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Alkhathami AM, Alturki AT, Ulhaq MM, Al-Meshal O. Pattern of Cleft Lip and Palate Clefts at a Tertiary Care Hospital in Saudi Arabia. Cleft Palate Craniofac J 2024:10556656241267234. [PMID: 39094378 DOI: 10.1177/10556656241267234] [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: 08/04/2024] Open
Abstract
BACKGROUND Clefts of the lip and palate (CL/P) and cleft palate (CP) are the most common craniofacial congenital anomalies. Clefts are classified as syndromic and nonsyndromic. Nonsyndromic clefts have no known genetic causes. OBJECTIVES This study combines prospective and retrospective studies to review the patterns of CL/P and CP and associated syndromes and conditions in patients registered for CL/P surgery at a tertiary care pediatric center in our tertiary care hospital in Saudi Arabia. METHODS It included patient data from May 2015 through April 2023. Patient record forms and SPSS (IBM version 20.0) were used to collect and analyze data. A significance level of 5% was used, with p ≤ 0.05 considered statistically significant. RESULTS Of the 319 patients who met our inclusion criteria, 175 were male. Of the total, 99 had a left unilateral isolated cleft lip, 61 had a right unilateral isolated cleft lip, 69 had a bilateral cleft lip, and 90 had an isolated CP. Of the total, 140 had CL/P. Around 242 were nonsyndromic. The Chi-square test revealed a significant association between the prevalence of isolated CP and CLP and gender. The prevalence of left unilateral isolated cleft lip and bilateral and isolated CP was significantly associated with syndromic and nonsyndromic cases. CONCLUSION Males are more likely to be affected by orofacial clefts, which is consistent with the global trend. Isolated CP was the most common orofacial cleft. Within the sample, syndromes' association with orofacial clefts was significantly weaker than that of isolated and bilateral clefts.
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Affiliation(s)
- Ali M Alkhathami
- Department of Plastic Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ahmed T Alturki
- Department of Plastic Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Muhammad M Ulhaq
- Department of Plastic Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Obaid Al-Meshal
- Department of Plastic Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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Alkharafi L, Mokhtar A, Burezq H, Almerjan D, Dashti G, Almutalaqem R, Alshammari A, Alhasawi S, Alqatami F, Geevarghese A. Seasonal, Geographic, and Ethnic Influence on the Prevalence of Orofacial Clefts in Kuwait: A Nationwide Study. Cleft Palate Craniofac J 2024; 61:1257-1265. [PMID: 36945783 DOI: 10.1177/10556656231163023] [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] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVE Accurate nationwide epidemiological evidence is vital to study the seasonal, geographic, and ethnic influence on the trends of orofacial cleft prevalence in Kuwait. DESIGN Data obtained from the National Center for Health Information and Ministry of Health Hospital digital records were reviewed retrospectively to identify patients with orofacial clefts (OFC) using the ICD-10 diagnostic codes. The Jonckheere-Terpstra test was used to assess the trend of birth prevalence across the different years. The associations of types of OFC with ethnic and geographic influences were tested with chi-square or Fisher's exact tests, while the strength of that association was tested with multi-nominal logistic regression. RESULTS Birth prevalence in Kuwait ranged from 0.75-2.55 per 1000 live births (0.73- 2.73 among Kuwaitis, 0.60-3.27 among non-Kuwaitis), with no statistically significant change observed during the past 28 years. The risk of unilateral cleft lip and palate was eight times higher during summer compared to Autumn, while the risk of cleft lip and palate remained lower during winter. Jahra (OR-7.76, CI- 1.51-39.80), Farwaneya (OR-6.65, CI- 1.34-33.06), and Hawalli (OR-6.72, CI- 1.26-35.98) governorates had higher odds of bilateral cleft lip when compared to Mubarak Alkabeer. CONCLUSIONS The study outcome is an indicator to improve patient care and customize healthcare infrastructure in the Ministry of Health. It also provides insight to develop projections of future needs. Future studies should focus on understanding the factors that might be a potential contributor to the seasonal change observed in the prevalence of OFC.
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Affiliation(s)
| | - Ashraf Mokhtar
- Department of Orthodontics, Ministry of Health, Sulaibikhat, Kuwait
| | - Hisham Burezq
- Department of Plastic Surgery, Ministry of Health, Sulaibikhat, Kuwait
| | - Deemah Almerjan
- Department of Dentistry, Ministry of Health, Sulaibikhat, Kuwait
| | - Ghaidaa Dashti
- Department of Dentistry, Ministry of Health, Sulaibikhat, Kuwait
| | - Reem Almutalaqem
- Department of Dentistry, Ministry of Health, Sulaibikhat, Kuwait
| | | | - Saud Alhasawi
- Department of Orthodontics, Ministry of Health, Sulaibikhat, Kuwait
| | - Fawzi Alqatami
- Department of Orthodontics, Ministry of Health, Sulaibikhat, Kuwait
| | - Amrita Geevarghese
- Kuwait Institute for Medical Specializations, Ministry of Health, Sulaibikhat, Kuwait
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3
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Denadai R, Lo LJ. Reducing delayed detection of isolated cleft palate-related deformity: a call for routine intraoral examination of newborns. J Pediatr (Rio J) 2024; 100:350-359. [PMID: 38307119 DOI: 10.1016/j.jped.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVE To provide healthcare professional-friendly practical recommendations for early detection of cleft palate-related deformities in newborns and offer an overview of managing these high-prevalent congenital abnormalities. SOURCE OF DATA PubMed, SciELO, Lilacs, Cochrane, ScienceDirect, and Scopus databases were reviewed for cleft- and diagnosis-related studies. SUMMARY OF THE FINDINGS Unfortunately, the global prevalence of delayed detection of cleft palate-related deformities remains unacceptably high, with over a quarter of cleft palates missed at birth. This delayed identification causes physical and psychological distress for patients and families, including feeding challenges and weight faltering. To improve cleft management, it is essential to adopt routine detailed, in-depth intraoral examination immediately after birth. It is recommended not only to finger-assisted palpate the intraoral structures but also to visually inspect the oral cavity from gingiva to uvula using a wooden tongue depressor and light-assisted examination. With timely diagnosis and referral to specialized care, pediatricians, nurses, speech therapists, and plastic surgeons provide life-changing treatments, including health care maintenance, anticipatory guidance, feeding support, primary surgical reconstruction, and age- and condition-specific protocols. CONCLUSIONS Encouraging neonatologists and pediatricians, who are the first to examine newborns, to actively investigate the intraoral region for cleft palate-related deformities is instrumental in optimizing therapeutic approaches and prioritizing age-phases in treatment. Their crucial role in early detection and referral can lead to transformative outcomes, impacting not only the future of the newborns by facilitating functional integration into society but also yielding positive effects on families and the health system.
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Affiliation(s)
- Rafael Denadai
- Centro Avançado de Cirurgia Plástica Facial, A&D DermePlastique, São Paulo, SP, Brazil; Centro Universitário Max Planck (UniMAX), Faculdade de Medicina, Indaiatuba, SP, Brazil; Chang Gung Memorial Hospital, Craniofacial Research Center, Taoyuan, Taiwan.
| | - Lun-Jou Lo
- Chang Gung Memorial Hospital, Craniofacial Research Center, Taoyuan, Taiwan; Chang Gung University, Chang Gung Memorial Hospital, Department of Plastic and Reconstructive Surgery, Taoyuan, Taiwan
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4
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Patiño AMB, Rodrigues MDP, Pessoa RS, Rubinsky SY, Kim KB, Soares CJ, Almeida GDA. Biomechanical behavior of three maxillary expanders in cleft lip and palate: a finite element study. Braz Oral Res 2024; 38:e010. [PMID: 38597509 DOI: 10.1590/1807-3107bor-2024.vol38.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/09/2023] [Indexed: 04/11/2024] Open
Abstract
This study evaluated the stress distribution in the dentoalveolar and palatal bone structures during maxillary expansion in a 17-year-old male patient with bilateral cleft lip and palate (BCLP) using expanders with dental (HYRAX) and skeletal anchorage (MARPE). For the generation of the specific finite element models, cone-beam computed tomography was used, and the DICOM files were exported to Mimics 3-Matic (Materialise) and Patran (MSC Software) software. Three specific three-dimensional models were generated: A) HYRAX: conventional four-banded hyrax screw (9 mm); B) MARPE-DS: 3 miniscrews (1.8 mm diameter - 5.4 mm length) and four-banded dental anchorage; and C) MARPE-NoDS: 3 miniscrews without dental anchorage. Maxillary expansion was simulated by activating the expanders transversely 1 mm on the "X" axis. HYRAX resulted in higher levels of deformation predominantly in the dentoalveolar region. MARPE-DS showed stress in the dentoalveolar region and mainly in the center of the palatal region, at approximately 4,000 με. MARPE-NoDS exhibited evident stress only in the palatal region. High stress levels in the root anchoring teeth were observed for HYRAX and MARPE-DS. In contrast, MARPE-NoDS cause stress on the tooth structure. The stress distribution from the expanders used in the BLCP showed asymmetric expansive behavior. During the initial activation phase of expansion, the HYRAX and MARPE-DS models produced similarly high strain at the dentoalveolar structures and upper posterior teeth displacement. The MARPE-NoDS model showed restricted strain on the palate.
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Affiliation(s)
- Angela Maria Bautista Patiño
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Uberlândia, MG, Brazil
| | - Monise de Paula Rodrigues
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Roberto Sales Pessoa
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Uberlândia, MG, Brazil
| | - Salomón Yezioro Rubinsky
- Universidad Nacional de Colombia, School of Dentistry, Department of Orthodontics, Bogotá, Colombia
| | - Ki Beom Kim
- Saint Louis University, Center for Advanced Dental Education, Department of Orthodontics, Saint Louis, MI, USA
| | - Carlos José Soares
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Guilherme de Araújo Almeida
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Uberlândia, MG, Brazil
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Sharif H, Ziaei H, Rezaei N. Stem Cell-Based Regenerative Approaches for the Treatment of Cleft Lip and Palate: A Comprehensive Review. Stem Cell Rev Rep 2024; 20:637-655. [PMID: 38270744 DOI: 10.1007/s12015-024-10676-9] [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] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
Cleft lip and/or palate (CLP) is a prevalent congenital craniofacial abnormality that can lead to difficulties in eating, speaking, hearing, and psychological distress. The traditional approach for treating CLP involves bone graft surgery, which has limitations, post-surgical complications, and donor site morbidity. However, regenerative medicine has emerged as a promising alternative, employing a combination of stem cells, growth factors, and scaffolds to promote tissue regeneration. This review aims to provide a comprehensive overview of stem cell-based regenerative approaches in the management of CLP. A thorough search was conducted in the Medline/PubMed and Scopus databases, including cohort studies, randomized controlled trials, case series, case controls, case reports, and animal studies. The identified studies were categorized into two main groups: clinical studies involving human subjects and in vivo studies using animal models. While there are only a limited number of studies investigating the combined use of stem cells and scaffolds for CLP treatment, they have shown promising results. Various types of stem cells have been utilized in conjunction with scaffolds. Importantly, regenerative methods have been successfully applied to patients across a broad range of age groups. The collective findings derived from the reviewed studies consistently support the notion that regenerative medicine holds potential advantages over conventional bone grafting and represents a promising therapeutic option for CLP. However, future well-designed clinical trials, encompassing diverse combinations of stem cells and scaffolds, are warranted to establish the clinical efficacy of these interventions with a larger number of patients.
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Affiliation(s)
- Helia Sharif
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Dental Society, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Heliya Ziaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, US
| | - Nima Rezaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
- Children's Medical Center Hospital, Dr. Qarib St, Keshavarz Blvd, Tehran, 14194, Iran.
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Maili L, Tandon B, Yuan Q, Menezes S, Chiu F, Hashmi SS, Letra A, Eisenhoffer GT, Hecht JT. Disruption of fos causes craniofacial anomalies in developing zebrafish. Front Cell Dev Biol 2023; 11:1141893. [PMID: 37664458 PMCID: PMC10469461 DOI: 10.3389/fcell.2023.1141893] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/21/2023] [Indexed: 09/05/2023] Open
Abstract
Craniofacial development is a complex and tightly regulated process and disruptions can lead to structural birth defects, the most common being nonsyndromic cleft lip and palate (NSCLP). Previously, we identified FOS as a candidate regulator of NSCLP through family-based association studies, yet its specific contributions to oral and palatal formation are poorly understood. This study investigated the role of fos during zebrafish craniofacial development through genetic disruption and knockdown approaches. Fos was expressed in the periderm, olfactory epithelium and other cell populations in the head. Genetic perturbation of fos produced an abnormal craniofacial phenotype with a hypoplastic oral cavity that showed significant changes in midface dimensions by quantitative facial morphometric analysis. Loss and knockdown of fos caused increased cell apoptosis in the head, followed by a significant reduction in cranial neural crest cells (CNCCs) populating the upper and lower jaws. These changes resulted in abnormalities of cartilage, bone and pharyngeal teeth formation. Periderm cells surrounding the oral cavity showed altered morphology and a subset of cells in the upper and lower lip showed disrupted Wnt/β-catenin activation, consistent with modified inductive interactions between mesenchymal and epithelial cells. Taken together, these findings demonstrate that perturbation of fos has detrimental effects on oral epithelial and CNCC-derived tissues suggesting that it plays a critical role in zebrafish craniofacial development and a potential role in NSCLP.
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Affiliation(s)
- Lorena Maili
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States
- Genetics and Epigenetics Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, TX, United States
| | - Bhavna Tandon
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Qiuping Yuan
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Simone Menezes
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry at Houston, Houston, TX, United States
| | - Frankie Chiu
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States
| | - S. Shahrukh Hashmi
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Ariadne Letra
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry at Houston, Houston, TX, United States
- Department of Diagnostic and Biomedical Sciences, University of Texas Health Science Center School of Dentistry at Houston, Houston, TX, United States
| | - George T. Eisenhoffer
- Genetics and Epigenetics Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, TX, United States
- Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jacqueline T. Hecht
- Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States
- Genetics and Epigenetics Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, TX, United States
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry at Houston, Houston, TX, United States
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Hattori Y, Pai BCJ, Saito T, Chou PY, Lu TC, Chang CS, Chen YR, Lo LJ. Long-term treatment outcome of patients with complete bilateral cleft lip and palate: a retrospective cohort study. Int J Surg 2023; 109:1656-1667. [PMID: 37073546 PMCID: PMC10389451 DOI: 10.1097/js9.0000000000000406] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/06/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Patients with cleft lip and palate have functional and esthetic impairment and typically require multiple interventions in their life. Long-term evaluation following a treatment protocol, especially for patients with complete bilateral cleft lip and palate (BCLP), is important but was rarely reported in the literature. PATIENTS AND METHODS A retrospective review was conducted on all patients with complete BCLP born between 1995 and 2002 and treated at our center. Inclusion criteria were having adequate medical records and receiving continuous multidisciplinary team care at least until 20 years of age. Exclusion criteria were lack of regular follow-up and congenital syndromic abnormalities. The medical records and photos were reviewed, and facial bone development was evaluated using cephalometric analysis. RESULTS A total of 122 patients were included, with a mean age of 22.1 years at the final evaluation in this study. Primary one-stage cheiloplasty was performed in 91.0% of the patients, and 9.0% underwent two-stage repair with an initial adhesion cheiloplasty. All patients underwent two-flap palatoplasty at an average of 12.3 months. Surgical intervention for velopharyngeal insufficiency was required in 59.0% of patients. Revisional lip/nose surgery was performed in 31.1% during growing age and in 64.8% after skeletal maturity. Orthognathic surgery was applied in 60.7% of patients with retruded midface, of which 97.3% underwent two-jaw surgery. The average number of operations to complete the treatment was 5.9 per patient. CONCLUSION Patients with complete BCLP remain the most challenging group to treat among the cleft. This review revealed certain suboptimal results, and modifications have been made to the treatment protocol. Longitudinal follow-up and periodic assessment help to establish an ideal therapeutic strategy and improve overall cleft care.
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Affiliation(s)
- Yoshitsugu Hattori
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center
| | - Betty C.-J. Pai
- Department of Craniofacial Orthodontics and Craniofacial Research Center, Chang Gung Memorial Hospital, Kwei Shan, Taoyuan, Taiwan
| | - Takafumi Saito
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center
| | - Pang-Yun Chou
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center
| | - Ting-Chen Lu
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center
| | - Chun-Shin Chang
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center
| | - Yu-Ray Chen
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center
| | - Lun-Jou Lo
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center
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Long-Term Stability of Alveolar Bone Graft in Cleft Lip and Palate Patients: Systematic Review and Meta-Analysis. J Craniofac Surg 2022; 33:e194-e200. [DOI: 10.1097/scs.0000000000008254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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9
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Michael A, Olusaya A. Health-related quality of life and facial function in children with repaired cleft palate attending a speech camp: A descriptive cross-sectional study. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_42_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ultrasonic Imaging Investigation of Tongue Movement Patterns of Cleft-Related Lateralized and Palatalized Misarticulation. J Craniofac Surg 2021; 33:e421-e426. [PMID: 34775447 DOI: 10.1097/scs.0000000000008366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To explore the tongue movement patterns on Mandarin speaking children with repaired cleft palate with lateralized and palatalized misarticulation (LPM) using ultrasound imaging technique. METHODS A group of 20 subjects who were diagnosed with speech sound disorder after cleft palate repairment, and another group of 18 children with LPM were recruited. A group of 20 typical children were recruited as the control group. The ultrasonography was used to collect the articulation pattern of the 8 single vowels that are /a/, /o/, /[Latin Small Letter Reversed e]/, /i/, /u/, /y/, /ɨ/, /u/ in Mandarin Chinese. Various ultrasonic tongue parameters were analyzed from both sagittal and coronal planes. RESULTS Compared with the control group, coronal height of peak point, coronal tongue dorsum constraint index, sagittal peak point offset distance, sagittal distance between tongue tip and peak point, and sagittal tongue dorsum constraint index of /[Latin Small Letter Reversed e]/,/i/, /y/ and /ɨ/ were significantly smaller in the cleft-related lateralized and palatalized group (CLP) and noncleft-related lateralized and palatalized group (NLP) (P < 0.05). Compared with the noncleft-related lateralized and palatalized group and control group, sagittal peak point offset distance of the vowels /[Latin Small Letter Reversed e]/ and /i/ was significant smaller in the cleft-related lateralized and palatalized group group (P < 0.05). CONCLUSIONS The ultrasound images on the children with cleft palate showed a midline elevation of the tongue and a significant apical constriction. The children with LPM showed a midline elevation at the coronal plane and anterior movement of the tongue high point at the sagittal plane. The apical vowels were more informative and accurate in indicating the features of LPM than other vowels.
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Brézulier D, Chaigneau L, Jeanne S, Lebullenger R. The Challenge of 3D Bioprinting of Composite Natural Polymers PLA/Bioglass: Trends and Benefits in Cleft Palate Surgery. Biomedicines 2021; 9:1553. [PMID: 34829782 PMCID: PMC8615666 DOI: 10.3390/biomedicines9111553] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 11/22/2022] Open
Abstract
Cleft lip and palate is the fourth most common congenital malformation. Its prevalence is about 1 in 750 to 1 in 2000 live births. The consequences of this malformation are major: maxillary growth deficit, unaesthetic appearance, phonation disorders, difficulty in eating, and psycho-social disorders. Cleft palate repair establishes the division between the oral and nasal cavities. The alveolar bone graft is a key step. Different sites of autogenous bone harvesting are used, the most common being the iliac crest. Nevertheless, the large number of complications associated with harvesting has led to the use of substitute biomaterials. Bioactive glasses, discovered in 1969, are a group of synthetic silica-based materials with bone-bonding properties. Although 45S5 granular composition is commonly used in bone surgery to repair critical defects, it is only rarely used in the repair of cleft palates because this galenic form is only moderately adapted. However, advances in bone tissue engineering allow the shaping of three-dimensional scaffolds, which support colonization by host cells. Recent advances in computer-aided design/computer-aided manufacturing (CAD/CAM) have even led to the 3D printing of scaffolds combining 45S5 bioglass with a natural and biocompatible poly-lactic acid matrix. The shape of the parts is customized and adapted to the particular shape of the critical bone defects. The objective of this literature review is to highlight the particularities of alveolar defects subsequent to facial clefts, then to detail the characteristics of the materials and technologies used to elaborate 3D matrices by bioprinting. Finally, we will explore research directions regarding their use in reconstructive surgery of cleft palates.
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Affiliation(s)
- Damien Brézulier
- CNRS, University of Rennes, ISCR-UMR 6226, 35000 Rennes, France; (L.C.); (S.J.); (R.L.)
- Pôle Odontologie, CHU Rennes, University of Rennes, 35043 Rennes, France
| | - Louis Chaigneau
- CNRS, University of Rennes, ISCR-UMR 6226, 35000 Rennes, France; (L.C.); (S.J.); (R.L.)
| | - Sylvie Jeanne
- CNRS, University of Rennes, ISCR-UMR 6226, 35000 Rennes, France; (L.C.); (S.J.); (R.L.)
- Pôle Odontologie, CHU Rennes, University of Rennes, 35043 Rennes, France
| | - Ronan Lebullenger
- CNRS, University of Rennes, ISCR-UMR 6226, 35000 Rennes, France; (L.C.); (S.J.); (R.L.)
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Zhu Y, Miao H, Zeng Q, Li B, Wang D, Yu X, Wu H, Chen Y, Guo P, Liu F. Prevalence of cleft lip and/or cleft palate in Guangdong province, China, 2015-2018: a spatio-temporal descriptive analysis. BMJ Open 2021; 11:e046430. [PMID: 34341041 PMCID: PMC8330564 DOI: 10.1136/bmjopen-2020-046430] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/17/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the temporal and spatial characteristics of cleft lip and/or palate based on a large-scale birth defect monitoring database. METHODS Data on perinatal infants and children with cleft lip and/or palate defects from 1 January 2015 to 31 December 2018 in Guangdong province of China were collected. The variables including the demographic data, basic family information (address, education level, etc.), the infant's birth weight, gender and other basic parameters were collected and analysed. RESULTS During the study period, the prevalence of cleft lip and/or palate was 7.55 per 10 000 perinatal infants. The prevalence of cleft lip, cleft palate and cleft lip and palate were 2.34/10 000, 2.22/10 000 and 2.98/10 000, respectively. The prevalence of cleft lip and/or palate showed a pronounced downward trend, reducing from 8.47/10 000 in 2015 to 6.51/10 000 in 2018. We observed spatial heterogeneity of prevalence of cleft lip and/or palate across the study period in Guangdong. In the Pearl River Delta region, the overall prevalence of cleft lip and/or palate was 7.31/10 000, while the figure (7.86/10 000) was slightly higher in the non-Pearl River Delta region (p<0.05). Concerning infant gender, the prevalence was in general higher in boys than girls (p<0.05). In addition, the higher prevalence was more common in mothers older than 35 years old. For the birth season, infants born in spring tended to have a higher prevalence than those born in other seasons, regardless of the prevalence of cleft lip and palate calculated separately or jointly (p<0.05). The majority of newborns with cleft lip and palate were accompanied by other birth defects. CONCLUSION This study contributes a better understanding of the characteristics of spatio-temporal trends for birth defects of cleft lip and/or palate in south China.
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Affiliation(s)
- Yingxian Zhu
- Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Huazhang Miao
- Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Qinghui Zeng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Bing Li
- Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Degang Wang
- Boai Hospital of Zhongshan, Zhongshan, China
| | - Xiaolin Yu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Haisheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Fenghua Liu
- Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
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13
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Denault WRP, Romanowska J, Haaland ØA, Lyle R, Taylor J, Xu Z, Lie RT, Gjessing HK, Jugessur A. Wavelet Screening identifies regions highly enriched for differentially methylated loci for orofacial clefts. NAR Genom Bioinform 2021; 3:lqab035. [PMID: 33987535 PMCID: PMC8092375 DOI: 10.1093/nargab/lqab035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 04/05/2021] [Accepted: 04/16/2021] [Indexed: 12/04/2022] Open
Abstract
DNA methylation is the most widely studied epigenetic mark in humans and plays an essential role in normal biological processes as well as in disease development. More focus has recently been placed on understanding functional aspects of methylation, prompting the development of methods to investigate the relationship between heterogeneity in methylation patterns and disease risk. However, most of these methods are limited in that they use simplified models that may rely on arbitrarily chosen parameters, they can only detect differentially methylated regions (DMRs) one at a time, or they are computationally intensive. To address these shortcomings, we present a wavelet-based method called 'Wavelet Screening' (WS) that can perform an epigenome-wide association study (EWAS) of thousands of individuals on a single CPU in only a matter of hours. By detecting multiple DMRs located near each other, WS identifies more complex patterns that can differentiate between different methylation profiles. We performed an extensive set of simulations to demonstrate the robustness and high power of WS, before applying it to a previously published EWAS dataset of orofacial clefts (OFCs). WS identified 82 associated regions containing several known genes and loci for OFCs, while other findings are novel and warrant replication in other OFCs cohorts.
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Affiliation(s)
- William R P Denault
- Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, 0473, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, 5006, Bergen, Norway
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473, Oslo, Norway
| | - Julia Romanowska
- Department of Global Public Health and Primary Care, University of Bergen, 5006, Bergen, Norway
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473, Oslo, Norway
| | - Øystein A Haaland
- Department of Global Public Health and Primary Care, University of Bergen, 5006, Bergen, Norway
| | - Robert Lyle
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, 0450, Oslo, Norway
| | - Jack A Taylor
- Epidemiology Branch and Epigenetics and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences (NIH/NIEHS), 27709, Durham, North Carolina, USA
| | - Zongli Xu
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIH/NIEHS), 27709, Durham, North Carolina, USA
| | - Rolv T Lie
- Department of Global Public Health and Primary Care, University of Bergen, 5006, Bergen, Norway
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473, Oslo, Norway
| | - Håkon K Gjessing
- Department of Global Public Health and Primary Care, University of Bergen, 5006, Bergen, Norway
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473, Oslo, Norway
| | - Astanand Jugessur
- Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, 0473, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, 5006, Bergen, Norway
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473, Oslo, Norway
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14
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Nasreddine G, El Hajj J, Ghassibe-Sabbagh M. Orofacial clefts embryology, classification, epidemiology, and genetics. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2021; 787:108373. [PMID: 34083042 DOI: 10.1016/j.mrrev.2021.108373] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 01/14/2023]
Abstract
Orofacial clefts (OFCs) rank as the second most common congenital birth defect in the United States after Down syndrome and are the most common head and neck congenital malformations. They are classified as cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO). OFCs have significant psychological and socio-economic impact on patients and their families and require a multidisciplinary approach for management and counseling. A complex interaction between genetic and environmental factors contributes to the incidence and clinical presentation of OFCs. In this comprehensive review, the embryology, classification, epidemiology and etiology of clefts are thoroughly discussed and a "state-of-the-art" snapshot of the recent advances in the genetics of OFCs is presented.
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Affiliation(s)
- Ghenwa Nasreddine
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 13-5053, Chouran, 1102 2801, Beirut, Lebanon.
| | - Joelle El Hajj
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 13-5053, Chouran, 1102 2801, Beirut, Lebanon.
| | - Michella Ghassibe-Sabbagh
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 13-5053, Chouran, 1102 2801, Beirut, Lebanon.
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15
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Gil-da-Silva-Lopes VL, Tacla MA, Sgardioli IC, Vieira TP, Monlleó IL. Brazil's Craniofacial Project: Different approaches on orofacial clefts and 22q11.2 deletion syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2020; 184:912-927. [PMID: 33166033 DOI: 10.1002/ajmg.c.31852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/25/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022]
Abstract
This article reports the present situation of Brazilian health care in genetics for Orofacial Cleft (OFC) and 22q11.2 Deletions Syndrome (22q11.2 DS) based on research conducted by Brazil's Craniofacial Project (BCFP). Established in 2003, BCFP is a voluntary and cooperative network aiming to investigate the health care of people with these diseases and other craniofacial anomalies. The initiatives and research results are presented in four sections: (a) a comprehensive report of the Brazilian public health system in craniofacial genetics; (b) multicentric studies developed on OFC and 22q11.2 DS; (c) education strategies focused on addressing these conditions for both population and health-care professionals; and (d) the nosology through the Brazilian Database on Craniofacial Anomalies (BDCA). Since 2006, BDCA uses a standardized method with detailed clinical data collection, which allows for conducting studies on nosology, genotype-phenotype correlations, and natural history; data can also contribute to public policies. Currently, the BDCA stores data on 1,724 individuals, including 1,351 (78.36%) who were primarily admitted due to OFC and 373 (21.63%) with clinical suspicion of 22q11.2 DS. Chromosomal abnormalities/genomic imbalances were represented by 92/213 (43.19%) individuals with syndromic OFC, including 43 with 22q11.2 DS, which indicates the need for chromosomal microarray analysis in this group. The nosologic diversity reinforces that monitoring clinical is the best strategy for etiological investigation. BCFP's methodology has introduced the possibility of increasing scientific knowledge and genetic diagnosis of OFC and 22q11.2 DS to in turn improve health care and policies for this group of diseases.
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Affiliation(s)
- Vera Lúcia Gil-da-Silva-Lopes
- Faculty of Medical Sciences, Department of Medical Genetics and Genomic Medicine, University of Campinas (Unicamp), Campinas, Sao Paulo, Brazil
| | - Milena Atique Tacla
- Faculty of Medical Sciences, Department of Medical Genetics and Genomic Medicine, University of Campinas (Unicamp), Sao Paulo, Brazil
| | - Ilária Cristina Sgardioli
- Faculty of Medical Sciences, Department of Medical Genetics and Genomic Medicine, University of Campinas (Unicamp), Campinas, Sao Paulo, Brazil
| | - Társis Paiva Vieira
- Faculty of Medical Sciences, Department of Medical Genetics and Genomic Medicine, University of Campinas (Unicamp), Campinas, Sao Paulo, Brazil
| | - Isabella Lopes Monlleó
- Faculty of Medicine, Clinical Genetics Service, University Hospital, Medical Genetics Sector, Federal University of Alagoas-UFAL, Maceió, Alagoas, Brazil
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16
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Evaluating the Anatomical Traits of Lip on Three-Dimensional Computed Tomography Images. J Craniofac Surg 2020; 31:e163-e166. [PMID: 31934969 DOI: 10.1097/scs.0000000000006124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Lips and mouth are the most recognizable parts of the lower face. The morphometry of the facial organs is important for the balance of the face. Besides congenital anomalies occur on the lips, some kinds of deformities might be seen because of trauma or carcinoma. In this respect, lips are in the study of plastic surgery, maxillofacial surgery and orthodontics. Lip morphology also takes an important role in forensic facial reconstruction (facial approximation). MATERIALS AND METHODS Twenty parameters on the soft tissue and 12 parameters on the hard tissue were measured on three dimensional (3D) computed tomography (CT) images belonging 50 individuals (25 female, mean age 35.40 ± 9.97; 25 male, mean age 34.32 ± 11.06). RESULTS Statistical significance was observed on 4 parameters measured at soft tissue and 6 parameters measured in hard tissue. Statistical significance was not seen between the measurements taken bilaterally. Fourteen equations were developed in order to estimate the lip morphometry using the morphometric traits of hard tissue. CONCLUSION We hope that the results of current study will be useful at surgery and forensic sciences.
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17
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Bishop MR, Diaz Perez KK, Sun M, Ho S, Chopra P, Mukhopadhyay N, Hetmanski JB, Taub MA, Moreno-Uribe LM, Valencia-Ramirez LC, Restrepo Muñeton CP, Wehby G, Hecht JT, Deleyiannis F, Weinberg SM, Wu-Chou YH, Chen PK, Brand H, Epstein MP, Ruczinski I, Murray JC, Beaty TH, Feingold E, Lipinski RJ, Cutler DJ, Marazita ML, Leslie EJ. Genome-wide Enrichment of De Novo Coding Mutations in Orofacial Cleft Trios. Am J Hum Genet 2020; 107:124-136. [PMID: 32574564 PMCID: PMC7332647 DOI: 10.1016/j.ajhg.2020.05.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/26/2020] [Indexed: 01/05/2023] Open
Abstract
Although de novo mutations (DNMs) are known to increase an individual's risk of congenital defects, DNMs have not been fully explored regarding orofacial clefts (OFCs), one of the most common human birth defects. Therefore, whole-genome sequencing of 756 child-parent trios of European, Colombian, and Taiwanese ancestry was performed to determine the contributions of coding DNMs to an individual's OFC risk. Overall, we identified a significant excess of loss-of-function DNMs in genes highly expressed in craniofacial tissues, as well as genes associated with known autosomal dominant OFC syndromes. This analysis also revealed roles for zinc-finger homeobox domain and SOX2-interacting genes in OFC etiology.
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Affiliation(s)
- Madison R. Bishop
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Kimberly K. Diaz Perez
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Miranda Sun
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - Samantha Ho
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Pankaj Chopra
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nandita Mukhopadhyay
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15219, 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-Uribe
- Department of Orthodontics, College of Dentistry, University of Iowa, Iowa City, IA 52242, USA
| | | | | | - George 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
| | | | - Seth M. Weinberg
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15219, USA,Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15219, USA
| | - Yah Huei Wu-Chou
- Department of Medical Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Philip K. Chen
- Craniofacial Centre, Taipei Medical University Hospital and Taipei Medical University, Taipei, Taiwan
| | - Harrison Brand
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Michael P. Epstein
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Ingo Ruczinski
- Department of Biostatistics, 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
| | - Terri H. Beaty
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Eleanor Feingold
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15219, USA
| | - Robert J. Lipinski
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - David J. Cutler
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Mary L. Marazita
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15219, USA,Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15219, USA
| | - Elizabeth J. Leslie
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA,Corresponding author
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18
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Tao Y, Liu X, Cui L, Liu X, Chen Y, He Z, Ji M, Gao Z, Li N, Wan Z, Yu Z. Oct4 plays a role in 2, 3, 7, 8 - tetrachlorobenzo-p-dioxin (TCDD) inducing cleft palate and inhibiting mesenchymal proliferation. Toxicology 2020; 438:152444. [PMID: 32283119 DOI: 10.1016/j.tox.2020.152444] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/17/2020] [Accepted: 03/25/2020] [Indexed: 02/07/2023]
Abstract
As a common birth defect, Cleft palate can be caused by the disturbance during the developmental process of the palatal shelves. The 2,3,7,8-tetrachlorodibenzo- p-dioxin (TCDD) is a well-known environmental teratogenic agent for cleft palate and Aryl hydrocarbon receptor (AhR) pathway can be activated by dioxins. Oct4 as a pluripotent stem cell transcription factor is also involved in the process of embryonic development. The AHR and retinoid receptors have cross-talk at CYP1A1 (cytochrome P450, family 1, subfamily A, polypeptide 1) promoter. There are also bidirectional talk between AhR and Oct4. In this study, we used C57/BL6 N mice and TCDD (64 μg/Kg body weight) to establish a model of fetal cleft palate to observe the effects of dioxin on fetal mesenchymal proliferation and apoptosis, and explore the role of Oct4 in inducing cleft palate. The results showed that dioxin inhibited mesenchymal proliferation and promoted apoptosis. In addition, dioxin inhibited Oct4 expression, and preliminary data suggest that hypermethylation of the Oct4 promoter may be a putative mechanism, suggesting that TCDD might induce cleft palate by inhibiting the proliferation of palatal mesenchymal cells mediated by Oct4.
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Affiliation(s)
- Yuchang Tao
- School of Public Health, Zhengzhou University, No. 100 of Science Road, Zhengzhou, 450001, China
| | - Xiaozhuan Liu
- Center for Clinical Single-Cell Biomedicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, No. 7 of Weiwu Road, Zhengzhou, 450001, China
| | - Lingling Cui
- School of Public Health, Zhengzhou University, No. 100 of Science Road, Zhengzhou, 450001, China
| | - Xinxin Liu
- School of Public Health, Zhengzhou University, No. 100 of Science Road, Zhengzhou, 450001, China
| | - Yao Chen
- School of Public Health, Zhengzhou University, No. 100 of Science Road, Zhengzhou, 450001, China
| | - Zhidong He
- School of Public Health, Zhengzhou University, No. 100 of Science Road, Zhengzhou, 450001, China
| | - Mengmeng Ji
- School of Public Health, Zhengzhou University, No. 100 of Science Road, Zhengzhou, 450001, China
| | - Zhan Gao
- The Fifth Affiliated Hospital of Zhengzhou University, No. 3 of Kangfu Front Street, Zhengzhou, 450052, China
| | - Ning Li
- Henan Agricultural University, No. 63 of Agricultural Road, Zhengzhou, 450002, China
| | - Zhongxiao Wan
- School of Public Health, Zhengzhou University, No. 100 of Science Road, Zhengzhou, 450001, China.
| | - Zengli Yu
- School of Public Health, Zhengzhou University, No. 100 of Science Road, Zhengzhou, 450001, China.
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19
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Maili L, Letra A, Silva R, Buchanan EP, Mulliken JB, Greives MR, Teichgraeber JF, Blackwell SJ, Ummer R, Weber R, Chiquet B, Blanton SH, Hecht JT. PBX-WNT-P63-IRF6 pathway in nonsyndromic cleft lip and palate. Birth Defects Res 2019; 112:234-244. [PMID: 31825181 DOI: 10.1002/bdr2.1630] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/18/2019] [Accepted: 11/21/2019] [Indexed: 01/01/2023]
Abstract
Nonsyndromic cleft lip and palate (NSCLP) is one of the most common craniofacial anomalies in humans, affecting more than 135,000 newborns worldwide. NSCLP has a multifactorial etiology with more than 50 genes postulated to play an etiologic role. The genetic pathway comprised of Pbx-Wnt-p63-Irf6 genes was shown to control facial morphogenesis in mice and proposed as a regulatory pathway for NSCLP. Based on these findings, we investigated whether variation in PBX1, PBX2, and TP63, and their proposed interactions were associated with NSCLP. Fourteen single nucleotide variants (SNVs) in/nearby PBX1, PBX2, and TP63 were genotyped in 780 NSCLP families of nonHispanic white (NHW) and Hispanic ethnicities. Family-based association tests were performed for individual SNVs stratified by ethnicity and family history of NSCLP. Gene-gene interactions were also tested. A significant association was found for PBX2 rs3131300 and NSCLP in combined Hispanic families (p = .003) while nominal association was found for TP63 rs9332461 in multiplex Hispanic families (p = .005). Significant haplotype associations were observed for PBX2 in NHW (p = .0002) and Hispanic families (p = .003), and for TP63 in multiplex Hispanic families (.003). An independent case-control group was used to validate findings, and significant associations were found with PBX1 rs6426870 (p = .007) and TP63 rs9332461 (p = .03). Gene-gene interactions were detected between PBX1/PBX2/TP63 with IRF6 in NHW families, and between PBX1 with WNT9B in both NHW and Hispanic families (p < .0018). This study provides the first evidence for a role of PBX1 and PBX2, additional evidence for the role of TP63, and support for the proposed PBX-WNT-TP63-IRF6 regulatory pathway in the etiology of NSCLP.
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Affiliation(s)
- Lorena Maili
- Department of Pediatrics, University of Texas Health Science Center McGovern Medical School at Houston, Houston, Texas
| | - Ariadne Letra
- Department of Diagnostic and Biomedical Sciences, University of Texas Health Science Center School of Dentistry at Houston, Houston, Texas.,Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry at Houston, Houston, Texas
| | - Renato Silva
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry at Houston, Houston, Texas.,Department of Endodontics, University of Texas Health Science Center School of Dentistry at Houston, Houston, Texas
| | - Edward P Buchanan
- Department of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | | | - Matthew R Greives
- Department of Pediatric Surgery, University of Texas Health Science Center McGovern Medical School at Houston, Houston, Texas
| | - John F Teichgraeber
- Department of Pediatric Surgery, University of Texas Health Science Center McGovern Medical School at Houston, Houston, Texas
| | | | - Rohit Ummer
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry at Houston, Houston, Texas
| | - Ryan Weber
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry at Houston, Houston, Texas
| | - Brett Chiquet
- Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry at Houston, Houston, Texas.,Department of Pediatric Dentistry, University of Texas Health Science Center School of Dentistry at Houston, Houston, Texas
| | - Susan H Blanton
- Dr. John T. MacDonald Foundation Department of Human Genetics, John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Jacqueline T Hecht
- Department of Pediatrics, University of Texas Health Science Center McGovern Medical School at Houston, Houston, Texas.,Center for Craniofacial Research, University of Texas Health Science Center School of Dentistry at Houston, Houston, Texas
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20
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Shu X, Dong Z, Zhang M, Shu S. Integrated analysis identifying long non-coding RNAs (lncRNAs) for competing endogenous RNAs (ceRNAs) network-regulated palatal shelf fusion in the development of mouse cleft palate. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:762. [PMID: 32042778 PMCID: PMC6990043 DOI: 10.21037/atm.2019.11.93] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 11/05/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cleft palate results from the defective palatal fusion of the medial-edge epithelium after cells undergo epithelial-mesenchymal transition, a process that involves regulation by microRNAs (miRNAs). However, in palatal shelf fusion, miRNA regulation by long non-coding RNAs (lncRNAs) when acting as competing endogenous RNAs (ceRNAs) or miRNA sponges, remains unclear. METHODS We systematically analyzed the correlation between lncRNAs, miRNAs, and mRNAs from RNA sequencing profiling in embryonic gestation day 14.5 (E14.5) mouse embryos from control (n=3) and all-trans retinoic acid (ATRA)-treated (n=3) mice. We then constructed a lncRNA-associated ceRNA network. The expression profiles of mRNA, lncRNA, and miRNA were verified by quantitative polymerase chain reaction (qPCR). RESULTS In total, 18 aberrantly expressed miRNAs, 861 mRNAs, and 583 lncRNAs were identified from palate samples of control and ATRA-treated samples. Bioinformatics data and integrative analysis identified 69 lncRNAs, 18 miRNAs, and 78 mRNAs that were aberrantly expressed, and a ceRNA network was then constructed. Finally, we identified a NONMMUT004850.2/NONMMUT024276.2-miR-741-3p/miR-465b-5p-Prkar1α ceRNA network associated with palatal shelf fusion at E14.5. The qPCR results showed that NONMMUT004850.2 (P=5E-05), NONMMUT024276.2 (P=0.0012), and Prkar1α (P=3E-05) were up-regulated, whereas miR-741-3p (P=0.006) and miR-465b-5p (P=1E-04) were down-regulated in ATRA-treated mice compared to the control samples. The qPCR results were in concordance with the RNA sequencing profiling. CONCLUSIONS Our study demonstrated that NONMMUT004850.2/NONMMUT024276.2-miR-741-3p/miR-465b-5p-Prkar1α could potentially serve as an important regulatory mechanism of palatal fusion in the development of the cleft palate.
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Affiliation(s)
- Xuan Shu
- The Cleft Lip and Palate Treatment Center, Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Zejun Dong
- The Cleft Lip and Palate Treatment Center, Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Mingjun Zhang
- The Cleft Lip and Palate Treatment Center, Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Shenyou Shu
- The Cleft Lip and Palate Treatment Center, Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
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21
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Adetayo AM, Adetayo MO, Funmi A O, Somoye MS, Adeyemi MO, Adeyemo WL. Comparison of professional and laypeople evaluation of nasolabial esthetics following unilateral cleft lip repair. Eur J Dent 2019; 12:516-522. [PMID: 30369796 PMCID: PMC6178684 DOI: 10.4103/ejd.ejd_31_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives: The objective is to know the extent of agreement of clinicians’ perception of nasolabial esthetic compared to that of laypeople (parents). Materials and Methods: This was a prospective study of comparison of clinician's perception of nasolabial esthetics with that of laypeople following surgical repair of UCL. Participants were recruited from the Cleft Clinic of the Lagos University Teaching Hospital, and surgical repair of the cleft was performed under general anesthesia. Surgical evaluation was done through direct clinical evaluation using the modified form of the Christofides’ criteria by laypeople and professionals. Results: A total of 48 cleft participants were enrolled in the study. The evaluation of the lip by both the laypeople and professionals was similar, and there was no difference (0.588) in their rating. However, there was a significant disagreement (P = 0.001) between them in the nose assessment. Conclusion: Neither the solitary opinion of the professionals nor that of the laypeople is satisfactory in the evaluation of facial esthetics; both are equally important, especially in the assessment of nasal esthetics. However, opinion of either the laypeople or the professional might be enough in the evaluation of the lip esthetics.
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Affiliation(s)
- Adekunle Moses Adetayo
- Department of Surgery, Benjamin Carson Snr School of Medicine, Babcock University, Ogun State, Nigeria.,Department of Surgery, Dental Unit, Babcock University Teaching Hospital, Ogun State, Nigeria
| | | | - Oguntade Funmi A
- Department of Surgery, Benjamin Carson Snr School of Medicine, Babcock University, Ogun State, Nigeria.,Department of Anaesthesia, Babcock University Teaching Hospital, Ogun State, Nigeria
| | - Mayowa Solomon Somoye
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Michael O Adeyemi
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos State, Nigeria
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22
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Bezerra JF, Silva HPVD, Bortolin RH, Luchessi AD, Ururahy MAG, Loureiro MB, Gil-da-Silva-Lopes VL, Almeida MDG, Amaral VSD, Rezende AAD. IRF6 polymorphisms in Brazilian patients with non-syndromic cleft lip with or without palate. Braz J Otorhinolaryngol 2019; 86:696-702. [PMID: 31495697 PMCID: PMC9422540 DOI: 10.1016/j.bjorl.2019.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 02/04/2019] [Accepted: 04/17/2019] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Non-syndromic orofacial clefts have a complex etiology due to the contribution from both genetic and environmental risk factors, as well as the interaction between them. Among the more than 15 susceptibility loci for non-syndromic orofacial clefts with considerable statistical and biological support, the IRF6 is the most validated gene by the majority of studies. Nonetheless, in genetically heterogeneous populations such as Brazilian, the confirmation of association between non-syndromic orofacial clefts and IRF6 common variants is not a consolidated fact and unrecognized IRF6 variants are poorly investigated. OBJECTIVE The aim of this study was to investigate the association of IRF6 polymorphisms with non-syndromic orofacial clefts development in a population from northeast Brazil. METHODS Blood samples of 186 non-syndromic orofacial clefts patients and 182 controls from Rio Grande do Norte, Brazil, were obtained to analyze IRF6 polymorphisms (rs2235371, rs642961, rs2236907, rs861019, and rs1044516) by real-time polymerase chain reaction. Non-syndromic orofacial clefts patients were classified in cleft lip and palate, cleft palate only and cleft lip only groups. RESULTS The genotype and allele frequencies of single nucleotide polymorphism rs2235371 in IRF6 showed significant differences in patients with cleft palate when compared to the controls, whereas no association was shown between rs642961, rs2236907, rs861019, and rs1044516 and non-syndromic orofacial clefts. CONCLUSION The association found between rs2235371 and isolated cleft palate should be interpreted with caution due to the low number of individuals investigated, and more studies with larger sample size are needed to confirm these association. In addition, there is a lack of association of the rs642961, rs2236907 and rs861019 polymorphisms with non-syndromic orofacial clefts susceptibility.
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Affiliation(s)
- João Felipe Bezerra
- Universidade Federal do Rio Grande do Norte, Departamento de Análises Clínicas e Toxicológicas, Natal, RN, Brazil
| | | | - Raul Hernandes Bortolin
- Universidade Federal do Rio Grande do Norte, Departamento de Análises Clínicas e Toxicológicas, Natal, RN, Brazil; Universidade de São Paulo (USP), Departamento de Análises Clínicas e Toxicológicas, São Paulo, SP, Brazil
| | - André Ducati Luchessi
- Universidade Federal do Rio Grande do Norte, Departamento de Análises Clínicas e Toxicológicas, Natal, RN, Brazil
| | | | - Melina Bezerra Loureiro
- Universidade Federal do Rio Grande do Norte, Departamento de Análises Clínicas e Toxicológicas, Natal, RN, Brazil
| | - Vera Lúcia Gil-da-Silva-Lopes
- Universidade Estadual de Campinas, Escola de Ciências Médicas, Departamento de Genética Médica, Campinas, Campinas, SP, Brazil
| | - Maria das Graças Almeida
- Universidade Federal do Rio Grande do Norte, Departamento de Análises Clínicas e Toxicológicas, Natal, RN, Brazil
| | - Viviane Souza do Amaral
- Universidade Federal do Rio Grande do Norte, Departamento de Biologia Celular e Genética, Natal, RN, Brazil
| | - Adriana Augusto de Rezende
- Universidade Federal do Rio Grande do Norte, Departamento de Análises Clínicas e Toxicológicas, Natal, RN, Brazil.
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Zhang JN, Song FQ, Zhou SN, Zheng H, Peng LY, Zhang Q, Zhao WH, Zhang TW, Li WR, Zhou ZB, Lin JX, Chen F. [Analysis of single-nucleotide polymorphism of Sonic hedgehog signaling pathway in non-syndromic cleft lip and/or palate in the Chinese population]. JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:556-563. [PMID: 31209431 DOI: 10.19723/j.issn.1671-167x.2019.03.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study the relationship between Sonic hedgehog (Shh) associated single-nucleotide polymorphism (SNP) and non-syndromic cleft lip and/or palate (NSCL/P), and to explore the risk factors of cleft lip and/or palate. Many studies suggest that the pathogenesis of NSCL/P could be related to genes that control early development, in which the Shh signaling pathway plays an important role. METHODS Peripheral blood was collected from 197 individuals (100 patients with NSCL/P and 97 healthy controls). Haploview software was used for haplotype analysis and Tag SNP were selected, based on the population data of Han Chinese in Beijing of the international human genome haplotype mapping project. A total of 27 SNP were selected for the 4 candidate genes of SHH, PTCH1, SMO and GLI2 in the Shh signaling pathway. The genotypes of 27 SNP were detected and analyzed by Sequenom mass spectrometry. The data were analyzed by chi-squared test and an unconditional Logistic regression model. RESULTS The selected SNP basically covered the potential functional SNP of the target genes, and its minimum allele frequency (MAF) was >0.05: GLI2 73.5%, PTCH1 91.0%, SMO 100.0%, and SHH 75.0%. It was found that the genotype frequency of SNP (rs12674259) located in SMO gene and SNP (rs2066836) located in PTCH1 gene were significantly different between the NSCL/P group and the control group. Linkage disequilibrium was also found on 3 chromosomes (chromosomes 2, 7 and 9) where the 4 candidate genes were located. However, in the analysis of linkage imbalance haplotype, there was no significant difference between the disease group and the control group. CONCLUSION In China, NSCL/P is the most common congenital disease in orofacial region. However, as it is a multigenic disease and could be affected by multiple factors, such as the external environment, the etiology of NSCL/P has not been clearly defined. This study indicates that Shh signaling pathway is involved in the occurrence of NSCL/P, and some special SNP of key genes in this pathway are related to cleft lip and/or palate, which provides a new direction for the etiology research of NSCL/P and may provide help for the early screening and risk prediction of NSCL/P.
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Affiliation(s)
- J N Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - F Q Song
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - S N Zhou
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - H Zheng
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - L Y Peng
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Q Zhang
- Department of Center Laboratory, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - W H Zhao
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou 510000, China
| | - T W Zhang
- Department of Orthodontics, Yantai Stomatological Hospital, Yantai 264000, Shandong, China
| | - W R Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Z B Zhou
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - J X Lin
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - F Chen
- Department of Center Laboratory, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Shu X, Cheng L, Dong Z, Shu S. Identification of circular RNA-associated competing endogenous RNA network in the development of cleft palate. J Cell Biochem 2019; 120:16062-16074. [PMID: 31074068 DOI: 10.1002/jcb.28888] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/28/2019] [Accepted: 03/15/2019] [Indexed: 02/05/2023]
Abstract
Circular RNAs (circRNAs) serve as competing endogenous RNAs (ceRNAs) and indirectly regulate gene expression through shared microRNAs (miRNAs). However, the regulatory mechanisms of circRNA as ceRNA associated with the fusion of palatal shelves in palatogenesis are yet unclear. This study aimed to explore the potential mechanism underlying the role of circRNA as ceRNA in cleft palate (CP). First, we systematically analyzed RNA-seq and miRNA-seq data after high-throughput sequencing for embryonic palatal shelf tissues from a mouse CP model induced by maternal exposure to all-trans retinoic acid on embryonic gestation day 14.5 (E14.5). Thirty-nine circRNAs, 18 miRNAs, and 936 messenger RNAs (mRNAs) were significantly dysregulated (log2 [fold change {FC}] > 1; P < 0.05). Thereafter, we constructed a circRNA-associated ceRNA network. Finally, we determined the circRNA_0954-miRNA-881-3p-PRKAR1α ceRNA network as a hub involved in palatogenesis. Gene Ontology analysis revealed that ceRNA-related genes were associated with facial morphogenesis and developmental gene silencing. Kyoto Encyclopedia of Genes and Genomes pathway analysis indicated that ceRNA-related genes are involved in apoptosis (P < 0.05, fold enrichment >1). Quantitative reverse transcription polymerase chain reaction was performed to verify the results of ceRNA analysis. We found that the circRNA-miRNA-mRNA ceRNA network is involved in palatogenesis. The present results imply that circRNA_0954-miRNA-881-3p-PRKAR1α ceRNA network may cause dysfunctional palatal fusion and might facilitate the development of novel epigenetic biomarkers to treat CP in the future.
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Affiliation(s)
- Xuan Shu
- The Cleft Lip and Palate Center, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Liuhanghang Cheng
- The Cleft Lip and Palate Center, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zejun Dong
- The Cleft Lip and Palate Center, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Shenyou Shu
- The Cleft Lip and Palate Center, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
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The Electrical Activity of Masseter and Anterior Temporal Muscles in Patients With Unilateral Cleft Lip and Palate. J Craniofac Surg 2019; 30:e547-e551. [PMID: 31022137 DOI: 10.1097/scs.0000000000005560] [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
This study aimed to determine the electrical activity of masseter and anterior temporal muscles in patients with unilateral cleft lip and palate (CLP) and compare it with healthy volunteers. The study involved 20 female patients (mean age 20 ± 4 years) with unilateral cleft lip and palate who had undergone lip and palate surgery in childhood and finished the first-phase orthodontic therapy with level and align teeth. Twenty age- and sex-matched volunteers with no cleft lip and palate were involved as controls. Electromyographic (EMG) signals of masseter and anterior temporal muscles were recorded at rest position, during swallowing and during maximum bite force (MBF). EMG signals at different test conditions were compared between the cleft and noncleft sides of CLP patients and between CLP patients and healthy individuals. The EMG potentials of masseter (rest, swallowing, MBF) and temporal (rest, MBF) muscles were significantly higher in the cleft than the noncleft side of CLP patients (P value <0.001). Generally, patients with unilateral cleft lip and palate experienced a significant increase in the electrical activity of the masseter and temporal muscles in both sides compared to the control group (P <0.05). In conclusion, patients with unilateral cleft lip and palate exhibit overall greater masticatory muscle activity compared to healthy individuals. The asymmetric masticatory function in subjects with unilateral cleft lip and palate may be associated with severe consequences such as asymmetric facial growth, implying the importance of early diagnosis and orthodontic treatment to achieve a favorable environment for balanced facial growth in CLP affected patients.
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Induced ankylosis of primary canines for absolute anchorage in the treatment of a patient with Class III malocclusion and cleft soft palate. Am J Orthod Dentofacial Orthop 2019; 155:398-410. [PMID: 30826043 DOI: 10.1016/j.ajodo.2017.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 08/01/2017] [Accepted: 08/01/2017] [Indexed: 11/24/2022]
Abstract
This case report describes the induced ankylosis of the primary canines for use as absolute anchorage for maxillary protraction. The patient was a young boy with Class III malocclusion and cleft soft palate. The final occlusion was esthetic, functional, healthy, and stable 4 years after treatment.
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Guo W, Zhu X, Yan L, Qiao J. The present and future of whole-exome sequencing in studying and treating human reproductive disorders. J Genet Genomics 2018; 45:517-525. [DOI: 10.1016/j.jgg.2018.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 12/16/2022]
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28
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Three-dimensional development of the upper dental arch in unilateral cleft lip and palate patients after early neonatal cheiloplasty. Int J Pediatr Otorhinolaryngol 2018; 109:1-6. [PMID: 29728158 DOI: 10.1016/j.ijporl.2018.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/06/2018] [Accepted: 03/10/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This prospective morphometric study evaluated the growth of the upper dental arch in UCLP patients after early neonatal cheiloplasty and compared the selected dimensions with published data on non-cleft controls and on later operation protocol patients. METHODS The sample comprised 36 Czech children with nonsyndromic complete UCLP (cUCLP) and 20 Czech children with nonsyndromic incomplete UCLP (UCLP + b). 2-D and 3-D analyses of palatal casts were made at two time points: before neonatal cheiloplasty at the mean age of 3 days (±1 day), and 10 months after surgery at the mean age of 10 months (±1 month). RESULTS The upper dental arch of cUCLP and UCLP + b patients showed similar developmental changes, but the cleft type influenced growth significantly. The initial high shape variability in cUCLP patients diminished after 10 months, and approached the variability in UCLP + b patients. Both the width and length dimensions increased after surgery. Important growth concerned the anterior ends of both segments. The width and length dimensions illustrated similar growth trends with non-cleft controls and UCLP patients who underwent later cheiloplasty. CONCLUSION Early neonatal cheiloplasty caused no reduction in the length or width dimensions during the first year of life. Our data suggest a reconstructed lip has a natural formative effect on the actively growing anterior parts of upper dental arch segments, which cause narrowing of the alveolar cleft.
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Abstract
Objective: To determine the clefting birth prevalence among Asian populations, specifically Chinese and Japanese, using raw counts from nonoverlapping published studies of Asian populations, and to investigate whether Asian clefting rates have been interpreted accurately as being up to twice the Caucasian rate. Design: A literature review of articles giving raw counts of clefting in Asian populations, primarily Japanese and Chinese. Main Outcome Measures: Where possible, clefts were identified by the patients’ ethnicity, country of origin, cleft type, syndromic status, and birth status. Results: Prevalence rates of cleft lip with or without cleft palate per 1000 live births are reported. Syndromic plus nonsyndromic cleft lip with or without cleft palate: Chinese, 1.30; Japanese, 1.34; Other Asian, 1.47; and total, 1.33. Nonsyndromic cleft lip with or without cleft palate: Chinese, 1.20; Japanese, 1.18; Other Asian, 1.22; and total, 1.19. Conclusions: Overall, Chinese and Japanese live birth prevalence rates for nonsyndromic cleft lip with or without cleft palate, based on the published reports of birth prevalence, are significantly lower than the oft-quoted rate of 2 per 1000 for Asians. The apparent reason for the discrepancy is that many published prevalence rates included all pregnancies (live births plus pregnancy losses) and do not distinguish between syndromic and nonsyndromic clefts or between cleft palate alone and cleft lip with or without cleft palate. These results demonstrate that it is extremely important for current population-based studies of clefts to include careful delineation of population groups, syndromes, cleft type, and birth status.
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Affiliation(s)
- Margaret E Cooper
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, USA
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30
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Dong S, Zhang Y, Huang H. Involvement of RBP4 in all‑trans retinoic acid induced cleft palate. Mol Med Rep 2017; 16:5915-5923. [PMID: 28849085 PMCID: PMC5865769 DOI: 10.3892/mmr.2017.7327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 04/24/2017] [Indexed: 12/29/2022] Open
Abstract
The current study was designed to elucidate the mechanism of retinol binding protein 4 (RBP4) in cleft palate induced by all‑trans retinoic acid (atRA). To establish a cleft palate model in C57BL/6J mice, pregnant mice were administered atRA (100 mg/kg) by gavage at the tenth embryonic stage (E10.0). Control groups were given the equivalent volume of corn oil. Pregnant mice were dissected at E12.5, E13.5 and E14.5 to obtain the embryonic palates. The expression levels of RBP4 in the embryonic palatal mesenchyme (EPM) were determined by immunohistochemistry, reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) and western blotting. Human embryonic palatal mesenchymal cells were exposed to atRA to detect the variation in RBP4 induced by atRA in vitro. Small interfering RNA was used to suppress the expression of RBP4, and a plasmid overexpressing RBP4 was used to examine upregulated expression. The cell counting kit‑8 assay was used to evaluate the effect of RBP4 on cell proliferation. The expression levels of p27 and cyclin D1 were determined by RT‑qPCR and western blotting, while the expression levels of extracellular signal‑related kinase (ERK) 1/2 and protein kinase B (AKT) were assessed by western blotting. At E14.5, RBP4 was strongly expressed in the EPM, while it was downregulated following atRA treatment, which induced cleft palate in vivo. In vitro experiments indicated that atRA suppressed the expression of RBP4 and altered the expression of p27 and cyclin D1 to cause growth inhibition. Knockdown of RBP4 resulted in decreased expression of cyclin D1 and increased p27, and suppressed proliferation. Overexpression of RBP4 reversed the inhibitory effect of atRA and promoted proliferation via the ERK1/2 and AKT signaling pathways. These results suggested that RBP4 was involved in cleft palate induced by atRA and it can be suppressed by atRA to cause growth inhibition in the embryonic palate.
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Affiliation(s)
- Shiyi Dong
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Yadong Zhang
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Hongzhang Huang
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
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Volpe-Aquino RM, Monlleó IL, Lustosa-Mendes E, Mora AF, Fett-Conte AC, Félix TM, Xavier AC, Tonocchi R, Ribeiro EM, Pereira R, Boy da Silva RT, de Rezende AA, Cavalcanti DP, Gil-da-Silva-Lopes VL. CranFlow
: An Application for Record-Taking and Management Through the Brazilian Database on Craniofacial Anomalies. Birth Defects Res 2017; 110:72-80. [DOI: 10.1002/bdr2.1123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 07/23/2017] [Accepted: 08/09/2017] [Indexed: 01/15/2023]
Affiliation(s)
- Roberta M. Volpe-Aquino
- Department of Medical Genetics; School of Medical Sciences, State University of Campinas - Unicamp; Campinas SP Brazil
| | - Isabella L. Monlleó
- Clinical Genetics Service; School of Medicine, University Hospital, Federal University of Alagoas - Ufal; Maceió AL Brazil
| | - Elaine Lustosa-Mendes
- Department of Medical Genetics; School of Medical Sciences, State University of Campinas - Unicamp; Campinas SP Brazil
- Assistance Center for Cleft Lip and Palate - CAIF-AFISSUR; Curitiba PR Brazil
| | - Amanda F. Mora
- Department of Medical Genetics; School of Medical Sciences, State University of Campinas - Unicamp; Campinas SP Brazil
| | - Agnes C. Fett-Conte
- Department of Molecular Biology; Medical School of São José do Rio Preto - FAMERP/FUNFARME; São José do Rio Preto SP Brazil
| | - Têmis M. Félix
- Medical Genetics Service; Clinical Hospital of Porto Alegre - HCPA; Porto Alegre RS Brazil
| | - Ana C. Xavier
- Center for Research and Rehabilitation of Lip and Palate Lesions - CRRLPL; Centrinho Prefeito Luiz Gomes; Joinville SC Brazil
| | - Rita Tonocchi
- Assistance Center for Cleft Lip and Palate - CAIF-AFISSUR; Curitiba PR Brazil
| | - Erlane M. Ribeiro
- Medical Genetics Service; Hospital Infantil Albert Sabin - HIAS; Fortaleza CE Brazil
| | - Rui Pereira
- Institute of Integral Medicine, Prof. Fernando Figueira - IMIP; Recife PE Brazil
| | | | - Adriana A. de Rezende
- Department of Clinical and Toxicological Analysis; School of Pharmaceutical Sciences; Hospital Onofre Lopes (HUOL), Federal University of Rio Grande do Norte (UFRN); Natal RN Brazil
| | - Denise P. Cavalcanti
- Perinatal Genetics Program; Department of Medical Genetics, Faculty of Medical Sciences, State University of Campinas; Campinas SP Brazil
| | - Vera L. Gil-da-Silva-Lopes
- Department of Medical Genetics; School of Medical Sciences, State University of Campinas - Unicamp; Campinas SP Brazil
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Tettamanti L, Avantaggiato A, Nardone M, Silvestre-Rangil J, Tagliabue A. Cleft palate only: current concepts. ACTA ACUST UNITED AC 2017; 10:45-52. [PMID: 28757935 DOI: 10.11138/orl/2017.10.1.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cleft palate only (CPO) is one of the most common congenital malformations worldwide. The etiopathogenesis of CPO is not completely understood. Environmental factors, such as smoking, alcohol consumption, intake of drugs during pregnancy, advanced paternal age, have been demonstrated to be a risk of CPO, but conflicting results have also been published. Insufficient intake of folic acid during the pregnancy has been suggested to increase the risk for CPO. The demonstrated risk for siblings and the higher risk for monozygotic twins suggest a genetic etiopathogenesis for CPO. In some cases of CPO a prevalent mode of inheritance has been reported, but oligogenic models with reduced penetrance, and the risk related to environmental factors have also been proved. One of the first manifestations associated with CPO is difficulty with feeding. Aerophagia is a problem in these infants with CPO and requires more frequent burping and slower feeding. The inability to generate intraoral breath pressure due to nasal air emission in CPO children frequently manifests as articulation difficulties, particularly consonant weakness, and unintelligible speech. Hearing disorders are prevalent among individuals with CPO, as a result of chronic otitis media with effusion due to eustachian tube dysfunction. A multidisciplinary team is essential to manage the many aspects of CPO. In treating CPO, the reconstructive surgeon works in cooperation with otolaryngologists, dentists and orthodontists, speech pathologists, audiologists, geneticists, psychiatrists, maxillofacial surgeons, social workers, and prosthodontists. CPO can be considered a genetically complex disease, but new knowledge and new therapeutic approaches have greatly improved the quality of life of these children. Prenatal diagnosis is an important step in the treatment of this disease.
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Affiliation(s)
- L Tettamanti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - A Avantaggiato
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - M Nardone
- Ministry of Public Health, Rome, Italy
| | | | - A Tagliabue
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Almuhizi Y, Leser A, Pegelow M. Correlation between the modified Huddart and Bodenham index and the GOSLON yardstick for assessing occlusal characteristics at 5 and 10 years of age in individuals born with unilateral cleft lip and palate. Eur J Orthod 2016; 38:359-65. [DOI: 10.1093/ejo/cjw046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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James JN, Schlieder DW. Prenatal Counseling, Ultrasound Diagnosis, and the Role of Maternal-Fetal Medicine of the Cleft Lip and Palate Patient. Oral Maxillofac Surg Clin North Am 2016; 28:145-51. [DOI: 10.1016/j.coms.2015.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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35
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Burg ML, Chai Y, Yao CA, Magee W, Figueiredo JC. Epidemiology, Etiology, and Treatment of Isolated Cleft Palate. Front Physiol 2016; 7:67. [PMID: 26973535 PMCID: PMC4771933 DOI: 10.3389/fphys.2016.00067] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/12/2016] [Indexed: 01/21/2023] Open
Abstract
Isolated cleft palate (CPO) is the rarest form of oral clefting. The incidence of CPO varies substantially by geography from 1.3 to 25.3 per 10,000 live births, with the highest rates in British Columbia, Canada and the lowest rates in Nigeria, Africa. Stratified by ethnicity/race, the highest rates of CPO are observed in non-Hispanic Whites and the lowest in Africans; nevertheless, rates of CPO are consistently higher in females compared to males. Approximately fifty percent of cases born with cleft palate occur as part of a known genetic syndrome or with another malformation (e.g., congenital heart defects) and the other half occur as solitary defects, referred to often as non-syndromic clefts. The etiology of CPO is multifactorial involving genetic and environmental risk factors. Several animal models have yielded insight into the molecular pathways responsible for proper closure of the palate, including the BMP, TGF-β, and SHH signaling pathways. In terms of environmental exposures, only maternal tobacco smoke has been found to be strongly associated with CPO. Some studies have suggested that maternal glucocorticoid exposure may also be important. Clearly, there is a need for larger epidemiologic studies to further investigate both genetic and environmental risk factors and gene-environment interactions. In terms of treatment, there is a need for long-term comprehensive care including surgical, dental and speech pathology. Overall, five main themes emerge as critical in advancing research: (1) monitoring of the occurrence of CPO (capacity building); (2) detailed phenotyping of the severity (biology); (3) understanding of the genetic and environmental risk factors (primary prevention); (4) access to early detection and multidisciplinary treatment (clinical services); and (5) understanding predictors of recurrence and possible interventions among families with a child with CPO (secondary prevention).
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Affiliation(s)
- Madeleine L Burg
- Department of Medicine, Keck School of Medicine, University of Southern California Los Angeles, CA, USA
| | - Yang Chai
- Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California Los Angeles, CA, USA
| | - Caroline A Yao
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA; Division of Plastic and Maxillofacial Surgery, Children's Hospital Los AngelesLos Angeles, CA, USA
| | - William Magee
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA; Division of Plastic and Maxillofacial Surgery, Children's Hospital Los AngelesLos Angeles, CA, USA
| | - Jane C Figueiredo
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Los Angeles, CA, USA
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Liu X, Qi J, Tao Y, Zhang H, Yin J, Ji M, Gao Z, Li Z, Li N, Yu Z. Correlation of proliferation, TGF-β3 promoter methylation, and Smad signaling in MEPM cells during the development of ATRA-induced cleft palate. Reprod Toxicol 2016; 61:1-9. [PMID: 26916447 DOI: 10.1016/j.reprotox.2016.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 02/17/2016] [Accepted: 02/19/2016] [Indexed: 01/03/2023]
Abstract
Mesenchymal cell proliferation is one of the processes in shelf outgrowth. Both all-trans retinoic acid (atRA) and transforming growth factor-β3 (TGF-β3) play an important role in mouse embryonic palate mesenchymal (MEPM) cell proliferation. The cellular effects of TGF-β are mediated by Smad-dependent or Smad-independent pathways. In the present study, we demonstrate that atRA promotes TGF-β3 promoter demethylation and protein expression, but can cause depression of mesenchymal cell proliferation, especially at embryonic day 14 (E14). Moreover, the inhibition of MEPM cell proliferation by atRA results in the downregulation of Smad signaling mediated by transforming growth interacting factor (TGIF). We speculate that the effects of atRA on MEPM cell proliferation may be mediated by Smad pathways, which are regulated by TGIF but are not related to TGF-β3 expression. Finally, the cellular effects of TGF-β3 on MEPM cell proliferation may be mediated by Smad-independent pathways.
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Affiliation(s)
- Xiaozhuan Liu
- Public Health College, Zhengzhou University, China; Medical College, Henan University of Science & Technology, China
| | - Jingjiao Qi
- Medical College, Henan University of Science & Technology, China
| | - Yuchang Tao
- Public Health College, Zhengzhou University, China
| | | | - Jun Yin
- Public Health College, Zhengzhou University, China
| | - Mengmeng Ji
- Public Health College, Zhengzhou University, China
| | - Zhan Gao
- The Fifth Affiliated Hospital, Zhengzhou University, China
| | - Zhitao Li
- Medical College, Henan University of Science & Technology, China
| | - Ning Li
- Institute of Food Science and Technology, Henan Agricultural University, China
| | - Zengli Yu
- Public Health College, Zhengzhou University, China.
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Analysis of the dentoalveolar effects of slow and rapid maxillary expansion in complete bilateral cleft lip and palate patients: a randomized clinical trial. Clin Oral Investig 2015; 20:1837-47. [PMID: 26620733 DOI: 10.1007/s00784-015-1675-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/19/2015] [Indexed: 10/22/2022]
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Jiang C, Whitehill TL, McPherson B, Ng ML. Consonant accuracy in Mandarin-speaking children with repaired cleft palate. Int J Pediatr Otorhinolaryngol 2015; 79:2270-6. [PMID: 26564617 DOI: 10.1016/j.ijporl.2015.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 10/16/2015] [Accepted: 10/17/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the consonant production of Chinese-speaking cleft palate children with perceived hypernasal resonance (PHR) after palatoplasty and those with perceived normal resonance (PNR), and to assess the possible influence of language on articulation. SETTING Two hospital cleft lip and palate centers in mainland China. PARTICIPANTS Thirty-one speakers were allocated into two groups based on perceptual judgment results of their resonance provided by three speech therapists: one group with PNR (n=20, average age=9.3 years), and another group with PHR (n=11, average age=8.3 years). All participants had no known hearing or cognitive deficits. INTERVENTION Articulation was evaluated using two Mandarin Chinese assessment tools, the Putonghua Segmental Phonology Test and the Deep Test for Cleft Palate Speakers in Putonghua. Speaker consonant accuracy was evaluated by two experienced speech therapists. RESULTS Compared to individuals with PNR, the PHR group exhibited more difficulties on production of unaspirated consonants, including/b/,/t/,/k/,/ts/,/tʂ/ and/tɕ/, than for aspirated consonants. CONCLUSION The distinctive feature of aspiration in Mandarin phonology brought a language specific pattern to consonant production among those speakers with PHR after primary palatal closure.
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Affiliation(s)
- Chenghui Jiang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University; Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China; Division of Speech and Hearing Sciences, Faculty of Education, University of Hong Kong, Hong Kong, Hong Kong.
| | - Tara L Whitehill
- Division of Speech and Hearing Sciences, Faculty of Education, University of Hong Kong, Hong Kong, Hong Kong
| | - Bradley McPherson
- Division of Speech and Hearing Sciences, Faculty of Education, University of Hong Kong, Hong Kong, Hong Kong
| | - Manwa L Ng
- Division of Speech and Hearing Sciences, Faculty of Education, University of Hong Kong, Hong Kong, Hong Kong
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Seifeldin SA. Is alveolar cleft reconstruction still controversial? (Review of literature). Saudi Dent J 2015; 28:3-11. [PMID: 26792963 PMCID: PMC4688438 DOI: 10.1016/j.sdentj.2015.01.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/15/2014] [Accepted: 01/27/2015] [Indexed: 11/18/2022] Open
Abstract
Cleft lip and palate (CL/P) is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to provide a bony bridge at the cleft site that allows maxillary arch continuity, oronasal fistula repair, eruption of the permanent dentition into the newly formed bone, enhances nasal symmetry through providing alar base support, orthodontic movement and placement of osseointegrated implants when indicated. Other goals include improving speech, improvement of periodontal conditions, establishing better oral hygiene, and limiting growth disturbances. In order to rehabilitate oral function in CL/P patients alveolar bone grafting is necessary. Secondary bone grafting is the most widely accepted method for treating alveolar clefts. Autogenous bone graft is the primary source for reconstructing alveolar cleft defects and is currently the preferred grafting material.
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Affiliation(s)
- Sameh A. Seifeldin
- Corresponding author at: 11545, Riyadh- B.O. 60169, Riyadh, Saudi Arabia. Tel.: +966 506944359; fax: +966 14678548.
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40
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Metgud R, Kumar A, Bhat K. Isolated cleft lip with generalized aggressive periodontitis: A rare entity. J Indian Soc Periodontol 2015; 19:88-92. [PMID: 25810600 PMCID: PMC4365165 DOI: 10.4103/0972-124x.145825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/15/2014] [Indexed: 12/03/2022] Open
Abstract
Oro-facial clefts are one of the most common birth defects and may be associated with other genetic anomalies. Aggressive periodontitis is a rare condition that progresses rapidly, but affects only a small percentage of the population. Most of the cases of aggressive periodontitis are familial. Even though, literature has documented the association of various genetic disorders with aggressive periodontitis, the aggressive periodontitis in patients with isolated cleft lip (CL) have never been addressed. Here, we report a rare case of isolated CL with generalized aggressive periodontitis. The concomitant presentation of isolated CL with aggressive periodontitis in an individual has clinical significance for multi-disciplinary care.
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Affiliation(s)
- Renuka Metgud
- Department of Periodontics, KLE University, Belgaum, Karnataka, India
| | - Ajay Kumar
- Department of Periodontics, KLE University, Belgaum, Karnataka, India
| | - Kishore Bhat
- KLE Dr. Prabhakar Kore Basic Science Research Centre, KLE VK Institute of Dental Sciences, KLE University, Belgaum, Karnataka, India
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Vieira AR, De Carvalho FM, Johnson L, DeVos L, Swailes AL, Weber ML, Deeley K. Fine Mapping of 6q23.1 Identifies TULP4 as Contributing to Clefts. Cleft Palate Craniofac J 2015; 52:128-34. [DOI: 10.1597/13-023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective The aim of this work was to fine-map the region 6q23.1, which obtained suggestive linkage signal (logarithm of the odds [LOD] score = 2.22 under a recessive model) to cleft lip with or without cleft palate (CL±P) in our previous genome-wide linkage scan to identify possible genetic variants that may contribute to CL±P. Design We used densely spaced markers spanning the entire 6q23.1 region to test for association with CL±P in a family cohort sample. Setting Clinical information and DNA samples were obtained from families in the Philippines at their homes or primary health care clinics. Participants The study sample consisted of 477 subjects (224 females and 253 males), segregating isolated CL±P, from 72 living in the same area in the Philippines. Main Outcome Measure Overtransmission of alleles to persons born with CL±P. Results We found statistical evidence of association between a marker of TULP4 (rs651333) with CL±P ( P = .00007). Conclusions Our results further support the linkage results for the chromosome 6q region and reveal a novel candidate gene for CL±P.
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Affiliation(s)
- Alexandre R. Vieira
- Department of Oral Biology and Center for Craniofacial and Dental Genetics and Department of Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Flavia M. De Carvalho
- Department of Genetics, Institute of Biology, Center of Health Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lindsay Johnson
- Health Information Management, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lauren DeVos
- Department of Oral Biology; School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alexa L. Swailes
- Department of Oral Biology, School of Dental Medicine, and Cancer Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Megan L. Weber
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kathleen Deeley
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Shkoukani MA, Lawrence LA, Liebertz DJ, Svider PF. Cleft palate: A clinical review. ACTA ACUST UNITED AC 2014; 102:333-42. [DOI: 10.1002/bdrc.21083] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 10/27/2014] [Indexed: 01/30/2023]
Affiliation(s)
- Mahdi A. Shkoukani
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
- Department of Otolaryngology-Head and Neck Surgery; Division of Craniofacial Surgery, Wayne State University School of Medicine; Detroit Michigan
- Division of Facial Plastic and Reconstructive Surgery; Wayne State University School of Medicine; Detroit Michigan
| | - Lauren A. Lawrence
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
| | - Daniel J. Liebertz
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
| | - Peter F. Svider
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
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Balkin DM, Samra S, Steinbacher DM. Immediate fat grafting in primary cleft lip repair. J Plast Reconstr Aesthet Surg 2014; 67:1644-50. [DOI: 10.1016/j.bjps.2014.08.049] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 06/20/2014] [Accepted: 08/18/2014] [Indexed: 10/24/2022]
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Investigation of genetic factors underlying typical orofacial clefts: mutational screening and copy number variation. J Hum Genet 2014; 60:17-25. [PMID: 25391604 DOI: 10.1038/jhg.2014.96] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/01/2014] [Accepted: 10/10/2014] [Indexed: 12/13/2022]
Abstract
Typical orofacial clefts (OFCs) comprise cleft lip, cleft palate and cleft lip and palate. The complex etiology has been postulated to involve chromosome rearrangements, gene mutations and environmental factors. A group of genes including IRF6, FOXE1, GLI2, MSX2, SKI, SATB2, MSX1 and FGF has been implicated in the etiology of OFCs. Recently, the role of the copy number variations (CNVs) has been studied in genetic defects and diseases. CNVs act by modifying gene expression, disrupting gene sequence or altering gene dosage. The aims of this study were to screen the above-mentioned genes and to investigate CNVs in patients with OFCs. The sample was composed of 23 unrelated individuals who were grouped according to phenotype (associated with other anomalies or isolated) and familial recurrence. New sequence variants in GLI2, MSX1 and FGF8 were detected in patients, but not in their parents, as well as in 200 control chromosomes, indicating that these were rare variants. CNV screening identified new genes that can influence OFC pathogenesis, particularly highlighting TCEB3 and KIF7, that could be further analyzed. The findings of the present study suggest that the mechanism underlying CNV associated with sequence variants may play a role in the etiology of OFC.
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Esteve-Altava B, Rasskin-Gutman D. Beyond the functional matrix hypothesis: a network null model of human skull growth for the formation of bone articulations. J Anat 2014; 225:306-16. [PMID: 24975579 PMCID: PMC4166971 DOI: 10.1111/joa.12212] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2014] [Indexed: 11/29/2022] Open
Abstract
Craniofacial sutures and synchondroses form the boundaries among bones in the human skull, providing functional, developmental and evolutionary information. Bone articulations in the skull arise due to interactions between genetic regulatory mechanisms and epigenetic factors such as functional matrices (soft tissues and cranial cavities), which mediate bone growth. These matrices are largely acknowledged for their influence on shaping the bones of the skull; however, it is not fully understood to what extent functional matrices mediate the formation of bone articulations. Aiming to identify whether or not functional matrices are key developmental factors guiding the formation of bone articulations, we have built a network null model of the skull that simulates unconstrained bone growth. This null model predicts bone articulations that arise due to a process of bone growth that is uniform in rate, direction and timing. By comparing predicted articulations with the actual bone articulations of the human skull, we have identified which boundaries specifically need the presence of functional matrices for their formation. We show that functional matrices are necessary to connect facial bones, whereas an unconstrained bone growth is sufficient to connect non-facial bones. This finding challenges the role of the brain in the formation of boundaries between bones in the braincase without neglecting its effect on skull shape. Ultimately, our null model suggests where to look for modified developmental mechanisms promoting changes in bone growth patterns that could affect the development and evolution of the head skeleton.
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Affiliation(s)
- Borja Esteve-Altava
- Theoretical Biology Research Group, Cavanilles Institute for Biodiversity and Evolutionary Biology, University of ValenciaValencia, Spain
| | - Diego Rasskin-Gutman
- Theoretical Biology Research Group, Cavanilles Institute for Biodiversity and Evolutionary Biology, University of ValenciaValencia, Spain
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46
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Sequencing of the interferon regulatory factor 6 (IRF6) gene and correlation to its phenotypes in familial non-syndromic cleft lip and palate in North Indian population. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-014-0937-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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47
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Jiang C, Whitehill TL. Evaluation of speech errors in Putonghua speakers with cleft palate: a critical review of methodology issues. CLINICAL LINGUISTICS & PHONETICS 2014; 28:283-296. [PMID: 24093158 DOI: 10.3109/02699206.2013.839745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Speech errors associated with cleft palate are well established for English and several other Indo-European languages. Few articles describing the speech of Putonghua (standard Mandarin Chinese) speakers with cleft palate have been published in English language journals. Although methodological guidelines have been published for the perceptual speech evaluation of individuals with cleft palate, there has been no critical review of methodological issues in studies of Putonghua speakers with cleft palate. A literature search was conducted to identify relevant studies published over the past 30 years in Chinese language journals. Only studies incorporating perceptual analysis of speech were included. Thirty-seven articles which met inclusion criteria were analyzed and coded on a number of methodological variables. Reliability was established by having all variables recoded for all studies. This critical review identified many methodological issues. These design flaws make it difficult to draw reliable conclusions about characteristic speech errors in this group of speakers. Specific recommendations are made to improve the reliability and validity of future studies, as well to facilitate cross-center comparisons.
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Affiliation(s)
- Chenghui Jiang
- Division of Speech and Hearing Sciences, Faculty of Education, The University of Hong Kong , Hong Kong , China
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The multidisciplinary management of fused maxillary lateral incisor with a supernumerary tooth in cleft lip adolescence. Case Rep Dent 2014; 2014:459416. [PMID: 24516763 PMCID: PMC3910257 DOI: 10.1155/2014/459416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 12/02/2013] [Indexed: 12/22/2022] Open
Abstract
Fusion, an uncommon anomaly of the hard dental tissues, is potentially the cause of clinical problems related to esthetics, tooth spacing, and other periodontal complications. This paper describes a multidisciplinary approach involving surgical, endodontic, restorative, and orthodontic attention for the successful, functional, and esthetic rehabilitation of a maxillary left lateral incisor fused with a supernumerary tooth in unilateral cleft lip adolescence in contralateral side. After clinical and radiographic examinations, a fusion between the left maxillary lateral incisor and a supernumerary tooth was diagnosed in the patient, and a small connection was detected between the pulp systems of the two root canals. The case reported in this paper presents the successful resolution of a fused maxillary lateral incisor with a supernumerary tooth, using endodontic, surgical, restorative, and orthodontic management. The decision made in extracting or retaining the fused tooth depends on the arch discrepancy and esthetic needs. Future studies, with long-term followup, will be helpful in evaluating the long-term efficacy of the different treatment options.
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Abstract
Our understanding of cleft palates has come a long way over the last few decades. A better understanding of the long-term consequences of a cleft palate and its effect on speech development challenges surgeons to not only effectively repair the cleft, but to also restore function of the palate for adequate speech. Coordination with speech pathologists is integral for effective management of cleft palate patients, particularly as children begin to develop language. In this article, the authors review and summarize the various challenges and goals of cleft palate management.
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Affiliation(s)
- Tomasz R Kosowski
- Division of Plastic Surgery, Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
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50
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Brinkley JF, Borromeo C, Clarkson M, Cox TC, Cunningham MJ, Detwiler LT, Heike CL, Hochheiser H, Mejino JLV, Travillian RS, Shapiro LG. The ontology of craniofacial development and malformation for translational craniofacial research. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2013; 163C:232-45. [PMID: 24124010 DOI: 10.1002/ajmg.c.31377] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We introduce the Ontology of Craniofacial Development and Malformation (OCDM) as a mechanism for representing knowledge about craniofacial development and malformation, and for using that knowledge to facilitate integrating craniofacial data obtained via multiple techniques from multiple labs and at multiple levels of granularity. The OCDM is a project of the NIDCR-sponsored FaceBase Consortium, whose goal is to promote and enable research into the genetic and epigenetic causes of specific craniofacial abnormalities through the provision of publicly accessible, integrated craniofacial data. However, the OCDM should be usable for integrating any web-accessible craniofacial data, not just those data available through FaceBase. The OCDM is based on the Foundational Model of Anatomy (FMA), our comprehensive ontology of canonical human adult anatomy, and includes modules to represent adult and developmental craniofacial anatomy in both human and mouse, mappings between homologous structures in human and mouse, and associated malformations. We describe these modules, as well as prototype uses of the OCDM for integrating craniofacial data. By using the terms from the OCDM to annotate data, and by combining queries over the ontology with those over annotated data, it becomes possible to create "intelligent" queries that can, for example, find gene expression data obtained from mouse structures that are precursors to homologous human structures involved in malformations such as cleft lip. We suggest that the OCDM can be useful not only for integrating craniofacial data, but also for expressing new knowledge gained from analyzing the integrated data.
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