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1.
Stomatologiia (Mosk) ; 99(5): 58-61, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33034178

RESUMO

Congenital malformations of the maxillofacial region are significant, not completely decisive, medical and social problems. Recent literature data indicate a trend towards improvement. PURPOSE OF THE STUDY: Improving the effectiveness of treatment of children with bilateral orthodontic and surgical training. MATERIAL AND METHODS: Under the supervision were 80 children with cleft lip and palate, with an age of up to 3 years. Of these 56 patients, 28 patients are the 2nd group prepared for surgery according to the developed technique. RESULTS: Preoperative orthodontic preparation of 28 children with bilateral cleft and an indicator that 22 (78.6%) patients should not have fully achieved results between the interhuman and fragmentary alveolar process of the upper jaw. In the second group of patients, 27 (96.4%) patients showed a normal ratio of the intermaxillary bone and lateral fragments. CONCLUSION: The use of the developed orthodontic design with active elements and mini implants in 96.4% of cases requires the presence of pre-spiral orthodontic preparation, normalization of the position of the intercellular bone and shape, followed by primary chelorinoplastics and in relation to additional uranoplastics, as well as the periodic stages of rehabilitation of patients with bilateral cleft lip and achieved thereby a stable aesthetic and functional result.


Assuntos
Fenda Labial , Fissura Palatina , Implantes Dentários , Criança , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Humanos , Aparelhos Ortodônticos
2.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 809-814, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047712

RESUMO

OBJECTIVE: Non-syndromic cleft lip with or without cleft palate (NSCL/P) is a common birth defect, affecting 1.4 per 1 000 live births, and multiple genetic and environmental risk factors influencing its risk. All the known genetic risk factors accounted for a small proportion of the heritability. Several authors have suggested parent-of-origin effects (PoO) may play an important role in the etiology of this complex and heterogeneous malformation. To clarify the genetic association between PTCH1, PTCH2, SHH and SMO in hedgehog (HH) pathway and NSCL/P, as well as testing for potential PoO effects in Chinese case-parent trios. METHODS: We tested for transmission disequilibrium tests (TDT) and PoO effects using 83 common single nucleotide polymorphic (SNP) markers of HH pathway genes from 806 NSCL/P case-parent trios. These trios were drawn from an international consortium established for a genome-wide association studies (GWAS) of non-syndromic oral clefts of multiple ethnicities. DNA samples were collected from each trio. Single marker and haplotype based analysis were performed both in TDT tests and PoO effects. SNPs were excluded if they (ⅰ) had a call rate of < 95%, (ⅱ) had a minor allele frequency (MAF) of < 0.05, (ⅲ) had Mendelian errors over all trios of >5%, (ⅳ) had a genotype distribution in the parents that deviated from the Hardy-Weinberg equilibrium (HWE) (P < 0.000 1). The process was done using Plink (version 1.07, http://pngu.mgh.harvard.edu/~purcell/plink/data.shtml). TDT test was performed in Plink v1.07. A log-linear model was used to explore PoO effects using Haplin v6.2.1 as implemented in R package v3.4.2. Significance level was assessed using the Bonferroni correction. RESULTS: A total of 18 SNPs were dropped due to low MAF, thus leaving 65 SNPs available for the analysis. Thus the Bonferroni threshold was 7.7×10-4 (0.05/65). Nominal significant association with NSCL/P was found at a SNP (rs4448343 in PTCH1, P=0.023) and six haplotypes (rs10512249-rs4448343, rs1461208-rs7786445, rs10512249-rs4448343, rs16909865-rs10512249-rs4448343, rs1461208-rs7786445-rs12698335, and rs288756-rs288758-rs1151790, P < 0.05). A total of six haplotypes (rs288765-rs1233563, rs12537550-rs11765352, rs872723-rs288765-rs1233563, rs288765-rs1233563-rs288756, rs6459952-rs12537550-rs11765352, and rs12537550-rs11765352-rs6971211) showed PoO effect (P < 0.05). None of the results remained significant after the Bonferroni correction (P>7.7×10-4). CONCLUSION: Neither significant association between SNPs within HH pathway and the risk of NSCL/P nor PoO effects was seen in this study.


Assuntos
Fenda Labial , Fissura Palatina , Grupo com Ancestrais do Continente Asiático , Fenda Labial/genética , Fissura Palatina/genética , Estudo de Associação Genômica Ampla , Proteínas Hedgehog/genética , Humanos , Receptor Patched-2 , Receptor Smoothened
3.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 815-820, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047713

RESUMO

OBJECTIVE: In this study, we used genome-wide association study (GWAS) data to explore whether WNT pathway genes were associated with non-syndromic oral clefts (NSOC) considering gene-gene interaction and gene-environment interaction. METHODS: We conducted the analysis using 806 non-syndromic cleft lip with or without cleft palate (NSCL/P) case-parent trios and 202 non-syndromic cleft palate (NSCP) case-parent trios among Chinese populations selected from an international consortium established for a GWAS of non-syndromic oral clefts. Genotype data and maternal environmental exposures were collected through DNA samples and questionnaires. Conditional Logistic regression models were adopted to explore gene-gene interaction and gene-environment in teraction using trio package in R software. The threshold of significance level was set as 3.47×10-4 using Bonferroni correction. RESULTS: A total of 144 single nucleotide polymorphisms (SNPs) in seven genes passed the quality control process in NSCL/P trios and NSCP trios, respectively. Totally six pairs of SNPs interactions showed statistically significant SNP-SNP interaction (P < 3.47×10-4) after Bonferroni correction, which were rs7618735 (WNT5A) and rs10848543 (WNT5B), rs631948 (WNT11) and rs556874 (WNT5A), and rs631948 (WNT11) and rs472631 (WNT5A) among NSCL/P trios; rs589149 (WNT11) and rs4765834 (WNT5B), rs1402704 (WNT11) and rs358792 (WNT5A), and rs1402704 (WNT11) and rs358793 (WNT5A) among NSCP trios, respectively. In addition, no significant result was found for gene-environment interaction analysis in both of the NSCL/P trios and NSCP trios. CONCLUSION: Though this study failed to detect significant association based on gene-environment interactions of seven WNT pathway genes and the risk of NSOC, WNT pathway genes may influence the risk of NSOC through potential gene-gene interaction.


Assuntos
Fenda Labial , Fissura Palatina , Grupo com Ancestrais do Continente Asiático/genética , Fenda Labial/genética , Fissura Palatina/genética , Estudo de Associação Genômica Ampla , Humanos , Via de Sinalização Wnt/genética
4.
Plast Reconstr Surg ; 146(4): 847-858, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32970007

RESUMO

BACKGROUND: No consensus exists about the safest position for performing the osseous genioplasty, with 5 to 6 mm below the mental foramen being the most frequently recommended position. This study intends to generate a safe distance guide to minimize the risk of inferior alveolar nerve injury during osteotomy. METHODS: Pretreatment cone-beam computed tomography-derived three-dimensional models from adult patients with skeletal class I to III patterns and cleft lip/palate deformity who underwent orthodontic-surgical interventions (n = 317) were analyzed. A three-dimensional vertical distance between the inferior margin of the mental foramen and the lowest point of the inferior alveolar nerve canal was measured in each three-dimensional hemimandible (n = 634). Statistical analysis was performed to generate the safe distance guide in a stepwise fashion at 95, 99, and 99.99 percent confidence levels. RESULTS: Class III (4.35 ± 1.42 mm) and cleft lip/palate (4.42 ± 1.53 mm) groups presented significantly (p < 0.001) larger three-dimensional distances than class I (3.44 ± 1.54 mm) and class II (3.66 ± 1.51 mm) groups. By considering the 5- to 6-mm safe distance parameter, 6.4, 5.0, 10.6, 16, and 9.9 percent of hemimandibles were at risk of osteotomy-induced nerve injury in the class I, class II, class III, cleft lip/palate, and overall cohorts, respectively. Overall, the safe distance zone to perform the osteotomy was set at 7.06, 8.01, and 9.12 mm below the mental foramen, with risk probabilities of 2.5, 0.5, and 0.0005 percent, respectively. CONCLUSION: This study contributes to patient safety and surgeon practice by proving a safe distance guide for genioplasty.


Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Tomografia Computadorizada de Feixe Cônico , Mentoplastia/métodos , Imageamento Tridimensional , Complicações Intraoperatórias/prevenção & controle , Traumatismos do Nervo Mandibular/prevenção & controle , Nervo Mandibular/diagnóstico por imagem , Cirurgia Assistida por Computador , Adolescente , Adulto , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Período Intraoperatório , Masculino , Estudos Retrospectivos , Adulto Jovem
5.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(4): 364-370, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32865352

RESUMO

OBJECTIVE: To explore the association between two single nucleotide polymorphisms (SNPs), namely, rs4691383 and rs7667857, in the platelet-derived growth factor-C (PDGF-C) gene, the genotypes, environmental exposure factors, and nonsyndromic cleft lip with or without cleft palate (NSCL/P) in Western Chinese population. METHODS: A total of 268 case-parent trios were selected, and two SNPs (rs4691383 andrs7667857) were genotyped by using polymerase chain reaction and restriction enzyme fragment length polymorphic method and direct sequencing method. Hardy-Weinberg equilibrium, linkage disequilibrium test, transmission disequilibrium test, and haplotype analysis were conducted to analyze the data. Meanwhile, the questionnaires on the epidemiology of cleft lip and palate filled by the included samples were collected, and the interaction between the genotypes of the two SNPs and environmental exposure factors was assessed by conditional logistic regression. RESULTS: The A allele at rs4691383 and the G allele at rs7667857 of PDGF-C gene were over-transmitted for NSCL/P (P<0.05). No interaction effect was observed between the three environmental exposure factors (history of smoking/passive smoking, folic acid supplementation, and long-term inhalation of harmful environmental gases) and the PDGF-C genotypes among NSCL/P (P>0.05). CONCLUSIONS: The rs4691383 and rs7667857 at PDGF-C gene are closely related to the occurrence of NSCL/P in Western Chinese population. However, the interaction between environmental exposure factors and PDGF-C genotypes is not obvious in the occurrence of NSCL/P.


Assuntos
Fenda Labial , Fissura Palatina , Estudos de Casos e Controles , Predisposição Genética para Doença , Genótipo , Humanos , Linfocinas , Fator de Crescimento Derivado de Plaquetas , Polimorfismo de Nucleotídeo Único
6.
J Craniomaxillofac Surg ; 48(10): 962-968, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32933825

RESUMO

This study aimed to explore the preoperative factors that are potentially associated with the outcome of Furlow palatoplasty in treating nonsyndromic submucous cleft palate (SMCP). In this study, we reviewed patients with nonsyndromic SMCP who received Furlow palatoplasty between 2008 and 2017 at our department. A comprehensive panel of preoperative variables was included for analyses including gender, age at operation, concurrence of cleft lip, preoperative hypernasality, nasal emission, velopharyngeal closure ratio (VCR), velopharyngeal closure pattern, velum and pharyngeal wall movement, presence of Passavant Ridge and articulation error. The improvement of velopharyngeal function was considered a good outcome. Both univariate and multivariate analyses were performed to screen the potential predictors of the postoperative velopharyngeal function. Multivariate regression analyses indicated preoperative VCR as the only factor that was significantly associated with surgical outcome (p = 0.025). The receiver operating characteristic curve and Youden index indicated that VCR>52.5% was the cutoff value for predicting preferable postoperative velopharyngeal function (OR, 0.240; 95% IC, 0.059-0.979; p = 0.047). In conclusion, Furlow palatoplasty was recommended for non-syndromic SMCP patient with preoperative VCR>52.5% as the primary surgical treatment.


Assuntos
Fissura Palatina/cirurgia , Insuficiência Velofaríngea/cirurgia , Humanos , Palato Mole/cirurgia , Faringe , Estudos Retrospectivos , Resultado do Tratamento
7.
J Craniomaxillofac Surg ; 48(10): 977-984, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32938558

RESUMO

AIM: To assess the efficacy of double opposing buccal flap in lengthening the soft palate for velopharyngeal insufficiency correction, and its potential complications in different age groups. CASE SERIES: From March 2016 to June 2019, 50 patients (24 children, 12 adolescents and 14 adults) underwent palatal lengthening using double opposing buccinator myomucosal flaps. Postoperative complications were assessed by two surgeons and the speech outcomes were evaluated by two speech-language pathologists after assessing changes in the hypernasality and intelligibility using a scoring approach. Following the procedure, mild-to-moderate surgical complications were seen, mostly among the adults. There was a significant improvement in hypernasality and intelligibility in all the groups. None of the patients showed hyponasal speech postoperatively. CONCLUSION: To conclude, the double opposing buccal flap technique is an effective and safe surgical treatment option for the management of velopharyngeal insufficiency in all age groups of patients.


Assuntos
Fissura Palatina/complicações , Fissura Palatina/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Insuficiência Velofaríngea/cirurgia , Adolescente , Adulto , Criança , Humanos , Palato Mole/cirurgia , Retalhos Cirúrgicos/cirurgia , Resultado do Tratamento
8.
Bull Tokyo Dent Coll ; 61(3): 201-209, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32801263

RESUMO

Alveolar bone grafting is routinely performed in repair of alveolar clefts. When the alveolar cleft is wider than 11 mm, however, the survival rate of the bone graft and prognosis are poor. Here, we describe successful orthodontic treatment using interdental distraction osteogenesis (IDO) with a tooth-tooth type distractor to reduce the width of the alveolar cleft in a patient with unilateral cleft lip and palate. The patient was a 12-year-old girl with unilateral cleft lip and palate, maxillary dentition midline deviation, congenitally missing maxillary lateral incisors, a palatally-displaced right upper first premolar, a wide alveolar cleft (20 mm), and mandibular prognathism due to maxillary hypoplasia. Treatment comprised a combination of orthodontic treatment and IDO. After treatment, appropriate occlusion, space closure in the maxillary arch, coincidence of the maxillary and facial midlines, and incorporation of the right maxillary first premolar into the arch were obtained. These results suggest that IDO is effective in treating cleft lip and palate patients with a wide alveolar cleft.


Assuntos
Fenda Labial , Fissura Palatina , Osteogênese por Distração , Criança , Feminino , Humanos , Maxila
9.
Plast Reconstr Surg ; 146(2): 371-379, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740590

RESUMO

BACKGROUND: As a component of the Maintenance of Certification process from 2003 to 2019, the American Board of Plastic Surgery tracked 20 common plastic surgery operations. By evaluating the data collected over 16 years, the authors are able to examine the practice patterns of pediatric/craniofacial surgeons in the United States. METHODS: Cumulative tracer data for cleft palate repair was reviewed as of April of 2014 and September of 2019. Evidence-based medicine articles were reviewed. Results were tabulated in three categories: pearls, or topics that were covered in both the tracer data and evidence-based medicine articles; topics that were covered by evidence-based medicine articles but not collected in the tracer data; and topics that were covered in tracer data but not addressed in evidence-based medicine articles. RESULTS: Two thousand eight hundred fifty cases had been entered as of September of 2019. With respect to pearls, pushback, von Langenbeck, and Furlow repairs all declined in use, whereas intravelar veloplasty increased. For items not in the tracer, the quality of studies relating to analgesia is among the highest of all areas of study regarding cleft palate repair. In terms of variables collected by the tracer but not studied, in 2019, 41 percent of patients received more than 1 day of antibiotics. CONCLUSIONS: This article provides a review of cleft palate tracer data and summarizes the research in the field. Review of the tracer data enables cleft surgeons to compare their outcomes to national norms and provides an opportunity for them to consider modifications that may enhance their practice.


Assuntos
Fissura Palatina/cirurgia , Medicina Baseada em Evidências/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Medicina Baseada em Evidências/métodos , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Reconstrutivos/estatística & dados numéricos , Cirurgiões/legislação & jurisprudência , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/legislação & jurisprudência , Cirurgia Plástica/estatística & dados numéricos , Resultado do Tratamento , Estados Unidos , Adulto Jovem
10.
Dental Press J Orthod ; 25(3): 54-64, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32844974

RESUMO

INTRODUCTION: The cleft lip and palate is the most frequent craniofacial anomaly and as a consequence of this malformation some inadequate occlusal relationship between the arches are observed. Furthermore, dental absences, individual positioning changes of teeth as rotations, and in more rare situations the transpositions may be found as well. DESCRIPTION: In this context, in this article is reported a case of a 9-year-old patient with unilateral cleft lip and palate, with anterior and posterior crossbite on the left side, absence of the maxillary left lateral incisor, and transposition of the maxillary left canine and first premolar. The patient was treated with slow maxillary expansion, secondary graft and fixed orthodontic appliance, transposition maintenance and closing of the lateral incisor space with the first premolar, by means of mesialization of the posterior teeth. RESULTS: At the end of the treatment, good intercuspation and an important aesthetic gain for the patient were achieved. The analysis three years after treatment revealed a good stability of the results obtained.


Assuntos
Fenda Labial , Fissura Palatina , Dente Pré-Molar , Criança , Estética Dentária , Humanos
11.
Mutat Res ; 785: 108319, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32800270

RESUMO

Cleft lip and palate (CL/P) is among the most common congenital malformations and affects 1 in 700 newborns. CL/P is caused by genetic and environmental factors (maternal smoking, alcohol or drug use and others). Many genes and loci were associated with cleft lip/palate but the amount of heterogeneity justifies identifying new causal genes and variants. AHRR (Aryl-Hydrocarbon Receptor Repressor) gene has recently been related to CL/P however, few functional studies analyze the genotypephenotype interaction of AHRR with CL/P. Several studies associate the molecular pathway of AHRR to CL/P which indicates this gene as a functional candidate in CL/P etiology. METHODS: Systematic Literature Review was performed using PUBMED database with the keywords cleft lip, cleft palate, orofacial cleft, AHRR and synonyms. SLR resulted in 37 included articles. RESULTS: AHRR is a positional and functional candidate gene for CL/P. In silico analysis detected interactions with other genes previously associated to CL/P like ARNT and CYP1A1. AHRR protein regulates cellular toxicity through TCDD mediated AHR pathway. Exposure to TCDD in animal embryos is AHR mediated and lead to cleft palate due to palate fusion failure and post fusion rupture. AHRR regulates cellular growth and differentiation, fundamental to lip and palatogenesis. AHRR decreases carcinogenesis and recently a higher tumor risk has been described in CL/P patients and families. AHRR is also a smoking biomarker due to changed methylation sites found in smokers DNA although folate intake may partially revert these methylation alterations. This corroborates the role of maternal smoking and lack of folate supplementation as risk factors for CL/P. CONCLUSION: This research identified the importance of AHRR in dioxin response and demonstrated an example of genetic and environmental interaction, indispensable in the development of many complex diseases.


Assuntos
Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Fenda Labial/genética , Fissura Palatina/genética , Proteínas Repressoras/genética , Fumar/efeitos adversos , Motivos de Aminoácidos , Fatores de Transcrição Hélice-Alça-Hélice Básicos/química , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Biomarcadores/metabolismo , Metilação de DNA , Suplementos Nutricionais , Feminino , Ácido Fólico/metabolismo , Estudos de Associação Genética , Humanos , Recém-Nascido , Masculino , Modelos Moleculares , Domínios Proteicos , Isoformas de RNA/genética , Proteínas Repressoras/química , Proteínas Repressoras/metabolismo , Fatores de Risco
12.
J Craniomaxillofac Surg ; 48(10): 919-927, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32768251

RESUMO

OBJECTIVE: This study assessed the rate of maxillary osteotomies after cleft palate surgery following a standardized two-stage palatoplasty protocol. In order to improve our treatment strategy, the results were compared with the data extracted from the literature by means of a systematic review. DESIGN: Retrospective cohort study. PATIENTS: Non-syndromic cleft lip, alveolus, and palate patients with complete records who underwent primary cleft palate surgery. INTERVENTION: The incidence of midface hypoplasia after primary cleft surgery that required surgical intervention was retrospectively evaluated. RESULTS: Of the final 51 patients included in our retrospective analysis, two required a maxillary repositioning osteotomy. The frequency was lower than reported in the literature. In the literature, there was no difference between patients treated according to a one-stage protocol (21%) and patients treated according to a two-stage protocol (20.8%), but a higher incidence of pharyngeal surgery was noted in the two-stage closure group. Only the cleft type, timing of hard palate closure, and orthodontic treatment proved to influence the need for maxillary osteotomy. CONCLUSION: Our protocol shows promising results and needs more validation.


Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Osteotomia Maxilar , Humanos , Maxila/cirurgia , Palato Duro , Estudos Retrospectivos , Resultado do Tratamento
13.
J Craniomaxillofac Surg ; 48(10): 969-976, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32826151

RESUMO

The aim of the study was to describe the attractiveness of a newborn with CL/P and the maternal reaction in relation to the child. Another purpose was to explore and describe the experience and subjectively perceived reaction of the mother and the social environment to the child before and after cleft lip surgery. MATERIAL AND METHODS: A study to describe and evaluate mothers' experiences, feelings and emotions (n = 84) regarding having a child with CL/P was performed. Therefore mothers were asked to complete a self-reported, standardized Likert-scale questionnaire. The questions were focused on the mother's own experiences, and the reaction of close family members and the social environment (friends, unknown people) to the child. Therefore two essential situations during the first year of life were analyzed: the first contact with the child, and a second one after lip surgery. The influence of lip reconstruction on the attractiveness of the child and the following reactions were analyzed. The timeline includes surveys from 01/2014 to 12/2016. RESULTS: 84 mothers of affected children (CL/P) replied to the questionnaire (84/103). Most mothers (n = 64) described the attractiveness of their child at birth as "very good" (n = 37) and "good" (n = 27). After lip reconstruction the subjective attractiveness in the mothers' opinions increased to 90.5% (n = 76): 24 "good" (p = 0.23) and 52 "very good" (p = 0.73). 50 mothers defined the postoperative surgical result as "very good", 21 did not see any improvement (p = 0.001). Poor postoperative evaluations like "very poor" (n = 0), "insufficient" (n = 1) or "sufficient" (n = 1) were found two times. The majority of mothers (n = 78) reported negative reactions of the social environment to the child before lip surgery. Friends reacted in general more positively to the child with the visible deformity than did the social environment. 41 mothers described that their life partner or husband reacted "always" more positively to the child (p = 0.018). After surgical lip closure, strangers (n = 22) and even friends (n = 27) did not change their reactions obviously. CONCLUSION: For the mother, the attractiveness of a child with CL/P is not significantly affected by the visible facial malformation. Even if the lip reconstruction increases the child's attractiveness from the mother's perspective, the often negative reactions of the family and social environment did not change.


Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Criança , Feminino , Humanos , Recém-Nascido , Mães , Estudos Retrospectivos , Autorrelato , Meio Social
14.
Univ. salud ; 22(2): 198-202, mayo-ago. 2020. graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1115969

RESUMO

Resumen Introducción: El labio y paladar hendido son malformaciones craneofaciales que se presentan en 1:1000 nacidos vivos en Colombia. Realizar un moldeado nasoalveolar previo a la cirugía favorece el reposicionamiento de los cartílagos nasales deformados y de los procesos alveolares. Objetivo: Dar a conocer a los profesionales la importancia de realizar moldeado nasoalveolar en un paciente con labio y paladar hendido antes de la intervención quirúrgica. Materiales y métodos: En la clínica odontológica de la Universidad del Sinú de Montería (Córdoba, Colombia), se atendió una paciente de 17 días de nacida que presentaba labio y paladar hendido completo unilateral izquierdo severo. Luego de diligenciar la historia clínica odontológica, se realizó placa de órtesis, que se cambió cada 15 días y se hizo el retoque del "tutor" cada 8 días. Resultados: La placa de órtesis permitió un moldeado naso alveolar, con el progreso en la alimentación y mejoras en el contorneado de los tejidos nasales, que mejoró la preparación para la operación de la hendidura a los 8 meses de edad. Conclusiones: La importancia del moldeado nasoalveolar en casos como el presentado, es propiciar mejores condiciones físicas, favoreciendo la ingesta de alimentos y beneficiando la apariencia física.


Abstract Introduction: Cleft lip and palate is a craniofacial birth defect that accounts for 1:1000 live birhts in Colombia. Performing nasoalveolar molding before surgery facilitates the reshaping of deformed nasal cartilage and alveolar processes. Objective: To make professionals aware of the importance of performing nasoalveolar molding in a patient with cleft lip and palate before surgical intervention. Materials and methods: A 17-day-old infant with a full left unilateral cleft lip and palate was treated at the dental clinic of the University of Sinú, Montería (Córdoba, Colombia). Once the dental clinical history was recorded, an orthosis plate was made. The plate was changed every 15 days and the molding appliance was repositioned every 8 days. Results: The orthosis plate promoted nasoalveolar molding, which facilitated feeding and improved the shape of nasal tissues. Consequently, this early intervention improved the preparation for the surgery of the cleft when the child reached 8 months of age. Conclusions: Nasoalveolar molding in patients with full cleft lip and palate is important to promote better physical conditions, which favor food intake and benefit their physical appearance.


Assuntos
Recém-Nascido , Fenda Labial , Modelos Anatômicos , Aparelhos Ortopédicos , Contenções , Fissura Palatina
18.
Vestn Otorinolaringol ; 85(3): 18-22, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32628377

RESUMO

The purpose: to compare the types of cytograms of exudate from the middle ear between patients with exudative otitis media (EOM) with congenital clefts of the lip/palate (CCLP) and without CCLP, determining the stages of chronic disease and the significance of surgery on the middle ear. PATIENTS AND METHODS: Two clinics was parallel conducted a cytological examination of exudate of the middle ear in children. The first group consisted of 30 patients aged 2 to 17 years with EOM without CCLP (n=54 ears). The 2nd group included 17 patients aged 1 year 4 months to 10 years with EOM with CCLP (n=34 ears). RESULTS: In the 1st group, in 61% of cases (n=33), an inflammatory-regenerative type of cytogram was detected, in 39% (n=21) - a regenerative, inflammatory type of cytogram was not detected. In the 2nd group, in 82.4% of cases (n=28), an inflammatory type of cytogram was observed, in 14.7% (n=5) - an inflammatory-regenerative type, in 2.9% (n=1 ear) - a regenerative type. CONCLUSION: With CCLP, the inflammatory nature of the cytogram of the resulting exudate from the middle ear is more common, which is characterized by signs of destruction of the mucous membrane, decay and degradation of the basal and cell membranes. Patients with CCLP often suffer from EOM. They are more likely to development of chronic purulent otitis media, including with cholesteatoma. Destructive changes in the mucous membrane of the middle ear are found in children of different ages. Taking into account the analysis of cytograms of the exudate of the middle ear with CCLP, the imposition of long-term ventilation tubes is justified.


Assuntos
Fissura Palatina , Otite Média com Derrame/cirurgia , Otite Média Supurativa , Adolescente , Criança , Pré-Escolar , Orelha Média , Humanos , Lactente , Ventilação da Orelha Média
19.
Am J Orthod Dentofacial Orthop ; 158(3): 452-458, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32709578

RESUMO

INTRODUCTION: Nasoalveolar molding (NAM) was introduced over 20 years ago as adjunctive therapy for the correction of cleft lip and palate. In the current study, we propose a new approach using a digital workflow and 3-dimensional printing to fabricate clear aligner NAM devices. METHODS: A polyvinyl siloxane (PVS) impression of an infant with a unilateral complete cleft lip and palate (UCLP) is acquired and poured, and the stone model is scanned with an intraoral scanner. The stereolithography file is digitized, and the alveolar segments are digitally segmented and moved to the desired final position. The total distance moved is divided into a sequence of 1-1.5 mm increments, creating a series of digital models. The models are 3-dimensionally printed along with button templates to allow free form positioning of the button on each model. A Vacuform machine (Taglus, Mumbai, India) was used to fabricate a 0.040-in aligner for each stage. RESULTS: We present 1 case that was treated successfully with this approach. Appointments for the NAM adjustments were primarily to monitor progress and counseling with less time spent adjusting the appliance. The appointment length was reduced by over 30 minutes. Benefits of the aligner are improved fit, more precise increments of activation, reduced chairside time, and potentially minimized number of visits. CONCLUSIONS: NAM custom aligners may provide similar benefits to the traditional approach while reducing the burden of care by reducing the number of visits and appointment duration. Further studies with a sample and longitudinal observations are needed to investigate the benefits of the proposed digital approach.


Assuntos
Fenda Labial , Fissura Palatina , Aparelhos Ortodônticos Removíveis , Humanos , Índia , Lactente , Nariz , Cuidados Pré-Operatórios , Fluxo de Trabalho
20.
Stomatologiia (Mosk) ; 99(3): 57-59, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32608951

RESUMO

Multi-stage therapy of children with congenital diseases of the maxillofacial region requires a multidisciplinary team of specialists coordinated consistently conducted treatment, not only providing a complete reconstruction of the maxillary bones, but also improving the quality of life of children. In our study, it was found that the most significant independent predictors of the total indicator of quality of life are indicators of structures and functions of the maxillofacial region, as well as the level of activity and participation of children in real life situations and the level of parental compliance.


Assuntos
Fenda Labial , Fissura Palatina , Criança , Humanos , Prognóstico , Qualidade de Vida
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