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Fell M, Bradley D, Chadha A, Butterworth S, Davies A, Russell C, Richard B, Wren Y, Lewis S, Chong D. Sidedness in Unilateral Orofacial Clefts: A Systematic Scoping Review. Cleft Palate Craniofac J 2023:10556656231221027. [PMID: 38092732 DOI: 10.1177/10556656231221027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE An overview of the literature relating to the sidedness of unilateral cleft lip with or without cleft palate to map current knowledge on the cause and impact of directional asymmetry. DESIGN Scoping review with a systematic search of Medline and Embase from inception to May 2023. PATIENTS, PARTICIPANTS Humans born with a left or right unilateral cleft lip with or without a cleft palate. MAIN OUTCOME MEASURES Cleft sidedness as a co-occurrence, an outcome or an exposure. RESULTS Forty studies were eligible for inclusion and confirmed the predilection for the occurrence of left sided cleft lips; 12 studies reported cleft sidedness co-occurring with another phenotype, 11 studies report sidedness as an outcome and 17 studies as an exposure. Phenotypes which were reported to co-occur with either left or right sided clefts included congenital dental anomalies, handedness and additional congenital anomalies. Variables investigated as a potential cause of left or right sided clefts as an outcome included chromosomal anomalies, genetic variants and environmental factors. Outcomes investigated in relation to cleft sidedness as an exposure included facial anatomical features, facial growth, educational attainment, functional and psychological characteristics. More studies showed worse outcomes in right sided clefts versus left sided clefts than vice versa, although studies were inconsistent, and a quality assessment was not performed. CONCLUSIONS The field of cleft sidedness research is expanding and there are promising early findings to differentiate cause and outcome by sidedness of the cleft.
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Affiliation(s)
- Matthew Fell
- Spires Cleft Centre, John Radcliffe Hospital, Oxford, UK
- The Cleft Collective, Bristol Dental School, University of Bristol, Bristol, UK
| | | | - Ambika Chadha
- Cleft.Net.East, University of Cambridge NHS Hospitals Trust, Cambridge, UK
- Department of Perinatal Imaging and Health, Kings College London & South Thames Cleft Service, St. Thomas Hospital, London, UK
| | - Sophie Butterworth
- Cleft Registry and Audit Network, Clinical Excellence Unit, The Royal College of Surgeons of England, London, UK
| | - Amy Davies
- The Cleft Collective, Bristol Dental School, University of Bristol, Bristol, UK
| | - Craig Russell
- Cleft Care Scotland, Royal Hospital for Children, Queen Elizabeth University Hospital, Glasgow, UK
| | - Bruce Richard
- West Midlands Cleft Service, Birmingham Women and Children's Hospital, Birmingham, UK
| | - Yvonne Wren
- The Cleft Collective, Bristol Dental School, University of Bristol, Bristol, UK
- Speech and language therapy research unit, North Bristol NHS Trust, Bristol, UK
| | - Sarah Lewis
- The Cleft Collective, Bristol Dental School, University of Bristol, UK
| | - David Chong
- Plastic and Maxillofacial Surgery, The Royal Children's Hospital, Melbourne, Australia
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Campos LD, Trindade IEK, Trindade SHK, Pimenta LAF, Kimbell J, Drake A, Marzano-Rodrigues MN, Trindade-Suedam IK. Effects of 3D Airway Geometry on the Airflow of Adults with Cleft Lip and Palate and Obstructive Sleep Apnea: A Functional Imaging Study. Sleep Sci 2023; 16:e430-e438. [PMID: 38197022 PMCID: PMC10773502 DOI: 10.1055/s-0043-1776868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 02/09/2023] [Indexed: 01/11/2024] Open
Abstract
Objective Individuals with cleft lip and palate (CLP) are at a high risk of developing obstructive sleep apnea (OSA). Hypothetically, the severity of OSA might be associated with the morphology of the upper airway (UAW) and the characteristics of the airflow. Thus, the present study aimed to assess and compare, in adults with CLP and skeletal class-III discrepancy, with or without OSA, simulations of airflow resistance and pressure according to the geometrical characteristics of the UAW and cephalometric parameters. Materials and Methods According to the results of type-I polysomnography tests, the sample ( n = 21) was allocated in 2 groups: 1) without OSA (N-OSA; n = 6); and 2) with OSA (OSA; n = 15). Cephalometric measurements were performed on the cone-beam computed tomography (CBCT) scans of the groups. After three-dimensional (3D) reconstructions, the volume (V) and minimal cross-sectional area (mCSA) of the UAW were generated. Computational fluid dynamics (CFD) simulations were used to assess key airflow characteristics. The results were presented at a significance level of 5%. Results The UAW pressure values and airway resistance did not differ between the groups, but there was a tendency for more negative pressures (26%) and greater resistance (19%) in the OSA group. Volume and mCSA showed a moderate negative correlation with resistance and pressure. The more inferior the hyoid bone, the more negative the pressures generated on the pharyngeal walls. Conclusion The position of the hyoid bone and the geometry of the UAW (V and mCSA) exerted effects on the airway-airflow resistance and pressure. However, key airflow characteristics did not differ among subjects with CLP, were they affected or not by OSA.
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Affiliation(s)
- Leticia Dominguez Campos
- Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
| | - Inge Elly Kiemle Trindade
- Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
- School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Biological Sciences, School of Dentistry, Universidade de São Paulo, Bauru, SP, Brazil
| | - Sergio Henrique Kiemle Trindade
- Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
- Department of Pediatric Dentistry, Orthodontics and Public Health, School of Medicine, Universidade de São Paulo, Bauru, SP, Brazil
| | - Luiz André Freire Pimenta
- Department of Biological Sciences, School of Dentistry, Universidade de São Paulo, Bauru, SP, Brazil
| | - Julia Kimbell
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Amelia Drake
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Maria Noel Marzano-Rodrigues
- Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
| | - Ivy Kiemle Trindade-Suedam
- Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
- School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Biological Sciences, School of Dentistry, Universidade de São Paulo, Bauru, SP, Brazil
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Idso S, Holloway J, Patel P, Zhao L, Forbes D, Liu D. Airway changes in patients with unilateral cleft lip/palate (UCL/P) after maxillary advancement. Angle Orthod 2023; 93:727-735. [PMID: 37319320 PMCID: PMC10633796 DOI: 10.2319/110722-764.1] [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: 11/01/2022] [Accepted: 04/01/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVES To assess the effect on the retropalatal airway (RPA), retroglossal airway (RGA), and total airway (TA) volumes and cephalometrics (SNA, SNB, ANB, PP-SN, Occl-SN, N-A, A-TVL, B-TVL) after maxillary advancement orthognathic surgery in patients with unilateral cleft lip/palate (UCL/P) using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT scans of 30 patients (13 males and 17 females, 17-20 years old) with UCL/P were evaluated at two time points: preoperative (T1) and postoperative (T2). The interval between T1 and T2 ranged from 9-14 weeks, except for two patients in whom the interval was 24 weeks. Intraexaminer reliability was measured with an intraclass correlation coefficient test. A paired t-test was used to compare the airway and cephalometric measurements between T1 and T2, with a P value of .05 being considered significant. RESULTS From T1 to T2, significant increases were found in the volumes of RPA (from 9574 ± 4573 to 10,472 ± 4767, P = .019), RGA (from 9736 ± 5314 to 11,358 ± 6588, P = .019), and TA (from 19,121 ± 8480 to 21,750 ± 10,078, P = .002). In addition, the RGA (from 385 ± 134 to 427 ± 165, P = .020) and TA (from 730 ± 213 to 772 ± 238, P = .016) sagittal area increased significantly. For minimal cross-sectional area (MCA), only the RPA increased significantly (from 173 ± 115 to 272 ± 129, P = .002). All cephalometric changes were statistically significant between T1 and T2 except for SNB. CONCLUSIONS Maxillary advancement in patients with UCL/P produces statistically significant increases in the retropalatal (volumetric and MCA), retroglossal (volumetric and sagittal), and total (volumetric and sagittal) airways based on data from CBCT imaging.
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Affiliation(s)
| | | | | | | | | | - Dawei Liu
- Corresponding author: Dr Dawei Liu, Department of Developmental Sciences/Orthodontics, Marquette University School of Dentistry, 1801 West Wisconsin Ave, Milwaukee, WI 53233, USA (e-mail: )
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Comparison of Nasopharyngeal Airway Volume in Cleft Lip and Palate Patients With Normal Individuals Using Cone Beam Computed Tomography. J Craniofac Surg 2022; 34:1111-1114. [PMID: 36210490 DOI: 10.1097/scs.0000000000009055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/08/2022] [Indexed: 11/26/2022] Open
Abstract
This study aimed to compare nasopharyngeal airway volume in cleft lip and palate patients with normal individuals using Cone Beam Computed Tomography (CBCT). In this cross-sectional study, 40 CBCT scans of 9 to 12-years-old patients were enrolled and divided into 3 groups: normal individuals (n=16), unilateral cleft lip and palate (UCLP, n=14) and bilateral cleft lip and palate patients (BCLP, n=10). Superior and middle pharyngeal airway volumes and nasal width were measured and compared between 3 groups. ANOVA and χ 2 tests were used for statistical comparison. P <0.05 was considered significant. Superior airway volume was not significantly different between the 3 groups ( P =0.36). However, there was a significant difference between the 3 groups regarding middle pharyngeal volume ( P =0.49) and nasal width ( P =0.021). There was not a significant difference in the upper and middle pharyngeal volume and also nasal width between the 2 sexes. Considering different dimensions of evaluation of the pharyngeal airway volume of cleft lip and palate patients, the evaluation of airway volume is essential during orthodontic or orthognathic surgical treatments that expand or protect the maxilla.
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Marya A, Venugopal A, Karobari MI, Chaudhari PK, Heboyan A, Rokaya D. The Contemporary Management of Cleft Lip and Palate and the Role of Artificial Intelligence: A Review. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2202240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
Cleft management is an exhaustive process for the patient, the orthodontist, and the caregiver. In recent decades, a wide number of challenges have been addressed with the inclusion of various dental specialties for the detection, diagnosis, and treatment of orofacial clefts. The orthodontist plays a very pivotal role during the overall management of children with cleft lip and palate as they need to make critical decisions for when to intervene orthodontically and at what stage to set priorities for individual treatment goals.
Objectives:
The objectives of this study were to provide an in-depth review of the evolving role of various disciplines focusing on orthodontics in the management of cleft cases.
Methods:
A general search was carried out to identify the published data on cleft lip and cleft palate management on PubMed and Scopus until the 1st of June 2021 using keywords such as cleft lip, cleft palate, cleft orthodontics, naso-alveolar molding, and surgical cleft orthodontics. The related literature was then reviewed and analyzed.
Results:
With improvements in 3D modeling, CT scans of patients can be used to construct precise 3D models, and these can be utilized to demonstrate various clinical issues related to clefts. The orthodontist has a major role in the various stages and steps, follow-up, treatment care, and outcome assessment. With the advent of technological advancements and artificial intelligence, the role is only going to evolve and expand further in the management of the cleft lip and palate. Diagnostic techniques utilizing artificial intelligence to detect cleft during the prenatal period have also been tested and have been shown to have a high rate of accuracy. The evolution of distraction osteogenesis came into the limelight as a revolutionary modality for cleft treatment. Computer-assisted orthognathic surgery is a widely used modality for reshaping the osseous defects of the maxilla in patients with congenital clefts. With the development of additional modalities such as aligners, patients that need to undergo complex orthognathic surgeries can also be treated with aligners without compromising the outcomes.
Conclusion:
The cleft lip and palate can be managed by a multi-disciplinary team. Orthodontics has an important role in the overall management of a cleft affected individual as they must make critical decisions regarding orthodontic interventions as well as set priorities for each treatment goal. With the advent of technological advancements and artificial intelligence, the diagnosis and management of the cleft lip and palate have become simplified.
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Kiaee B, Nucci L, Sarkarat F, Talaeipour AR, Eslami S, Amiri F, Jamilian A. Three-dimensional assessment of airway volumes in patients with unilateral cleft lip and palate. Prog Orthod 2021; 22:35. [PMID: 34746995 PMCID: PMC8572890 DOI: 10.1186/s40510-021-00382-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/18/2021] [Indexed: 11/28/2022] Open
Abstract
Background Considering the adverse consequences of respiratory insufficiency in cleft lip and palate (CLP) patients, this study aimed to assess the pharyngeal airway dimensions in 9–12-year-old patients with unilateral CLP. This historical cohort evaluated the cone-beam computed tomography (CBCT) scans of 30 patients with non-syndromic unilateral CLP between 9 and 12 years and 30 age- and sex-matched non-cleft controls. Three-dimensional (3D) images were reconstructed by the Mimics software, and the nasopharyngeal, oropharyngeal, and total airway volumes, as well as the minimal cross-sectional area of the airway (minAx), and posterior airway length (PAL) were all measured in the sagittal plane. Data were analyzed by the Student’s t test. Results The oropharyngeal and the total airway volumes, as well as the minAx and PAL in CLP patients, were significantly smaller than the corresponding values in the control group (P < 0.05). Despite smaller nasopharyngeal airway volume in CLP patients than controls, this difference was not statistically significant (P > 0.05). Conclusions Nine- to twelve-year-old non-syndromic unilateral CLP patients have smaller pharyngeal airway dimensions than non-cleft controls, and are therefore at higher risk of respiratory insufficiency.
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Affiliation(s)
- Bita Kiaee
- Department of Orthodontic, Tehran University of Medical Sciences, Tehran, Iran
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Farzin Sarkarat
- Department of Oral and Maxillofacial Surgery, Dental School, Cranio Maxillofacial Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Ahmad Reza Talaeipour
- Department of Oral and Maxillofacial Radiology, Dental School, Cranio Maxillofacial Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sara Eslami
- Orthodontist at Private Orthodontic Office, Tiergartenstraße 130, Hannover, Germany
| | - Faezeh Amiri
- DDS, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolreza Jamilian
- Department of Orthodontics, Dental School, Cranio Maxillofacial Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
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A New Method for Anterior Boundary Demarcation of the Nasopharynx in Three-Dimensional Analysis. J Craniofac Surg 2021; 33:400-403. [PMID: 34320585 DOI: 10.1097/scs.0000000000008033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Three-dimensional (3D) measurements of the upper airway have been extensively applied and researched, but the division of the airway is carried out in various ways, especially when demarcating the anterior boundary of the nasopharynx. The present study was to propose a new method based on the anatomical definition for the anterior boundary demarcation of the nasopharynx used in three-dimensional analysis. Twenty computed tomography scans (age 9.5 ± 2.5 years, 11 males, and 9 females) of head and neck were randomly selected and transferred to Materialism's interactive medical image control system 19.0 for segmentation of the nasopharynx. Precise localization of the reference points that determining the nasopharyngeal anterior and inferior boundaries was managed by recording their coordinates in the interface of the software. The area of the anterior and the inferior boundaries, and the volume of the nasopharynx were measured and repeated with a 2-week interval for the consistency test. Both the interobserver reliability as well as the intra-observer reliability were very high (intraclass correlation coefficients, 0.985-0.997). Paired t test showed no significant difference between the first and the second examinations. This new simple method proposed for demarcation of the nasopharyngeal anterior boundary was based on the innate anatomical boundary, which was statistically reliable, technically convenient, and clinically reasonable.
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Correlation between alveolar cleft volume and alveolar bone quality in patients with unilateral cleft lip and palate: A cone-beam computed tomography study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e69-e75. [PMID: 34186229 DOI: 10.1016/j.jormas.2021.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This study aimed to determine the correlation between alveolar cleft volume and fenestration and dehiscence in the adjacent alveolar bone in patients with unilateral cleft lip and palate (UCLP) using cone-beam computed tomography (CBCT) sections. MATERIALS AND METHODS In this descriptive, cross-sectional study, CBCT scans of 68 non-syndromic patients with UCLP aged between 6 and14 years were selected. All patients were treated in Iran and had undergone lip and palate repair surgery within the first 3 to 18 months after birth. CBCT scans had been taken after orthodontic expansion and prior to alveolar bone grafting surgery. Cleft volume, fenestration and dehiscence were assessed using Mimics software. Data were analyzed using independent t-test, Kruskal-Wallis test, Spearman's correlation coefficient and logistic regression model. RESULTS The mean alveolar cleft volume was 628.66±172.84 mm3. There was a significant negative correlation between cleft volume and fenestration (P<0.001). Also, there was a significant positive correlation between cleft volume and dehiscence (P<0.001) in the adjacent bone. CONCLUSION The Mimics software can be successfully used to estimate the cleft volume prior to surgical procedures in UCLP patients. The results suggest that the alveolar cleft volume can be used as an aid to assess the periodontal condition of adjacent teeth. The cleft volume has a negative and positive correlation with fenestration and dehiscence respectively.
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Paknahad M, Pourzal A, Mahjoori-Ghasrodashti M, Khojastepour L. Evaluation of Maxillary Sinus Characteristics in Patients With Cleft Lip and Palate Using Cone Beam Computed Tomography. Cleft Palate Craniofac J 2021; 59:589-594. [PMID: 34151601 DOI: 10.1177/10556656211023239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The detection of anatomical variation impairments in patients with cleft lip and palate (CLP) is crucial in combined orthodontic and maxillofacial surgical treatments. Therefore, this study aimed at evaluating the anatomical maxillary sinus characteristics, nasal septum deviation (NSD), and mucosal thickening of the maxillary sinus in patients with CLP using cone beam computed tomography (CBCT). DESIGN The CBCT images were classified into 3 groups of unilateral cleft lip and palate (UCLP; n = 40), bilateral cleft lip and palate (BCLP; n=14), and noncleft (control; n = 54). Subsequently, the maxillary sinus linear dimensions were assessed. Height, width, depth, infundibulum height, and ostium width were assessed as quantitative measures, whereas nasal septum deviation and mucosal thickening were assessed as qualitative measures. One-way analysis of variance and χ2 tests were utilized to identify any significant differences among the groups regarding the aforementioned variables. RESULTS Significant differences were observed among the groups regarding maxillary sinus height and depth, NSD, and mucosal thickening. Moreover, UCLP and BCLP groups showed higher incidence of NSD and mucosal thickening. However, the size of maxillary sinus height and depth was lower in the UCLP and BCLP groups. CONCLUSION The results showed that BCLP and UCLP groups obtained lower maxillary sinus height and depth compared to the control group. On the other hand, incidence of the NSD and mucosal thickening was significantly higher in UCLP and BCLP groups than those in the control group.
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Affiliation(s)
- Maryam Paknahad
- Oral and Dental Disease Research Center, Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aida Pourzal
- Student Research Committee, School of Dentistry, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Leila Khojastepour
- Oral and Maxillofacial Radiology, School of Dentistry, 48435Shiraz University of Medical Sciences, Shiraz, Iran
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Garcia-Usó M, Lima TF, Trindade IEK, Pimenta LAF, Trindade-Suedam IK. Three-dimensional tomographic assessment of the upper airway using 2 different imaging software programs: A comparison study. Am J Orthod Dentofacial Orthop 2021; 159:217-223. [PMID: 33483220 DOI: 10.1016/j.ajodo.2020.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 03/01/2020] [Accepted: 04/01/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Several imaging software programs with different tools are available for upper airway (UAW) analysis by means of cone beam computed tomography. Because of this wide variability, this study aimed to compare the reproducibility of two of the most used software programs on UAW segmentation, that is, Dolphin Imaging (Dolphin Imaging and Management Solutions, Chatsworth, Calif) and Mimics Research (Materialise, Leuven, Belgium). METHODS The sample consisted of 50 scans of adult subjects with Class III malocclusion; pharyngeal volume and minimal cross-sectional area (mCSA) were assessed twice by 2 experienced evaluators using both software programs. Intra- and intersoftware and/or evaluator agreement were calculated using the intraclass correlation coefficient (ICC). Bland-Altman analysis was used to visualize the intersoftware and interevaluator agreement. RESULTS Using Mimics Research and Dolphin Imaging, the respective mean values of volume (cm3) were 27.1 ± 8.4 and 24.7 ± 8.1 (P < 0.05) and of mCSA (mm2) were 167.8 ± 95.5 and 176.5 ± 102.3 (P < 0.05). Although differences between software packages were observed on both the analyzed variables, the results showed a high intersoftware agreement, with ICC of 0.87 (volume) and 0.97 (mCSA) and mean bias of 24.6 (volume) and -8.8 (mCSA). A high intrasoftware agreement was also observed, with values varying from 0.83 to 0.99. Excellent intra- and interevaluator agreement was also obtained, with ICC values from 0.93 to 0.99. CONCLUSIONS Dolphin Imaging and Mimics Research individually provide highly reproducible results, with clinically acceptable agreement between them for UAW segmentation, providing consistent values for volume and mCSA.
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Affiliation(s)
- Michele Garcia-Usó
- Former Post-Graduation Student, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Thiago F Lima
- Former Post-Graduation Student, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Inge Elly K Trindade
- Department of Biological Sciences, Bauru School of Dentistry, and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Luiz Andre F Pimenta
- Craniofacial Center, and Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Ivy Kiemle Trindade-Suedam
- Department of Biological Sciences, Bauru School of Dentistry, and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil.
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Banari AS, Datana S, Agarwal SS, Bhandari SK. Does Presurgical Nasoalveolar Molding Have a Long-Term Effect on Nasal and Upper Airway Dimensions? Cleft Palate Craniofac J 2020; 58:1257-1264. [PMID: 33356522 DOI: 10.1177/1055665620980234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To compare nasal and upper airway dimensions in patients with cleft lip and palate (CLP) who underwent nasoalveolar molding (NAM) with those without NAM during infancy using acoustic pharyngometry and rhinometry. MATERIALS AND METHODS Eccovision acoustic pharyngometry and rhinometry (Sleep Group Solutions) was used for assessment of mean area and volume of nasal and upper airway in patients with complete unilateral CLP (age range 16-21 years) treated with NAM (group 1, n = 19) versus without NAM (group 2, n = 22). RESULTS The mean nasal cross-sectional areas and volume were higher in group 1 compared to group 2 on both cleft (P value <.001) and noncleft side (P value >.05). The mean area and volume of upper airway were also significantly higher in group 1 compared to group 2 (P value <.05). CONCLUSIONS Nasoalveolar molding being one of the first interventions in chronology of treatment of patients with CLP, its long-term outcome on nasal and upper airway patency needs to be ascertained. The results of the present study show that the patients with CLP who have undergone NAM during infancy have better improvement in nasal and upper airway patency compared with those who had not undergone NAM procedure. The basic advantages of being noninvasive, nonionizing and providing dynamic assessment of nasal and upper airway patency make acoustic pharyngometry and rhinometry a diagnostic tool of choice to be used in patients with CLP.
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Affiliation(s)
- Ashwina S Banari
- Department of Orthodontics and Dentofacial Orthopedics, 355441Armed Forces Medical College, Pune, India
| | - Sanjeev Datana
- Department of Orthodontics and Dentofacial Orthopedics, 355441Armed Forces Medical College, Pune, India
| | - Shiv Shankar Agarwal
- Department of Orthodontics and Dentofacial Orthopedics, 355441Armed Forces Medical College, Pune, India
| | - Sujit Kumar Bhandari
- Department of Dental surgery & Oral Health Sciences, 355441Armed Forces Medical College, Pune, India
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Kimura E, Obata T, Kitai S, Ishii T, Sakamoto T, Watanabe M, Watanabe A, Narita M, Nakano Y, Takano N, Sueishi K, Nishii Y. Three-Dimensional Measurements of Pharyngeal Airway in Patients with Unilateral Cleft Lip and Palate. THE BULLETIN OF TOKYO DENTAL COLLEGE 2020; 61:213-219. [PMID: 33177272 DOI: 10.2209/tdcpublication.2020-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this study was to investigate 3-dimensional (3D) airway volume in patients with unilateral cleft lip and palate (UCLP) using computed tomography (CT). The study population comprised 15 UCLP patients (UCLP group) scheduled to receive alveolar bone grafts and 15 with impacted teeth (control group). The clinical requirements for a CT scan were met in both groups. Measurements were recorded from 3D reconstructions of Digital Imaging and Communications in Medicine data obtained from the CT images. Airway volume, cross-sectional area, and linear and angular measurements were recorded. Airway volume and cross-sectional area showed no significant difference between the two groups. The narrowest section of the airway in the UCLP group was tighter than that in the control group, however (p=0.017). The results of this study suggest that this difference in the measurements of the narrowest section of the airway is involved in the particular maxillofacial morphology found in UCLP patients.
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Affiliation(s)
- Emiko Kimura
- Department of Orthodontics, Tokyo Dental College
| | - Tomoko Obata
- Department of Orthodontics, Tokyo Dental College
| | - Shuto Kitai
- Department of Orthodontics, Tokyo Dental College
| | | | | | - Miki Watanabe
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Akira Watanabe
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Masato Narita
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Yoko Nakano
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
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Ataol M, Ertaş Ü. Evaluation of nasal airflow resistance of operated unilateral cleft lip and palate surgery patients compared with skeletal class III individuals. Int J Pediatr Otorhinolaryngol 2020; 137:110188. [PMID: 32682165 DOI: 10.1016/j.ijporl.2020.110188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/25/2020] [Accepted: 06/07/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The purpose of this study was to measure the nasal airflow resistance of operated unilateral cleft lip and palate (UCLP) patients using the anterior rhinomanometry method compared with non-cleft skeletal class III individuals with isolated maxillary hypoplasia serving as the control group. MATERIAL&METHODS Sixteen UCLP patients who have undergone lip and palate reconstructions and alveolar cleft grafting but not advanced surgeries as the study group and 16 non-cleft skeletal class III participants as the control group (corresponded for age and sex to the study group) were included in this prospective study. All of the patients had class III occlusion due to isolated maxillary hypoplasia. Nasal airflow was measured with anterior rhinomanometry (in ml/sec) for each nostril separately. For evaluation of nasal side subgroups of the UCLP group for nasal resistance, the cleft sides and non-cleft sides of individuals were examined in two separate groups. The nasal side resistance of the control group was evaluated as the average of both nasal side resistances. The nasal resistances for nasal sides and total nasal resistance were measured in Pa/L/sec. The observed data were analyzed using Kolmogorov-Smirnov test used for normality, and the Student t-test and Mann Whitney U test used to determine the differences between the groups. P values of <0.05 were considered statistically significant. RESULTS As the primary outcome of this study, it was found that both the cleft sides and non-cleft sides of the UCLP individuals had statistically significantly higher nasal resistance than the healthy skeletal class III control group (p < 0.05). It was revealed that the cleft side had more nasal resistance than the non-cleft side for both inspiration and expiration, but the results were not statistically significant (p = 0.41/p = 0.28). CONCLUSION The results showed that operated UCLP patients have nasal resistance and breathing problems, even when lip, palate, and alveolar cleft operations have been performed.
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Affiliation(s)
- Mert Ataol
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey.
| | - Ümit Ertaş
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ataturk University, Erzurum, Turkey.
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Kim JE, Yim S, Choi JY, Kim S, Kim SJ, Baek SH. Effects of the long-term use of maxillary protraction facemasks with skeletal anchorage on pharyngeal airway dimensions in growing patients with cleft lip and palate. Korean J Orthod 2020; 50:238-248. [PMID: 32632043 PMCID: PMC7369382 DOI: 10.4041/kjod.2020.50.4.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/27/2020] [Accepted: 03/03/2020] [Indexed: 11/15/2022] Open
Abstract
Objective To investigate the effects of the long-term use of a maxillary protraction facemask with miniplate (FM-MP) on pharyngeal airway dimensions in growing patients with cleft lip and palate (CLP). Methods The study included 24 boys with CLP (mean age, 12.2 years; mean duration of FM-MP therapy, 4.9 years), divided into two groups according to the amount of A point advancement to the vertical reference plane (VRP): Group 1, > 4 mm; Group 2, < 2 mm; n = 12/group. After evaluating the skeletodental and airway variables using lateral cephalograms acquired before and after FM-MP therapy, statistical analyses were performed. Results Group 1 showed greater forward and downward displacements of the posterior maxilla (posterior nasal spine [PNS]-horizontal reference plane [HRP]; PNS-VRP), greater increase in ANB, more forward tongue position (tongue tip-Pt vertical line to Frankfort horizontal plane), and greater increase in the oropharynx (superior posterior airway space [SPAS]; middle airway space [MAS]) and upper nasopharynx (PNS-adenoid2) than did Group 2. While maxillary advancement (A-VRP and PNS-VRP) correlated with increases in SPAS, MAS, and PNS-adenoid2, downward displacement of the PNS (PNS-HRP) correlated with increases in SPAS, MAS, PNS-adenoid1, and PNS-adenoid2, and with a decrease in vertical airway length (VAL). Mandibular forward displacement and decrease in mandibular plane correlated with increases in MAS. Conclusions FM-MP therapy had positive effects on the oropharyngeal and nasopharyngeal airway spaces without increases in VAL in Group 1 rather than in Group 2. However, further validation using an untreated control group is necessary.
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Affiliation(s)
- Jung-Eun Kim
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Sunjin Yim
- Department of Dentistry, Graduate School, Seoul National University, Seoul, Korea
| | - Jin-Young Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sukwha Kim
- Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul, Korea
| | - Su-Jung Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Seung-Hak Baek
- Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea
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15
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Three-dimensional analysis of the velopharyngeal region in patients with cleft palate and healthy individuals. Surg Radiol Anat 2020; 42:1033-1042. [PMID: 32638103 PMCID: PMC7363670 DOI: 10.1007/s00276-020-02526-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/25/2020] [Indexed: 11/02/2022]
Abstract
PURPOSE This study aims to attain metric data of the velopharyngeal dimensions of healthy subjects as well as patients with velopharyngeal insufficiency using the example of cleft and lip palate (CLP) in order to determine possible differences in the volumes of both groups. METHODS Volumes and distances of velopharyngeal areas were analyzed retrospectively using cone beam computed tomography data sets (n = 60). Group 1 included healthy patients receiving dental implants (n = 31). Group 2 was represented by patients with surgically closed cleft lip and palate (n = 29). RESULTS Biggest differences among mean values of both groups were found for: minimum axial area (p = 0.000), airway area caudal (p = 0.000), distance between posterior nasal spine and posterior pharyngeal wall (PPW) (p = 0.014), mean distance between velum and PPW (p = 0.000), length of PPW (p = 0.000) and length of anterior pharyngeal wall (p = 0.000). CONCLUSION Differences in the shape and geometry of the velopharyngeal area in subjects with a regular velopharyngeal structure and function and patients with cleft palate do exist. The significant differences found here can be categorized into two groups: one reflects distances between the anterior and posterior pharynx, presenting longer distances for patients with CLP. The second significant difference regards values of length in cranio-caudal direction, which is longer in healthy subjects. With regards to these values, one could conclude, that even though total volumes of both groups did not differ in size, group 1 shows three-dimensional velopharyngeal shapes that are longer and narrower, whereas shapes of patients of group 2 tend to be wider and shorter in general.
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16
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Campos LD, Trindade IEK, Yatabe M, Trindade SHK, Pimenta LA, Kimbell J, Drake AF, Trindade-Suedam IK. Reduced pharyngeal dimensions and obstructive sleep apnea in adults with cleft lip/palate and Class III malocclusion. Cranio 2019; 39:484-490. [DOI: 10.1080/08869634.2019.1668997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Leticia Dominguez Campos
- Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, SP, Brazil
| | - Inge Elly Kiemle Trindade
- Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, SP, Brazil
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | | | - Luiz Andre Pimenta
- Craniofacial Center and Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julia Kimbell
- Department of Otolaryngology/Head and Neck Surgery (A.F.D.), School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amelia F. Drake
- Craniofacial Center, Department of Otolaryngology/Head and Neck Surgery (A.F.D.), School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ivy Kiemle Trindade-Suedam
- Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, SP, Brazil
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17
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Iwasaki T, Suga H, Minami-Yanagisawa A, Hashiguchi-Sato M, Sato H, Yamamoto Y, Shirazawa Y, Tsujii T, Kanomi R, Yamasaki Y. Upper airway in children with unilateral cleft lip and palate evaluated with computational fluid dynamics. Am J Orthod Dentofacial Orthop 2019; 156:257-265. [PMID: 31375236 DOI: 10.1016/j.ajodo.2018.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 09/01/2018] [Accepted: 09/01/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Children with unilateral cleft lip and palate (UCLP) exhibit snoring and mouth breathing. They are also reported to show obstructive sleep apnea syndrome. However, their upper airway ventilation condition is not clearly understood. Therefore, this study was performed to evaluate upper airway ventilation condition in children with UCLP with the use of computational fluid dynamics. METHODS Twenty-one children (12 boys, 9 girls; mean age 9.1 years) with UCLP and 25 children (13 boys, 12 girls; mean age 9.2 years) without UCLP who required orthodontic treatment underwent cone-beam computed tomography (CBCT). Nasal resistance and upper airway ventilation condition were evaluated with the use of computational fluid dynamics from CBCT data. The groups were compared with the use of Mann-Whitney U tests and Student t tests. RESULTS Nasal resistance of the UCLP group (0.97 Pa/cm3/s) was significantly higher than that of the control group (0.26 Pa/cm3/s; P < 0.001). Maximal pressure of the upper airway (335.02 Pa) was significantly higher in the UCLP group than in the control group (67.57 Pa; P < 0.001). Pharyngeal airway (from choanae to base of epiglottis) pressure in the UCLP group (140.46 Pa) was significantly higher than in the control group (15.92 Pa; P < 0.02). CONCLUSIONS Upper airway obstruction in children with UCLP resulted from both nasal and pharyngeal airway effects.
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Affiliation(s)
- Tomonori Iwasaki
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan.
| | - Hokuto Suga
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - Ayaka Minami-Yanagisawa
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - Makiko Hashiguchi-Sato
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - Hideo Sato
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - Yuushi Yamamoto
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - Yoshito Shirazawa
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | - Toshiya Tsujii
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
| | | | - Youichi Yamasaki
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-City, Japan
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18
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Zhang Y, Wang Y, Zhang Y, Li S, Wang L, Qian Y. Cone-Beam Computed Tomography Evaluation of Skeletal Deformities and Pharyngeal Airway in Chinese Han Individuals With Nonsyndromic Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2019; 57:65-72. [PMID: 31296040 DOI: 10.1177/1055665619860700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: This study examined the relationships between skeletal deformities and the pharyngeal airway of patients with nonsyndromic unilateral cleft lip and palate (UCLP). Design: Retrospective study. Setting: Orthodontics and Oral and Maxillofacial Surgery Departments in the Affiliated Hospital of Stomatology, Nanjing Medical University, China. Patients, Participants: The sample comprised 30 nonsyndromic UCLP patients and 30 healthy controls. Each group has 23 males and 7 females. Interventions: All cone-beam computed tomography images were obtained with the participant in the standard supine position and asked to bite with intercuspal position without swallowing or moving their heads and tongues during scanning. Main Outcome Measure(s): SNA, SNB, ANB, anterior cranial base, Wits appraisal, maxillary length (PTM-ANS || FH), maxillary position (S-PTM || FH), mandibular length (Go-Pog || MP), FMA, posterior face height, anterior face height, Posterior-Anterior face height, lower face height, pharyngeal airway volumes, and areas were evaluated by Dolphin imaging software. Results: The UCLP group showed significantly decreased SNA, SNB, ANB, PTM-ANS || FH, S-PTM || FH, P-A Face Height compared with the controls. However, the airway volumes and areas showed no significant difference between 2 groups. The total airway volume and minimum cross-sectional area in UCLP patients were related to the Go-Pog || MP and FMA. Conclusions: Patients with UCLP have both the maxillary and mandibular deficiencies in the sagittal dimension. Both the sagittal and vertical relationships of the jaw might affect the airway volume and area. However, no significant difference was detected in airway volume and area in UCLP patients when compared with the controls.
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Affiliation(s)
- Yuan Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuhua Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yaoyuan Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Sheng Li
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lin Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yajing Qian
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, China
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Takahashi M, Yamaguchi T, Lee MK, Suzuki Y, Adel M, Tomita D, Nakawaki T, Yoshida H, Hikita Y, Furuhata M, Tsuneoka M, Nagahama R, Marazita ML, Weinberg SM, Maki K. Three-dimensional assessment of the pharyngeal airway in Japanese preschoolers with orofacial clefts. Laryngoscope 2019; 130:533-540. [PMID: 30977521 DOI: 10.1002/lary.27957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 02/15/2019] [Accepted: 03/13/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Individuals with orofacial clefts often experience respiratory problems because of nasopharyngeal abnormalities. Pharyngeal airway morphology is thought to differ among the various cleft types. We measured three-dimensional (3D) airway volume using cone-beam computed tomography (CBCT) analysis to evaluate and compare pharyngeal airways in Japanese preschoolers with and without orofacial clefts. STUDY DESIGN Retrospective case-control study. METHODS We enrolled 83 subjects (37 boys, 46 girls; mean age = 4.66 ± 0.56 years) with nonsyndromic orofacial clefts and 16 noncleft healthy subjects (seven boys, nine girls; mean age = 5.30 ± 0.52 years) as controls. The subjects were divided into five groups. Four groups were based on the cleft type: isolated cleft palate, unilateral cleft lip and alveolus), unilateral cleft lip and palate, and bilateral cleft lip and palate. The fifth group included the noncleft controls. All subjects were examined with CBCT, and the 3D airway volume was measured. We analyzed group differences statistically using analysis of covariance with the Bonferroni post hoc pairwise comparison tests for the corrected means. RESULTS Compared with the noncleft group, each cleft group exhibited significantly decreased total and nasal airway volumes and increased superior and inferior pharyngeal airway volumes. The differences were all statistically significant. CONCLUSIONS Our findings suggest that anatomical differences exist in pharyngeal airway volumes among various cleft groups and in those without a cleft. LEVEL OF EVIDENCE 3b Laryngoscope, 130:533-540, 2020.
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Affiliation(s)
- Masahiro Takahashi
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Tetsutaro Yamaguchi
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Myoung K Lee
- Department of Oral Biology, Center for Craniofacial and Dental Genetics, Pittsburgh, Pennsylvania, U.S.A
| | - Yoko Suzuki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Mohamed Adel
- Department of Orthodontics, Suez Canal University, Ismailia, Egypt
| | - Daisuke Tomita
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Takatoshi Nakawaki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Hiroshi Yoshida
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Yu Hikita
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Mayu Furuhata
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Misato Tsuneoka
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Ryo Nagahama
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Mary L Marazita
- Department of Oral Biology, Center for Craniofacial and Dental Genetics, Pittsburgh, Pennsylvania, U.S.A.,Department of Human Genetics, Graduate School of Public Health, Clinical and Translational Science Institute, Pittsburgh, Pennsylvania, U.S.A.,Department of Human Genetics, Clinical and Translational Science Institute, Pittsburgh, Pennsylvania, U.S.A.,Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
| | - Seth M Weinberg
- Department of Oral Biology, Center for Craniofacial and Dental Genetics, Pittsburgh, Pennsylvania, U.S.A.,Department of Human Genetics, Graduate School of Public Health, Clinical and Translational Science Institute, Pittsburgh, Pennsylvania, U.S.A.,Department of Anthropology, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
| | - Koutaro Maki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
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Akarsu-Guven B, Karakaya J, Ozgur F, Aksu M. Upper airway features of unilateral cleft lip and palate patients in different growth stages. Angle Orthod 2019; 89:575-582. [PMID: 30694706 DOI: 10.2319/022518-155.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To compare growth-related changes of skeletal and upper airway features of unilateral cleft lip and palate subjects (UCLP) with non-cleft control (NCC) subjects by using lateral cephalograms. MATERIALS AND METHODS The sample comprised 238 subjects, collected cross-sectionally, divided into 2 groups: 94 with UCLP, and 144 NCC, subdivided into 4 groups according to their growth stages by using cervical vertebral maturation stage (CVMS). The subgroups were defined as early childhood (stage 1), prepubertal (stage 2: CVMS I and II), pubertal (stage 3: CVMS III and IV), and postpubertal (stage 4: CVMS V and VI). RESULTS The maxilla was more retrognathic at stages 2, 3, and 4 in females with UCLP. The mandible was more retrognathic in UCLP at stage 1 in males, and stages 2 and 3 in females. ANB (angle between NA plane and NB plane) was significantly smaller in UCLP subjects at stage 4 for both sexes. A vertical growth pattern was seen in UCLP subjects except males at stages 2 and 3, and females at stage 2. Posterior airway space was significantly narrower at all stages in males and after stage 1 in females. Middle airway space was significantly wider at all stages in females and after stage 1 in males. Epiglottic airway space was significantly narrower in males at stage 3. CONCLUSIONS Age- and sex-dependent differences in skeletal morphology and upper-airway widths of the UCLP subjects were identified when compared with controls.
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21
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Evaluation of Airway Volume in Cleft Lip and Palate Following Nasoalveolar Molding. J Craniofac Surg 2018; 29:2143-2147. [DOI: 10.1097/scs.0000000000004681] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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22
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Pinheiro ML, Yatabe M, Ioshida M, Orlandi L, Dumast PD, Trindade-Suedam IK. Volumetric reconstruction and determination of minimum crosssectional area of the pharynx in patients with cleft lip and palate: comparison between two different softwares. J Appl Oral Sci 2018; 26:e20170282. [PMID: 30304121 PMCID: PMC6172025 DOI: 10.1590/1678-7757-2017-0282] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 10/27/2017] [Indexed: 11/22/2022] Open
Abstract
Objective: The aim of this study was to assess the accuracy of volumetric reconstruction of the pharynx by comparing the volume and minimum crosssectional area (mCSA) determined with open-source applications (ITK-Snap, www.itksnap.org ; SlicerCMF) and commercial software (Dolphin3D, 11.8, Dolphin Imaging & Management Solutions, Chatsworth, CA, USA) previously validated in the literature. Material and Methods: The sample comprised of 35 cone-beam computed tomography (CBCT) scans of patients with unilateral cleft lip and palate, with mean age of 29±15. Three-dimensional volumetric models of the pharynx were reconstructed using semi-automatic segmentation using the applications ITK-Snap (G1) and Dolphin3D (G2). Volumes and minimum cross-sectional areas were determined. Inter- and intra-observer error were calculated using ICC test. Comparison between applications was calculated using the Wilcoxon test. Results: Volumes and minimum crosssectional area were statistically similar between applications. ITK-Snap showed higher pharynx volumes, but lower mCSA. Visual assessment showed that 62.86% matched the region of mCSA in Dolphin3D and SPHARM-PDM. Conclusion: Measurements of volume and mCSA are statistically similar between applications. Therefore, open-source applications may be a viable option to assess upper airway dimensions using CBCT exams.
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Affiliation(s)
| | - Marília Yatabe
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil; University of Michigan, School of Dentistry, Ann Arbor, United States of America.,Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil; University of Michigan, School of Dentistry, Ann Arbor, United States of America
| | - Marcos Ioshida
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil
| | - Luan Orlandi
- Universidade de São Paulo, Instituto de Ciências Matemáticas e de Computação, São Carlos, São Paulo, Brasil
| | - Priscille de Dumast
- University of Michigan, School of Dentistry, Ann Arbor, United States of America
| | - Ivy Kiemle Trindade-Suedam
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas; Hospital de Reabilitação de Anomalias Craniofaciais, Laboratório de Fisiologia, Bauru, São Paulo, Brasil
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Ertaş Ü, Ataol M. Evaluation of Nasal Airway Volume of Operated Unilateral Cleft Lip and Palate Patients Compared With Skeletal Class III Individuals. Cleft Palate Craniofac J 2018; 56:15-20. [PMID: 29738291 DOI: 10.1177/1055665618774024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cleft lip and palate (CLP) patients have various problems with nasal anatomy beyond just oronasal separation. The alar base, concha, and septum are over impressed in these individuals. Additionally, skeletal class III deformity is seen. These conditions may limit nasal function. In our study, 15 unilateral patients with CLP older than 15 years (10 females, 5 males; mean age: 19.13) who had received surgery were included as the study group, and 15 participants with noncleft skeletal class III deformities were included as the control group (10 females, 5 males; mean age: 19.20). The individuals' nasal airway volumes (total/cleft side/noncleft side/control/ nasal passages) were examined and compared statistically. The results showed that the study group had significantly higher values in terms of total airway volume ( P < .05). Additionally, there were significant differences between the cleft side and noncleft side volumes, between the cleft side volumes and the volumes of the control group participants, and between the noncleft side volumes and the volumes of the control group participants ( P < .05). There was no difference between the groups in terms of nasopharyngeal ( P = .39) and nasal passage volumes ( P = .73). The results show there are some problems regarding nasal airway volume in patients with CLP, even when lip, palate, and alveolar cleft operations have been performed. The aim of this study was to evaluate differentiation of nasal airway volumes between unilateral patients with CLP and individuals with noncleft skeletal class III serving as the control group.
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Affiliation(s)
- Ümit Ertaş
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Mert Ataol
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
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Demirtas O, Kalabalik F, Dane A, Aktan AM, Ciftci E, Tarim E. Does Unilateral Cleft Lip and Palate Affect the Maxillary Sinus Volume? Cleft Palate Craniofac J 2017; 55:168-172. [PMID: 29351024 DOI: 10.1177/1055665617726991] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The purposes of this study were to evaluate and compare the maxillary sinus volume (MSV) of patients with a unilateral cleft lip and palate (UCLP) between the cleft side and noncleft side and between adolescent patients with UCLP and a control (noncleft) group using cone beam computed tomography (CBCT). METHODS CBCT images of 44 UCLP patients (29 males and 15 females, with a mean [SD] age of 13.5 [5.0] years) and 44 (22 males and 22 females, with a mean [SD] age 14.9 [4.2] years) age- and sex-matched controls were evaluated in this study. Each maxillary sinus was assessed 3-dimensionally, segmented, and its volume was calculated. RESULTS There were no statistically significant differences between the age and gender distributions of the groups. There was a statistically significant difference in the MSVs of the cleft (10996.78±3522.89 mm3) versus the noncleft side (10382.3±3416.2 mm3; P < .05)] but no significant difference between the MSVs of the right and left sides ( P > .05). In the intergroup comparison, the mean MSVs of the UCLP patients (10701.52±3369.33 mm3) were significantly smaller than those of the control group (16054.08 ± 5293.96 mm3; P < .001). CONCLUSIONS The MSVs of the UCLP patients showed a statistically significant decrease compared to those of the controls ( P < .001). There was also a significant difference in the MSVs of the cleft and noncleft sides of the UCLP patients ( P < .05).
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Affiliation(s)
- Omer Demirtas
- 1 Department of Dentomaxillofacial Radiology, İzmir Katip Çelebi University, İzmir, Turkey
| | - Fahrettin Kalabalik
- 1 Department of Dentomaxillofacial Radiology, İzmir Katip Çelebi University, İzmir, Turkey
| | - Asim Dane
- 2 Department of Pediatric Dentistry, Faculty of Dentistry, İzmir Katip Çelebi University, İzmir, Turkey
| | - Ali Murat Aktan
- 3 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
| | - Ertugrul Ciftci
- 4 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Elif Tarim
- 1 Department of Dentomaxillofacial Radiology, İzmir Katip Çelebi University, İzmir, Turkey
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Celikoglu M, Buyuk SK, Hatipoglu M, Sekerci AE, Ciftci ME. Evaluation of dehiscence and fenestration in adolescents affected by bilateral cleft lip and palate using cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2017; 152:458-464. [DOI: 10.1016/j.ajodo.2017.01.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 01/01/2017] [Accepted: 01/01/2017] [Indexed: 11/17/2022]
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Karia H, Shrivastav S, Karia AK. Three-dimensional evaluation of the airway spaces in patients with and without cleft lip and palate: A digital volume tomographic study. Am J Orthod Dentofacial Orthop 2017; 152:371-381. [DOI: 10.1016/j.ajodo.2016.12.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 10/19/2022]
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Ivy Kiemle TS, Thiago FL, Letícia DC, Renato Yassutaka FY, Hugo Nary F, Inge Elly KT. Tomographic Pharyngeal Dimensions in Individuals with Unilateral Cleft Lip/Palate and Class III Malocclusion are Reduced When Compared with Controls. Cleft Palate Craniofac J 2017; 54:502-508. [DOI: 10.1597/15-124] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective The objective of this study was to three-dimensionally evaluate the pharyngeal dimensions of individuals with complete nonsyndromic unilateral cleft lip and palate (UCLP) using cone beam computed tomography. Design This was a cross-sectional prospective study. Setting The study took place at the Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil. Patients and Participants The control group (CON) consisted of 23 noncleft adults with class III malocclusion, and the cleft group (UCLP) consisted of 22 individuals with UCLP and class III malocclusion. Two subgroups of individuals with class III malocclusion as a result of maxillary retrusion with (UCLP'; n = 19) and without (CON'; n = 8) clefts were also assessed. Interventions Pharyngeal volume, pharyngeal minimal cross-sectional area (CSA), location of CSA, pharyngeal length, sella-nasion-A point angle (SNA), sella-nasion-B point angle (SNB), and A point-nasion-B point angle (ANB), and body mass index were assessed using Dolphin software. Main Outcome Measure The pharyngeal dimensions of UCLP individuals are smaller when compared with controls. Results Mean pharyngeal volume (standard deviation) for the UCLP patients (20.8 [3.9] cm3) and the UCLP’ patients (20.3 [3.9] cm3) were significantly decreased when compared with the CON (28.2 [10.0] cm3) and CON’ patients (29.1 [10.2] cm3), respectively. No differences were found in the pharyngeal minimal CSA, ANB, or pharyngeal length values between groups (CON versus UCLP and CON’ versus UCLP'). CSAs were located mostly at the oropharynx, except in the UCLP’ patients, which were mainly at the hypopharynx. Mean SNA in the UCLP (76.4° [4.6°]) and UCLP’ groups (75.1 [3.1°]) were significantly smaller than those in the CON (82.8° [4.1°]) and CON’ groups (78.6° [1.2°]). SNB values were statistically smaller only for the comparison of CON versus UCLP patients. Conclusion The pharynx of individuals with UCLP and class III malocclusion is volumetrically smaller than that of individuals with class III malocclusion and no clefts.
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Affiliation(s)
- Trindade-Suedam Ivy Kiemle
- Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Freire Lima Thiago
- Oral and Maxillofacial Surgeon, Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Dominguez Campos Letícia
- Physical Therapist and PhD student, Postgraduate Program in Rehabilitation Science, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Faria Yaedú Renato Yassutaka
- Department of Stomatology, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Filho Hugo Nary
- Oral and Maxillofacial Surgeon, Brånemark Institute Bauru, Professor, University of Sacred Heart, Bauru, SP, Brazil
| | - Kiemle Trindade Inge Elly
- Full Professor, Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
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Al-Fahdawi MA, Farid MM, El-Fotouh MA, El-Kassaby MA. Cone-Beam Computed Tomography Analysis of the Nasopharyngeal Airway in Nonsyndromic Cleft Lip and Palate Subjects. Cleft Palate Craniofac J 2017; 54:202-209. [DOI: 10.1597/15-134] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objective To assess the nasopharyngeal airway volume, cross-sectional area, and depth in previously repaired nonsyndromic unilateral cleft lip and palate versus bilateral cleft lip and palate patients compared with noncleft controls using cone-beam computed tomography with the ultimate goal of finding whether cleft lip and palate patients are more liable to nasopharyngeal airway obstruction. Design A retrospective analysis comparing bilateral cleft lip and palate, unilateral cleft lip and palate, and control subjects. Significance at P ≤ .05. Setting Cleft Care Center and the outpatient clinic that are both affiliated with our faculty. Participants Cone-beam computed tomography data were selected of 58 individuals aged 9 to 12 years: 14 with bilateral cleft lip and palate and 20 with unilateral cleft lip and palate as well as 24 age- and gender-matched noncleft controls. Variables Volume, depth, and cross-sectional area of nasopharyngeal airway were measured. Results Patients with bilateral cleft lip and palate showed significantly larger nasopharyngeal airway volume than controls and patients with unilateral cleft lip and palate ( P < .001). Patients with bilateral cleft lip and palate showed significantly larger cross-sectional area than those with unilateral cleft lip and palate ( P < .001) and insignificant cross-sectional area compared with controls ( P > .05). Patients with bilateral cleft lip and palate showed significantly larger depth than controls and those with unilateral cleft lip and palate ( P < .001). Patients with unilateral cleft lip and palate showed insignificant nasopharyngeal airway volume, cross-sectional area, and depth compared with controls ( P > .05). Conclusions Unilateral and bilateral cleft lip and palate patients did not show significantly less volume, cross-sectional area, or depth of nasopharyngeal airway than controls. From the results of this study we conclude that unilateral and bilateral cleft lip and palate patients at the studied age and stage of repaired clefts are not more prone to nasopharyngeal airway obstruction than controls.
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Affiliation(s)
| | - Mary Medhat Farid
- Department of Oral Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Mona Abou El-Fotouh
- Department of Oral Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Marwa Abdelwahab El-Kassaby
- Cleft Care Center, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Celikoglu M, Buyukcavus MH. Changes in pharyngeal airway dimensions and hyoid bone position after maxillary protraction with different alternate rapid maxillary expansion and construction protocols: A prospective clinical study. Angle Orthod 2017; 87:519-525. [PMID: 28139938 DOI: 10.2319/082316-632.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the changes in pharyngeal airway dimensions and the position of the hyoid bone after maxillary protraction with different alternate rapid maxillary expansion and construction (Alt-RAMEC) protocols in patients with skeletal class III malocclusion as a result of maxillary retrusion. MATERIAL AND METHODS The patients with skeletal class III malocclusions were consecutively divided into two groups. Group 1 consisted of 17 patients (11 boys and 6 girls, mean age 11.31 ± 1.71 years) who had the Alt-RAMEC protocol for 5 weeks, and group 2 consisted of 17 patients (10 boys and 7 girls, mean age 11.64 ± 1.24 years) who had the Alt-RAMEC procedure for 9 weeks. In this study, 4 angular and 13 linear measurements were performed to evaluate the skeletal and pharyngeal airway changes that occurred after maxillary protraction. RESULTS A significant increase in the maxillary growth, inhabitation of mandibular growth, and clockwise rotation of the mandible caused the improvement of the maxillo-mandibular relationship in both groups. Those changes caused a significant increase in the upper pharyngeal airway dimension (P < .01) and affected the vertical position of the hyoid bone in both groups (P < .05 and P < .01, respectively). However, changes that occurred in both groups were found to be similar for all airway variables (P > .05). CONCLUSION Upper pharyngeal dimension and vertical position of the hyoid bone were affected by the maxillary protraction with different Alt-RAMEC protocols. There were no statistically significant differences between the groups.
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Celikoglu M, Buyuk SK, Ekizer A, Unal T. Pharyngeal airway effects of Herbst and skeletal anchored Forsus FRD EZ appliances. Int J Pediatr Otorhinolaryngol 2016; 90:23-28. [PMID: 27729139 DOI: 10.1016/j.ijporl.2016.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 08/25/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate the skeletal and pharyngeal airway effects of skeletal anchored Forsus FRD EZ appliance using bilateral miniplates inserted on mandibular symphyses and to compare the findings with a well matched control group treated using a Herbst appliance. METHODS Thirty patients with skeletal Class II malocclusion due to mandibular retrusion were divided into two groups. Group 1 consisted of 15 patients (8 females and 7 males; mean age: 13.11 ± 1.29 years) treated using the Herbst appliance and Group 2 consisted of 15 patients (9 females and 7 males; 12.84 ± 1.27 years) treated using the skeletal anchored Forsus FRD EZ appliance. Treatment changes were assessed by means of linear, angular, and area measurements. RESULTS The groups were well matched regarding to the chronological ages, gender distribution and initial cephalometric values (P > 0.05). In both groups, skeletal Class II malocclusion was corrected by decrease in SNA and increase in SNB, Co-Gn, VRL-B and VRL-Pog measurements. Those changes caused a significant correction in the maxillo-mandibular relationship. Upper and lower pharyngeal airway dimensions were increased in both group, while the increase in the lower pharyngeal dimension was found to be statistically significant in the skeletal anchored Forsus FRD EZ group (P < 0.05). Oropharyngeal area measurements significantly increased in both groups (P < 0.001 and P < 0.01, respectively). Comparison of the groups showed that both groups had similar changes with no statistically significant differences (P > 0.05). CONCLUSION Skeletal changes produced by both appliances caused significant pharyngeal airway changes.
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Affiliation(s)
- Mevlut Celikoglu
- Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
| | | | - Abdullah Ekizer
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Tuba Unal
- Privite Practice, İskenderun, Hatay, Turkey
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Uçar FI, Buyuk SK, Şekerci AE, Celikoglu M. Evaluation of temporomandibular fossa and mandibular condyle in adolescent patients affected by bilateral cleft lip and palate using cone beam computed tomography. SCANNING 2016; 38:720-726. [PMID: 27103610 DOI: 10.1002/sca.21320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 03/31/2016] [Indexed: 06/05/2023]
Abstract
The purposes of this study were to investigate the position of the mandibular condyle and temporomandibular fossa between the adolescent patients affected by bilateral cleft lip and palate (BCLP) and well-matched controls without any cleft by using cone-beam computed tomography (CBCT). The study sample consisted of 17 patients (7 females and 10 males; mean age, 14.27 ± 2.83 years) affected by BCLP and 17 patients (6 females and 11 males; mean age, 14.27 ± 2.12 years) as age-and sex-matched control group without any cleft. Using cone-beam computed tomography segmented three-dimensional temporomandibular fossa and mandibular condyle images were reconstructed and angular, linear, and volumetric measurements of the patients in both sides of the groups were examined using Paired and Student's t-tests. Comparison of the sides showed that both sides were found to be similar in BCLP and control groups, except the condylar angulation of the right side was found to be higher compared to that of the left side in both groups (p < 0.05). Comparison of the groups showed that the patients affected by BCLP and non-cleft patients had similar values for all parameters, except for the condylar angulation in the right side (BCLP group had less angulation compared to controls; p < 0.05). The condylar volume was found to be slightly less in the BCLP group in both sides compared to the controls (p > 0.05). The positions of the mandibular condyle and temporomandibular fossa were found to be similar in patients affected by BCLP and control group of without any cleft. SCANNING 38:720-726, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Faruk Izzet Uçar
- Faculty of Dentistry, Department of Orthodontics, Selcuk University, Konya, Turkey
| | | | - Ahmet Ercan Şekerci
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Erciyes University, Kayseri, Turkey
| | - Mevlut Celikoglu
- Faculty of Dentistry, Department of Orthodontics, Akdeniz University, Antalya, Turkey
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Evaluation of the Transverse Craniofacial Morphology of Adolescents With Repaired Unilateral Cleft Lip and Palate Using Cone-Beam Computed Tomography. J Craniofac Surg 2016; 27:1870-1874. [DOI: 10.1097/scs.0000000000003065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Patini R, Arrica M, Di Stasio E, Gallenzi P, Cordaro M. The use of magnetic resonance imaging in the evaluation of upper airway structures in paediatric obstructive sleep apnoea syndrome: a systematic review and meta-analysis. Dentomaxillofac Radiol 2016; 45:20160136. [PMID: 27440304 PMCID: PMC5606260 DOI: 10.1259/dmfr.20160136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/19/2016] [Accepted: 07/18/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES A systematic review was conducted to assess the effectiveness of MRI in evaluating upper airway structures in children affected by obstructive sleep apnoea syndrome (OSAS). METHODS A literature search was performed in the Cochrane Central Register of Controlled Trials, Web of Science, Scopus and PubMed databases from their inception to 31/03/2016, including available randomized controlled trials and controlled clinical trials published in English assessing the use of MRI integrated with traditional polysomnography (PSG) among children up to 15 years of age affected by OSAS. The primary outcome to be evaluated was the efficacy of MRI in analyzing the upper airway total volume among healthy children compared with children affected by OSAS. Secondary outcomes were to compare the efficacy of MRI in analyzing the upper airway cross-sectional area in the areas adjacent to the adenoids and tonsils, adenoid and tonsil volume, and soft-tissue and maxillofacial bone parameters in the same sample. Results were expressed using a random-effects model and mean differences (MD) with 95% confidence intervals (CI). RESULTS The search yielded 1005 titles in total; the selection process narrowed to 3 titles, which were all assessed as indicating an unclear level of risk of bias. The meta-analysis found evidence of MRI effectiveness in evaluating differences in the upper airway total volume between paediatric patients affected by OSAS and paediatric patients not affected by OSAS (MD -0.56 cm(3); 95% CI: -1.05 to -0.07). CONCLUSIONS Although MRI could be considered effective in evaluating upper airway structures in children affected by OSAS, based on the present evidence, PSG is still the golden standard and further studies are required to verify MRI reliability.
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Affiliation(s)
- Romeo Patini
- Dentistry Unit of Head and Neck
Clinical Area, School of Dentistry, Catholic University of Sacred Heart,
Rome, Italy
| | - Mariantonietta Arrica
- Department of Surgery,
Microsurgery and Medical Sciences, School of Dentistry, University of
Sassari, Sassari, Italy
| | - Enrico Di Stasio
- Molecular Clinical Biology Unit
of Laboratory Medicine Clinical Area, Catholic University of Sacred Heart,
Rome, Italy
| | - Patrizia Gallenzi
- Dentistry Unit of Head and Neck
Clinical Area, School of Dentistry, Catholic University of Sacred Heart,
Rome, Italy
| | - Massimo Cordaro
- Dentistry Unit of Head and Neck
Clinical Area, School of Dentistry, Catholic University of Sacred Heart,
Rome, Italy
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Al-Fahdawi MA, El-Kassaby MA, Farid MM, El-Fotouh MA. Cone Beam Computed Tomography Analysis of Oropharyngeal Airway in Preadolescent Nonsyndromic Bilateral and Unilateral Cleft Lip and Palate Patients. Cleft Palate Craniofac J 2016; 55:883-890. [PMID: 27427930 DOI: 10.1597/15-322] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of this study was to assess the volume, area, and dimensions of the oropharyngeal airway (OPA) in a previously repaired nonsyndromic unilateral cleft lip and palate (UCLP) versus bilateral cleft lip and palate (BCLP) patients when compared with noncleft controls using cone beam computed tomography (CBCT). DESIGN This was a retrospective case-control study. SETTING The Cleft Care Center and outpatient clinic that are affiliated to our faculty were the settings for the study. PARTICIPANTS A total of 58 CBCT scans were selected of preadolescent individuals: 14 BCLP, 20 UCLP, and 24 age- and gender-matched noncleft controls. VARIABLES Variables were volume, cross-sectional area (CSA), midsagittal area (MSA), and dimensions of OPA. STATISTICAL ANALYSIS One-way analysis of variance and post hoc tests were used to compare variables. Statistical significance was set at P ≤ .05. RESULTS UCLP showed significantly smaller superior oropharyngeal airway volume than both controls and BCLP ( P ≤ .05). BCLP showed significantly larger CSA at soft palate plane and significantly larger MSA than both UCLP and controls ( P < .05). CONCLUSIONS UCLP patients at the studied age and stage of previously repaired clefts have significantly less superior oropharyngeal airway volume than both controls and BCLP patients. This confirms that preadolescents with UCLP are at greater risk for superior oropharyngeal airway obstruction when compared with those BCLP and controls. Furthermore, BCLP patients showed significantly larger CSA at soft palate plane and MSA than both controls and UCLP patients. These variations in OPA characteristics of cleft patients can influence function in terms of respiration and vocalization.
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Celik S, Celikoglu M, Buyuk SK, Sekerci AE. Mandibular vertical asymmetry in adult orthodontic patients with different vertical growth patterns: A cone beam computed tomography study. Angle Orthod 2016; 86:271-277. [PMID: 26065465 PMCID: PMC8603629 DOI: 10.2319/030515-135.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 05/01/2015] [Indexed: 11/11/2023] Open
Abstract
OBJECTIVE To evaluate condylar and ramal vertical asymmetry in adult orthodontic patients with different vertical growth patterns and a clinically normal sagittal skeletal pattern using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The study sample consisted of 101 adult orthodontic patients (48 men and 53 women) divided into three groups according to their vertical growth patterns: high- (33 patients; mean age, 25.06 ± 6.05 years), low- (34 patients; mean age, 24.88 ± 5.22 years), and normal-angle (34 patients; mean age, 24.14 ± 4.26 years) groups. Condylar, ramal, condylar plus ramal height, and index measurements were performed using CBCT images and analyzed using one-way analysis of variance and post hoc Tukey tests. RESULTS There was no statistically significant difference in height measurements between right and left sides in each group, except a slight difference of approximately 0.5 mm for condylar height (CH) in the low-angle group (P < .05). No statistically significant gender differences were found for the values (P > .05). In the high-angle group, the ramal height (RH) and condylar plus ramal height (CH + RH) on both sides were found to be less than those of the low- (P < .001) and normal-angle groups (P < .017 and P > .017, respectively), and the asymmetry index values were slightly higher than those of the low- and normal-angle groups (P > .05). CONCLUSIONS The high-angle group showed statistically significantly smaller values of RH and CH + RH on both sides and statistically insignificantly higher asymmetry index values than the low- and normal-angle groups.
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Affiliation(s)
- Salih Celik
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Mevlut Celikoglu
- Associate Professor, Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Suleyman K. Buyuk
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - A. Ercan Sekerci
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Evaluation of the mandibular volume and correlating variables in patients affected by unilateral and bilateral cleft lip and palate: a cone-beam computed tomography study. Clin Oral Investig 2015; 20:1741-6. [PMID: 26556574 DOI: 10.1007/s00784-015-1651-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 11/03/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aims of the present study were to evaluate the mandibular volume in patients affected by unilateral (UCLP) and bilateral cleft lip and palate (BCLP) and to compare the findings with a well-matched normal occlusion sample without cleft. MATERIALS AND METHODS The study sample consisted of 66 patients divided into UCLP (24 patients; mean age, 14.46 ± 3.24 years), BCLP (17 patients; mean age, 14.28 ± 2.85 years), and control (25 patients; mean age, 14.40 ± 2.81 years) groups. The volume of the mandible including the condyle and the roots of the teeth and craniofacial measurements were performed using cone-beam computed tomography and analyzed using the one-way variance analysis and post hoc Tukey's tests. Regression analyses were used to evaluate the relationships of the measurements and the mandibular volume. RESULTS Patients affected by UCLP and BCLP had similar craniofacial features (p > 0.05), including decreased SNB, Co-A, Co-Gn, Co-Go, and Go-Gn and increased ANB and SN-MP measurements compared to the control group. Both UCLP and BCLP groups had decreased values of mandibular volume compared to the normal occlusion group, while these differences were found to be statistically insignificant (p > 0.05). Co-Go (Beta = 0.420; p = 0.014) and Co-Gn variables (Beta = 0.708; p = 0.045) were positively correlated with mandibular volume, while SNB (Beta = -0.669; p = 0.044) and SN-MP (Beta = -0.358; p = 0.049) variables were negatively correlated (R (2) = 60.3 and p = 0.000). CONCLUSION Mandibular volume insignificantly differs in cleft patients (p > 0.05), and the variables of Co-Go, Co-Gn, SNB, and SN-MP significantly correlate with the volume. CLINICAL RELEVANCE This article investigates mandibular volume in patients affected by UCLP and BCLP that has never been investigated in the literature. The present study showed that both UCLP and BCLP groups had insignificantly decreased values of mandibular volume compared to the normal occlusion group.
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Overview of orthodontic care for children with cleft lip and palate, 1915-2015. Am J Orthod Dentofacial Orthop 2015; 148:543-56. [DOI: 10.1016/j.ajodo.2015.07.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 11/19/2022]
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Erdur O, Ucar FI, Sekerci AE, Celikoglu M, Buyuk SK. Maxillary sinus volumes of patients with unilateral cleft lip and palate. Int J Pediatr Otorhinolaryngol 2015; 79:1741-4. [PMID: 26292906 DOI: 10.1016/j.ijporl.2015.08.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 07/31/2015] [Accepted: 08/02/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Studies about maxillary sinuses of cleft lip-palate patients have increased since sinusitis is commonly observed in these patients. It is evident that maxillary sinus will be morphologically affected in these patients. And anatomic differences may be a cause or at least a contributor of sinusitis. The aim of this study was to compare maxillary sinus volumes of the non-syndromic patients with unilateral cleft lip-palate and control group by using Cone-Beam computed tomography. METHODS Tomography scans of 44 unilateral cleft lip-palate patients (18 right and 26 left) with age and gender matched 45 control patients were evaluated for the study. The images used in the study were part of the diagnostic records collected due to dental treatment needs. All tomographs were obtained in supine position by using Cone-Beam computed tomography (NewTom 5G, QR, Verona, Italy). The patient-specific Hounsfield values were set to include the largest amount of voxels in the sinuses volume calculation individually. All data were measured in mm(3). RESULTS There was no statistically difference between the gender and age distributions of the groups. No statistically significant difference was found on the cleft and non-cleft side, the right and left side of the unilateral cleft lip-palate patients and the control group (P>0.05). For the inter group comparison, mean maxillary sinus volumes volume of unilateral cleft lip-palate patients (9894.55±4171.44mm(3)) was statistically smaller than the control group (11,977.90±4484.93mm(3)) (P<0.05). CONCLUSION Maxillary sinus volumes were effected negatively in unilateral cleft lip-palate patients when compared with the healthy control group. No difference was found on the cleft, non-cleft side and the right-left side of the unilateral cleft lip-palate patients.
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Affiliation(s)
- Omer Erdur
- Selcuk University, Faculty of Medicine, Department of Otolaryngology, Konya, Turkey.
| | - Faruk Izzet Ucar
- Selcuk University, Faculty of Dentistry, Department of Orthodontics, Konya, Turkey
| | - Ahmet Ercan Sekerci
- Erciyes University, Faculty of Dentistry, Department of Oral Diagnosis, Kayseri, Turkey
| | - Mevlut Celikoglu
- Akdeniz University, Faculty of Dentistry, Department of Orthodontics, Antalya, Turkey
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Introduction of "Papazian Pusher: " A Modified-Design Knot Pusher for Surgical Repair of Cleft Palates. J Craniofac Surg 2015; 26:1975-6. [PMID: 26355980 DOI: 10.1097/scs.0000000000001926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Tying sutures is an integral aspect of any surgery and reliable instruments are essential for hassle-free procedures including craniofacial surgeries. Knot pushers have been widely known for their application in various laparoscopic, arthroscopic, and anal surgeries. The literature reveals numerous articles pertaining to knot pushers, as well as improvements on existing designs. Nevertheless, no application of knot pushers in the surgical repair of cleft palates has been described. We describe a new knot pusher "Papazian Pusher" (PP) finely designed for application in oral surgeries in general and repair of cleft palates in particular. The instrument was used satisfactorily in repair of cleft palate surgeries and no complications were encountered. The PP was found, overall, to be easy to use, and helps in performing faster, stronger, smooth, and secure knots.
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Buyuk SK, Ercan E, Celikoglu M, Sekerci AE, Hatipoglu M. Evaluation of dehiscence and fenestration in adolescent patients affected by unilateral cleft lip and palate: A retrospective cone beam computed tomography study. Angle Orthod 2015; 86:431-6. [PMID: 26284755 DOI: 10.2319/042715-289.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the presence of dehiscence and fenestration defects around anterior teeth in the cleft region and to compare these findings with the noncleft side in the same patients using cone beam computed tomography (CBCT). MATERIALS AND METHODS CBCT scans of 44 patients (26 males, 18 females; mean age, 14.04 ± 3.81 years) with unilateral cleft lip and palate (UCLP) were assessed to define dehiscences and fenestrations of the anterior teeth in both cleft and noncleft sides of the UCLP patients and a control group of noncleft patients (51 patients; 21 males, 30 females; mean age, 14.52 ± 1.16 years). Data were analyzed using Pearson's χ(2) and Student's t-test. RESULTS The prevalence of dehiscences at the maxillary central incisors, lateral incisors, and canines teeth were 43.2%, 70.6%, and 34.1% on the cleft side and 22.7%, 53.1%, and 27.3% on the noncleft side of UCLP patients, and 13.7%, 7.8%, and 13.7% in controls, respectively (statistically no difference between the sides of cleft patients). The cleft patients had a statistically significantly higher prevalence of dehiscences than did the controls on both the cleft and noncleft sides (P < .05), except for the maxillary central incisors. Fenestrations for these teeth were significantly more common on the cleft side in UCLP patients compared with controls (P < .05), whereas the difference for maxillary lateral incisors was not statistically significant. CONCLUSIONS Patients with UCLP showed a higher prevalence of dehiscence and fenestration defects around the maxillary anterior teeth.
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Affiliation(s)
- Suleyman Kutalmis Buyuk
- a Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - Esra Ercan
- b Assistant Professor, Department of Periodontology, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Mevlut Celikoglu
- c Associate Professor, Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Ahmet Ercan Sekerci
- d Assistant Professor, Department of Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Mukerrem Hatipoglu
- e Assistant Professor, Department of Periodontology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Ercan E, Celikoglu M, Buyuk SK, Sekerci AE. Assessment of the alveolar bone support of patients with unilateral cleft lip and palate: a cone-beam computed tomography study. Angle Orthod 2015; 85:1003-8. [PMID: 25650761 DOI: 10.2319/092614-691.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the bone support of the teeth adjacent to a cleft using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT scans of 31 patients with unilateral cleft lip and palate (UCLP) were assessed. The data for teeth neighboring the cleft were compared with those of contralateral noncleft teeth. For each tooth analyzed, the distance between the cementoenamel junction (CEJ) and the bone crest (AC) at the buccal side was measured as was the thickness of the buccal bone level at 0, 1, 2, and 4 mm. RESULTS The bone thicknesses of the central teeth at the cleft region at the crest and 2 mm apically were statistically significantly thinner than that of the central incisor at a noncleft region. The CEJ-AC distance for central teeth at the cleft region was higher than that for central teeth in a noncleft region. CONCLUSIONS Subjects with UCLP showed reduced bone support at teeth neighboring the cleft compared with controls. This may cause some problems during orthodontic treatment.
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Affiliation(s)
- Esra Ercan
- a Assistant Professor, Department of Periodontology, Karadeniz Technical University, Trabzon, Turkey
| | - Mevlut Celikoglu
- b Associate Professor, Department of Orthodontics, Akdeniz University, Antalya, Turkey
| | | | - Ahmet Ercan Sekerci
- d Assistant Professor, Department of Oral and Maxillofacial Radiology, Erciyes University, Kayseri, Turkey
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Suter VGA, Warnakulasuriya S, Reichart PA, Bornstein MM. Radiographic volume analysis as a novel tool to determine nasopalatine duct cyst dimensions and its association with presenting symptoms and postoperative complications. Clin Oral Investig 2015; 19:1611-8. [PMID: 25579059 DOI: 10.1007/s00784-014-1391-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 12/18/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The aims of the study were to use cone beam computed tomography (CBCT) images of nasopalatine duct cysts (NPDC) and to calculate the diameter, surface area, and 3D-volume using a custom-made software program. Furthermore, any associations of dimensions of NPDC with age, gender, presence/absence of maxillary incisors/canines (MI/MC), endodontic treatment of MI/MC, presenting symptoms, and postoperative complications were evaluated. MATERIAL AND METHODS The study comprised 40 patients with a histopathologically confirmed NPDC. On preoperative CBCT scans, curves delineating the cystic borders were drawn in all planes and the widest diameter (in millimeter), surface area (in square millimeter), and volume (in cubic millimeter) were calculated. RESULTS The overall mean cyst diameter was 15 mm (range 7-47 mm), the mean cyst surface area 566 mm(2) (84-4,516 mm(2)), and the mean cyst volume 1,735 mm(3) (65-25,350 mm(3)). For 22 randomly allocated cases, a second measurement resulted in a mean absolute aberration of ±4.2 % for the volume, ±2.8 % for the surface, and ±4.9 % for the diameter. A statistically significant association was found for the CBCT determined cyst measurements and the need for preoperative endodontic treatment to MI/MC and for postoperative complications. CONCLUSION In the hands of a single experienced operator, the novel software exhibited high repeatability for measurements of cyst dimensions. Further studies are needed to assess the application of this tool for dimensional analysis of different jaw cysts and lesions including treatment planning. CLINICAL RELEVANCE Accurate radiographic information of the bone volume lost (osteolysis) due to expansion of a cystic lesion in three dimensions could help in personalized treatment planning.
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Affiliation(s)
- Valerie G A Suter
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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Celikoglu M, Buyuk SK, Sekerci AE, Ersoz M, Celik S, Sisman Y. Facial soft-tissue thickness in patients affected by bilateral cleft lip and palate: a retrospective cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2014; 146:573-8. [PMID: 25439207 DOI: 10.1016/j.ajodo.2014.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 07/01/2014] [Accepted: 07/01/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The purposes of this study were to evaluate the facial soft-tissue thicknesses and craniofacial morphologies of patients affected by bilateral cleft lip and palate (BCLP) and to compare the findings with a well-matched control group without any clefts using cone-beam computed tomography. METHODS The study sample consisted of 40 retrospectively and randomly selected patients divided into 2 groups: a BCLP group (20 patients; mean age, 13.78 ± 3.20 years) and an age- and sex-matched control group without clefts (20 patients; mean age, 13.94 ± 2.52 years). Craniofacial and facial soft-tissue thickness measurements were made with cone-beam computed tomography. The Student t test and multiple linear regression analyses were performed for the statistical evaluations. RESULTS The BCLP group had an increased SN-MP angle (P = 0.003), a decreased Co-A (P = 0.000), and retruded maxillary (P = 0.000) and mandibular (P = 0.026) incisors. In addition, patients affected by BCLP had statistically significantly decreased thickness measurements for the variables subnasale (P = 0.005) and labrale superior (P = 0.026) compared with the controls. The most predictive variables were found at U1-SN (r = 0.417, P = 0.004), IMPA (r = 0.368, P = 0.010), and ANB (r = -0.297, P = 0.031) for subnasale and U1-SN (r = 0.284, P = 0.038) for labrale superior. CONCLUSIONS The BCLP group showed greater vertical growth, greater retrusion of the maxilla and the maxillary and mandibular incisors, and decreased subnasale and labrale superior thicknesses compared with the well-matched controls without clefts. These differences should be taken into account when planning orthodontic and orthognathic surgery treatment for those patients.
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Affiliation(s)
- Mevlut Celikoglu
- Associate professor, Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
| | - Suleyman K Buyuk
- Research assistant, Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ahmet E Sekerci
- Assistant professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Mustafa Ersoz
- Assistant professor, Department of Orthodontics, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Salih Celik
- Assistant professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Yildiray Sisman
- Associate professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Celikoglu M, Buyuk SK, Ekizer A, Sekerci AE. Evaluation of mandibular transverse widths in patients affected by unilateral and bilateral cleft lip and palate using cone beam computed tomography. Angle Orthod 2014; 85:611-5. [PMID: 25230812 DOI: 10.2319/061614-438.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the mandibular dental, alveolar, and skeletal transversal widths in patients affected by unilateral (UCLP) and bilateral (BCLP) cleft lip and palate and to compare the findings with a well-matched normal occlusion sample using cone beam computed tomography images. MATERIALS AND METHODS The study sample consisted of 75 patients divided into three groups: the UCLP (29 patients; mean age: 15.40 ± 3.22 years), BCLP (18 patients; mean age: 15.54 ± 3.72 years), and normal occlusion (28 patients; mean age: 15.82 ± 2.11 years) groups. Mandibular dental (intercanine and -molar), alveolar (intercanine and -molar), and skeletal (bigonial width) transversal measurements were performed three-dimensionally and analyzed using the one-way variance analysis and post hoc Tukey tests. RESULTS Patients affected by UCLP and BCLP had statistically significantly lower intercanine alveolar widths (P < .05 and P < .001, respectively) and larger intermolar (P < .001 and P < .05, respectively) and intermolar alveolar widths (P < .001) compared with the normal occlusion group. Furthermore, the patients affected by UCLP and BCLP had similar mandibular dental, alveolar, and skeletal transversal widths (P > .05). CONCLUSION The UCLP and BCLP groups showed statistically significantly smaller values for intercanine alveolar widths and larger values for intermolar dental and alveolar widths compared with the normal occlusion group. This shows the importance of using individualized archwires according to the pretreatment arch widths of the patients affected by UCLP and/or BCLP.
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Affiliation(s)
- Mevlut Celikoglu
- a Associate Professor, Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Suleyman K Buyuk
- b Research Assistant, Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Abdullah Ekizer
- c Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ahmet E Sekerci
- d Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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