Evaluation of lip force in patients with unilateral and bilateral cleft lip

Evaluation of oral function using a composite sensor during maximum lip closure and swallowing in normal children and adults

BACKGROUND

There is growing interest in the development of objective methods for assessing lip-closing function in children.

OBJECTIVE

To obtain normative data for healthy children in the developmental stages of lip closure function, we quantitatively evaluated oral movements associated with lip closure in children and adults using a composite sensor (CS).

METHODS

Twenty-five normal children (11 boys, 14 girls) aged 8.8 ± 1.6 years and 25 young adults (13 men, 12 women) aged 27.4 ± 3.9 years were asked to perform test movements, maximal lip closure and swallowing of 3 mL of water. Lip-closing pressure (LP), intraoral baro-pressure (IP) and electromyographic (EMG) activity of the upper orbicularis oris muscle were simultaneously recorded using the CS.

RESULTS

EMG activity of the upper orbicularis oris muscle during closure was significantly greater in adults than in children. There were significant positive correlations between integral values of LP and EMG for closure in adults (r = .527, p = .008) but not in children, and significant positive correlations between integral values of LP and IP for swallowing in children (r = .508, p = .010) but not in adults.

CONCLUSIONS

The CS may provide an effective tool for evaluating lip function in children acquiring oral function. For the combination of maxillary orbicularis oculus contraction and formation of intraoral negative pressure, EMG activity of the upper orbicularis oris muscle involvement in LP and IP involvement in LP may differ between children and adults.

Changes in maximum lip-closing force after extraction and nonextraction orthodontic treatments

Objective

The aims of the present study were to evaluate the changes in the maximum lip-closing force (MLF) after orthodontic treatment with or without premolar extractions and verify the correlation of these changes with dentoskeletal changes.

Methods

In total, 17 women who underwent nonextraction orthodontic treatment and 15 women who underwent orthodontic treatment with extraction of all four first premolars were included in this retrospective study. For all patients, lateral cephalograms and dental models were measured before (T0) and after (T1) treatment. In addition, MLF was measured at both time points using the Lip De Cum LDC-110R® device. Statistical analyses were performed to evaluate changes in clinical variables and MLF and their correlations.

Results

Both groups showed similar skeletal patterns, although the extraction group showed greater proclination of the maxillary and mandibular incisors and lip protrusion compared to the nonextraction group at T0. MLF at T0 was comparable between the two groups. The reduction in the arch width and depth and incisor retroclination from T0 to T1 were more pronounced in the extraction group than in the nonextraction group. MLF in the extraction group significantly increased during the treatment period, and this increase was significantly greater than that in the nonextraction group. The increase in MLF was found to be correlated with the increase in the interincisal angle and decrease in the intermolar width, arch depth, and incisor-mandibular plane angle.

Conclusions

This study suggests that MLF increases to a greater extent during extraction orthodontic treatment than during nonextraction orthodontic treatment.

Anatomical Reconstruction in Bilateral Cleft Lip With Mendoza Technique

: The bilateral cleft lip (BCL) is the most severe manifestation of orofacial clefts. Multiple techniques have been described to reconstruct BCL to obtain good aesthetic and functional results with minimal complications.

OBJECTIVE

Description of surgical technique for BCL reconstruction and present the postoperative results obtained.

METHODS

Patients with BCL of the cleft lip and palate at ABC Medical Center from June 2013 to June 2017 operated with Mendoza bilateral cheiloplasty were included. The procedure includes an anatomical reconstruction of the lip with minimal resection of tissue, alignment of the orbicularis muscle, vestibule creation, and complete use of the prolabium. The evaluation was carried out by photographs analyzing parameters of quality, symmetry, and alignment of lip and nose structures.

RESULTS

The authors included 36 patients, 15 women and 16 men. The average procedure time was 57 minutes. Photographs were evaluated 1 year postoperatively, symmetry in lip was observed in 91.6% of the patients, muscle continuity in 100%, deep gingivolabial sulcus in 94.5% of cases, closed nasal floor in 100% with no presence of nasovestibular fistulas.

CONCLUSIONS

This technique allows an anatomical BCL reconstruction with good aesthetic and functional results.