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Branson EK, Branson VM, McGrath R, Rausa VC, Kilpatrick N, Crowe LM. Psychological and Peer Difficulties of Children with Cleft Lip and/or Palate: A Systematic Review and Meta-Analysis. Cleft Palate Craniofac J 2024; 61:258-270. [PMID: 36082954 DOI: 10.1177/10556656221125377] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES A systematic review and meta-analysis were conducted to determine if children born with cleft lip and/or palate are at increased risk of psychological and peer difficulties, and if so, which difficulties they develop. METHODS EMBASE, MEDLINE, and PsycINFO were searched for English language studies published between January 2005 and January 2022 which investigated the psychological outcomes and peer function of children with nonsyndromic cleft lip and palate. Outcomes included internalizing problems, such as anxiety and depression, externalizing problems, such as hyperactivity, conduct disorders, self-concept including self-image and self-esteem, peer problems, resilience, coping, and overall psychological function. A risk of bias assessment was performed using the Newcastle-Ottawa Scale. Random effects models were used in the meta-analysis to compare the outcomes for children born with a cleft and those without. RESULTS In total 41 studies met inclusion criteria, with 9 included in the meta-analysis. Children born with a cleft appear to have similar psychological outcomes compared to normative controls when using the strengths and difficulties questionnaire. There are some minor differences between self-report and parent report, with parents generally reporting that their child with a cleft has increased emotional, conduct, and hyperactivity problems. The small differences between the study cohort and control cohorts are unlikely to imply any differences on a clinical level. CONCLUSIONS Overall psychological outcomes appear to be similar between children born with a cleft and the nonaffected population, however, some symptoms such as anxiety and depression appear higher in children with cleft lip and/or palate.
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Affiliation(s)
- Emma K Branson
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Victoria M Branson
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Roisin McGrath
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
| | - Vanessa C Rausa
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Nicky Kilpatrick
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Dentistry, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Louise M Crowe
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Psychology Service, The Royal Children's Hospital, Melbourne, Victoria, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Verdier EF, Saloux AL, Azzis OM, Lebullenger RM, Davit-Béal TA, Brézulier DY. Bioglass 45S5, a relevant alternative to autogenous harvesting for secondary alveolar bone grafts in clefts? Retrospective study of one hundred surgeries. J Craniomaxillofac Surg 2024; 52:85-92. [PMID: 38129189 DOI: 10.1016/j.jcms.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/26/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023] Open
Abstract
The secondary alveolar bone grafting (SABG) step restores the continuity of the alveolar bone necessary for dentition. Faced with the complications of autografts, synthetic biomaterials such as Bioglass (BG) 45S5 have been proposed. The objective was to evaluate the success rate of SABG with the addition of BG 45S5 and to highlight the prognostic factors. Patients who underwent operation between 2015 and 2021 and had follow-up cone-beam computed tomography (CBCT) were analyzed. Multivariate analysis was performed to determine factors influencing radiographic success. A total of 102 SABG were analyzed. They were unilateral total cleft lip and palate (49, 48.0%). The mean age at surgery was 9.32 ± 3.09 years. Surgeries were performed mainly outside a syndromic context and without a family history after orthodontic preparation. The radiographic success rate at 1 year was 80.4%. Mixed dentition stage (odds ratio [OR] = 7.3, p = 0.024), absence of syndromic context (OR = 20.7, p = 0.024) and female sex (OR = 4.88, p = 0.021) were factors predictive of surgical success. The use of BG 45S5 instead of autograft is relevant for SABG, with a 1-year success rate of over 80%. The stage of mixed dentition, the absence of syndromic context, and female sex were factors for good prognosis.
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Affiliation(s)
| | | | - Olivier M Azzis
- CHU Rennes, Univ Rennes, Service de Chirurgie Pédiatrique, France
| | | | | | - Damien Y Brézulier
- CHU Rennes, Univ Rennes, Pôle Odontologie, France; Univ Rennes, ISCR UMR 6226, France.
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Liao M, Wang L, Shang N, Hu X, He B, Liu X, Xiang G, Zhong W. Ultrasound measurements of fetal facial profile markers and their associations with congenital malformations during early pregnancy. BMC Pregnancy Childbirth 2023; 23:772. [PMID: 37925422 PMCID: PMC10625258 DOI: 10.1186/s12884-023-06067-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 10/13/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Fetal facial profile could be measured during the early pregnancy. Its abnormalities might be associated with certain congenital malformations. We aimed to study the associations between fetal facial profile measurements with crown-rump length and congenital malformations (cleft lip and palate, micrognathia, and open spina bifida) during early pregnancy. METHODS We performed a prospective cross-sectional study between June 2019 and April 2022. Pregnant women at a gestational age between 11-13+ 6 weeks were enrolled. Two sonographers performed fetal facial profile measurements independently. The associations between these measurements with crown-rump length and congenital malformations were evaluated. RESULTS There were 406 and 25 fetuses without or with congenital malformations, respectively. Two sonographers showed satisfactory inter- and intra-observer agreements and reproducibility. The maxillary gap was only observed in 7.6% of normal fetuses, whereas all cleft lip and palate fetuses had a maxillary gap ≥ 0.8 mm. The crown-rump length was negatively correlated with frontomaxillary facial angle, inferior facial angle, and profile line distance but positively correlated with maxilla-nasion-mandible angle, facial maxillary angle, frontal space distance, and palatine maxillary diameter. These measurements showed various significant changes with different congenital malformations. CONCLUSIONS Measurements of fetal facial profile in early pregnancy were feasible with satisfactory reproducibility. These measurements correlated with crown-rump length and showed significant differences with certain fetal congenital malformations.
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Affiliation(s)
- Minyan Liao
- Guangdong Women and Children Hospital, 521 Xing-nan Avenue Pan-Yu, Guangzhou, 510499, China
| | - Limin Wang
- Guangdong Women and Children Hospital, 521 Xing-nan Avenue Pan-Yu, Guangzhou, 510499, China
| | - Ning Shang
- Guangdong Women and Children Hospital, 521 Xing-nan Avenue Pan-Yu, Guangzhou, 510499, China.
| | - Xueyi Hu
- Guangdong Women and Children Hospital, 521 Xing-nan Avenue Pan-Yu, Guangzhou, 510499, China
| | - Bingjia He
- Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, China
| | - Xiangjiao Liu
- Guangdong Women and Children Hospital, 521 Xing-nan Avenue Pan-Yu, Guangzhou, 510499, China
| | - Guanghua Xiang
- Guangdong Women and Children Hospital, 521 Xing-nan Avenue Pan-Yu, Guangzhou, 510499, China
| | - Wei Zhong
- Guangdong Women and Children Hospital, 521 Xing-nan Avenue Pan-Yu, Guangzhou, 510499, China
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Influence of Cleft Lip and Palate on Oral Health-Related Quality of Life in Northern Italy: Exploring Both the Children's and Caregivers' Perspectives. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121986. [PMID: 36553429 PMCID: PMC9776790 DOI: 10.3390/children9121986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/07/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
The aim of this cross-sectional study was to examine whether parents/caregivers' perceptions of oral health-related quality of life (OHRQoL) differ from that of their cleft children, exploring the impact of demographic variables and cleft type on their agreement. Fifty-three primary and secondary schoolchildren, with non-syndromic orofacial cleft, and their parents answered the Child Oral Health Impact Profile (COHIP) questionnaire. Concordance between caregivers' and children's reports was low to moderate. Parents/caregivers had worse perceptions of OHRQoL compared to that of their children, peer interaction and functional well-being domains being statistically significantly different (p = 0.033 and p = 0.005, respectively). Cleft type, gender and parents' country of origin seemed to be potential contributing factors of disagreement. Parents overestimated the impact of unilateral (p = 0.047) and bilateral cleft lip and palate (p = 0.021) on OHRQoL, and they rated more poorly than their male children did. Italian parents were more concerned about the functional well-being of their children (p = 0.014), and foreign parents about peer interaction (p = 0.010) and school environment (p = 0.012) dimensions. These findings suggest that parental assessment of OHRQoL cannot replace that of school-aged children, but they are complementary as they cover different, but equally relevant perspectives.
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Defabianis P, Cogo C, Massa S, Romano F. Oral-Health-Related Quality of Life among Non-Syndromic School-Age Children with Orofacial Clefts: Results from a Cross-Sectional Study in Northern Italy. CHILDREN 2022; 9:children9071098. [PMID: 35884082 PMCID: PMC9321112 DOI: 10.3390/children9071098] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 11/16/2022]
Abstract
The aim of this cross-sectional study was to determine the influence of orofacial clefts on the oral-health-related quality of life (OHRQoL) in a group of Italian children and adolescents and to examine whether gender, age, cleft type, and surgical protocol were associated with patients’ OHRQoL. A total of 71 patients with cleft lip and/or cleft palate (CLP) and 71 age- and gender-matched controls (aged 8 to 18 years) were asked to complete the Child Oral Health Impact Profile (COHIP), a validated and reliable questionnaire to assess self-reported OHRQoL in children and teenagers. Children with orofacial clefts showed statistically significant lower quality of life scores than controls for total OHRQoL and for each of the subscales. Gender, the type of cleft, and the type of surgical protocol had no significant influence on OHRQoL. The negative impact of CLP on the area of self-image was greater in 12–18-year-olds, indicating a higher need for psychosocial counselling. These findings suggest that Italian CLP children and adolescents experience a poorer OHRQoL in comparison to their non-cleft peers.
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Francisco I, Caramelo F, Fernandes MH, Vale F. A Comparative Study of Oral Health-Related Quality of Life among Cleft Lip and Palate Patients and Their Families during Orthodontic Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312826. [PMID: 34886552 PMCID: PMC8657209 DOI: 10.3390/ijerph182312826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: It has been recognized that CLP condition may affect oral health-related quality of life (OHRQoL) due to dental anomalies and abnormal craniofacial development. Aim: To assess whether orthodontic treatment affected the levels of OHRQoL in CLP patients and their families. (2) Methods: 226 individuals (111 with cleft and 115 control) and their parents were invited to complete the Oral Health Impact Profile-14 (OHIP-14) and Family Impact Scale (FIS), respectively. The Mann–Whitney test was used for quantitative variables and the Fisher’s exact test for categorical variables. The Spearman Rank Correlation Coefficient was used to correlate the results of the OHIP and FIS questionnaires. (3) Results: No significant difference was found between groups in OHIP-14 but FIS score revealed a significant difference between the two groups evaluated (p < 0.001). Only the social limitation in OHIP score revealed a significant difference (p = 0.001). Regarding FIS score, the most affected dimensions were family activities (p < 0.001), parental emotions (p = 0.001), and family conflict (p = 0.011). (4) Conclusion: Undergoing orthodontic treatment had a similar impact on the overall quality of life in CLP patients and non-cleft patients. Parents of cleft children had a poorer OHRQoL compared to what was perceived by their children and parents of non-cleft children.
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Affiliation(s)
- Inês Francisco
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Correspondence: (I.F.); (F.V.)
| | - Francisco Caramelo
- Institute of Clinical and Biomedical Research of Coimbra (iCBR), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal;
| | - Maria Helena Fernandes
- Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal;
- LAQV/REQUIMTE, University of Porto, 4160-007 Porto, Portugal
| | - Francisco Vale
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Correspondence: (I.F.); (F.V.)
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Guillén AR, Olmo MJG, Puente CP, Maroto MR. Personality and Cognitive-Emotional Variables in Spanish Children and Adolescents With and Without Cleft Lip and/or Palate. Cleft Palate Craniofac J 2020; 58:872-880. [PMID: 34128404 DOI: 10.1177/1055665620965114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To analyze personality (Big Five Model) and cognitive-emotional variables in children and adolescents with a cleft lip/palate (s) in comparison to an equivalent peer sample without an orofacial cleft. DESIGN Cross-sectional study with data collected using self-reported questionnaires over 2 years. SETTING Data were collected during visits to health center dental clinics. PATIENTS Children and adolescents (aged 8-18 years) with nonsyndromic CL/P (n = 60) and without a cleft (n = 60). METHOD Patients completed questionnaires with assistance as needed from a member of the research team. MAIN OUTCOME MEASURES Children's Perceived Self-Efficacy, Cognitive Emotion Regulation Questionnaire (child version), Big Five Questionnaire for Children, and Alexithymia Questionnaire for Children. RESULTS When accounting for age, children with CL/P had normative self-efficacy and cognitive-emotional regulation strategies, with the protective factor of significantly lower rumination than peers. Children with CL/P were significantly lower on the Big Five personality areas of conscientiousness, openness to experience, extraversion, and agreeableness along with significantly higher neuroticism. They were similarly significantly higher than peers for alexithymia. CONCLUSION Children with CL/P showed strengths in self-efficacy typical of peers and less use of some maladaptive coping strategies; however, they also had higher levels of alexithymia and risk factors associated with the Big Five Model of personality. Strategies may be clinically useful that maximize areas of strength to support children with CL/P in expressing their emotions to reduce alexithymia, coping with of negative affect, and building assertiveness.
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Affiliation(s)
- Ana Ruiz Guillén
- Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Nursing and Dentistry, 16776Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - María José González Olmo
- Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Nursing and Dentistry, 16776Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Cecilia Peñacoba Puente
- Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Nursing and Dentistry, 16776Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Martín Romero Maroto
- Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Nursing and Dentistry, 16776Rey Juan Carlos University, Alcorcón, Madrid, Spain.,Orthodontic Department, 16776Rey Juan Carlos University, Alcorcón, Madrid, Spain
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