies were observed at the cleft side. The frequency of most anomalies was not significantly different between the 2 sexes.

Oral health-related quality of life in children with cleft lip and palate.

Considering the essential need for oral health-related quality-of-life measures for patients with craniofacial malformations, the current study aimed to investigate the oral health-related quality of life of Iranian patients with cleft lip and palate. Fifty children referred to Cleft lip/Palate Research Center of Mashhad Dental School (Iran) were recruited. Participants were asked to complete the Child Oral Health Impact Profile questionnaire. The questionnaire comprised 38 items and was divided over 5 subscales. The scores on all subscales were compared with regard to patients' age, sex, and type of cleft. A significant difference between boys and girls was found on the subscale "emotional well-being" (P = 0.027). There was no significant difference between 8- to 12-year-old patients and those older than 12 years. Also, no significant difference was found between bilateral and unilateral cleft lip and palate patients regarding mean score of Child Oral Health Impact Profile questionnaire and its subscales. Oral health-related quality of life of cleft lip and palate patients did not change with patients' age. Also, the impact of unilateral and bilateral clefts on OHRQoL was similar. Quality of life of girls was more affected by oral health.