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Objective@#The aim of this study is to summarize the experience of the orthognathic surgical treatment forsecondary maxillary deformities following the cleft lip and palate repair.@*Methods@#Twenty-two patients with secondary maxillary deformities following the cleft lip and palate repairment(orthognathic approach), were retrospectively analyzed.All the cases were treated in the Hospital of Stomatology, China Medical University from January 2007 to December 2016. There were 9 males and 13 females, ranging from 18 to 24 years in age. Only 3 of those cases were not undergone preoperative and postoperative orthodontic treatments. The anteroposterior maxilla and mandible discrepancy was 6-11 mm preoperatively. The modified surgical procedures are as follows: One-stage alveolar bone graftand maxillary osteotomy were performed for unilateral cleft patients; Internal fixation with micro-plate at the alveolar cleft region was performed to stabilize the maxillary dental arch intraoperatively; Intermolar wire ligation and palatal arch were used to control the width of maxilla intraoperatively and 1 month after operation; 2-3 mm overcorrection for the Le Fort Ⅰ advancement was produced to reduce relapse in sagittal direction. Mandibular set back was performed using bilateral sagittal split osteotomy at the same time. Rigid internal fixation with titanium palates and screws was applied for all the cases. All patients had been followed up for 1 to 2 years postoperatively.@*Results@#Most of the patients had satisfactory facial proportion, and good and stable occlusion relationship, with only one patient developed severely uncontrollable relapse to class Ⅲ malocclusion, and 3 patients experienced relapse resulted in edge to edge incisor relationship.@*Conclusions@#Le Fort Ⅰ osteotomy combined with bilateral sagittal split osteotomy was effective to correct the secondary maxillary deformities following the cleft lip and palate repair. The treatment plan should be individualized, depending on the patients′ occlusion relationship, skeletal deformity, and facial appearance as well. It is necessary to modify the surgical techniques of Le Fort Ⅰ osteotomy for the cleft patients.
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Objective@#To evaluate the feasibility and outcome of computer assisted distraction osteogenesis in the treatment of extensive alveolar cleft.@*Methods@#Four patients [1 male and 3 females, aged (15.5±3.7) years] received treatment in the Department of Oral-Maxillofacial Surgery and Plastic Surgery, School of Stomatology, China Medical University from June 2016 to April 2018 were involved in this study. All the patients with extensive alveolar cleft [cleft width (7.64±1.29) mm] were performed orthodontic treatment to expand the dental arch and interdental space between the first molar and premolars. Three-dimensional (3D) model of the maxilla and the osteotomy guider were printed according to the CT data. The fix wings of the distractor were pre-shaped according to the 3D model. The osteotomy was performed at the interdental space and horizontal plate of palate to dissociate the alveolar bone segment. The distractor was fixed on the predetermined position. Distraction (0.4-0.8 mm/day) was performed in 7 days later and stopped when the incision connected with the canine. The distractor was removed after six months.@*Results@#The distraction period was (10.8±2.5) d in four cases. The cleft was completely closed with interdental bone anchored distraction in four cases. The imaging examination in six months showed good new bone structure in the distraction zone and bone connection of the cleft.@*Conclusions@#Computer assisted distraction osteogenesis was effective and feasible to close the extensive alveolar cleft and provide sufficient new bone tissue.
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Objective:To investigate the association between dihyrofolate reductase(DHFR)gene rs1 1 742688 polymorphism and non-syndrom cleft lip with or without cleft palate (NSCL/P)in northest Chinese population.Methods:PCR-restriction fragment length polymorphism(PCR-RFLP)was used to identify the rs1 1 742688 polymorphism of DHFR gene of 220 NSCL/P patients(inclu-ding 1 38 core families)and 1 80 healthy controls.Hardy-Weinberg test and SPSS statistical software were used to calculate the data, OR and 95% confidence intervalarents.Results:In case-contral analysis,there was no significant difference in TT genotype of rs1 1 742688 between NSCL/P subjects and the controls(χ2 =0.439,P >0.05)in.Conclusion:The polymorphism of rs1 1 742688 in DHFR gene is not associated with NSCL/P in northest Chinese population.
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<p><b>OBJECTIVE</b>To explore the surgical technique of a modified Onizuka cheiloplasty for repairing the unilateral cleft lip.</p><p><b>METHODS</b>24 patients with unilateral cleft lip were repaired by modified Onizuka cheiloplasty. The rotation flap ended at the midpoint of nasal columella crease. A small triangle skin flap was formed above the vermilion border of the advancement flap. The small triangle flap was inserted to the medial side after the Cupid's bow was built. The skin of the flap C was denuded along the nasal columella crease and the muscle was sutured to the alar base for augmentation of nostril floor on the cleft side. The tip of the advancement flap was sutured at the midpoint of nasal columella crease and the skin of nasal floor was trimmed to hide the incision line around the nasal columella base.</p><p><b>RESULTS</b>It was found that the Cupid's bow was rebuilt in a natural form and the configuration of the upper lip was reconstructed symmetrically. The long term follow up studies showed that the philtrum column was not disturbed by the small triangle flap and the nasal floor was rebuilt without obvious scars.</p><p><b>CONCLUSION</b>The modified Onizuka cheiloplasty is an easy learning technique and efficient for repairing the unilateral cleft lip. This technique can satisfy the patients by reducing the length of scar as well as rebuilding a natural form of upper lip and nostril floor.</p>
Subject(s)
Female , Humans , Male , Cleft Lip , Lip , Mouth Mucosa , Plastic Surgery Procedures , Surgical FlapsABSTRACT
Objective:To study the effects of NS-398 on the expression of vascular endothelial growth factor (VEGF) in human tongue squamous cell carcinoma Tca8113 cells.Methods:Tca 8113 cells were exposed to the COX-2 inhibitor NS-398 at 150 ?mol/L for 48,72 and 96 h respectively,then cells were collected. VEGF expression was examined by RT-PCR and Western blot. Results:NS-398 inhibited VEGF mRNA and protein expression time-dependently in Tca8113 cells. Conclusion:NS-398 may inhibit VEGF expression in tongue squamous cell carcinoma.