[Functional and aesthetic significance of the uvula in cleft palate repair]. / Rol' yazychka v dostizhenii funktsional'nogo i esteticheskogo rezul'tata uranoplastiki.

OBJECTIVE: To investigate functional and aesthetic role of uvula in cleft palate repair. MATERIALS AND METHODS: Forty-one patients aged from 1 year 2 months to 7 years were included in this study with congenital cleft lip and/or palate. The morphological investigation of the resected hemi- uvula was done. Palatoplasty was performed in all cases. RESULTS: According to morphological results, most of the resected hemi-uvula consisted of vascularized fibrous tissue, covered with epithelium. In three groups of patients (with unilateral, bilateral and isolated cleft palate), the duration of the surgery and intraoperative blood loss did not exceed similar values for conventional methods. The volume of infusion therapy revealed a deficit of fluid intake of no more than 30%, which indicates early restoration of swallowing function. CONCLUSION: The technique of preserving one of the «hemi-uvulas¼ lead to excellent aesthetic results and increasing functionality. Resection of one of the «hemi-uvulas¼ is safe and physiological.

[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.

[Application of semi-buried curvilinear distraction devices in complex management of lower micrognathia in children].

The aim of the study was to apply an effective treatment protocol with low morbidity for children with syndromic and nonsyndromic micrognathia using curvilinear distractors, intraoral approach and early orthodontic treatment. We report 7 patients aged from 3 to 13 years with bilateral mandibular hypoplasia. These patients were characterized by severe malocclusion, esthetic facial deformation and respiratory disorders. In 3 patients mandibular hypoplasia was combined with anterior open bite. The intraoral surgical approach was used in all cases. Good functional and esthetic results were achieved during treatment. The less traumatic intraoral approach, curvilinear distractors, ultrasound callus formation control and early orthodontic treatment assure the good functional and esthetic results in severe cases facilitating the continuinty in complex rehabilitation of the growing child.

[Compression-distraction osteosynthesis in management of children with craniosynostoses].

Le Fort III midfacial distraction using internal and external devices is a generally accepted procedure for midfacial retrusion in patients with craniosynostoses. Many novel techniques for correction of cranial deformities in craniosynostoses are being introduced today. The authors described 14 consecutive cases of Le Fort III midfacial distraction using internal and external distraction devices. The paper discusses advantages and limitations of these methods.

[Ultrasound study possibilities in evaluation of anatomical structures in children with congenital cleft of upper lip and palate].

Congenital cleft of upper lip and palate (CCULP) is one of the most widely spread and complicated developmental malformation of maxillofacial region, its frequency makes up for 16.4% of the total number of inherited defects. Ultrasound study (USS) let receive clinically significant information about anatomical structures peculiarities of upper lip, alveolar process and palate in patients with crest CCULP that could be important for surgical and prosthetic treatment planning and also significant for assessment of immediate and postponed treatment results. Verification of the received during surgical interventions and orthodontic manipulations data showed high diagnostic reliability of the USS results.

Familial cherubism: the experience of the Moscow Central Institute for Stomatology and Maxillo-Facial Surgery.

The Central Institute for Stomatology and Maxillo-facial Surgery in Moscow is one the main centers for the treatment of pediatric head and neck tumors in the territory of the former Soviet Union. A series of 33 patients presenting with cherubism (24 children and 9 of their parents) is presented. The authors discuss the atypical clinical presentations, the relevant associated anomalies and the different treatment strategies. They report the first case of cherubism associated with gingival hypertrophy without neurological signs.

Laser stereolithography and supercritical fluid processing for custom-designed implant fabrication.

This paper describes the laser photopolymerization of a liquid mixture of polyfunctional acrylic monomers, photoinitiator and hydroxyapatite (HA). Pure polymeric and composite materials of specific shape and structure were fabricated by laser stereolithography based on images derived from three-dimensional (3D) computer modeling. The polymeric objects then were treated with supercritical carbon dioxide to remove potentially toxic residues (monomers, low molecular weight oligomers, etc.) and to provide interconnective microporosity. Finally, samples were implanted into white rats (diastolic epiphysis of femoral bone) to study living tissue response and processes of osteointegration and osteoinduction. It was shown that incorporation of HA into the composite implant structure encouraged periosteal as well as endosteal osteogenesis and improved their osteointegrative characteristics in particular. Supercritical carbon dioxide treatment significantly enhanced the biocompatibility of the materials, increasing the area of direct contact of the implant surface with regenerated bone tissue.