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1.
J. Health Biol. Sci. (Online) ; 10(1): 1-4, 01/jan./2022. ilus
Artigo em Inglês | LILACS | ID: biblio-1370925

RESUMO

Introduction: orofacial clefts are common congenital malformations with an important social, psychological, and economic impact. The treatment of this condition may include different surgical procedures that previously require an adequate oral condition. Case report: we report a case of dental treatment before palatoplasty in a male patient of 17 years-old with bilateral cleft lip and palate and lesion in the jugal mucosa. Final considerations: the adequacy of the oral environment is a fundamental step in the treatment of patients with orofacial clefts and aims to restore oral health regardless of the degree of complexity of the dental treatment through the reduction of the pathogenic microbiota, elimination of retentive niches, instructions on diet and adequate oral hygiene and constant patient motivation.


Objetivos: as fissuras orofaciais são malformações congênitas comuns, com importante impacto social, psicológico e econômico. O tratamento dessa condição pode incluir vários procedimentos cirúrgicos que requerem previamente uma adequada condição bucal. Relato de caso: Relatamos o caso de tratamento odontológico prévio a palatoplastia em um paciente do gênero masculino de 17 anos de idade, com fissura transforame incisivo bilateral e lesão em mucosa jugal. Considerações finais: A adequação do meio bucal é uma etapa fundamental no tratamento de pacientes com fissuras orofaciais e visa restabelecer a saúde bucal independente do grau de complexidade do tratamento odontológico por meio da redução da microbiota patogênica, eliminação de nichos retentivos, orientações sobre dieta e higiene bucal adequada e motivação constante do paciente.


Assuntos
Fissura Palatina , Higiene Bucal , Palato , Fenda Labial , Cissus , Cárie Dentária , Fissura , Reabilitação Bucal
2.
Contrast Media Mol Imaging ; 2022: 9410161, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35655725

RESUMO

Objective: The purpose was to explore the diagnostic value and application of prenatal magnetic resonance imaging (MRI) and ultrasound (US) in fetal cleft lip and palate. Methods: From January 2018 to December 2019, 39 pregnant women without normal fetal maxillofacial structure or with fetal maxillofacial deformity under US examination in our hospital were selected as the study subjects. Not knowing the clinical data of the pregnant women, MRI and US physicians performed diagnostic analysis on the MRI or US images of all the study subjects and analyzed the results of prenatal MRI and US diagnosis and postpartum follow-up to compare the diagnostic efficacy and confidence of MRI and US. Results: The follow-up found that there were 20 cases of cleft lip, 15 cases of cheilopalatognathus, 3 cases of cleft palate, and 1 case of unilateral cleft lip with alveolar cleft, with a total of 39 cases having cleft lip and palate deformity. MRI and US had the same efficacy in the diagnosis of cleft lip. As for cleft palates, the diagnostic accuracy of MRI (94.87%) was significantly better than that of US (48.72%, P < 0.001). The diagnostic confidence of fetal cleft lip and palate by MRI (89.73%) was significantly better than that of US (43.59%, P < 0.001). The AUC of US (0.597) was significantly less than that of MRI (0.940), indicating that the diagnostic accuracy of US was not as good as that of MRI (P < 0.05). The sensitivity and 1 - specificity of MRI were significantly higher than those of US. Conclusion: MRI is more accurate than US in the diagnosis of fetal cleft lip and palate, and MRI can be the preferred method for prenatal detection of cleft lip and palate, thus providing more accurate opinions and information for perinatal pregnant women.


Assuntos
Fenda Labial , Fissura Palatina , Fenda Labial/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética/métodos , Gravidez , Diagnóstico Pré-Natal/métodos , Ultrassonografia Pré-Natal/métodos
3.
Beijing Da Xue Xue Bao Yi Xue Ban ; 54(3): 387-393, 2022 Jun 18.
Artigo em Chinês | MEDLINE | ID: mdl-35701113

RESUMO

OBJECTIVE: To explore the association between de novo mutations (DNM) and non-syndromic cleft lip with or without palate (NSCL/P) using case-parent trio design. METHODS: Whole-exome sequencing was conducted for twenty-two NSCL/P trios and Genome Analysis ToolKit (GATK) was used to identify DNM by comparing the alleles of the cases and their parents. Information of predictable functions was annotated to the locus with SnpEff. Enrichment analysis for DNM was conducted to test the difference between the actual number and the expected number of DNM, and to explore whether there were genes with more DNM than expected. NSCL/P-related genes indicated by previous studies with solid evidence were selected by literature reviewing. Protein-protein interactions analysis was conducted among the genes with protein-altering DNM and NSCL/P-related genes. R package "denovolyzeR" was used for the enrichment analysis (Bonferroni correction: P=0.05/n, n is the number of genes in the whole genome range). Protein-protein interactions among genes with DNM and genes with solid evidence on the risk factors of NSCL/P were predicted depending on the information provided by STRING database. RESULTS: A total of 339 908 SNPs were qualified for the subsequent analysis after quality control. The number of high confident DNM identified by GATK was 345. Among those DNM, forty-four DNM were missense mutations, one DNM was nonsense mutation, two DNM were splicing site mutations, twenty DNM were synonymous mutations and others were located in intron or intergenic regions. The results of enrichment analysis showed that the number of protein-altering DNM on the exome regions was larger than expected (P < 0.05), and five genes (KRTCAP2, HMCN2, ANKRD36C, ADGRL2 and DIPK2A) had more DNM than expected (P < 0.05/(2×19 618)). Protein-protein interaction analysis was conducted among forty-six genes with protein-altering DNM and thirteen genes associated with NSCL/P selected by literature reviewing. Six pairs of interactions occurred between the genes with DNM and known NSCL/P-related genes. The score measuring the confidence level of the predicted interaction between RGPD4 and SUMO1 was 0.868, which was higher than the scores for other pairs of genes. CONCLUSION: Our study provided novel insights into the development of NSCL/P and demonstrated that functional analyses of genes carrying DNM were warranted to understand the genetic architecture of complex diseases.


Assuntos
Fenda Labial , Fissura Palatina , Estudos de Casos e Controles , Fenda Labial/genética , Fissura Palatina/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Mutação , Pais , Polimorfismo de Nucleotídeo Único , Sequenciamento Completo do Exoma
4.
Beijing Da Xue Xue Bao Yi Xue Ban ; 54(3): 394-399, 2022 Jun 18.
Artigo em Chinês | MEDLINE | ID: mdl-35701114

RESUMO

OBJECTIVE: To explore whether WNT signaling pathway genes were associated with non-syndromic oral clefts (NSOC) based on haplotypes analyses among 1 008 Chinese NSOC case-parent trios. METHODS: The genome-wide association study (GWAS) data of 806 Chinese non-syndromic cleft lip with or without cleft palate (NSCL/P) trios and 202 Chinese non-syndromic cleft palate (NSCP) case-parent trios were drawn from the International Consortium to Identify Genes and Interactions Controlling Oral Clefts (ICOCs) study GWAS data set, whose Chinese study population were recruited from four provinces in China, namely Taiwan, Shandong, Hubei, and Sichuan provinces. The process of DNA genotyping was conducted by the Center for Inherited Disease Research in the Johns Hopkins University, using Illumina Human610-Quad v.1_B Bead Chip. The method of sliding windows was used to determine the haplotypes for analyses, including 2 SNPs haplotypes and 3 SNPs haplotypes. Haplotypes with a frequency lower than 1% were excluded for further analyses. To further assess the association between haplotypes and NSOC risks, and the transmission disequilibrium test (TDT) was performed. The Bonferroni method was adopted to correct multiple tests in the study, with which the threshold of statistical significance level was set as P < 0.05 divided by the number of tests, e.g P < 3.47×10-4 in the current stu-dy. All the statistical analyses were performed by using plink (v1.07). RESULTS: After quality control, a total of 144 single nucleotide polymorphisms (SNPs) mapped in seven genes in WNT signaling pathway were included for the analyses among the 806 Chinese NSCL/P trios and 202 Chinese NSCP trios. A total of 1 042 haplotypes with frequency higher than 1% were included for NSCL/P analyses and another 1 057 haplotypes with frequency higher than 1% were included for NSCP analyses. Results from the TDT analyses showed that a total of 69 haplotypes were nominally associated with the NSCL/P risk among Chinese (P < 0.05). Another 34 haplotypes showed nominal significant association with the NSCP risk among Chinese (P < 0.05). However, none of these haplotypes reached pre-defined statistical significance level after Bonferroni correction (P>3.47×10-4). CONCLUSION: This study failed to observe any statistically significant associations between haplotypes of seven WNT signaling pathway genes and the risk of NSOC among Chinese. Further studies are warranted to replicate the findings here.


Assuntos
Fenda Labial , Fissura Palatina , Fenda Labial/genética , Fissura Palatina/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Genótipo , Haplótipos , Humanos , Polimorfismo de Nucleotídeo Único , Via de Sinalização Wnt/genética
5.
Arch Oral Biol ; 140: 105465, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35662681

RESUMO

OBJECTIVE: This review aimed to present an overview of the effect of bone morphogenetic protein 4 (BMP4) on craniofacial and skeletal development, particularly the specific role of BMP4 in tooth development. DESIGN: The search for this narrative review was conducted in PubMed, Web of Science, Embase, and ScienceDirect using relevant keywords, including checking reference lists of journal articles by hand searching. RESULTS: Mutations or deletions of BMP4 cause tissue development defects in mice and humans, such as fragile bone, craniofacial deformity, cleft lip and palate, tooth development stagnation, and abnormal structure. CONCLUSIONS: BMP4 is a reliable and vital candidate to regulate the development of bones, craniofacies, and teeth. It also has high clinical application potential.


Assuntos
Fenda Labial , Fissura Palatina , Dente , Animais , Proteína Morfogenética Óssea 4/genética , Proteína Morfogenética Óssea 4/metabolismo , Fenda Labial/genética , Fissura Palatina/genética , Camundongos , Odontogênese/genética
6.
Plast Reconstr Surg ; 149(6): 1404-1411, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35613289

RESUMO

BACKGROUND: Secondary alveolar bone grafting of autologous bone from the iliac crest is a widely accepted modality for repair of residual alveolar cleft in patients with mixed dentition with previously repaired complete cleft lip and palate. There remains debate regarding surgical timing and preoperative, perioperative, and postoperative management of these cases. METHODS: This retrospective study reviewed patient demographic information in addition to preoperative, perioperative, and postoperative course to evaluate how patient and practice factors impact graft outcomes as assessed by three-dimensional cone beam computed tomographic evaluation at the 6-month postoperative visit. RESULTS: On univariate analysis, age at operation older than 9 years, history of oronasal fistula, history of cleft lip or palate revision, and history of international adoption were all found to significantly increase likelihood of graft failure (p < 0.05). On multivariate analysis, age older than 9 years was found to be the single most significant predictor of graft failure (p < 0.05). There was no significant difference in graft outcomes between patients with unilateral or bilateral cleft lip and palate, and no single variable was found to significantly correlate to increased complication rates. The graft success rate overall of the authors' practice was 86.2 percent, with a complication rate of 7.7 percent. CONCLUSIONS: Secondary alveolar bone grafting is an integral part of the cleft lip and palate surgical treatment series; this study identified several outcome predictors for both graft failure and adverse events, the most significant of which was age at operation. Although the mixed dentition phase often extends to 12 years of age, it is recommended that bone grafting be performed before 9 years of age to optimize outcomes. CLINICAL QUESTIONS/LEVEL OF EVIDENCE: Risk, III.


Assuntos
Enxerto de Osso Alveolar , Fenda Labial , Fissura Palatina , Enxerto de Osso Alveolar/métodos , Criança , Fenda Labial/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Estudos Retrospectivos
8.
West Afr J Med ; 39(5): 478-485, 2022 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-35633627

RESUMO

BACKGROUND: Cleft lip and/or cleft palate (CLP) is a prevalent condition with a multifactorial etiology. An understanding of its etiologic factors discourages harmful habits and promotes societal acceptability. OBJECTIVES: To assess the knowledge of environmental and genetic risk factors of CLP and determine its effect on predisposing social habits in a suburban community in Nigeria. METHODS: This was a descriptive cross-sectional study conducted at Ifo Local Government Area (LGA), Ogun state, Nigeria. Participants were adult residents of Ifo L.G.A. Knowledge of CLP categorized into description, environmental risk factors and genetic factors were assessed using a well structured interviewer administered questionnaire. RESULTS: A total of 300 adults (104 males; 196 females) aged 44.3 + 13.17 years with predominantly secondary level education participated in the study. Majority of participants (89.7%) had low overall knowledge of CLP including low knowledge on description of CLP (81.7%), environmental factors of CLP (81.3%), and genetic factors of CLP (93.7%). High level of education was significantly associated with increased knowledge on description of CLP (P < 0.05). No other significant association was noted between sociodemographic factors and knowledge of CLP. Decreased smoking history was associated with high knowledge on description of CLP (P = 0.043). CONCLUSION: Majority of the population had low knowledge of CLP which was to an extent influenced by their lack of high level of education. This low knowledge was significantly associated with increased practices of social habits such as cigarette smoking that predispose unborn children to CLP. The low knowledge of CLP shown in this study highlights the need for increased community education and health promotion to encourage avoidance of risk factors that predispose to the condition and promote societal acceptability and quest for treatment of the condition.


CONTEXTE: La fente labiale et/ou la fente palatine (CLP) sont répandues condition avec une étiologie multifactorielle. Une compréhension de son les facteurs étiologiques découragent les habitudes néfastes et favorisent la société acceptabilité. OBJECTIFS: Évaluer la connaissance de l'environnement et de la génétique facteurs de risque de CLP et déterminer son effet sur les réseaux sociaux prédisposants habitudes dans une communauté de banlieue au Nigeria. MÉTHODES: Il s'agissait d'une étude transversale descriptive menée à Ifo Local Government Area (LGA), État d'Ogun, Nigéria. Participants étaient des résidents adultes d'Ifo L.G.A. Connaissance du CLP catégorisée dans la description, les facteurs de risque environnement aux et les facteurs génétiques étaient évalué à l'aide d'un intervieweur bien structuré administré questionnaire. RÉSULTATS: Un total de 300 adultes (104 hommes; 196 femmes) âgés de 44,3 ans+ 13,17 ans avec un enseignement principalement secondaire ont participé à l'étude. La majorité des participants (89,7%) avaient un faible taux connaissance globale du CLP, y compris faible connaissance de la description de CLP (81,7%), facteurs environnement aux de CLP (81,3%) et génétique(93,7 %). Le niveau d'éducation élevé était significatif associé à une connaissance accrue de la description du CLP (P <0.05). Aucune autre association significative n'a été notée entre les facteurs sociodémographiques et la connaissance de la CLP. Diminution du tabagisme l'histoire était associée à une grande connaissance de la description du CLP (P = 0,043). CONCLUSION: La majorité de la population avait une faible connaissance du CLP qui a été dans une certaine mesure influencée par leur manque de niveau élevé de éducation. Cette faible connaissance était significativement associée àdes pratiques accrues d'habitudes sociales telles que le tabagisme qui prédisposer les enfants à naître à la CLP. La faible connaissance du CLP montrée dans cette étude souligne la nécessité d'une éducation communautaire accrue et la promotion de la santé pour encourager l'évitement des facteurs de risque qui prédisposer à la condition et promouvoir l'acceptabilité sociétale et quête de traitement de la maladie. Mots-clés: Connaissances, facteurs de risque, fente labiale et palatine, suburbaineNigéria.


Assuntos
Fenda Labial , Fissura Palatina , Adulto , Fenda Labial/etiologia , Fenda Labial/genética , Fissura Palatina/etiologia , Fissura Palatina/genética , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Fatores de Risco
9.
Arch Oral Biol ; 140: 105448, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35550192

RESUMO

OBJECTIVE: This study aims to explore and compare the histopathology of upper cleft lip tissue in order to identify the abnormalities and orientation of muscle and collagen fibers in patients affected with non-syndromic cleft lip with or without cleft palate (NSCL±P) and normal controls. MATERIALS AND METHODS: Eight fresh lip tissues of consented patients with NSCL±P and two controls were fixed and stained with hematoxylin and eosin (H&E), Masson's trichrome (MT), and modified Gomori trichrome techniques. The images were captured and examined using imaging cellSens software (Olympus, Tokyo, Japan) and Mirax Scan (Carl Zeiss, Germany). The H&E stained tissues were analysed for muscle fiber size using image processing program (imageJ, USA). Histopathological appearance of epidermal and dermal layers including collagen orientation, as well as muscle fibers abnormalities were observed. RESULTS: Tissues stained with H&E exhibit pseudoepitheliomatous hyperplasia, epidermal and sebaceous glands hyperplasia. Morphometric analysis of muscle fibers showed the diameter was between 6.912 and 10.246 µm. Collagen fibers were densely packed in cleft tissue, but muscle fibers were sparse in MT stain. Modified Gomori trichrome stain revealed hypoplastic muscle with fibrosis, including ragged red fibers. CONCLUSION: Disoriented collagen fibers, significant sparse and disorganized orbicularis oris muscle fibers with classical myopathic appearances proved that cleft tissue had abnormal histology findings. These findings further support the mechanism of collagen and muscle fibers during embryonic development that causing cleft formation.


Assuntos
Fenda Labial , Fissura Palatina , Miopatias Mitocondriais , Corantes , Músculos Faciais , Feminino , Fibrose , Humanos , Hiperplasia/patologia , Miopatias Mitocondriais/patologia , Fibras Musculares Esqueléticas , Gravidez
10.
J Craniomaxillofac Surg ; 50(5): 400-405, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35491325

RESUMO

The aim of this retrospective long-term study was to assess the influence of primary columella lengthening and presurgical nasoalveolar molding (NAM) on the skeletal development at the completion of growth in patients with bilateral cleft lip and palate (BCLP). Lateral cephalometric radiographs at the completion of growth of consecutively treated patients BCLP patients, operated by the same surgeon, who had undergone NAM were compared with a second group of BCLP patients who were not treated with NAM. The groups were matched for sex and age. Independent samples t tests were carried out. 23 Lateral cephalometric radiographs of BCLP patients (mean age 18.2 ± 1.3 years) who had undergone NAM were compared with a second group of 23 BCLP patients (mean age 18.4 ± 1.3 years) who were not treated with NAM. The only two significant differences were observed in Ans-Me/N-Me (control group = 0.6 ± 0.02; sample group = 0.57 ± 0.05; p = 0.019) and ILs^AnsPns (control group = 105.5 ± 7.9; sample group = 112.4 ± 8.6; p = 0.007). No other significant differences were observed in terms of facial skeletal development between the two groups. Presurgical NAM performed during infancy in BCLP patients does not seem to have negative effects on the skeletal development at the completion of craniofacial growth compared to the group of patients treated without NAM.


Assuntos
Fenda Labial , Fissura Palatina , Adolescente , Adulto , Fenda Labial/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Humanos , Septo Nasal , Moldagem Nasoalveolar , Nariz/diagnóstico por imagem , Nariz/cirurgia , Estudos Retrospectivos , Adulto Jovem
11.
Ann Glob Health ; 88(1): 25, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35509431

RESUMO

Background: Cleft lip/palate (CLP) is a congenital orofacial anomaly appearing in approximately one in 700 births worldwide. While in high-income countries CLP is normally addressed surgically during infancy, in developing countries CLP is often left unoperated, potentially impacting multiple dimensions of life quality. Previous research has frequently compared CLP outcomes to those of the general population. But because local environmental and genetic factors contribute to the risk of CLP and also may influence life outcomes, such studies may downwardly bias estimates of both CLP status and correction. Objectives: This research represents the first study to use causal econometric methods to estimate the effects of both CLP status and CLP correction on the physical, social, and mental well-being of children. Methods: Data were collected first-hand from 1,118 Indian children, where we obtained first-hand data on height, weight, grip strength, cognitive ability, reading, and math ability. A professional speech therapist reviewed digital recordings of speech taken at the interview to obtain four measures of speech quality. Using this data, the household fixed-effects model we employ jointly estimates effects of CLP status and CLP surgical intervention. Findings: Our results indicate that adolescents with median-level CLP severity show statistically significant losses in indices of speech quality (-1.59σ), physical well-being (0.32σ), academic and cognitive ability (-0.37σ), and social integration (-0.32σ). We find strong evidence that CLP surgery significantly restores speech if performed before five years of age. The first surgeries performed on less-severe CLP cases significantly restore social integration, psychological well-being, academic/cognitive ability, and a general index of human flourishing. Conclusions: Children born with CLP in India face statistically significant losses in speech, physical health, mental health, and social inclusion. CLP surgical intervention significantly restores speech quality if carried out at an early age. Surgeries with the most significant impact on life outcomes are the first surgeries performed on less-severe CLP cases.


Assuntos
Fenda Labial , Fissura Palatina , Doenças Musculoesqueléticas , Adolescente , Criança , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Face , Humanos , Qualidade de Vida
13.
BMC Pediatr ; 22(1): 303, 2022 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-35606744

RESUMO

BACKGROUND: The objective of the Swedish cleft lip and palate registry (CLP registry) is to promote quality control, research and improvement of treatment, by the comparison of long-term results. The aim was to compare data from the CLP registry among the six treatment centres, regarding data on surgery and speech outcomes at 5 years of age. METHODS: The participants were 430 children born in Sweden from 2009 to 2014, with cleft palate with or without cleft lip and without known syndromes and/or additional malformations. The number of primary and secondary palatal surgeries up to 5 years of age, timing of the last primary palatal surgery, percentage consonants correct, percentage non-oral speech errors and perceived velopharyngeal competence at 5 years were assessed. Multivariable binary logistic regression adjusted for sex and cleft type was used to compare results between the six centres. RESULTS: At one centre (centre 4), the palate was closed in one to three stages, and at the remaining centres in one or two stages. At centre 4, more children underwent a higher number of palatal surgeries, and the last primary palatal surgery was performed at a higher age. Children in centre 4 were also less likely to achieve ≥86% correct consonants (OR = 0.169, P = < 0.001), have no non-oral speech errors (OR = 0.347, P = < 0.001), or have competent or marginally incompetent velopharyngeal competence (OR = 0.244, P = < 0.001), compared to the average results of the other centres. No clear association between patient volume and speech outcome was observed. CONCLUSIONS: The results indicated the risk of a negative speech result if the last primary palatal surgery was performed after 25 months of age. Whether the cleft in the palate was closed in one or two stages did not affect speech outcome. The Swedish CLP registry can be used for open comparisons of treatment results to provide the basis for improvements of treatment methods. If deviating negative results are seen consistently at one centre, this information should be acted upon by further investigation and analysis, making changes to the treatment protocol as needed.


Assuntos
Fenda Labial , Fissura Palatina , Criança , Pré-Escolar , Fenda Labial/complicações , Fenda Labial/cirurgia , Fissura Palatina/complicações , Fissura Palatina/cirurgia , Humanos , Sistema de Registros , Fala , Suécia , Resultado do Tratamento
14.
Biomed Eng Online ; 21(1): 31, 2022 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-35596229

RESUMO

BACKGROUND: The objective is to clarify the effect of alveolar cleft bone graft on maxillofacial biomechanical stabilities, the key areas when bone grafting and in which should be supplemented with bone graft once bone resorption occurred in UCCLP (unilateral complete cleft lip and palate). METHODS: Maxillofacial CAD (computer aided design) models of non-bone graft and full maxilla cleft, full alveolar cleft bone graft, bone graft in other sites of the alveolar cleft were acquired by processing the UCCLP maxillofacial CT data in three-dimensional modeling software. The maxillofacial bone EQV (equivalent) stresses and bone suture EQV strains under occlusal states were obtained in the finite element analysis software. RESULTS: Under corresponding occlusal states, the EQV stresses of maxilla, pterygoid process of sphenoid bone on the corresponding side and anterior alveolar arch on the non-cleft side were higher than other maxillofacial bones, the EQV strains of nasomaxillary, zygomaticomaxillary and pterygomaxillary suture on the corresponding side were higher than other maxillofacial bone sutures. The mean EQV strains of nasal raphe, the maximum EQV stresses of posterior alveolar arch on the non-cleft side, the mean and maximum EQV strains of nasomaxillary suture on the non-cleft side in full alveolar cleft bone graft model were all significantly lower than those in non-bone graft model. The mean EQV stresses of bilateral anterior alveolar arches, the maximum EQV stresses of maxilla and its alveolar arch on the cleft side in the model with bone graft in lower 1/3 of the alveolar cleft were significantly higher than those in full alveolar cleft bone graft model. CONCLUSIONS: For UCCLP, bilateral maxillae, pterygoid processes of sphenoid bones and bilateral nasomaxillary, zygomaticomaxillary, pterygomaxillary sutures, anterior alveolar arch on the non-cleft side are the main occlusal load-bearing structures before and after alveolar cleft bone graft. Alveolar cleft bone graft mainly affects biomechanical stabilities of nasal raphe and posterior alveolar arch, nasomaxillary suture on the non-cleft side. The areas near nasal floor and in the middle of the alveolar cleft are the key sites when bone grafting, and should be supplemented with bone graft when the bone resorbed in these areas.


Assuntos
Fenda Labial , Fissura Palatina , Fenda Labial/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Análise de Elementos Finitos , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia
15.
Orv Hetil ; 163(21): 826-831, 2022 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-35598212

RESUMO

INTRODUCTION: The majority of facial clefts are isolated developmental anomalies. In a minority of the cases, however, facial clefts may occur as part of particular genetic syndromes. OBJECTIVE: We aimed to analyse the treatment of the syndromic patients and determine whether the algorithm of complex treatment - used in non-syndromic patients - has changed in patients who had syndromes. METHOD: Documentation of the patients, treated by the Pecs Cleft Team between 1999 and 2015, were obtained and analysed retrospectively. These included surgical and genetical data as well. Epidemiological data from the national registry of birth were also used. RESULTS: 607 patients were treated by the Cleft Team in the given period. Among these patients, 25 (4.11%) were found to have associated anomalies. Sixteen patients (2.6%) were identified as having a particular syndrome. 8 different syndromes occurred. Robin sequence represented 50% of this cohort. In 13 patients, the usual treatment algorithm had to be modified. The modifications were necessary due to the given genetic syndromes. CONCLUSION: Genetic syndromes significantly may affect the treatment algorithm in children born with cleft lip and palate. The (surgical) treatment of associated anomalies have priority over the reconstruction of cleft lip and palate. Orv Hetil. 2022; 163(21): 826-831.


Assuntos
Fenda Labial , Fissura Palatina , Criança , Fenda Labial/epidemiologia , Fenda Labial/genética , Fenda Labial/cirurgia , Fissura Palatina/genética , Fissura Palatina/cirurgia , Humanos , Sistema de Registros , Estudos Retrospectivos , Síndrome
16.
J Coll Physicians Surg Pak ; 32(5): 682-684, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35546713

RESUMO

Repairing bilateral cleft lip (BCL) with a modified Z-Plasty technique to overcome many complications encountered with other traditional techniques was attempted in a group of Egyptian subjects at the Department of Oral and Maxillofacial Surgery, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt between May 2018 to May 2021. The study included 20 patients suffering from primary BCL of both genders with ages ranging from one week to one year. 60% of the patients were female and 40% were males. The modified Z-Plasty technique was used in all patients. Wound healing in all cases was uneventful. No inflammation, infection or wound dehiscence were reported in this study. Postoperative gummy show improved significantly (p=0.001), and 70% of patients had zero postoperative maxillary ridge show as lip lengths improved significantly. The clinical results of the modified double Z-Plasty technique used for closure of BCL were very interesting and avoid scarifying vermillion tissue in addition to the increase of both philtrum length and lip volume. Key Words: Bilateral cleft left lip, Repair, Z-Plasty.


Assuntos
Fenda Labial , Procedimentos Cirúrgicos Reconstrutivos , Cirurgia Bucal , Fenda Labial/complicações , Fenda Labial/cirurgia , Feminino , Humanos , Lábio/cirurgia , Masculino , Complicações Pós-Operatórias/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos
17.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 47(1): 123-128, 2022 Jan 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-35545372

RESUMO

At present, nasal abnormalities is often classified from different perspectives, such as the alar-columella relationship, nasal base width, and the condition of alar hyperplasia. However, due to the impact of race and region, different people may be applied to different classification methods, resulting in different clinical diagnosis and treatments. So far, there is no unified standard for alar deformity classification to guide clinical treatment. In alar-columella relationship, the retracted ala and the hanging columella, hanging ala and retracted columella are easily confused. According to the classification of nasal base width, it is easy to confuse the alar flare with wide alar base. Therefore, the accurate preoperative evaluation of the nasal ala and the selection of appropriate clinical treatments for different abnormalities are beneficial for surgeons to achieve perfect rhinoplasty results.


Assuntos
Fenda Labial , Rinoplastia , Humanos , Hiperplasia , Septo Nasal/cirurgia , Nariz , Cuidados Pré-Operatórios , Rinoplastia/métodos
18.
Artigo em Inglês | MEDLINE | ID: mdl-35577431

RESUMO

OBJECTIVES: to investigate auditory and language skills in children with repaired cleft lip and palate. METHODS: The sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p<.05). RESULTS: The central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills. CONCLUSION: There was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.


Assuntos
Fenda Labial , Fissura Palatina , Criança , Fenda Labial/complicações , Fenda Labial/cirurgia , Fissura Palatina/complicações , Fissura Palatina/cirurgia , Feminino , Testes Auditivos , Humanos , Idioma , Masculino
19.
Sci Rep ; 12(1): 8558, 2022 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-35595867

RESUMO

Alveolar bone grafting (ABG) is broadly performed for cleft lip and palate patients. The rate of canine impaction post-ABG is much higher than the prevalence of canine impaction in non-cleft patients. This pilot study was designed to investigate factors involved in canine eruption failure after ABG and to predict the possibility of canine impaction in unilateral cleft lip and palate (UCLP) patients. This retrospective observational study examined 45 patients with UCLP (mean age 7.9 years) classified into an impacted group (n = 9) and a spontaneously erupted group (n = 36). From 3D images, we measured lateral incisor presence or absence, lateral incisor position on the cleft side, canine position, movement change, cleft volume, and canine and first premolar overlap-area. Multivariate logistic regression analysis using independent variables indicated significant differences in results, selecting highly relevant items. Multivariate analysis indicated a significant association between the overlap-area between the canine and the first premolar at pre-ABG (p = 0.038) and the distance between the cleft side cusp tips of canine and the lateral cleft margin of pre-ABG (p = 0.005). Results suggest that canine impaction is predictable at an early stage in pre-ABG and show the possibility of comprehensive diagnosis of canine impaction using computed tomography.


Assuntos
Enxerto de Osso Alveolar , Fenda Labial , Fissura Palatina , Dente Impactado , Enxerto de Osso Alveolar/métodos , Fenda Labial/cirurgia , Fenda Labial/veterinária , Fissura Palatina/cirurgia , Dente Canino/cirurgia , Humanos , Projetos Piloto , Estudos Retrospectivos , Dente Impactado/complicações , Dente Impactado/cirurgia
20.
Front Immunol ; 13: 871200, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35572588

RESUMO

Objective: Residual scarring after cleft lip repair surgery remains a challenge for both surgeons and patients and novel therapeutics are critically needed. The objective of this preclinical experimental study was to evaluate the impact of the methyl-ester of pro-resolving lipid mediator lipoxin A4 (LXA4-ME) on scarring in a novel rabbit model of cleft lip repair. Methods: A defect of the lip was surgically created and repaired in eight six-week old New Zealand white rabbits to simulate human cleft lip scars. Rabbits were randomly assigned to topical application of PBS (control) or 1 ug of LXA4-ME (treatment). 42 days post surgery all animals were euthanized. Photographs of the cleft lip area defect and histologic specimens were evaluated. Multiple scar assessment scales were used to compare scarring. Results: Animals treated with LXA4-ME exhibited lower Visual Scar Assessment scores compared to animals treated with PBS. Treatment with LXA4-ME resulted in a significant reduction of inflammatory cell infiltrate and density of collagen fibers. Control animals showed reduced 2D directional variance (orientation) of collagen fibers compared to animals treated with LXA4-ME demonstrating thicker and more parallel collagen fibers, consistent with scar tissue. Conclusions: These data suggest that LXA4-ME limits scarring after cleft lip repair and improves wound healing outcomes in rabbits favoring the resolution of inflammation. Further studies are needed to explore the mechanisms that underlie the positive therapeutic impact of LXA4-ME on scarring to set the stage for future human clinical trials of LXA4-ME for scar prevention or treatment after cleft lip repair.


Assuntos
Fenda Labial , Lipoxinas , Animais , Cicatriz/patologia , Cicatriz/prevenção & controle , Fenda Labial/cirurgia , Colágeno , Humanos , Lipoxinas/farmacologia , Lipoxinas/uso terapêutico , Coelhos , Cicatrização
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