The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association最新文献

{"title":"Norwegian Orthodontists' Experience and Challenges With Treatment of Patients With Cleft Lip and Palate.","authors":"Paul K Saele,&nbsp;Anne-Kristine Nordrehaug Aastrøm,&nbsp;Harald Gjengedal,&nbsp;Elwalid F Nasir,&nbsp;Manal Mustafa","doi":"10.1177/10556656211028509","DOIUrl":"https://doi.org/10.1177/10556656211028509","url":null,"abstract":"<p><strong>Background: </strong>Patients born with cleft lip and/or palate (CL/P) have orthodontic treatment challenges due to maxilla deficiency, malocclusions, and dental abnormalities. In Norway, orthodontic treatment is done by centralized CL/P teams. Due to traveling restrictions, this treatment might be done locally in the future. The experience of Norwegian community orthodontists in managing such patients has not been investigated previously.</p><p><strong>Objective: </strong>To assess Norwegian orthodontists' management of patients with CL/P and need for further education.</p><p><strong>Material and methods: </strong>All orthodontists in Norway were sent a questionnaire about their experience, challenges, and knowledge and asked about their need of further theoretical education and clinical training in the management of patients with CL/P.</p><p><strong>Results: </strong>Norwegian orthodontists' standard of knowledge of CL/P treatment is adequate. However, few respondents have treated a high number of cleft patients. Eighty-six percent of the participants believed that treating CL/P patients involves challenges, such as time-consuming treatment and technical difficulties. Increased perceived need for more education was revealed among participants stated unpreparedness during education (4 folds), encountered challenges, and lack of knowledge (almost 3 folds).</p><p><strong>Conclusions: </strong>The study revealed that community orthodontists in Norway lack experience and acknowledged the challenges in treating patients with CL/P. Most of the respondents perceived a need for additional education and clinical training to treat CL/P patients competently. The findings suggested more focus on patients with CL/P management in the curricula and more collaboration between centralized CL/P teams and community orthodontists.</p>","PeriodicalId":520794,"journal":{"name":"The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association","volume":" ","pages":"859-866"},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10556656211028509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39201206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Longitudinal Treatment Review of Multidisciplinary Interventions in Nonsyndromic Robin Sequence With Cleft Palate.","authors":"Pinelopi K Palaska,&nbsp;Gregory S Antonarakis,&nbsp;Sunjay Suri","doi":"10.1177/10556656211026477","DOIUrl":"https://doi.org/10.1177/10556656211026477","url":null,"abstract":"<p><strong>Objective: </strong>To document and analyze the overall longitudinal institutional treatment experience of children with nonsyndromic Robin sequence (RS) from infancy to early adulthood.</p><p><strong>Design: </strong>Retrospective longitudinal treatment review.</p><p><strong>Setting: </strong>A tertiary-care, referral, teaching hospital.</p><p><strong>Patients: </strong>Children with nonsyndromic RS and cleft palate (N = 117) born between December, 1985, and January, 2012.</p><p><strong>Interventions: </strong>Data regarding airway management, nutritional management, audiological interventions, orthodontic treatment, and surgical interventions were documented and analyzed in different growth/developmental stages. Comparative data from other international centers were collected from the literature.</p><p><strong>Results: </strong>Airway management during infancy involved prone positioning (92%), nasopharyngeal airway (6%), tracheostomy (2%), and mandibular distraction osteogenesis (1%). Feeding with nasogastric, gastrostomy, and/or gastrojejunostomy tubes was used in 44%, Haberman feeders in 53%, and Mead Johnson feeders in 3%. Gastroesophageal reflux disease was documented in 6% of the sample. During childhood and early adolescent years, pharyngeal flap surgery was carried out in 22% of the children, while 11% had secondary palatal surgery. Audiological management included the use of tympanostomy tubes in 62%, with several children needing multiple tube replacements. At least 18% were diagnosed with obstructive sleep apnea. Adenoidectomy or adenotonsillectomy was undertaken in 4%. Analysis of data pertaining to middle childhood and adolescent years showed that orthodontic treatment was conducted for most children for crowding, tooth agenesis, and skeletal and/or dental dysplasia. Orthognathic surgery frequency (<18%) was low.</p><p><strong>Conclusions: </strong>Institutional treatment experience of children with nonsyndromic RS involves multidisciplinary care at different ages and stages of their development.</p>","PeriodicalId":520794,"journal":{"name":"The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association","volume":" ","pages":"882-890"},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10556656211026477","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39156828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photometric Evaluation of Adult Patients With Bilateral Cleft Lip and Palate Treated With Nasoalveolar Molding and Primary Columella Lengthening.","authors":"Maria Costanza Meazzini,&nbsp;Francesca Parravicini,&nbsp;Vera Donati,&nbsp;Roberto Brusati,&nbsp;Federico Biglioli,&nbsp;Luca Autelitano","doi":"10.1177/10556656211024069","DOIUrl":"https://doi.org/10.1177/10556656211024069","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess the nasal shape of young adults with BCLP treated with primary surgical columella lengthening and nasoalveolar molding (NAM).</p><p><strong>Setting and patients: </strong>A group of 28 young adult patients with BCLP (mean age: 19.1±1.4 years) was compared through normalized photogrammetry to a control of 28 age- and sex-matched noncleft young adults.</p><p><strong>Results: </strong>Nasal protrusion and length of the columella were not different from noncleft young adults. On the other hand, nasolabial angle, columellar width, interalar, and nasal tip width were significantly wider than the noncleft controls. Thus, 27% of the patients have requested at this time secondary correction of the excessive nasal width.</p><p><strong>Conclusions: </strong>Both NAM and primary rhinoplasty in patients with BCLP resulted in a near normal length of the columella and nasal projection until young adulthood. Nevertheless, width of all nasal features was significantly wider than the noncleft population and required secondary nasal correction in one-third of the sample.</p>","PeriodicalId":520794,"journal":{"name":"The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association","volume":" ","pages":"852-858"},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10556656211024069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39235950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micro-Computed Tomography-Based Three-Dimensional Anatomical Structure of the Region Around the Pterygoid Hamulus.","authors":"Jiuli Zhao,&nbsp;Hengyuan Ma,&nbsp;Yongqian Wang,&nbsp;Tao Song,&nbsp;Chanyuan Jiang,&nbsp;Di Wu,&nbsp;Ningbei Yin","doi":"10.1177/10556656211036302","DOIUrl":"https://doi.org/10.1177/10556656211036302","url":null,"abstract":"<p><strong>Objective: </strong>Palatoplasty would involve the structures around the pterygoid hamulus. However, clinicians hold different opinions on the optimal approach for the muscles and palatine aponeurosis around the pterygoid hamulus. The absence of a consensus regarding this point can be attributed to the lack of investigations on the exact anatomy of this region. Therefore, we used micro-computed tomography to examine the anatomical structure of the region surrounding the pterygoid hamulus.</p><p><strong>Design: </strong>Cadaveric specimens were stained with iodine-potassium iodide and scanned by micro-computed tomography to study the structures of the tissues, particularly the muscle fibers. We imported Digital Imaging and Communications in Medicine images to Mimics to reconstruct a 3-dimensional model and simplified the model.</p><p><strong>Results: </strong>Three muscles were present around the pterygoid hamulus, namely the palatopharyngeus (PP), superior constrictor (SC), and tensor veli palatini (TVP). The hamulus connects these muscles as a key pivot. The TVP extended to the palatine aponeurosis, which bypassed the pterygoid hamulus, and linked the PP and SC. Some muscle fibers of the SC originated from the hamulus, the aponeurosis of which was wrapped around the hamulus. There was a distinct gap between the pterygoid hamulus and the palatine aponeurosis. This formed a pulley-like structure around the pterygoid hamulus.</p><p><strong>Conclusions: </strong>Transection or fracture of the palatine aponeurosis or pterygoid hamulus, respectively, may have detrimental effects on the muscles around the pterygoid hamulus, which play essential roles in the velopharyngeal function and middle ear ventilation. Currently, cleft palate repair has limited treatment options with proven successful outcomes.</p>","PeriodicalId":520794,"journal":{"name":"The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association","volume":" ","pages":"918-925"},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39319426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Fat Injection for Nasal Contouring in Orthognathic Patients.","authors":"Daniel Lonic,&nbsp;Yen-Chang Hsiao,&nbsp;Jung-Ju Huang,&nbsp;Chun-Shin Chang,&nbsp;Jyh-Ping Chen,&nbsp;Paul I Heidekrueger,&nbsp;Andreas Kehrer,&nbsp;Lukas Prantl,&nbsp;Lun-Jou Lo,&nbsp;Yu-Ray Chen","doi":"10.1177/10556656211026476","DOIUrl":"https://doi.org/10.1177/10556656211026476","url":null,"abstract":"<p><strong>Background: </strong>Augmentation rhinoplasty with autologous fat grafting is a useful procedure to meet the demand for facial harmonization in the Asian population. We used this procedure during orthognathic surgery to address inadequate dorsum projection. This prospective study was conducted to determine the fat retention rate in patients undergoing simultaneous autologous fat injection augmentation rhinoplasty and orthognathic surgery.</p><p><strong>Methods: </strong>Nineteen patients were treated with simultaneous bimaxillary orthognathic surgery and autologous fat grafting of the nasal dorsum and tip. The paired <i>t</i> test was used to compare the nasal volumes before and at least 6 months after surgery measured by 3-dimensional computer tomography scans. All measurements were performed twice by the same evaluator at least 2 weeks apart for intrarater consistency.</p><p><strong>Results: </strong>Seventeen patients completed the study. The volume means before and after surgery were 22.3 ± 4.6 cm³ and 23.3 ± 4.7 cm³, respectively, with a mean difference of 1.0 ± 0.3 cm³ (<i>P</i> < .001). The mean retention rate was calculated to be 50.5% ± 7.0% (range: 40.5%-64.7%). Intrarater consistency was high with a Cronbach α of .97 (<i>P</i> < .001) and .98 (<i>P</i> < .001), respectively.</p><p><strong>Conclusion: </strong>This prospective study provides objective graft retention measurements for fat injection augmentation rhinoplasty combined with orthognathic surgery. All patients were satisfied with the results and no complications or additional morbidity was noted in the postoperative course. We consider this procedure to be a safe, reliable, and powerful adjunct to improve the aesthetic results of orthognathic surgery.</p>","PeriodicalId":520794,"journal":{"name":"The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association","volume":" ","pages":"910-917"},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39329012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors for Velopharyngeal Insufficiency Following Primary Cleft Palate Repair.","authors":"Brady J Anderson,&nbsp;Kasra N Fallah,&nbsp;Austin A Lignieres,&nbsp;Joseph K Moffitt,&nbsp;Kim-Loan Luu,&nbsp;Alfredo Cepeda,&nbsp;Irene L Doringo,&nbsp;Phuong D Nguyen,&nbsp;John F Teichgraeber,&nbsp;Matthew R Greives","doi":"10.1177/10556656211026861","DOIUrl":"https://doi.org/10.1177/10556656211026861","url":null,"abstract":"<p><strong>Objective: </strong>Velopharyngeal insufficiency (VPI) remains a known complication of primary palatoplasty. We sought to identify factors associated with the incidence of VPI and create a predictive model for VPI development in our population.</p><p><strong>Design: </strong>A single-institution, retrospective review.</p><p><strong>Setting: </strong>Multidisciplinary clinic in a tertiary academic institution.</p><p><strong>Patients: </strong>A total of 453 consecutive patients undergoing primary palatoplasty from 1999 to 2016 were reviewed. Inclusion required follow-up past age 5. Patients who were non-verbal, and thus unable to undergo speech evaluation, were excluded.</p><p><strong>Main outcome measures: </strong>Primary outcome was VPI, defined as revision palatoplasty or recommendation by speech-language pathology.</p><p><strong>Results: </strong>Of 318 patients included, 179 (56%) were male. Median age at primary repair was 1.0 years (0.9-1.1) with a median age of 8.8 years at last follow-up. One hundred nineteen (37%) patients developed VPI at a median age of 5.0 years (3.8-6.5). Higher rates were seen with posterior fistula (65% vs 14%, <i>P</i> <.01) and straight-line repair (41% vs 9%, <i>P</i> <.01), with lower rates in patients with Veau I clefts (22% vs 39%, <i>P</i> <.05). Patients with VPI were older at last follow-up. Following multivariate regression, factors remaining significant were posterior fistula (odds ratio [OR]: 11.3, 95% CI: 6.1-22.0), primary Furlow repair (OR: 0.18, 95% CI: 0.03-0.68), genetic diagnoses (OR: 2.92, 95% CI: 1.1-7.9), and age at last follow-up (OR: 1.11, 95% CI: 1.01-1.2).</p><p><strong>Conclusions: </strong>Length of follow-up, posterior fistulae, and genetic diagnoses are associated with VPI formation. Furlow repair may protect against formation of VPI. Use of allograft, Veau class, birth type, birth weight, and race are not independently associated with VPI formation.</p>","PeriodicalId":520794,"journal":{"name":"The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association","volume":" ","pages":"825-832"},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39316689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthognathic Surgery: My Experience of Transitioning to Adult Cleft Care.","authors":"Kenny Ardouin","doi":"10.1177/10556656211043417","DOIUrl":"https://doi.org/10.1177/10556656211043417","url":null,"abstract":"Kenny Ardouin grew up in East Sussex in the United Kingdom (UK), before moving to New Zealand, which he now considers home. Having been born with a cleft lip and palate, Kenny has a personal and professional dedication to the field. He served as CEO of the charitable organization Cleft New Zealand and recently completed 3.5 years as the Adult Services Manager for the Cleft Lip and Palate Association in the UK. Kenny works as a speech and language therapist, and is studying a Master's degree part-time, focused on the psychological impact of speech differences in adolescents and adults born with a cleft. Kenny is also a radio broadcaster and editor and a freelance public speaker. In this heartfelt and informative invited editorial, Kenny reflects on how his treatment journey unfolded as a young adult and offers key learning points for all health professionals wanting to become more person-focused in their clinical practice.","PeriodicalId":520794,"journal":{"name":"The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association","volume":" ","pages":"951-953"},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39429757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate.","authors":"Vijay Kumar,&nbsp;Vidya Rattan,&nbsp;Sachin Rai,&nbsp;Satinder Pal Singh,&nbsp;Jai Kumar Mahajan","doi":"10.1177/10556656211025197","DOIUrl":"https://doi.org/10.1177/10556656211025197","url":null,"abstract":"<p><strong>Objective: </strong>Comparison between bovine-derived demineralized bone matrix (DMBM) and iliac crest graft over long term for secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and palate (UCLP) in terms of radiological and clinical outcomes.</p><p><strong>Design: </strong>Prospective, randomized, parallel groups, double-blind, controlled trial.</p><p><strong>Setting: </strong>Unit of Oral and Maxillofacial Surgery, Oral Health Science Centre, Postgraduate Institute of Medical Education & Research, Chandigarh.</p><p><strong>Participants: </strong>Twenty patients with UCLP.</p><p><strong>Interventions: </strong>Patients were allocated into group I (Iliac crest bone graft) and group II (DMBM) for SABG. Outcomes were assessed at 2 weeks, 6 months, and then after mean follow-up period of 63 months.</p><p><strong>Outcomes measures: </strong>Volumetric analysis of the grafted bone in the alveolar cleft site was done through cone beam computed tomography using Cavalieri principle and modified assessment tool. Clinical assessment was performed in terms of pain, swelling, duration of hospital stay, cost of surgery, alar base symmetry, and donor site morbidity associated with iliac crest harvesting.</p><p><strong>Results: </strong>Volumetric analysis through Cavalieri principle revealed comparable bone uptake at follow-up of 6 months between group I (70%) and group II (69%). Modified assessment tool showed no significant difference between horizontal and vertical bone scores over short- and long-term follow-up. In group II, there was higher cost of surgery, but no donor site morbidity unlike group I.</p><p><strong>Conclusions: </strong>Demineralized bone matrix proved analogous to iliac crest bone graft as per volumetric analysis over shorter period. However, although statistically insignificant, net bone volume achieved was lower than the iliac crest graft at longer follow-up.</p>","PeriodicalId":520794,"journal":{"name":"The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association","volume":" ","pages":"833-840"},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10556656211025197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39239494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Guide to Bilateral Cleft Lip Markings: An Anthropometric Study of the Normal Cupid's Bow.","authors":"Yew L Loo,&nbsp;Aaron C Van Slyke,&nbsp;Pragaash Shanmuganathan,&nbsp;Robert Reitmaier,&nbsp;David K Chong","doi":"10.1177/10556656211036329","DOIUrl":"https://doi.org/10.1177/10556656211036329","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to define the ratio of the heights of the vermilion between the peaks and trough of the Cupid's bow and hence assist in defining the point of closure on the lateral lip element to achieve a balanced Cupid's bow in bilateral lip repair based on our findings.</p><p><strong>Design: </strong>This study is a retrospective observational study of the anthropometrics of the upper lip's Cupid's bow. Three-dimensional (3D) images of toddlers between 2009 and 2016 were extracted from a normative 3D image database of toddlers at the Royal Children's Hospital, Melbourne.</p><p><strong>Patients: </strong>Participants from the normative 3D image database at the age of 1 year were studied. This excluded any patients with prior trauma or surgical intervention of the nasolabial region.</p><p><strong>Intervention: </strong>Landmarks measured were right and left crista philtri (cphR and cphL), labial superius (ls), stomion (sto), right and left chelion, and labial fissure (lf).</p><p><strong>Outcome: </strong>Vermilion height of the right peak, trough, and left peak of the Cupid's bow was calculated by analyzing the vertical linear distance between cphR-lf, ls-sto, and cphL-lf. The ratio between the median and paramedian heights were recorded.</p><p><strong>Results: </strong>The paramedian height of the upper lip vermilion is consistently greater than the midline height. There was no significant sexual dysmorphism between ratio of paramedian to midline height on the right (<i>P</i> = .538) and left (<i>P</i> = .410).</p><p><strong>Conclusion: </strong>We describe an anthropometric observation of the vermilion relationship at the Cupid's bow and define a specific lateral lip marking for bilateral cleft lip repair based on our anthropometric findings.</p>","PeriodicalId":520794,"journal":{"name":"The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association","volume":" ","pages":"926-931"},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39319428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Final Posttreatment Occlusion in Patients With Unilateral Cleft Lip and Palate.","authors":"Christine B Staudt,&nbsp;Julia Bollhalder,&nbsp;Martina Eichenberger,&nbsp;Giorgio La Scala,&nbsp;Georges Herzog,&nbsp;Daniel B Wiedemeier,&nbsp;Gregory S Antonarakis","doi":"10.1177/10556656211028506","DOIUrl":"https://doi.org/10.1177/10556656211028506","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate final posttreatment occlusion in patients with complete unilateral cleft lip and palate (cUCLP) by comparing (1) 3 treatment centers, (2) males and females, (3) cleft and noncleft sides, (4) right- and left-sided clefts, and (5) orthodontic treatment with/without orthognathic surgery (OS).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Patients: </strong>Blinded posttreatment dental casts of 56 patients (19.4 ± 1.4 years) with cUCLP from 3 centers in Switzerland.</p><p><strong>Main outcome measure: </strong>Occlusal assessment using the modified Huddart/Bodenham (MHB) index.</p><p><strong>Results: </strong>Our sample comprised 35 males and 21 females, 46 with left- and 10 with right-sided clefts, of which 32 had undergone OS. The final posttreatment occlusion showed a median MHB score of 0 (interquartile range: -1.0 to 2.0) in the total sample and did not seem to depend on treatment center, sex, or OS. The MHB scores for the anterior buccal and the buccal segments were more negative on the cleft than on the noncleft side (<i>P</i> = .002 and <i>P</i> = .006, respectively). When the cleft was on the left side, the MHB score tended to be more positive in the labial (<i>P</i> = .046) and anterior buccal segments (<i>P</i> = .034).</p><p><strong>Conclusions: </strong>This study shows a very satisfactory final posttreatment occlusion in patients with cUCLP. The more constricted buccal occlusion on the cleft side emphasizes the attention that should be given in correcting the more medially positioned lesser maxillary segment. The influence of cleft-sidedness should be analyzed further on a sample including more patients with right-sided clefts.</p>","PeriodicalId":520794,"journal":{"name":"The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association","volume":" ","pages":"899-909"},"PeriodicalIF":1.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10556656211028506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39163145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}