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1.
Objectives: Clefts of the lip and/or palate (CL/P) are the most common congenital disorders of the head and neck. In Norway, the incidence is 1.9/1000 live births. The aim of this study was to investigate the frequency and distribution of various types of clefts and dental anomalies in patients treated by the cleft lip and palate (CLP) team in Bergen, Norway.

Material and methods: The material comprised the records of patients 6 years of age, examined by the CLP team in Bergen from spring 1993 to autumn 2012, incomplete records were excluded. The records of 989 patients were analysed, using frequencies and Chi-square test to compare differences in percentages between groups.

Results: The gender distribution was 58.8% male and 41.2% female. Isolated cleft palate (CP) was the most common condition (39.5%). Clefts of the lip, jaw and palate (CLP) constituted (30%) of cases and (30.5%) had isolated cleft lip (CL). The frequencies of agenesis, supernumerary and peg-shaped teeth were (36.5%), (17.8%) and (7.5%), respectively. Over 50% of the study population were diagnosed with one or more malocclusion. Of the CLP patients, 61.4% had Angle Class III occlusion. Statistical analysis disclosed a positive association of agenesis with Class III occlusion (OR =1.8, p≤?0.001).

Conclusions: The findings supported the hypothesis that the distribution of dental anomalies and occlusal disorders varied among patients with CL, CP and CLP. In patients with cleft, there is a twofold chance to get Class III malocclusion in the presence of agenesis.  相似文献   

2.
OBJECTIVE: A cross-sectional study was employed to determine the psychosocial effects of cleft lip and/or palate among children and young adults, compared with a control group of children and young adults without cleft lip and palate. PARTICIPANTS: The study comprised 160 children and young adults with cleft lip and/or palate and 113 children and young adults without cleft lip and/or palate. All participants were between 8 and 21 years of age. OUTCOME MEASURES: Psychological functioning (anxiety, self-esteem, depression, and behavioral problems) was assessed using validated psychological questionnaires. Happiness with facial appearance was rated using a visual analog scale. Social functioning, including experience of teasing/bullying and satisfaction with speech, was assessed using a semistructured interview. RESULTS: Participants with cleft lip and/or palate reported greater behavioral problems (p < .001) and more symptoms of depression (p < .01); they were teased more often (p < .001) and were less happy with their facial appearance (p < .01) and speech (p < .001), compared with controls. There were no significant difference between subjects with cleft lip and/or palate and subjects without cleft lip and/or palate in terms of anxiety (p > .05) or self-esteem (p > .05). Having been teased was a significant predictor of poor psychological functioning, more so than having a cleft lip and/or palate per se (p < .001). CONCLUSIONS: Teasing was greater among participants who had cleft lip and/ or palate and it was a significant predictor of poorer psychosocial functioning. Children and young adults with cleft lip and/or palate require psychological assessment, specifically focusing on their experience of teasing, as part of their routine cleft care.  相似文献   

3.
Objective. To determine the prevalence of dental caries and enamel defects in 5- and 10-year-old Swedish children with cleft lip and/or palate (CL(P)) in comparison to non-cleft controls. Materials and methods. The study group consisted of 139 children with CL(P) (80 subjects aged 5 years and 59 aged 10 years) and 313 age-matched non-cleft controls. All children were examined by one of two calibrated examiners. Caries was scored according to the International Caries Detection and Assessment System (ICDAS-II) and enamel defects as presence and frequency of hypoplasia and hypomineralization. Results. The caries prevalence among the 5-year-old CL(P) children and the non-cleft controls was 36% and 18%, respectively (p < 0.05). The CL(P) children had higher caries frequency (initial and cavitated lesions) in the primary dentition than their controls (1.2 vs 0.9; p < 0.05). A significantly higher prevalence of enamel defects was found in CL(P) children of both age groups and anterior permanent teeth were most commonly affected. Conclusions. Preschool children with cleft lip and/or palate seem to have more caries in the primary dentition than age-matched non-cleft controls. Enamel defects were more common in CL(P) children in both age groups.  相似文献   

4.
ObjectiveTo assess the bite force (BF) of children with repaired cleft lip and palate (CLP).DesignChildren aged 6–12 years, with and without CLP, were divided into the following 5 groups: (1) control group (CON): 34 children without CLP (17 female, 17 male, mean age 8.2 ± 1.4); (2) cleft lip group (CL): 31 children with cleft lip involving the pre-maxilla (15 female, 16 male, mean age 9.7± 1.3); (3) unilateral CLP group (UCLP): 36 children with complete unilateral CLP (11 female, 25 male, mean age 9.4± 1.6); (4) bilateral CLP group (BCLP): 32 children with complete bilateral CLP (11 female, 21 male, mean age 9.5± 1.7); and 5) cleft palate group (CP): 17 children with complete cleft palate (9 female, 8 male, mean age 9.4± 1.6). Briefly, in this clinical trial, BF was assessed before alveolar bone grafting with a gnathodynamometer (IDDK, Kratos, Cotia, SP, Brazil). For CON, BCLP, CL and CP groups, BF was obtained in the anterior and posterior region of the maxilla. For the UCLP group, BF was assessed in the anterior and posterior regions of both segments. Differences among groups were evaluated by ANOVA test, and Tukey’s test was used to assess any correlations among variables (P < 0.05).ResultsUnexpectedly, no differences of BF were observed among CON and any of the cleft groups. However, a stronger BF was observed in the CL group when compared to the UCLP and BCLP groups. Next, no differences were observed between the cleft side and the noncleft side in the UCLP group. Lastly, in all groups, BFs from the anterior region of the maxilla were less when compared to the posterior regions.ConclusionThe BF of children with CLP is no different from children without CLP.  相似文献   

5.
Oral clefts include cleft lip (CL), cleft lip with cleft palate (CLP) and cleft palate (CP), with wide variations in clinical presentation and degree of severity. We described a sample of individuals with CL and CP without alveolar arch involvement (CL + CP) to verify if the characteristics of this group are distinct from those with CL with or without CP (CL/P) described in literature. The sample was composed of 356 patients with CL + CP, registered at HRCA-USP, Bauru-SP-Brazil. The following characteristics were investigated: sex ratio, parental age at the time of conception, parental consanguinity, familial recurrence, laterality of the cleft and associated anomalies. A subgroup of 30 individuals with microforms of CL and CP were taken from the sample and compared with the remaining cases. Statistical differences were found between this CL + CP sample and the literature data for groups with CL/P regarding laterality, sex ratio, consanguinity, familial recurrence, and the presence of associated anomalies. The microform sample showed a statistical difference in paternal age. In most evaluated aspects, this sample presents similar characteristics to the consulted literature data for CL/P; as do the group of microform cleft cases when compared with the remaining CL + CP sample in this study. Microforms of cleft can represent a target group for investigation into the embryogenetic mechanisms of oral clefts and their phenotypic variability.  相似文献   

6.
Cleft lip and palate incidence is high in northern Finland. This study aimed to investigate the proportion of children in need of restorative dental treatment among cleft lip and palate patients in northern Finland, as well as their need for dental treatment under general anesthesia. The records of 183 cleft lip and palate patients, treated in Oulu University Hospital from 1997 to 2013, were reviewed. Data on dental caries were analyzed in association with cleft type, considering also the presence of syndromes. The frequency of dental general anesthetic (DGA) use, and of treatments, were also analyzed. Dental treatment need was most frequently observed, in this rather limited study population, in patients with the most severe deformities, namely bilateral cleft lip and palate, of whom 60% had caries. Among the study population, 11.5% (= 21) had a syndrome. Of those, 57.1% had dental caries at the age of 3 or 6 yr, and only four could be treated without a DGA. Dental treatment under general anesthesia was performed in 14.8% of cleft patients without a syndrome, but in 38.1% of those with a syndrome. General anaesthesia is required for the provision of dental care more often in cleft (17.5%) than in non‐cleft (0.2%) patients, and especially for those with a syndrome.  相似文献   

7.
OBJECTIVE: To review predisposing factors contributing to dental caries in patients with cleft lip, cleft palate, or both (CL/P). DESIGN: Patients with CL/P have a higher susceptibility to caries compared with the population group without clefts. A review of the literature was undertaken to determine factors that could account for the compromised oral hygiene and the high caries prevalence in patients with CL/P. RESULTS: After a literature review, modern strategies for the prevention of early childhood caries were developed and should be considered for integration into the overall management protocol of patients with CL/P. CONCLUSIONS: Preventive dental care is ever more so important in patients with CL/P compared with patients without clefts.  相似文献   

8.
ObjectivesTo determine if the skeletal form of individuals born with oral clefts was associated with maxillary position.Materials and MethodsLateral cephalometric radiographs of 90 individuals 8 to 12 years old born with or without cleft lip and palate paired by age and sex were used. Skull base length, cranial base angle, cranial deflection angle, and maxillary skeletal length and position were studied. Also, mandibular skeletal length and position, lower anterior facial height, and dental position were defined. Individuals were divided into three groups: 30 individuals born with cleft lip and palate with Class III malocclusion (UCLP Class III), 30 individuals born with cleft lip and palate with Class I malocclusion (UCLP Class I), and 30 individuals born without cleft lip and palate with Class III malocclusion (non-cleft Class III).ResultsWhen comparing the UCLP Class III group with the UCLP Class I group, there were differences in maxillary position (P < .001) and mandibular position (P = .004) found. No differences were found when comparing the UCLP Class III group with the non-cleft Class III group.ConclusionsThere are intrinsic factors that affect craniofacial morphology of individuals born with cleft lip and palate.  相似文献   

9.
Objective. Caries is a common disease in humans and has a multifactorial etiology. It has been suggested that children born with cleft lip and/or palate (CL/P) have a higher susceptibility to caries, but data from several independent cohorts does not support this assumption. Previous work from our group suggested DEFB 1 is associated with higher caries experience. Since it is suspected that children born with CL/P have the same risk factors predisposing them to caries as other children of the same ages, the aim was to test if DEFB 1 was associated with caries experience in children born with CL/P. Materials and methods. Sixty-nine children born with CL/P (aged 2–12 years) were included. Twenty-seven males and seven females had cleft lip and palate (CLP), six males and seven females had cleft lip (CL) and 13 males and nine females had cleft palate (CP). Caries was evaluated with the DMFT/dmft index by a calibrated evaluator. Two single nucleotide polymorphisms in DEFB 1 were selected (rs11362 and rs1800972) based on being associated with higher caries experience in previous work. Genotyping were carried out by real-time PCR using the Taqman assay method. The statistical analysis was performed between ‘low-to-moderate caries experience group' and the ‘high caries experience group'. Odds ratio calculations between caries experience and variant alleles and chi-square of Fisher exact tests at a level of significance of 0.05 were used. Results. There was no significant difference for caries experience between cleft types (p = 0.551). An association was found for the marker rs11362 and genotype distribution (p = 0.047). When analyzed in a recessive model, the genotype GG in this polymorphism increased the risk for caries susceptibility by more than 3-times (p = 0.031; OR = 3.16; 95% CI = 0.97–10.62). Conclusion. The genetic variant rs11362 in DEFB 1 influences caries susceptibility in CL/P children. The results support the hypothesis that expression of DEFB 1 in saliva may serve as a biomarker for future caries risk.  相似文献   

10.
Objective. To evaluate different groups of patients’ self-reported assessments of dental anxiety and pain related to various routine dental hygienist treatment procedures, and to investigate the relationship between anxiety concerning dental and dental hygienist treatment. Material and methods. A consecutive sample of 393 patients participated in the study (59.7% F, age range 20 to 85 years, mean 47.6 years). Periodontology (PC), oral medicine (OM), student and general practice (GP) clinics were included. Each patient was asked to answer a questionnaire which included different demographic information, self-reported levels of dental anxiety, and experience of pain in relation to different dental hygienist treatments. Results. Higher dental anxiety was found in relation to gender (women), dentist treatment, and PC and OM patients. Experiences of high or extreme pain were reported by between 7.1% and 9.7% of participants for all dental hygienist procedures except polishing (0.8%). There were significant correlations between dental hygienist fear levels and reported extreme pain experiences among all five treatment procedures. Patients treated at the PC clinic scored significantly higher on pain compared with patients at the other clinics, with the exception of the OM clinic. Conclusions. Patients reported higher dental anxiety levels for dentist treatment as compared with dental hygienist treatment. Moreover, dental anxiety was significantly associated with perceived pain related to different dental hygienist treatment procedures.  相似文献   

11.
OBJECTIVE: To determine the frequency of missed dental appointments among children with a cleft lip and/or palate (CL/P). DESIGN: A prospective study of failed appointments over a 12-month period. SETTING: Three different CL/P clinics within a British dental hospital. PATIENTS: Forty-five CL/P children (mean age of 8.8 years) and 45 age-matched, gender-matched, and postal code-matched noncleft patients. MAIN OUTCOME MEASURES: The overall percentage of missed appointments at three different clinics by CL/P patients and the difference in attendance rates at the pediatric dentistry clinic between CL/P and non-CL/P children. RESULTS: Pediatric dentistry had the highest rate of missed appointments (22.4%), followed by the multidisciplinary cleft clinic (9.2%) and the orthodontic clinic (8.8%). CL/P patients missed a significantly greater proportion of their pediatric dentistry appointments than noncleft children (22.4% versus 11.9%). Patients with a bilateral CL/P were significantly more likely to miss an appointment than patients with a unilateral CL/P. Age, gender, medical history, and distance traveled had no significant effect on attendance rates. CONCLUSIONS: Further work is needed to identify risk factors for poor attendance and to develop strategies to reduce the frequency of missed appointments in this vulnerable group.  相似文献   

12.
Abstract

Purpose: This study investigated the third molar mineralization in patients with cleft lip and palate.

Materials and methods: From a total of 253 digital panoramic radiographs from patients with cleft lip and palate within the age range of 7–21?years, 97 radiographs were selected (cleft group). A control group was formed from same sex individuals, without malformation and chronological age matched within 30?days. The analysis of third molar mineralization was carried out by three calibrated examiners using Demirjian’s and Nolla’s methods. McNemar and Wilcoxon test for paired samples were used for pairwise comparisons between the groups. The Likelihood Ratio test was used to check for an association between the type of cleft and tooth calcification.

Results: In both methods, the mineralization means were smaller in the case group than in the control, with significant differences for all third molars (p?<?.05). The type of cleft affected dental mineralization. There was no significant difference when comparing the left or right sides, but maxillary molars showed earlier mineralization.

Conclusions: A significant delay in third molar mineralization was observed in patients with cleft lip and palate according to Demirjian’s and Nolla’s methods.  相似文献   

13.

Objective

The aims of this study were to investigate the prevalence and distribution of dental anomalies in a group of Saudi subjects with cleft lip and palate (CLP), to examine potential sex-based associations of these anomalies, and to compare dental anomalies in Saudi subjects with CLP with published data from other population groups.

Design

This retrospective study involved the examination of pre-treatment records obtained from three CLP centers in Riyadh, Saudi Arabia, in February and March 2010. The pre-treatment records of 184 subjects with cleft lip and palate were identified and included in this study. Pre-treatment maxillary occlusal radiographs of the cleft region, panoramic radiographs, and orthodontic study models of subjects with CLP were analyzed for dental anomalies.

Results

Orthopantomographs and occlusal radiographs may not be reliable for the accurate evaluation of root malformation anomalies. A total of 265 dental anomalies were observed in the 184 study subjects. Hypodontia was observed most commonly (66.8%), followed by microdontia (45.6%), intra-oral ectopic eruption (12.5%), supernumerary teeth (12.5%), intra-nasal ectopic eruption (3.2), and macrodontia (3.2%). No gender difference in the prevalence of these anomalies was observed.

Conclusions

Dental anomalies were common in Saudi subjects with CLP type. This will complicate the health care required for the CL/P subjects. This study was conducted to epidemiologically explore the prevalence of dental anomalies among Saudi Arabian subjects with CLP.  相似文献   

14.
Social anxiety in Chinese adults with oral-facial clefts.   总被引:1,自引:0,他引:1  
OBJECTIVE: This study examined social anxiety and measures of psychosocial adjustment in Chinese adults with oral-facial clefts, their unaffected siblings, and age-matched controls. DESIGN: This cross-sectional study utilized a matched case-control study design. PARTICIPANTS: Eighty-five adult cleft lip and cleft palate (CL/CP) subjects and 85 unaffected siblings (one adult sibling of each CL/CP subject) were recruited in Shanghai, China, from a larger CL/CP study. Eighty-five unaffected controls, gender- and age-matched to the CL/CP subjects, were recruited from Shanghai work units including factories, universities, and other institutions. OUTCOME MEASURES: Social Avoidance and Distress Scale, Fear of Negative Evaluation, Rosenberg Self-Esteem Scale, Interpersonal Support Evaluation List. RESULTS: Affected adults reported significantly more social anxiety than unaffected siblings and controls. Affected adults also scored significantly lower on measures of self-esteem and social support than unaffected siblings and controls. Unaffected siblings and controls were not found to differ on any of these measures. CONCLUSIONS: Findings suggest that individuals with oral-facial clefts may be more disadvantaged with respect to social affiliation and adaptation than unaffected adults. Cross-cultural research is essential in enabling us to determine whether similar trends exist across cultures.  相似文献   

15.
Objective : To assess the level of dental fear in children with a cleft lip and/or palate, to compare this level with that of a normative group testing the hypothesis that children with a cleft lip and/or palate have a higher level of dental anxiety than children from the general population, and to assess the relation between dental fear and coping. Design : Cross-sectional study. Setting : VU Medical Centre University Amsterdam. Patients : A total of 110 children (4 to 12?years old, 50 girls) with a cleft lip and/or palate. Interventions : Dental fear in the study group was compared with a normative group of Dutch children. Main Outcome Measures : Dental fear was investigated using the parental version of the dental subscale of the Children's Fear Survey Schedule for children aged 4 and 5?years old (n = 36). Also the Inventory of Stressful Situations was completed. Children aged 6 to 12?years old also completed the Dental Cope Questionnaire. Results : Young children with a cleft lip and/or palate experience more dental fear compared with children in a normative control group (Children's Fear Survey Schedule dental subscale scores: 30.3 ± 14.6 compared with 24.6 ± 8.6, p < .01). A weak correlation was found between the child's dental anxiety (Children's Fear Survey Schedule dental subscale) and his or her coping behavior (Dental Coping Questionnaire) (r = .196 p < .05). A clear correlation exists between the total Inventory of Stressful Situations and total Children's Fear Survey Schedule scores of the youngest age group (r = .507 p < .01). Conclusions : Findings support the hypothesis that dental anxiety is related to a higher level of exposure to medical interventions at a young age.  相似文献   

16.
Abstract

Objective. The aim of this study was to examine the maxillary arch dimensions in cleft lip and/or palate infants in Northern Finland before surgery. Materials and methods. The subjects consisted of 70 Finnish cleft patients born between 1997–2004 in Northern Ostrobothnia Hospital District in Finland. The study casts were obtained before surgery at the mean age of 5.6 months (SD = 2.2). There were 42 children with cleft palate (CP) (26 girls/16 boys), 13 with unilateral cleft lip and palate (UCLP) (eight girls/five boys), eight children with cleft lip (CL)(two girls/six boys) and seven with bilateral cleft lip and palate (BCLP) (two girls/five boys). Conventionally-used landmarks were marked on study casts and cleft width, arch circumference, anterior and posterior arch width and arch length were measured with a digital sliding calliper. The statistical method was ANOVA. Results. The prevalence of CP in this study, 60% of all clefts, is higher than the average standards. There were statistically significant differences in cleft width, posterior and anterior arch width, arch length and arch circumference, when different cleft groups were compared. When differences between girls and boys were compared, boys had larger cleft size and arch dimensions generally, but the results were not statistically significant. Conclusions. The results show the large variation in the severity of cleft lip and/or palate deformity at birth and in maxillary arch dimensions between different cleft types. It also demonstrates the effect of phenotypic variability within the groups of cleft lip and/or palate.  相似文献   

17.

Objective

The purpose of this present study was to compare, by means of 3D digital casts, the anterior transverse dimension of the dental arch of newborns with and without cleft lip and palate.

Material and Methods

The sample was composed of ninety-four children aged from 3 to 9 months divided into three study groups: Group I - children without craniofacial deformities (control group); Group II - children with unilateral cleft lip and palate; Group III - children with bilateral cleft lip and palate. Impressions were executed before lip and palate repair in patients with clefts. Dental casts were digitized using a 3D scanner linked to a computer. Measurements of the intercanine distance were measured on the digital casts. Intergroup comparisons were performed using ANOVA (p<0.05).

Results

The results showed a mean of 36.5 mm for unilateral cleft lip and palate group, 34.8 mm for bilateral cleft lip and palate group and 27.52 mm for the control group. There was a statistically significant difference between the control group and both groups of patients with cleft lip and palate. There was no statistically significant difference between complete unilateral and bilateral cleft lip and palate groups.

Conclusions

Patients with complete cleft lip and palate were born with an increased anterior dimension of the maxillary dental arch compared to non cleft patients.  相似文献   

18.
This retrospective study was carried out on consecutively collected dental casts, x-rays, and photos of 129 Swedish children who had been born with non-syndromic unilateral (U) cleft lip (CL), cleft lip and alveolus (CLA), or cleft lip and palate (CLP). The following dental characteristics were investigated in the primary and permanent dentitions: 1. the presence, eruption, position, and shape of the lateral incisor; 2. the prevalence of rotation and enamel hypoplasia of the permanent central incisor; 3. the occurrence of hypodontia outside the cleft region; and 4. the transition from the primary to the succeeding permanent lateral incisor in the cleft region. Patients with clefts involving the palate (UCLP) exhibited a high frequency of hypodontia. In patients with clefts, which did not include the palate, malformed lateral incisors were a common finding. In the primary and permanent dentition, the lateral incisor had erupted distal to the cleft in 31.8 and 24.8 per cent of the UCLA and UCLP patients, respectively. No significant pattern was seen regarding the transition from the primary to the succeeding permanent lateral incisor (P = 0.15). The central incisor was rotated in 55 per cent of the patients and this positional deviation was particularly frequent in cases where the lateral incisor was missing in the premaxilla (P < 0.05). Hypodontia outside the cleft region was recorded in 15.5 per cent of the patients. Patients with UCLP had more often crossbite than patients with a UCL or a UCLA phenotype (P < 0.001).  相似文献   

19.
唇腭裂患儿家长的心理分析   总被引:3,自引:3,他引:0       下载免费PDF全文
的 评价唇腭裂患儿家长心理状态,探讨唇腭裂患儿家长负性心理状态与唇腭裂类型的关系,及改善 唇腭裂患儿家长负性心理的有效途径。方法 筛选非综合征性唇腭裂患儿家长100名作为试验组,另选择34名正 常儿童家长作为对照组。试验组按照患儿唇腭裂类型分为3个亚组:单纯性唇裂组(CL组)、单纯性腭裂组(CP组) 和唇腭裂组(CLP组)。选用生活事件量表和焦虑自评量表对试验组和对照组家长的心理状态进行定性和定量分 析。结果 试验组生活事件总刺激量、负性事件刺激量均高于对照组(P<0·05),3个亚组间生活事件总刺激量和 负性事件刺激量也有统计学差异(P<0·05),CLP组最高,CP组最低。焦虑自评量表调查结果显示,试验组焦虑自 评总分值与对照组无统计学差异(P>0·05)。结论 唇腭裂患儿家长普遍处于一种负性心理状态,少数表现出躯 体症状,唇腭裂患儿的畸形类型不同,家长的负性心理状态也不同,唇裂畸形比腭裂畸形对家长心理的影响更重, 说明唇腭裂患儿家长更在乎患儿的容貌畸形。  相似文献   

20.
ObjectiveNon-syndromic cleft lip with or without cleft palate (CL/P) is one of the most common congenital anomalies and arises from the interaction of environmental and genetic factors. The objective of this study was to investigate the association between the BMP2 (bone morphogenetic protein 2) and BMP4 (bone morphogenetic protein 4) polymorphisms with non-syndromic CL/P to clarify the potential role of these genes in the etiology of CL/P in Iranian population.DesignThe allelic and genotypic frequencies of BMP2 rs235768 A > T and BMP4 rs17563 T > C polymorphisms were determined in 107 unrelated Iranian subjects with non-syndromic CL/P and 186 control subjects using PCR and RFLP methods, and the results were compared with healthy controls. A p-value of <0.05 was considered statistically significant.ResultsThe BMP2 rs235768 AT genotype was significantly higher (P = 0.009, OR = 3, 95% CI = 1.3–7.0) in the CL/P (59.8%) than the control group (33.3%). Similarly, the BMP4 rs17563 TC genotype were significantly higher (P = 0.008, OR = 3.7, 95% CI = 1.4–9.9) in the CL/P (70.0%) than the control group (44.6%).ConclusionThe BMP2 rs235768 A > T and BMP4 rs17563 T > C polymorphisms could be considered as the risk factor for non-syndromic CL/P in Iranian population.  相似文献   

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