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Alissa M, Hjazi A, Abusalim GS, Aloraini GS, Alghamdi SA, Rizg WY, Hosny KM, Bukhary DM, Alkharobi H. Fabrication and optimization of phospholipids-based phase separation in-situ gel loaded with BMP-2 nanosized emulsion for bone defect. Front Pharmacol 2023; 14:1286133. [PMID: 37915413 PMCID: PMC10616790 DOI: 10.3389/fphar.2023.1286133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/05/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction: The health, development, and/or survival of a newborn can be impacted by congenital abnormalities such as cleft lip (CLP) and palate, one of alveolar bone defects that emerge thru pregnancy. Therefore, the primary purpose of this study is to use phospholipids-based phase separation in-situ gel (PPSG) in combination with bone morphogenetic protein-2 nanoemulsion (BMP-2-NE) to aid repairing alveolar bone defects. Methods: To investigate how formulation parameters, such as the concentrations of BMP-2 aqueous solution, LauroglycolTM FCC, and Labrafac PG oil, affect NE qualities including droplet size and stability index, an l-optimal co-ordinate exchange statistical design was opted. Injectable PPSG with the best NE formulation was tested for viscosity characteristics, gel strength, water absorption, and in-vitro BMP-2 release. In rabbits, the percentage of BMP-2 that was still in the maxilla after 14 days was assessed. Results: Collected results revealed that the droplet size and stability index of optimal NE were discovered to be 68 2.0 nm and 96 1.3%, respectively. When mixed with water, optimal BMP-2 NE loaded PPSG became viscous and reached a gel strength of 41 s, which is adequate for injectable in-situ gels. In comparison to BMP-2 solution loaded in-situ gel, the in-vivo studies indicated that the newly created BMP-2 NE loaded PPSG produced a sustained and controlled release of BMP-2 that continued for 336 h (14 days). Further, 8% of the BMP-2 was still entrapped and not completely dissolved after 14 days, thus, created formulation allowed a higher percentage of BMP-2 to remain in rabbits' maxilla for longer time. Conclusion: PPSG that has been loaded with BMP-2 NE may therefore be a promising, fruitful, and less painful paradigm for the noninvasive therapy of CLP with significant effect and extended release.
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Affiliation(s)
- Mohammed Alissa
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ahmed Hjazi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ghadah S. Abusalim
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ghfren S. Aloraini
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Suad A. Alghamdi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Waleed Y. Rizg
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
- Center of Innovation in Personalized Medicine (CIPM), 3D Bioprinting Unit, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khaled M. Hosny
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Deena M. Bukhary
- Department of Pharmaceutics, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hanaa Alkharobi
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Staudt CB, Bollhalder J, Eichenberger M, La Scala G, Herzog G, Wiedemeier DB, Antonarakis GS. Final Posttreatment Occlusion in Patients With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2021; 59:899-909. [PMID: 34235980 PMCID: PMC9260490 DOI: 10.1177/10556656211028506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To evaluate final posttreatment occlusion in patients with complete
unilateral cleft lip and palate (cUCLP) by comparing (1) 3
treatment centers, (2) males and females, (3) cleft and noncleft
sides, (4) right- and left-sided clefts, and (5) orthodontic
treatment with/without orthognathic surgery (OS). Design: Retrospective cohort study. Patients: Blinded posttreatment dental casts of 56 patients (19.4 ± 1.4
years) with cUCLP from 3 centers in Switzerland. Main Outcome Measure: Occlusal assessment using the modified Huddart/Bodenham (MHB)
index. Results: Our sample comprised 35 males and 21 females, 46 with left- and 10
with right-sided clefts, of which 32 had undergone OS. The final
posttreatment occlusion showed a median MHB score of 0
(interquartile range: −1.0 to 2.0) in the total sample and did
not seem to depend on treatment center, sex, or OS. The MHB
scores for the anterior buccal and the buccal segments were more
negative on the cleft than on the noncleft side
(P = .002 and P = .006,
respectively). When the cleft was on the left side, the MHB
score tended to be more positive in the labial
(P = .046) and anterior buccal segments
(P = .034). Conclusions: This study shows a very satisfactory final posttreatment occlusion
in patients with cUCLP. The more constricted buccal occlusion on
the cleft side emphasizes the attention that should be given in
correcting the more medially positioned lesser maxillary
segment. The influence of cleft-sidedness should be analyzed
further on a sample including more patients with right-sided
clefts.
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Affiliation(s)
- Christine B Staudt
- Cleft Lip and Palate Unit, Division of Orthodontics, Centre of Dental Medicine, University of Zurich, Switzerland
| | - Julia Bollhalder
- Division of Orthodontics, Centre of Dental Medicine, University of Zurich, Switzerland
| | - Martina Eichenberger
- Division of Orthodontics, Centre of Dental Medicine, University of Zurich, Switzerland
| | - Giorgio La Scala
- Division of Pediatric Surgery, Children's Hospital, University of Geneva, University Centre of Pediatric Surgery of Western Switzerland, Geneva, Switzerland
| | - Georges Herzog
- Division of Orthodontics, University Clinic of Dental Medicine, University of Geneva, Switzerland.,University Hospital CHUV, Lausanne, Switzerland
| | - Daniel B Wiedemeier
- Statistical Services, Centre of Dental Medicine, University of Zurich, Switzerland
| | - Gregory S Antonarakis
- Division of Orthodontics, University Clinic of Dental Medicine, University of Geneva, Switzerland
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Burhan AS, Nawaya FR. Comparison of dental arch dimensions in models of preschool children with cleft lip/palate repaired by means of surgery alone versus controls. J Egypt Public Health Assoc 2016; 91:150-155. [PMID: 27749647 DOI: 10.1097/01.epx.0000491269.07145.d1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Cleft lip and palate (CLP) anomaly is one of the most prevalent congenital defects causing disturbances of dental arch dimensions. This study aimed at investigating differences in these dimensions between preschool children with cleft lip/palate and a matched control group representing healthy individuals with normal occlusion (NO). MATERIALS AND METHODS The sample of this cross-sectional analytical study consisted of 108 plaster models of children aged from 4 to 5.5 years. They were divided into five groups: the cleft lip group, the cleft palate (CP) group, the unilateral cleft lip and palate group, the bilateral cleft lip and palate group, and the NO group. The NO group was used as a control group. All cleft-affected children were treated only with surgery. Dental arch length and widths were measured. RESULTS The dental arch dimensions of the cleft lip group were nearly similar to those in the controls. Moreover, the mandibular transverse widths of the CP group were close to those in the controls. However, the mandibular arch length and all maxillary dimensions of the CP group were smaller than those in the controls. In the unilateral cleft lip and palate group, the arch lengths in both jaws and the maxillary transverse widths were smaller than those in the controls, whereas the mandibular transverse widths were similar to those in the controls. In the bilateral cleft lip and palate group, the arch lengths in both jaws were close to those in the controls, but both arches were narrower than those in the controls. CONCLUSION AND RECOMMENDATIONS The various types of CLP were found to be associated with differences in most maxillary and some mandibular arch dimensions. These data can be used for cleft patient counseling and treatment planning.
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Affiliation(s)
- Ahmad S Burhan
- aDepartment of Orthodontics, Faculty of Dentistry, Damascus University, Damascus bDepartment of Pediatric Dentistry, Faculty of Dentistry, Syrian Private University, Damascus Countryside, Syria
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Hassan AH, Hosny KM, Murshid ZA, Alhadlaq A, Yamani A, Naguib G, Alkhalidi HM, Afify AR. Controlled release of injectable liposomal in situ gel loaded with recombinant human bone morphogenetic protein-2 for the repair of alveolar bone clefts in rabbits. J Liposome Res 2015; 26:148-55. [PMID: 26152279 DOI: 10.3109/08982104.2015.1060612] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of the present study was to develop and examine a new non-invasive injectable graft for the repair of alveolar bone clefts using recombinant human bone morphogenetic protein-2 (rhBMP-2) encapsulated within injectable liposomal in situ gel (LIG). METHOD Different liposomal formulations loaded with rhBMP-2 were prepared, and the effects of the preparation methods and lipid content on the efficiency of rhBMP-2 encapsulation within the liposomes were studied. For the preparation of in situ gel, deacetylated gellan gum (DGG) was used, and the in vitro gelation characteristics of the gel were evaluated. In vivo pharmacokinetics and histology were also assessed. Critical size alveolar defects were surgically created in the maxillae of 30 New Zealand rabbits and treated with different injectable formulae, including rhBMP-2 liposomes and in situ gel (rhBMP-2-LIG). RESULTS The results indicated that the prepared rhBMP-2-LIG prolonged the release and residence time of BMP-2 within rabbits for more than 7 days. Histomorphometric assessment showed 67% trabecular bone filling of the defects treated using this novel formula. CONCLUSION BMP-2-LIG is a promising delivery device for the repair of alveolar bone defects associated with cleft deformities.
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Affiliation(s)
- Ali H Hassan
- a Department of Orthodontics , Faculty of Dentistry, King Abdulaziz University , Jeddah , Saudi Arabia
| | - Khaled M Hosny
- b Department of Pharmaceutics and Industrial Pharmacy , Faculty of Pharmacy, King Abdulaziz University , Jeddah , Saudi Arabia .,c Department of Pharmaceutics and Industrial Pharmacy , Faculty of Pharmacy, Beni Suef University , Beni Suef , Egypt
| | - Zuahir A Murshid
- a Department of Orthodontics , Faculty of Dentistry, King Abdulaziz University , Jeddah , Saudi Arabia
| | - Adel Alhadlaq
- d Department of Pediatric Dentistry and Orthodontics , Collage of Dentistry, King Saud University , Riyadh , Saudi Arabia
| | | | - Ghada Naguib
- f Department of Restorative Dentistry , Faculty of Dentistry, King Abdulaziz University , Jeddah , Saudi Arabia , and
| | - Hala M Alkhalidi
- g Department of Clinical Pharmacy , Faculty of Pharmacy, King Abdulaziz University , Jeddah , Saudi Arabia
| | - Ahmed R Afify
- a Department of Orthodontics , Faculty of Dentistry, King Abdulaziz University , Jeddah , Saudi Arabia
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Treatment algorithm for bilateral alveolar cleft based on the position of the premaxilla and the width of the alveolar gap. J Plast Reconstr Aesthet Surg 2013; 66:1212-8. [DOI: 10.1016/j.bjps.2013.04.060] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 04/16/2013] [Accepted: 04/23/2013] [Indexed: 11/19/2022]
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Altalibi M, Saltaji H, Edwards R, Major PW, Flores-Mir C. Indices to assess malocclusions in patients with cleft lip and palate. Eur J Orthod 2013; 35:772-82. [PMID: 23504529 DOI: 10.1093/ejo/cjt009] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Several indices are now available to assess the severity of the malocclusion in cleft lip and/or palate (CLP) patients; and although it has been quite some time since the introduction of these indices, there is no consensus as to which index should be used for CLP populations. OBJECTIVE To systematically review the available literature on the indices used to assess the occlusal schemes in dental models of CLP patients, with respect to the most commonly used index and the index that most fulfils the World Health Organization (WHO) criteria. SEARCH METHODS Ten electronic databases, grey literature, and reference list searches were conducted. SELECTION CRITERIA The inclusion criteria consisted of studies that aimed to assess a particular malocclusion index on study models of patients with CLP. DATA COLLECTION AND ANALYSIS Full articles were retrieved from abstracts/titles that appeared to have met the inclusion -exclusion criteria which were subsequently reviewed using more detailed criteria for a final selection decision. The Quality Assessment of Diagnostic Accuracy Studies tool was used to appraise the methodological quality of the finally included studies. Due to the heterogeneity of the data, only a qualitative analysis was performed. RESULTS A total of 13 studies met the inclusion -exclusion criteria. These studies revealed seven utilized indices, namely the GOSLON Yardstick, Five-Year-Old, Bauru-Bilateral Cleft Lip and Palate Yardstick, Huddart -Bodenham, Modified Huddart -Bodenham, EUROCRAN Yardstick, and GOAL Yardstick. The GOSLON Yardstick was the most commonly used index, and the Modified Huddart -Bodenham performed the best according to the WHO criteria. CONCLUSIONS Current evidence suggests that the Modified Huddart -Bodenham Index equalled or outperformed the rest of the indices on all the WHO criteria and that the GOSLON Yardstick was the most commonly used index, possibly due to a longer time in use. Therefore, the Modified Huddart -Bodenham could be considered as the standard to measure outcomes of patients with CLP.
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Affiliation(s)
- Mostafa Altalibi
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Chigurupati R. Orthognathic surgery for secondary cleft and craniofacial deformities. Oral Maxillofac Surg Clin North Am 2012; 17:503-17. [PMID: 18088803 DOI: 10.1016/j.coms.2005.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Orthognathic surgery is a critical component of surgical management of craniofacial deformities such as cleft lip and palate, craniofacial dysostoses, and mandibulofacial dysostoses. These operations can correct discrepancy in jaw relationship and malocclusion, relieve airway obstruction, correct facial asymmetry, optimize facial aesthetics, improve speech articulation, improve ability to masticate, and enhance psychological development and social interaction. Oral and maxillofacial surgeons who treat these deformities should be part of a craniofacial team to provide interdisciplinary care for patients. Distraction osteogenesis is a useful technique in the management of severe craniofacial deformities but does not replace conventional orthognathic surgery, which is safe and predictable. Recent advances in three-dimensional imaging and planning tools have made it possible to plan surgery more accurately and predictably.
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Affiliation(s)
- Radhika Chigurupati
- Department of Oral and Maxillofacial Surgery, University of California-San Francisco, 521 Parnassus Avenue, C-522, San Francisco, CA 94143-0440, USA
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8
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Maxillary growth in patients with complete cleft lip and palate, operated on around 4-6 months of age. Int J Pediatr Otorhinolaryngol 2010; 74:482-5. [PMID: 20211494 DOI: 10.1016/j.ijporl.2010.01.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 01/27/2010] [Accepted: 01/31/2010] [Indexed: 11/20/2022]
Abstract
BACKGROUND The controversy about timing of cleft palate repair has been focused on early closure for improved speech versus delayed repair for enhancing maxillary growth. Early palatal repair enhances phonological development decreasing the frequency of articulation disorders associated with velopharyngeal insufficiency (VPI). In contrast, it has been described that early surgery adversely affects maxillary growth. OBJECTIVE The purpose of this paper is to study maxillary growth in a group of cleft palate patients operated on around 4-6 months of age, and receiving further orthodontic treatment. MATERIALS AND METHODS A group of 20 cleft palate patients, who were subjected to early minimal incision palatopharyngoplasty around 4-6 months of age, were followed for a minimum of 10 years (range: 10-14 years). All patients received the same orthodontic management, starting at 4 years of age. None of the patients had orthognatic surgery or alveolar bone grafting. After orthodontic treatment, their cephalometric data were compared with a group of subjects without cleft lip and palate, matched by gender and who were within the age range of the cleft palate group. RESULTS SNA, SNB, ANB, and WITS cephalometric measures were compared. A non-significant difference was found in all measurements between the two groups. CONCLUSION Early cleft palate repair enhances phonological development. Although maxillary growth is affected in cleft palate patients, appropriate orthodontic treatment can achieve normal maxillary growth as measured during adolescence.
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