腭裂硬腭后缘裂隙宽度与上颌结节后缘平面宽度比例变化规律的研究

目的 通过研究单纯性腭裂患者硬腭后缘裂隙宽度与上颌结节后缘平面宽度的比例的增龄性变化,了解患者的腭裂畸形程度和生长发育之间的关联性。方法 应用回顾性研究的方法选取581例单纯性腭裂患者,年龄为8个月至38岁,根据术前测量时的年龄段共分为7组。在患者术前采用直接测量法所获得的各项测量数据中,选取上颌结节后缘平面宽度和硬腭裂隙宽度两项,以每位患者的硬腭裂隙宽度除以上颌结节后缘平面宽度的比值（即腭裂指数）来分析腭裂裂隙的相对宽度。结果 随着患者年龄增长,腭裂裂隙在上颌所占横向比例增大,即腭裂的畸形程度随患者年龄增长呈现上升趋势。结论 本研究证实了单纯性腭裂患者腭裂裂隙宽度和上颌结节后缘平面宽度与患者年龄增长存在关联性,腭裂的严重程度和手术难度会随着患者的年龄增长而逐步加重。     

腭裂硬腭后缘裂隙宽度与上颌结节后缘平面宽度比例变化规律的研究

目的 通过研究单纯性腭裂患者硬腭后缘裂隙宽度与上颌结节后缘平面宽度的比例的增龄性变化,了解患者的腭裂畸形程度和生长发育之间的关联性。方法 应用回顾性研究的方法选取581例单纯性腭裂患者,年龄为8个月至38岁,根据术前测量时的年龄段共分为7组。在患者术前采用直接测量法所获得的各项测量数据中,选取上颌结节后缘平面宽度和硬腭裂隙宽度两项,以每位患者的硬腭裂隙宽度除以上颌结节后缘平面宽度的比值（即腭裂指数）来分析腭裂裂隙的相对宽度。结果 随着患者年龄增长,腭裂裂隙在上颌所占横向比例增大,即腭裂的畸形程度随患者年龄增长呈现上升趋势。结论 本研究证实了单纯性腭裂患者腭裂裂隙宽度和上颌结节后缘平面宽度与患者年龄增长存在关联性,腭裂的严重程度和手术难度会随着患者的年龄增长而逐步加重。     

Initial growth pattern of children with cleft before alveolar bone graft stage according to cleft type: Unilateral cleft lip and alveolus,unilateral cleft lip and palate,and cleft palate

Objective:To test the null hypothesis that there is no significant difference in the initial growth pattern among three cleft types before alveolar bone graft (ABG) according to cleft type (unilateral cleft lip and alveolus [UCLA], unilateral cleft lip and palate [UCLP], and cleft palate [CP]).Materials and Methods:Samples consisted of the UCLA group, the UCLP group, and the CP group. Individuals were treated with the identical surgical technique by the same surgeon and had no history of orthodontic/orthopedic treatment. Lateral cephalograms taken 1 month before ABG were analyzed using 29 variables. One-way analysis of variance (ANOVA) testing and bivariate and logistic regression analyses were performed.Results:An increasing tendency for Class III relationships in the order of UCLA, UCLP, and CP was noted (ANB, AB-to-facial plane angle, AB-to-mandibular plane angle; P < .001, respectively). UCLP and CP groups demonstrated more posterior positioning of the maxilla (SNA, A-to-N-perp; P < .001, respectively) and a hyperdivergent pattern (gonial angle, SN-GoMe angle, FMA; P < .001, respectively) compared with the UCLA group. Because no differences in palatal plane angle and SN-to-occlusal plane angle were noted among the three groups, the hyperdivergent pattern in the UCLP and CP groups might be due to an innate growth pattern and eventual adaptation of the mandible to maxillary growth. UCLP and CP groups showed more Class III relationships (ANB: P < .05, P < .001, respectively) and a more hyperdivergent pattern (FMA: P < .05, P < .01, respectively) than the UCLA group.Conclusion:When the degree of cleft involvement increases from the primary palate to the secondary palate, the predominance of the Class III relationship and the hyperdivergent pattern increases also.     

Tooth agenesis patterns in bilateral cleft lip and palate

Bartzela TN, Carels CEL, Bronkhorst EM, Rønning E, Rizell S, Kuijpers-Jagtman AM. Tooth agenesis patterns in bilateral cleft lip and palate. Eur J Oral Sci 2010; 118: 47–52. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci
Individuals with cleft lip and palate present significantly more dental anomalies, even outside the cleft area, than do individuals without clefts. Our aim was to evaluate the prevalence of tooth agenesis and patterns of hypodontia in a large sample of patients with complete bilateral cleft lip and palate (BCLP). Serial panoramic radiographs (the first radiograph was taken at 10.5–13.5 yr of age) of 240 patients with BCLP (172 male patients, 68 female patients) were examined. Third molars were not included in the evaluation. Agenesis of at least one tooth was present in 59.8% of patients. Upper laterals and upper and lower second premolars were missing most frequently. Using the tooth agenesis code (TAC), 52 different agenesis patterns were identified, of which simultaneous agenesis of 12, 22, 15, 25, 35, and 45 was the most frequent pattern. Nine of the 240 patients showed combined BCLP and oligodontia.     

Facial variations related to headform type

A comparison and evaluation of a range of basic anatomic relationships underlying facial form in Angle Class I and Class II dolichocephalic, brachycephalic, mesocephalic, and dinaric types of headform. Interrelated composites of these structural factors and their contributions to different malocclusion tendencies are described.     

Tessier type 3 oblique facial cleft with a contralateral complete cleft lip and palate

Oblique facial clefts are extremely rare congenital deformities with a reported incidence of 0.24% of all facial clefts. This report presents a patient with a right-sided oblique cleft extending through the upper lip, the alar groove and the lower palpebra accompanied by a left-sided complete cleft lip and palate. Hypertylorism and bilateral microphthalmia as well as flexion wrist contractures were also present. Primary straight-line closure of the oblique cleft was undertaken followed by primary closure of the contralateral cleft lip. The treatment modality and 2 year follow-up results are presented.     

A scoping review of outcomes related to orthodontic treatment measured in cleft lip and palate

The aim of this study was to identify and summarize the outcomes measured in orthodontic studies of children with cleft lip and/or palate. The objectives were to categorize the outcomes into pre-determined domains and to explore whether any domains were under-represented. Electronic databases and grey literature were searched until December 2016 to identify all studies of orthodontic treatment interventions in children and adolescents with cleft lip and palate. Abstracts and subsequently eligible full-text articles were screened independently and in duplicate by two reviewers. All reported outcome measures were identified and categorized into six predetermined outcome domains. The search identified 833 abstracts. The majority of studies did not assess orthodontic interventions and were therefore not eligible for inclusion. Consequently, following screening 71 eligible articles were retrieved in full, of which 40 met the inclusion criteria. Morphological features of malocclusion were measured in 27 studies (68%) and adverse effects of orthodontic treatment in 10 (25%). Functional status (n=4; 10%), physical consequences of malocclusion (n=3; 7.5%), quality of life (n=3; 7.5%) and health resource utilization (n=2; 5%) were rarely considered. Relatively few studies concerning patients with cleft lip and palate focused on orthodontic interventions. Most of the identified outcomes were concerned with measuring morphological treatment-related changes and do not reflect patient perspectives.     

Adolescents with cleft lip and palate: self-perceptions of appearance and behavior related to personality adjustment

Two groups of adolescents with cleft lip and palate were compared on their self-ratings of facial appearance and behavior. The two groups were identified as well adjusted (N = 19) or poorly adjusted (N = 17), based on their parents' ratings of behavior. T-test comparisons indicate that the group with good adjustment have realistic perceptions of facial appearance (based on independent ratings by their teachers), and their self-perceptions of behavior are similar to those of their parents. The poorly adjusted group have unrealistic perceptions of facial appearance and perceive their behavior as more socially acceptable than do their parents.     

Skeletal profile changes related to two patterns of activator effects

A longitudinal cephalometric study was carried out on twelve boys and thirteen girls who initially exhibited Class II, Division 1 malocclusion and who were treated exclusively with activators. Twenty-four boys and fifteen girls, corresponding with the experimental subjects with respect to initial age and observation period, were selected as controls. The aim of the investigation was to examine cephalometric profile changes associated with two patterns of effects of activator treatment detected previously. The findings demonstrate that the two types of reaction bring about similar corrections of both apical base discrepancy and dental Class II relationship but clearly differ in their effects on the skeletal profile. Whereas the first type of reaction results in an improvement in mandibular retrognathism, a marked rotation of the occlusal plane, and good vertical control of the upper and lower dental arches, the second type is distinguished by a significant reduction of maxillary prognathism, downward and backward rotation of the mandible, and forward tipping of the lower incisors. Additional evidence presented further suggests that the two patterns of effects are due to differences in the construction bites of the appliances. According to this hypothesis, a great interocclusal height of an activator would lead to the first and a low construction bite to the second type of reaction.     

Spontaneous verbal labeling: visual memory and reading ability in children with cleft.

OBJECTIVE: The purpose of this study was to examine different types of short-term memory deficits (visual versus verbal) of children with cleft and to determine what type of memory deficits were associated with reading disorders. DESIGN: The study examined memory and reading in 48 consecutive cases of children with cleft, aged 7 to 9 years. A memory test designed to assess memory modalities (verbal-visual) was administered, along with tests of reading ability. RESULTS: Visual and verbal memory were examined with a one-way analysis of variance (ANOVA). The memory pattern indicated greatest deficit in visual memory. Two subgroups were formed, according to whether or not there was evidence of visual memory impairment. A hit rate predicting reading disability based on group membership was calculated to be 65%. Visual memory was significantly correlated with reading ability (r = .48). CONCLUSION: A brief visual memory test was almost as good as Full Scale IQ in predicting reading disability.     

The impact of cleft type on early vocal development in babies with cleft palate.

OBJECTIVE: The purpose of the present investigation was to examine the impact of cleft type on early sound development in children with cleft palate (with or without cleft lip). PARTICIPANTS: The participants included 53 babies with unrepaired cleft palate aged 8 to 10 months. Thirty-five babies had cleft lip and palate (CLP) and 18 had cleft palate only (CPO). MAIN OUTCOME MEASURES: Spontaneous vocalizations of the CLP and CPO groups were compared to determine whether differences were evident in canonical babbling, size of consonant inventory as well as place and manner of consonant production, and frequency of vocalization. RESULTS: Student's t tests revealed no significant differences between the groups in canonical babbling, size of consonant inventory, place and manner of consonant production, or frequency of vocalization. However, there was a trend for babies in the CPO group to produce fewer compensatory stop consonants and more anterior place features. In addition, a larger percentage of children in the CPO group had entered the canonical babbling stage at the time of this study. CONCLUSIONS: In general, the findings of this study suggested that cleft type does not appear to play a significant role in early consonant development for babies with cleft palate. Additional study using a larger CPO group is recommended to further investigate the trend toward better performance noted in this group.     

Dietary patterns related to caries in a low-income adult population

The aim of this study was to examine the relationship between dietary patterns and caries experience in a representative group of low-income African-American adults. Participants were residents of Detroit, Michigan, with household incomes below 250% of the federally-established poverty level (n = 1,021). Dietary histories were obtained by trained interviewers in face-to-face interviews with the adult participants, using the Block 98.2 food frequency questionnaire. Caries was measured by the ICDAS criteria (International Caries Detection and Assessment System). There were 200 dietary records whose data were judged to be invalid; these participants were omitted from the dietary analyses to leave n = 821. Factor analysis identified patterns of liquid and solid food consumption, and the resulting factor scores were used as covariates in multivariable linear regression. Caries was extensive, with 82.3% of the 1,021 participants (n = 839) having at least one cavitated lesion. Nearly three quarters of the adult participants were overweight or obese. This population had severe caries, poor oral hygiene, and diets that are high in sugars and fats and low in fruits and vegetables. Apart from tap water, the most frequently consumed food item by adults of all ages was soft drinks; 19% of all energy from sugar came from soft drinks alone. In both the bivariate analyses and in the regression model, frequency of soft drink consumption and the presence of gingival plaque deposits were significantly associated with caries. Interventions to promote oral health are unlikely to be successful without improvements in the social and physical environment.     

腭裂相关基因mcpr1在不同组织细胞中的表达

目的：初步探讨新基因mcpr1在腭突外胚间充质细胞、下颌突外胚间充质细胞、牙囊细胞等中的表达情况。方法：取妊娠12.5d的胎鼠第3代腭研究会外胚间充质细胞及实验室已成功培养的人牙髓细胞、牙周膜细胞、牙囊细胞及下颌外胚间充质细胞，利用已制备的MCPR1多克隆抗体，进行细胞免疫组织化学染色，分析MCPR1的表达情况。结果：腭寄突外胚间充质细胞组织块培养法培养，稳定传至3代，免疫组化结果示腭突外胚间充质细胞及人牙击膜细胞强阳性表达，在下颌突外胚间充质细胞，牙囊细胞及牙髓细胞表达较弱。结论：MCPR1在不同来源的细胞中广泛表达，但表达水平不同。进一步提示MCPR1可能参与不同组织器官的发生发展，在胚胎发育的不同时期具有不同的表达模式。