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Gu B, Johns AL, Binhuwaishel L, Dass A, Sheller B, Kapadia HP, Yen SLK. Impact of protraction or orthognathic surgery for class III malocclusion on longitudinal quality of life in patients with cleft lip and palate. Orthod Craniofac Res 2024. [PMID: 38817081 DOI: 10.1111/ocr.12810] [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] [Accepted: 05/08/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES This study assessed overall quality of life (QoL) over time in youth with cleft lip and palate (CLP) undergoing maxillary protraction treatment or orthognathic surgery for class III malocclusion to identify any differences in QoL based on treatment group and outcome success. MATERIALS AND METHODS A prospective longitudinal cohort study was conducted in two pediatric hospitals. The Short Form Health Survey (SF-12) measured physical and mental QoL prior to treatment, at maximal correction, at treatment completion, and at 1-year post treatment. Analyses included one-sample, two-sample, and paired t-tests and analyses of variance and covariance. RESULTS Participants (N = 91) either completed protraction (n = 53) at age 11-14 or surgery (n = 38) at age 16-21. Participants were mostly Latinx (67%) males (55%) born with unilateral CLP (81%) and there were no demographic differences between the two groups other than age. The total sample's QoL was in the average range and significantly higher than national norms. No significant differences were found in QoL-based outcome success; however, the protraction group showed a gradual physical QoL improvement over time, while the surgery group experienced a temporary drop in physical QoL postoperatively. At treatment completion, higher physical QoL was associated with higher socioeconomic status. At a year post treatment, mental QoL was significantly higher for males. CONCLUSION Both protraction and surgery appear to be acceptable treatment options in terms of overall QoL for youth with CLP. While treatment success did not impact QoL, there were some differences in physical QoL coinciding with the treatment phase as well as individual factors.
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Affiliation(s)
- Bocheng Gu
- Department of Pharmaceutical and Health Economics, School of Pharmacy, University of Southern California, Los Angeles, California, USA
| | - Alexis L Johns
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Lamia Binhuwaishel
- Division of Dentistry, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Amarjit Dass
- Division of Dentistry, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Barbara Sheller
- Department of Dentistry, Seattle Children's Hospital and School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Hitesh P Kapadia
- Department of Dentistry, Seattle Children's Hospital and School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Stephen L-K Yen
- Division of Dentistry, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Kluge J, Bruggink R, Pandis N, Unkovskiy A, Jost-Brinkmann PG, Kuijpers-Jagtman AM, Bartzela T. Longitudinal Three-Dimensional Stereophotogrammetric Growth Analysis in Infants with Unilateral Cleft Lip and Palate from 3 to 12 Months of Age. J Clin Med 2023; 12:6432. [PMID: 37892569 PMCID: PMC10607132 DOI: 10.3390/jcm12206432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
This longitudinal study aimed to evaluate facial growth and soft tissue changes in infants with complete unilateral cleft lip, alveolus, and palate (CUCLAP) at ages 3, 9, and 12 months. Using 3D images of 22 CUCLAP infants, average faces and distance maps for the entire face and specific regions were created. Color-coded maps highlighted more significant soft tissue changes from 3 to 9 months than from 9 to 12 months. The first interval showed substantial growth in the entire face, particularly in the forehead, eyes, lower lip, chin, and cheeks (p < 0.001), while the second interval exhibited no significant growth. This study provides insights into facial soft tissue growth in CUCLAP infants during critical developmental stages, emphasizing substantial improvements between 3 and 9 months, mainly in the chin, lower lip, and forehead. However, uneven growth occurred in the upper lip, philtrum, and nostrils throughout both intervals, with an overall decline in growth from 9 to 12 months. These findings underscore the dynamic nature of soft tissue growth in CUCLAP patients, highlighting the need to consider these patterns in treatment planning. Future research should explore the underlying factors and develop customized treatment interventions for enhanced facial aesthetics and function in this population.
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Affiliation(s)
- Jennifer Kluge
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
| | - Robin Bruggink
- Radboudumc 3D Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, Freiburgstraße 7, 3010 Bern, Switzerland (A.M.K.-J.)
| | - Alexey Unkovskiy
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow 119146, Russia
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, Freiburgstraße 7, 3010 Bern, Switzerland (A.M.K.-J.)
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
- Faculty of Dentistry, Universitas Indonesia, Campus Salemba, Jalan Salemba Raya No. 4, Jakarta 10430, Indonesia
| | - Theodosia Bartzela
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
- Department of Orthodontics, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
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de Oliveira Júnior AG, Montagna E, Zaia V, Barbosa CP, Bianco B. Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysis. BMC Oral Health 2023; 23:670. [PMID: 37716942 PMCID: PMC10505326 DOI: 10.1186/s12903-023-03382-4] [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: 02/28/2023] [Accepted: 09/01/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Cleft lip and palate (CLP) is the most common facial birth defect worldwide and causes morphological, aesthetic, and functional problems with psychosocial implications for an individual's life and well-being. The present systematic review and meta-analysis assessed whether the treatment of CLP impacts the oral health-related quality of life (OHRQoL) in children and adolescents in comparison to healthy controls. METHODS We searched MEDLINE/PubMed, EMBASE, and PsycINFO databases using terms related to CLP, and included articles until August 2023. Observational comparison studies that assessed OHRQoL in non-syndromic CLP patients aged 8-19 years with validated scales designed to such aim or scales capable to identify aspects related to oral health compared to healthy controls were included. We used the ROBINS-I tool for risk of bias assessment. A meta-analysis of continuous variables was performed using inverse variance for pooling estimates, Standardized Mean Difference (SMD) as a summary measure, with random effects model. Heterogeneity was estimated by the I2 statistics. Sensitivity analyses included subgrouping based on the scale, risk of bias and scale domains. Meta-regression was performed under a mixed-effects model considering the variables type of scale, scale domains and risk of bias. RESULTS Fourteen studies were included comprising 1,185 patients with CLP and 1,558 healthy controls. The direction of the effect of OHRQoL favoured the healthy group (-0.92; 95% CI:-1,55;-0,10) and I2 = 95%. After removing three studies, I2 dropped to 80%. Meta-regression showed no influence on risk of bias (p = 0.2240) but influence of scale type (p = 0.0375) and scale domains (p < 0.001). The subgroup analysis indicated that the CPQ and COHIP scales presented very discrepant SMD values, despite pointing to the same effect direction. In contrast, the OHIP scale showed a non-significant difference between cases and controls, with estimates much lower than the other two scales. Results also suggest that OHRQoL associated with oral functionality and social well-being is more influential on outcomes than emotional well-being. CONCLUSION The global OHRQoL is slightly worst in the CLP patients than control group. The difference between OHRQoL was mainly detected through OHIP. The most affected domains are functional, emotional and social. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022336956.
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Affiliation(s)
| | - Erik Montagna
- Postgraduation Program in Health Sciences, Faculdade de Medicina do ABC/Centro Universitário FMABC, Santo André, Brazil
| | - Victor Zaia
- Postgraduation Program in Health Sciences, Faculdade de Medicina do ABC/Centro Universitário FMABC, Santo André, Brazil
| | - Caio Parente Barbosa
- Discipline of Sexual and Reproductive Health, and Populational Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro Universitário FMABC, Av. Lauro Gomes, 2000, Santo André, CEP 09060-870, SP, Brazil
| | - Bianca Bianco
- Discipline of Sexual and Reproductive Health, and Populational Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro Universitário FMABC, Av. Lauro Gomes, 2000, Santo André, CEP 09060-870, SP, Brazil.
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Alqadi S, Qazali A, Altamimi R, Altamimi R, Abdouh I, Othman A, Abdulhameed F. Perception and Attitude of Parents of Children With Orofacial Clefts Regarding the Use of Presurgical Orthopedics and Feeding Obturators. Cureus 2023; 15:e46131. [PMID: 37779676 PMCID: PMC10538351 DOI: 10.7759/cureus.46131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 10/03/2023] Open
Abstract
OBJECTIVE This study aims to evaluate the parents' attitude and their perception regarding the management of orofacial cleft (OFC) children with presurgical nasoalveolar molding (PNAM), DynaCleft and/or feeding obturators. MATERIAL AND METHODS A cross-sectional, descriptive and observational retrospective survey-based study was conducted among parents of OFC children treated with PNAM, DynaCleft and/or feeding obturators who attended a primary dental health care center in Al-Madinah, Saudi Arabia, from 2019 to 2023. A validated questionnaire was used after translating it from English to Arabic. The questionnaire consisted of 32 questions divided into two sections. The first section covers parents' sociodemographic data and OFC risk factors. The second section evaluates the parents' perception regarding the use of presurgical orthopedics (PSO) for OFC repair. The questionnaire was completed through telephone interviews carried out by two investigators with the parents of OFC children. RESULTS Out of 142 parents of OFC children, only 40 parents and their children met the inclusion criteria of the study. Most parents (95%) reported their satisfaction with the treatment and stated that they would encourage other parents of OFC children to use PSO. CONCLUSION This study concluded that parents of OFC children had a positive attitude toward PSO treatment. Based on the positive outcomes of PSO treatment reported in the current study and previous literature, PSO should be considered as a routine treatment in the early management of orofacial clefts.
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Affiliation(s)
- Soha Alqadi
- Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Ahmad Qazali
- Prosthodontics, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Raghad Altamimi
- General Dentistry, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Rahaf Altamimi
- General Dentistry, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Ismail Abdouh
- Oral Basic and Clinical Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Ahmad Othman
- Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Fatma Abdulhameed
- Pediatric Surgery, King Salman Bin Abdulaziz Medical City, Al-Madinah Al-Munawwarah, SAU
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Sahoo AR, Singh Dheer S, P C M, Goyal P, Sidhu R, Deepalakshmi S. A Questionnaire Study to Assess Patients With Cleft Lip and Palate for Their Oral Health-Related Quality of Life. Cureus 2023; 15:e38712. [PMID: 37292523 PMCID: PMC10246514 DOI: 10.7759/cureus.38712] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 05/04/2023] [Indexed: 06/10/2023] Open
Abstract
AIM The purpose of this survey was to assess the quality of life of patients with cleft lips and palates in relation to their dental health. MATERIALS AND METHODS Between January 2022 and December 2022, 50 people between the age of eight and 15 years who had treatment for cleft lip and/or palate were part of a study. A questionnaire was administered to the subjects, including questions pertaining to their general well-being and dental hygiene. The information was gathered and subjected to statistical analysis through appropriate software, with the outcomes presented in the form of descriptive statistics. RESULT The results of the research showed that those with cleft lip and palate had a significant negative effect on their oral health-related quality of life (OHRQoL). The patients reported having trouble speaking, eating, and smiling, which caused them to feel self-conscious and isolated from other people. Conclusion: The study's findings show that those born with cleft lip and/or palate have far greater challenges in achieving and maintaining optimal oral health and a satisfying quality of life, which has repercussions for their overall health and happiness. The study's results may provide successful strategies for enhancing patients' OHRQoL who have had treatment for cleft lip and/or palate.
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Affiliation(s)
- Amiya Ranjan Sahoo
- Department of Oral and Maxillofacial Surgery, Awadh Dental College and Hospital, Jamshedpur, IND
| | - Shiras Singh Dheer
- Department of Dentistry, Shrimant Rajmata Vijayaraje Scindia Medical College, Shivpuri, IND
| | - Mahesh P C
- Department of Public Health Dentistry, Dayananda Sagar College of Dental Sciences, Bangalore, IND
| | - Pragya Goyal
- Department of Oral Medicine and Radiology, KD Dental College and Hospital, Mathura, IND
| | - Ruhi Sidhu
- Department of Oral Medicine and Radiology, MNDAV Dental College and Hospital, Solan, IND
| | - S Deepalakshmi
- Department of Oral Medicine and Radiology, Seema Dental College and Hospital, Rishikesh, IND
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Burger E, 't Hart J, Hovius S, Van Nieuwenhoven C. Quality of life in children with preaxial polydactyly of the foot in comparison to adults, postaxial polydactyly and healthy controls. J Pediatr Orthop B 2023; 32:27-33. [PMID: 36125884 DOI: 10.1097/bpb.0000000000001004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The effect of preaxial polydactyly of the foot on health-related quality of life (HR-QoL) has not been investigated in current literature. To improve counseling, we investigated HR-QoL in this patient group. A patient-control study was performed with children with preaxial polydactyly ( n = 20), adults with preaxial polydactyly ( n = 15), children with postaxial polydactyly ( n = 15) and healthy controls ( n = 62). The primary outcome was the difference in the foot-specific quality of life (FS-QoL) between children with preaxial polydactyly and adults with preaxial polydactyly, children with postaxial polydactyly and controls, using the Oxford Ankle and Foot Questionnaire (OxAFQ-c) and five foot-specific visual analogue scales (VAS). The secondary outcome was the difference in general HR-QoL, using the Pediatric Quality of Life Inventory (PedsQL). Outcomes were compared with the Mann-Whitney-U test. Comparison between children with preaxial polydactyly and healthy controls and postaxial polydactyly showed worse outcomes in all OxAFQ-c domains. The foot-specific VAS score was significantly worse in children with preaxial polydactyly compared to postaxial polydactyly and controls. Only the PedsQL physical domain showed a lower outcome in children with preaxial polydactyly than in postaxial polydactyly and controls. Children and adults with preaxial polydactyly scored the same in all domains. The OxAFQ-c and the PedsQL physical domain showed significantly worse outcomes in children with preaxial polydactyly compared with healthy controls and postaxial polydactyly. However, large variation was observed, suggesting large differences between patients. In children and adults, the foot and scar appearance seems to be the biggest problem, while diminished foot function seems less of an issue.
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Affiliation(s)
- Elise Burger
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam
| | - Judith 't Hart
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam
| | - Steven Hovius
- Department of Plastic, Reconstructive and Hand surgery, Radboud University Medical Center, Nijmegen, The Netherlands
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Life Quality of Children Affected by Cleft Lip Palate and Alveolus (CLPA). CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050757. [PMID: 35626934 PMCID: PMC9139314 DOI: 10.3390/children9050757] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022]
Abstract
The aim of this study was to investigate the quality of life of children and adolescents affected by cleft lip, palate and alveolus (CLPA) in the Italian population after a tailored treatment dental program. A prospective study was conducted with subjects of both genders at the University Hospital of Pisa, Italy. This study included 32 patients (11 females and 21 males, mean age: 9.8 ± 2.1 years old) affected by CLPA (test group); a tailored oral hygiene instruction protocol was adopted in the test group since early age (6.1 ± 0.9 years old) after corrective surgery and regular dental hygiene appointments were scheduled. Moreover, a control group of 32 patients (11 females and 21 males, mean age: 10.1 ± 2.2 years old) without CLPA was included; control subjects were first-visit patients, matched for age and sex, who had not received a specific dental hygiene program before. The OHIP-14 (Oral Health Impact Profile) questionnaire was applied for the evaluation of the quality of life of patients of both groups and the questions were presented directly to the patients. Moreover, the DMFT (Decayed, Missed and Filled Teeth) index was measured. A statistical analysis was performed and the level of significance was set at: p < 0.05. The OHIP-14 scores presented significant differences between the two groups (p < 0.05); the test group exhibited a lower mean OHIP-14 score in comparison to the control group. The DMFT score was significantly lower in the test group in comparison to controls (p: 0.001, p < 0.05). The quality of life and DMFT score of children and adolescents affected by CLPA, after a tailored treatment dental program, were better than that of the subjects of the control group.
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Niinomi K, Ueki S, Fujita Y, Kitao M, Matsunaka E, Kumagai Y, Ike M. Differences in specific concerns perceived by parents of children with cleft lip and/or palate based on the types of cleft. Int J Paediatr Dent 2022; 32:304-313. [PMID: 34358380 DOI: 10.1111/ipd.12886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Parents of children with cleft lip and/or palate (CL/P) have concerns including guilt and worry. Differences in concerns by cleft type is, however, under-researched. AIM To compare differences in perceived concerns among parents of children with CL/P by cleft type, adjusting for children's gender and age. DESIGN Cross-sectional study conducted in an outpatient centre, assessing psychological status of 171 parents of children aged <12 with CL/P using 12 items. RESULTS Across cleft types, 'I am worried about whether the child's teeth will be straight' was the most strongly perceived concern (70.8%). After adjusting for gender and age, logistic regression showed significant differences in type of CL/P for (eg) 'I am worried that the child's appearance will not be beautiful', associated with CL over CP (OR = 0.07, 95% CI: 0.02-0.26) and CLP over CP (8.52, 3.23-22.50);' 'I am concerned about my child being able to speak well', associated with CP (3.12, 1.07-9.11) and CLP (5.69, 2.43-13.33) over CL, and 'I am worried that the child could suffer due to his/her appearance', associated with CL over CP (0.08, 0.02-0.29) and CLP over CP (10.07, 13.78-27.36). CONCLUSIONS Parents' concerns were influenced by cleft type.
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Affiliation(s)
- Kazuteru Niinomi
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Shingo Ueki
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuichi Fujita
- Department of Nursing, School of Nursing, Mukogawa Women's University, Nishinomiya, Japan
| | - Mika Kitao
- Department of Nursing, School of Nursing, Mukogawa Women's University, Nishinomiya, Japan
| | - Eriko Matsunaka
- Department of Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata, Japan
| | - Yukari Kumagai
- Department of Nursing, Osaka University Dental Hospital, Suita, Japan
| | - Miho Ike
- Department of Nursing, Osaka University Dental Hospital, Suita, Japan
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Mukhopadhyay N, Feingold E, Moreno-Uribe L, Wehby G, Valencia-Ramirez LC, Muñeton CPR, Padilla C, Deleyiannis F, Christensen K, Poletta FA, Orioli IM, Hecht JT, Buxó CJ, Butali A, Adeyemo WL, Vieira AR, Shaffer JR, Murray JC, Weinberg SM, Leslie EJ, Marazita ML. Genome-wide association study of multiethnic nonsyndromic orofacial cleft families identifies novel loci specific to family and phenotypic subtypes. Genet Epidemiol 2022; 46:182-198. [PMID: 35191549 PMCID: PMC9086172 DOI: 10.1002/gepi.22447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/06/2022] [Accepted: 01/20/2022] [Indexed: 11/11/2022]
Abstract
Nonsyndromic orofacial clefts (OFCs) are among the most common craniofacial birth defects worldwide, and known to exhibit phenotypic and genetic heterogeneity. Cleft lip plus cleft palate (CLP) and cleft lip only (CL) are commonly combined together as one phenotype (CL/P), separately from cleft palate alone. In comparison, our study analyzes CL and CLP separately. A sample of 2218 CL and CLP cases, 4537 unaffected relatives of cases, and 2673 pure controls with no family history of OFC were selected from the Pittsburgh Orofacial Cleft (Pitt-OFC) multiethnic study.genome-wide association studies were run for seven specific phenotypes created based on the cleft type(s) observed within these families, as well as the combined CL/P phenotype. Five novel genome-wide significant associations, 3q29 (rs62284390), 5p13.2 (rs609659), 7q22.1 (rs6465810), 19p13.3 (rs628271), and 20q13.33 (rs2427238), and nine associations (p ≤ 1.0E-05) within previously confirmed OFC loci-PAX7, IRF6, FAM49A, DCAF4L2, 8q24.21, ARID3B, NTN1, TANC2 and the WNT9B:WNT3 gene cluster-were observed. We also found that single nucleotide polymorphisms within a subset of the associated loci, both previously known and novel, differ substantially in terms of their effects across cleft- or family-specific phenotypes, indicating not only etiologic differences between CL and CLP, but also genetic heterogeneity within each of the two OFC subtypes.
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Affiliation(s)
- Nandita Mukhopadhyay
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
| | - Eleanor Feingold
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lina Moreno-Uribe
- Department of Orthodontics, & The Iowa Institute for Oral Health Research, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - George Wehby
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA, USA
| | | | | | - Carmencita Padilla
- Department of Pediatrics, College of Medicine, Institute of Human Genetics, National Institutes of Health, University of the Philippines, Manila, the Philippines
| | | | - Kaare Christensen
- Unit of Epidemiology, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Fernando A. Poletta
- CEMIC-CONICET: Center for Medical Education and Clinical Research, Buenos Aires, Argentina
| | - Ieda M Orioli
- Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Genética Médica Populacional INAGEMP, Porto Alegre, Brazil
| | - Jacqueline T. Hecht
- Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Carmen J. Buxó
- Dental and Craniofacial Genomics Core, School of Dental Medicine, University of Puerto Rico, San Juan, Puerto Rico
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine and Iowa Institute for Oral Health Research, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Wasiu L. Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Alexandre R. Vieira
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
| | - John R. Shaffer
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jeffrey C. Murray
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Seth M. Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Elizabeth J. Leslie
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Mary L. Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Clinical and Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Moraleda-Cibrián M, Edwards SP, Kasten SJ, Warschausky SA, Buchman SR, Monasterio-Ponsa C, O'Brien LM. Impact of sleep-disordered breathing on behavior and quality of life in children aged 2 to 7 years with non-syndromic cleft lip and/or palate. Pediatr Pulmonol 2021; 56:3358-3365. [PMID: 34407324 DOI: 10.1002/ppul.25611] [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: 02/28/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Children with cleft are at high risk for sleep-disordered breathing (SDB). However, little is known about the impact of SDB in this pediatric population. The aim of this study was to investigate whether SDB play a role in behavior and quality of life (QoL) in young children with cleft. METHODS Cross-sectional study of 95 children aged 2.0-7.9 years with cleft palate. Parents completed a sleep (Pediatric Sleep questionnaire), a behavior (Conners' Early Childhood scale), and a generic health-related QoL (KINDL questionnaire) assessment. Symptomatic children were referred for a polysomnography (PSG). RESULTS Overall, 14.7% of children (49.5% boys) screened positive for SDB and 27.4% had a PSG, which identified 84.6% with sleep apnea (apnea-hypopnea index [AHI] ≥1) and 27.2% with AHI ≥5. Positive screening for SDB was associated with elevated T-scores for anxiety and physical symptoms, significant differences in mean T-scores for inattention/hyperactivity (64.2 ± 15.7 vs. 53.9 ± 11.4, p = .02), social functioning/atypical behaviour, social functioning (60.6 ± 11.7 vs. 51.9 ± 7.3, p = .004 and 59.5 ± 10.9 vs. 51.2 ± 8.0, p = .01) and mood (57.5 ± 8.2 vs. 50.7 ± 8.2, p = .03). Lower QoL scores for emotional and family well-being were also reported in children with SDB (80.7 ± 13.4 vs. 90.0 ± 8.7, p = .01, 66.7 ± 15.8 vs. 76.9 ± 11.9, p = .04). Children with AHI ≥5 compared to those with AHI ≥1 and <5 showed significant differences in mean T-score for aggressive behaviour (65.2 ± 12.1 vs. 52.3 ± 11.3, p = .04), defiant temper (62.8 ± 9.2 vs. 51.6 ± 10.2, p = .03) and lower family QoL scores (59.4 ± 15.2 vs. 77.1 ± 9.6, p = .006). CONCLUSIONS In children with cleft palate the presence of SDB symptoms and moderate/severe sleep apnea was associated with behavioral (internalizing/externalizing) problems and lower family well-being.
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Affiliation(s)
- Marta Moraleda-Cibrián
- Michael S. Aldrich Sleep Disorders Laboratory and Sleep Disorders Clinic, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.,Sleep Disorders Center, Centro Médico Teknon, Barcelona, Spain
| | - Sean P Edwards
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Steven J Kasten
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Seth A Warschausky
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - Steven R Buchman
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Carme Monasterio-Ponsa
- Unit of Sleep Disorders, Department of Neumology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Louise M O'Brien
- Michael S. Aldrich Sleep Disorders Laboratory and Sleep Disorders Clinic, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, Michigan, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA
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11
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Dissaux C, Diop V, Wagner D, Talmant JC, Morand B, Bruant-Rodier C, Ruffenach L, Grollemund B. Aesthetic and psychosocial impact of dentofacial appearance after primary rhinoplasty for cleft lip and palate. J Craniomaxillofac Surg 2021; 49:914-922. [PMID: 34187731 DOI: 10.1016/j.jcms.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 04/23/2021] [Accepted: 06/05/2021] [Indexed: 10/21/2022] Open
Abstract
The primary aim of this study was to demonstrate whether primary rhinoplasty shows aesthetic and psychosocial advantages for children with a complete unilateral cleft lip and palate. The second aim was to determine the satisfaction levels concerning the dentofacial appearance. Group A corresponded to patients from a center specialised in primary cheilo-rhinoplasty with 20 years' experience and Group B to patients who did not benefit from primary rhinoplasty. Children and their parents filled in a custom-designed satisfaction questionnaire on dentofacial appearance and its psychosocial impact. The variables studied were the main criterion (the nose) and secondary criteria (the upper lip, the smile, the profile and the face as a whole). 56 families consented to be involved in the study. The children did not rate statistically differently their social relationships if they had primary rhinoplasty or not. Parents however expressed very different views. They considered the nasal appearance of the children who had primary rhinoplasty as statistically more attractive and evaluated their psychosocial experience as significantly better. For the other parts of the face, in both groups, satisfaction levels of dentofacial appearance and psychosocial comfort were good (scores above 80/100). Yet, 44% of the families would go for further interventions, especially concerning the nose (13% of whom were in Group A and 42% in Group B). Within the limitations of this study, primary rhinoplasty seems to improve the patient's well-being and social life and, therefore, should be considered whenever appropriate.
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Affiliation(s)
- Caroline Dissaux
- Cleft Competence Center, Maxillofacial and Plastic Surgery Department, Strasbourg University Hospital, Site Hautepierre 2, Av Molière, Strasbourg 67091, France.
| | - Valérie Diop
- Département d'Orthopédie Dento-Faciale, Pôle de médecine et chirurgie buccodentaires, Strasbourg University Hospital, Place de l'Hôpital 1, Strasbourg 67000, France
| | - Delphine Wagner
- Cleft Competence Center, Maxillofacial and Plastic Surgery Department, Strasbourg University Hospital, Site Hautepierre 2, Av Molière, Strasbourg 67091, France; Département d'Orthopédie Dento-Faciale, Pôle de médecine et chirurgie buccodentaires, Strasbourg University Hospital, Place de l'Hôpital 1, Strasbourg 67000, France
| | - Jean-Claude Talmant
- Centre de compétence des fentes labio-palatines des Pays de la Loire, Clinique Jules Verne, Nantes, France
| | - Béatrice Morand
- Centre de compétence des fentes labio-palatines de Grenoble, CHU Michallon, Avenue Maquis du Grésivaudan, 38700, La Tronche, France
| | - Catherine Bruant-Rodier
- Cleft Competence Center, Maxillofacial and Plastic Surgery Department, Strasbourg University Hospital, Site Hautepierre 2, Av Molière, Strasbourg 67091, France
| | - Laeticia Ruffenach
- Cleft Competence Center, Maxillofacial and Plastic Surgery Department, Strasbourg University Hospital, Site Hautepierre 2, Av Molière, Strasbourg 67091, France
| | - Bruno Grollemund
- Cleft Competence Center, Maxillofacial and Plastic Surgery Department, Strasbourg University Hospital, Site Hautepierre 2, Av Molière, Strasbourg 67091, France
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12
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Mukhopadhyay N, Feingold E, Moreno-Uribe L, Wehby G, Valencia-Ramirez LC, Muñeton CPR, Padilla C, Deleyiannis F, Christensen K, Poletta FA, Orioli IM, Hecht JT, Buxó CJ, Butali A, Adeyemo WL, Vieira AR, Shaffer JR, Murray JC, Weinberg SM, Leslie EJ, Marazita ML. Genome-Wide Association Study of Non-syndromic Orofacial Clefts in a Multiethnic Sample of Families and Controls Identifies Novel Regions. Front Cell Dev Biol 2021; 9:621482. [PMID: 33898419 PMCID: PMC8062975 DOI: 10.3389/fcell.2021.621482] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/15/2021] [Indexed: 01/20/2023] Open
Abstract
Orofacial clefts (OFCs) are among the most prevalent craniofacial birth defects worldwide and create a significant public health burden. The majority of OFCs are non-syndromic and vary in prevalence by ethnicity. Africans have the lowest prevalence of OFCs (~ 1/2,500), Asians have the highest prevalence (~1/500), Europeans and Latin Americans lie somewhere in the middle (~1/800 and 1/900, respectively). Thus, ethnicity appears to be a major determinant of the risk of developing OFC. The Pittsburgh Orofacial Clefts Multiethnic study was designed to explore this ethnic variance, comprising a large number of families and individuals (~12,000 individuals) from multiple populations worldwide: US and Europe, Asians, mixed Native American/Caucasians, and Africans. In this current study, we analyzed 2,915 OFC cases, 6,044 unaffected individuals related to the OFC cases, and 2,685 controls with no personal or family history of OFC. Participants were grouped by their ancestry into African, Asian, European, and Central and South American subsets, and genome-wide association run on the combined sample as well as the four ancestry-based groups. We observed 22 associations to cleft lip with or without cleft palate at 18 distinct loci with p-values < 1e-06, including 10 with genome-wide significance (<5e-08), in the combined sample and within ancestry groups. Three loci - 2p12 (rs62164740, p = 6.27e-07), 10q22.2 (rs150952246, p = 3.14e-07), and 10q24.32 (rs118107597, p = 8.21e-07) are novel. Nine were in or near known OFC loci - PAX7, IRF6, FAM49A, DCAF4L2, 8q24.21, NTN1, WNT3-WNT9B, TANC2, and RHPN2. The majority of the associations were observed only in the combined sample, European, and Central and South American groups. We investigated whether the observed differences in association strength were (a) purely due to sample sizes, (b) due to systematic allele frequency difference at the population level, or (c) due to the fact certain OFC-causing variants confer different amounts of risk depending on ancestral origin, by comparing effect sizes to observed allele frequencies of the effect allele in our ancestry-based groups. While some of the associations differ due to systematic differences in allele frequencies between groups, others show variation in effect size despite similar frequencies across ancestry groups.
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Affiliation(s)
- Nandita Mukhopadhyay
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Eleanor Feingold
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lina Moreno-Uribe
- Department of Orthodontics, The Iowa Institute for Oral Health Research, College of Dentistry, University of Iowa, Iowa City, IA, United States
| | - George Wehby
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA, United States
| | | | | | - Carmencita Padilla
- Department of Pediatrics, College of Medicine, Institute of Human Genetics, National Institutes of Health, University of the Philippines, Manila, Philippines
| | | | - Kaare Christensen
- Department of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Fernando A. Poletta
- CEMIC: Center for Medical Education and Clinical Research, Buenos Aires, Argentina
| | - Ieda M. Orioli
- Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Genética Médica Populacional INAGEMP, Porto Alegre, Brazil
| | - Jacqueline T. Hecht
- Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Carmen J. Buxó
- Dental and Craniofacial Genomics Core, School of Dental Medicine, University of Puerto Rico, San Juan, Puerto Rico
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, Iowa Institute for Oral Health Research, University of Iowa, Iowa City, IA, United States
| | - Wasiu L. Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Alexandre R. Vieira
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - John R. Shaffer
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jeffrey C. Murray
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Seth M. Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Mary L. Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Clinical and Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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13
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Ruiz-Guillén A, Suso-Ribera C, Romero-Maroto M, Gallardo C, Peñacoba C. Perception of quality of life by children and adolescents with cleft lip/palate after orthodontic and surgical treatment: gender and age analysis. Prog Orthod 2021; 22:10. [PMID: 33791877 PMCID: PMC8012431 DOI: 10.1186/s40510-021-00354-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/15/2021] [Indexed: 11/29/2022] Open
Abstract
Background The quality of life (QoL) of children and adolescents with cleft lip/palate (CL/P) has been shown to be a predictor of good psychosocial functioning in this population group. This study aimed to measure QoL, from the patient´s perception of change produced by the different surgical and orthodontic treatments carried out since early childhood, and if gender and age are modulating the outcome variables results. Materials and methods A cross-sectional research study was carried out. The study included 60 patients with cleft lip, cleft palate, or cleft lip/palate, aged between 8 and 18, who were in orthodontic treatment and had undergone at least one surgery. They were asked to complete the Quality-of-Life Adolescent Cleft Questionnaire (QoLAdoCleft), which allows the assessment of the QoL through self-perception of improvement after surgical and orthodontic interventions. In particular, this questionnaire (administered only once), allows the evaluation of self-perception of QoL at the present time and before orthodontic and surgical treatment. This double assessment was carried out for the domains of physical, psychological, and social health. The results were analysed by looking at the interaction of gender and age. Results Statistically significant differences were found in the perception of the current QoL in comparison to the retrospective perception in all the dimensions considered. The perception of QoL improved in all cases. The results also showed a moderation of gender in the relation between perception of previous behaviour and social function and actual behaviour and social function. Conclusion The results indicated that patients perceived their quality of life had improved as a result of the treatments received, with the highest effect sizes found in the physical health domain. Specifically, the improvement in QoL in behaviour and social function tended to be influenced to a greater extent by perception of previous QoL. In this sense, personalized preventative measures from holistic and biopsychosocial approaches are necessary.
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Affiliation(s)
- Ana Ruiz-Guillén
- Department of Nursing and Dentistry, Rey Juan Carlos University, Madrid, Spain.,Pediatric Dentist, Private Practice, Madrid, Spain
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellón, Spain
| | - Martín Romero-Maroto
- Department of Nursing and Dentistry, Rey Juan Carlos University, Madrid, Spain.,Orthodontic Department, Rey Juan Carlos University, Madrid, Spain
| | - Carmen Gallardo
- Department of Medical Specialties and Public Health, Rey Juan Carlos University, Madrid, Spain
| | - Cecilia Peñacoba
- Deparment of Psychology, Rey Juan Carlos University, Madrid, Spain.
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14
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Quality of life in early age Spanish children treated for cleft lip and/or palate: a case-control study approach. Clin Oral Investig 2020; 25:477-485. [PMID: 32556577 DOI: 10.1007/s00784-020-03394-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 06/04/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objectives of this study were to evaluate health-related quality of life (HRQoL) in 4-7-year-old children treated for cleft lip and/or palate (CL/P) compared to healthy controls and to estimate a possible association with cleft type, gender, age, and surgical re-interventions. MATERIALS AND METHODS A total of 171 children with CL/P (mean age 5.7 years) and 186 healthy controls (mean age 5.5 years) were included in the study. Sixty-four (37.4%) children experienced both cleft lip and palate, 56 (32.8%) cleft lip only, and 51 (29.8%) cleft palate only. HRQoL in children was assessed by Kiddy-KINDL and COHIP-14 questionnaires and in parents by KINDL-p. Total score and dimensions of each questionnaire were compared between cleft children, their parents, and controls. RESULTS The total scores and dimension scores of Kiddy-KINDL showed similar values between CL/P and control groups, except for "self-esteem" dimension (p = 0.036). The comparison of Kiddy-KINDL and KINDL-p showed a statistically significant total score (82.11 vs. 80.44, p = 0.047). The CL/P group presented significantly worse values with respect to controls in total score of COHIP-14 (10.53 vs 5.01, p < 0.001) and in all its dimensions. CONCLUSIONS Children treated for CL/P had a negative impact on HRQoL at early age compared to controls. Significant differences were found in the psychological and functional dimensions related to lip and palatal affectation, respectively. Parents reported significantly worse scores than their children. HRQoL measurement provided valuable complementary information to better inform to parents and make clinical decisions in children with CL/P at early age. CLINICAL RELEVANCE Our findings suggested that Spanish children between 4 and 7 years of age with a history of surgically treated CL/P experienced a poorer HRQoL when compared with their non-cleft peers.
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15
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Mukhopadhyay N, Bishop M, Mortillo M, Chopra P, Hetmanski JB, Taub MA, Moreno LM, Valencia-Ramirez LC, Restrepo C, Wehby GL, Hecht JT, Deleyiannis F, Butali A, Weinberg SM, Beaty TH, Murray JC, Leslie EJ, Feingold E, Marazita ML. Whole genome sequencing of orofacial cleft trios from the Gabriella Miller Kids First Pediatric Research Consortium identifies a new locus on chromosome 21. Hum Genet 2020; 139:215-226. [PMID: 31848685 PMCID: PMC6981325 DOI: 10.1007/s00439-019-02099-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/07/2019] [Indexed: 12/30/2022]
Abstract
Orofacial clefts (OFCs) are among the most prevalent craniofacial birth defects worldwide and create a significant public health burden. The majority of OFCs are non-syndromic, and the genetic etiology of non-syndromic OFCs is only partially determined. Here, we analyze whole genome sequence (WGS) data for association with risk of OFCs in European and Colombian families selected from a multicenter family-based OFC study. This is the first large-scale WGS study of OFC in parent-offspring trios, and a part of the Gabriella Miller Kids First Pediatric Research Program created for the study of childhood cancers and structural birth defects. WGS provides deeper and more specific genetic data than using imputation on present-day single nucleotide polymorphic (SNP) marker panels. Genotypes of case-parent trios at single nucleotide variants (SNV) and short insertions and deletions (indels) spanning the entire genome were called from their sequences using human GRCh38 genome assembly, and analyzed for association using the transmission disequilibrium test. Among genome-wide significant associations, we identified a new locus on chromosome 21 in Colombian families, not previously observed in other larger OFC samples of Latin American ancestry. This locus is situated within a region known to be expressed during craniofacial development. Based on deeper investigation of this locus, we concluded that it contributed risk for OFCs exclusively in the Colombians. This study reinforces the ancestry differences seen in the genetic etiology of OFCs, and underscores the need for larger samples when studying for OFCs and other birth defects in populations with diverse ancestry.
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Affiliation(s)
- Nandita Mukhopadhyay
- Department of Oral Biology, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Dr., Pittsburgh, PA, 15219, USA
| | - Madison Bishop
- Department of Human Genetics, School of Medicine, Emory University, Atlanta, GA, 30322, USA
| | - Michael Mortillo
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Pankaj Chopra
- Department of Human Genetics, School of Medicine, Emory University, Atlanta, GA, 30322, USA
| | - Jacqueline B Hetmanski
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Margaret A Taub
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Lina M Moreno
- Department of Orthodontics, College of Dentistry, University of Iowa, Iowa City, IA, 52242, USA
| | | | - Claudia Restrepo
- Fundación Clínica Noel (http://www.clinicanoel.org.co/), Medellín, Colombia
| | - George L Wehby
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA, 52242, USA
| | - Jacqueline T Hecht
- Department of Pediatrics, McGovern Medical School and School of Dentistry, UT Health at Houston, Houston, TX, 77030, USA
| | | | - Azeez Butali
- Iowa Institute of Oral Health Research, College of Dentistry, University of Iowa, Iowa City, IA, 52242, USA
| | - Seth M Weinberg
- Department of Oral Biology, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Dr., Pittsburgh, PA, 15219, USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15219, USA
| | - Terri H Beaty
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Jeffrey C Murray
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA
| | - Elizabeth J Leslie
- Department of Human Genetics, School of Medicine, Emory University, Atlanta, GA, 30322, USA
| | - Eleanor Feingold
- Department of Oral Biology, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Dr., Pittsburgh, PA, 15219, USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- Department of Biostatistics Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Mary L Marazita
- Department of Oral Biology, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Dr., Pittsburgh, PA, 15219, USA.
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15219, USA.
- Department of Psychiatry, School of Medicine and Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, 15260, USA.
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