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Alkadhi OH, Alotaibi LH, Alrashoud RR, Almutairi MH, Al Matar HA, Mallineni SK. Effect of Maxillary Expansion on the Maxillary Arch Width in Patients with Bilateral Cleft Palate: A Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:762. [PMID: 37238310 PMCID: PMC10217325 DOI: 10.3390/children10050762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/01/2023] [Accepted: 04/15/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To perform a comprehensive review of the literature to compare the effects of slow maxillary expansion (SME) and rapid maxillary expansion (RME) on maxillary arch width in patients with bilateral cleft palate. METHODS The databases include Medline, PubMed, Cochrane (CENTRAL) and (CDSR), OpenGrey, and ClinicalTrials.gov were searched for relevant studies that met the eligibility criteria published before or on 31 October 2022. The search was confined to the English language. The selection of eligible studies and collection of data were performed independently. Risk of bias assessment was conducted using the Cochrane Risk of Bias tool 2.0. RESULTS Two randomized controlled trials were available based on the search in the published literature. Both studies compared arch width between SME and RME in cleft palate patients and digitals casts and three-dimensional images used for the evaluation. A moderate risk of bias was evident in the available studies. CONCLUSIONS Both SME and RME can achieve similar amounts of maxillary expansion in patients with bilateral cleft palate.
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Affiliation(s)
- Omar H Alkadhi
- Preventive Dentistry Department, College of Dentistry, Riyadh Elm University (REU), Riyadh 13244, Saudi Arabia
| | - Lamis Hejab Alotaibi
- Department of Preventive Dental Science, College of Dentistry, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Rowaida R Alrashoud
- College of Dentistry, Riyadh Elm University (REU), Riyadh 13244, Saudi Arabia
| | - Mohammed Hamad Almutairi
- General Dentist, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia
| | | | - Sreekanth Kumar Mallineni
- Pediatric Dentistry, Dr. Sulaiman Al Habib Hospital, Ar Rayyan, Riyadh 14212, Saudi Arabia
- Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry Graduate School of Dentistry, Tohoku University, Sendai 980-8575, Japan
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Kuang W, Aarts M, Kuijpers-Jagtman AM, He H, Ongkosuwito EM. Treatment Outcome in Bilateral Cleft lip and Palate Patients Evaluated With the Huddart-Bodenham Scoring System and the Bilateral Cleft lip and Palate Yardstick: A Systematic Review. Cleft Palate Craniofac J 2021; 59:1377-1390. [PMID: 34658258 PMCID: PMC9537448 DOI: 10.1177/10556656211041883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives To assess treatment outcome (transversal and sagittal dental arch
relationships) and its determinants in complete bilateral cleft lip and
palate (BCLP) evaluated with the modified Huddart-Bodenham scoring system
and the BCLP Yardstick. Materials and methods Multiple electronic databases were searched without time limitation.
Randomized clinical trials, cohort and case control studies using BCLP
Yardstick and/or modified Huddart-Bodenham system to judge treatment outcome
of patients with BCLP were included. The Risk of Bias in Nonrandomized
Studies of Interventions tool and Grading of Recommendations, Assessment,
Development, and Evaluation was used. Results Of the 528 studies identified by the electronic search, only eight
retrospective studies met the inclusion criteria and were included. A total
of 12 cleft centers were represented. All treatment protocols differed and
background information was underreported. The results for the BCLP yardstick
showed that all except the centers in New Zealand had a mean score lower
than 3, indicating good treatment results. However, these studies had a
moderate to high risk of bias. The modified Huddart-Bodenham scores were
negative in all studies. No further meta-analysis was done due to
heterogeneity and high risk of bias. The quality of evidence was graded as
very low. Conclusion Results for the dental arch relationship of studies in complete BCLP and
possible determinants were not synthesized due to very low quality of
evidence. Clinical research for patients with BCLP should focus on sound
methodological designs to enable evidence-based decision making to improve
treatment for patients with BCLP and thereby hopefully their quality of
life.
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Affiliation(s)
- Wenying Kuang
- School & Hospital of Stomatology, 499766Wuhan University, Wuhan, China.,Radboud University Medical Center, 6034Radboud University, Nijmegen, the Netherlands
| | - Miranda Aarts
- Radboud University Medical Center, 6034Radboud University, Nijmegen, the Netherlands
| | - Anne Marie Kuijpers-Jagtman
- University Medical Center Groningen, 10173University of Groningen, Groningen, the Netherlands.,School of Dental Medicine/Medical Faculty, 27210University of Bern, Bern, Switzerland; Universitas Indonesia, Jakarta, Indonesia
| | - Hong He
- School & Hospital of Stomatology, 499766Wuhan University, Wuhan, China
| | - Edwin M Ongkosuwito
- Radboud University Medical Center, 6034Radboud University, Nijmegen, the Netherlands
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Protocol and Evaluation of 3D-Planned Microsurgical and Dental Implant Reconstruction of Maxillary Cleft Critical Size Defects in Adolescents and Young Adults. J Clin Med 2021; 10:jcm10112267. [PMID: 34073752 PMCID: PMC8197203 DOI: 10.3390/jcm10112267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/03/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Functional and esthetic final reconstruction of the cleft maxilla is still challenging. Current reconstructive and augmentation techniques do not provide sufficient bone and soft tissue support for the predictable rehabilitation with dental implants due to presence of maxillary bone critical size defects and soft tissue deficiency, scaring and poor vascularity. In this article the protocol for the use of 3D virtual surgical planning and microvascular tissue transfers for the reconstruction and rehabilitation of cleft maxilla is presented. Twenty-five patients (8 male/17 female) aged 14–41 years old with cleft-associated critical size defects were treated by 3D-virtual planned microvascular tissue transfers taken either from fibula, iliac crest, radial forearm, or medial femoral condyle. Follow-up lasted 1–5 years. No significant bone resorption (p > 0.005) nor volume loss of the graft was observed (p = 0.645). Patients received final permanent prosthetic reconstruction of the anterior maxilla based on 2–5 dental implants, depending on the defect severity. This is the first study presenting the use of virtual planning in the final restoration of the cleft maxilla with microvascular tissue transfers and dental implants. Presented protocol provide highly functional and aesthetic results.
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Téllez-Conti C, Mora-Diaz II, Díaz-Báez D, Ocampo-Arias IJ, Jiménez-Luna NE, Niño-Paz JC, González-Carrera MC. Craniofacial Growth Analysis of Individuals With and Without Cleft Lip and Palate in Colombia. Cleft Palate Craniofac J 2021; 59:577-588. [PMID: 34000838 DOI: 10.1177/10556656211013690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Craniofacial growth is a dynamic and unpredictable process influenced by genetic and environmental factors, presenting phenotypic and gender differences. OBJECTIVE Evaluate the differences in craniofacial growth and development in a group of Colombian individuals with complete unilateral and bilateral cleft lip and palate (CLP) and without CLP, classified by gender and age. SETTING AND SAMPLE POPULATION Five hundred forty-one profile radiographs of 126 patients with unilateral CLP, 126 with bilateral CLP, and 289 without CLP. All patients of affected groups had a history of CLP correction surgery without nasoalveolar molding with orthopedic and orthodontic treatments. MATERIALS AND METHODS This cross-sectional study was performed comparing 8 cephalometric measurements on radiographs, 5 linear/3 angular. Analysis was performed by median and interquartile range for all cephalometric measurements. Comparison between the groups was performed using Kruskal-Wallis and Mann-Whitney U, with a 95% confidence. RESULTS Significant differences between the groups of patients with and without CLP, between types of clefts and genders. The skeletal structures of patients with CLP were smaller than those of control but improved with growth. Patients with unilateral CLP presented flat profiles and predominant class III malocclusions, while patients with bilateral CLP, at early ages, were class II and in the prepubertal stage, the values were progressively negative until the end of the growth period, suggesting class III. Patients with CLP presented posteroinferior rotation of the mandible, vertical measurements increased, and deflection of the cranial base. CONCLUSION Given their growth alterations, patients with CLP benefit from orthopedic and orthodontic treatment.
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Affiliation(s)
- Carolina Téllez-Conti
- Integral Management Unit of Craniofacial Abnormalities-UMIMC, School of Dentistry, 28009Universidad El Bosque, Bogotá, Colombia
| | | | - David Díaz-Báez
- Unit of Basic Oral Investigation-UIBO, School of Dentistry, 28009Universidad El Bosque, Bogotá, Colombia
| | | | | | | | - María Clara González-Carrera
- Integral Management Unit of Craniofacial Abnormalities-UMIMC, School of Dentistry, 28009Universidad El Bosque, Bogotá, Colombia
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Cassi D, Di Blasio A, Di Benedetto L, De Biase C, Pedrazzi G, Piancino MG. Evaluation of masticatory function in patients with cleft lip and/or palate. Eur J Oral Sci 2021; 129:e12781. [PMID: 33786947 DOI: 10.1111/eos.12781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/28/2022]
Abstract
The aim of this study was to evaluate the masticatory pattern in children with cleft lip and/or palate (CL/P) through investigation of the prevalence of reverse sequencing chewing cycles. The study group included 18 patients with CL/P (mean age: 7.4 yr, SD: 1.4 yr), 15 of whom had dental crossbite. The controls included a group of 18 non-CL/P children with the same types of crossbite as the study group (mean age: 7.2 yr, SD: 1.5 yr) and a group of 18 non-CL/P subjects with normal occlusion (mean age: 9.8 yr, SD: 1.9 yr). Mandibular movements during chewing of soft and hard bolus were recorded with a kinesiograph. Kinematic signals were analysed using a custom-made software. A statistical analysis was performed to compare the degree of reverse-sequencing chewing cycles between patients and controls (Kruskal-Wallis test with Dwass-Steel-Critchlow-Fligner pairwise comparisons post hoc test). A significant difference between patients with CL/P and non-CL/P subjects with normal occlusion was highlighted on the left side of mastication, which was the side with the higher prevalence of crossbite with both types of bolus. No statistical differences were found between CL/P patients and healthy controls with crossbite. Cleft-affected patients with posterior crossbite exhibited an anomalous masticatory pattern with increased reverse chewing cycles on the crossbite side.
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Affiliation(s)
- Diana Cassi
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Di Blasio
- Orthodontic Division, Centro Universitario di Odontoiatria, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Laura Di Benedetto
- Doctoral School in Life and Health Science, University of Turin, Turin, Italy
| | - Corrado De Biase
- Orthodontic Division, Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Giuseppe Pedrazzi
- Unit of Neuroscience, Department of Medicine and Surgery, Interdepartmental Centre of Robust Statistics, University of Parma, Parma, Italy
| | - Maria Grazia Piancino
- Orthodontic Division, Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
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Bardellini E, Veneri F, Amadori F, Conti G, Majorana A. Photobiomodulation therapy for the management of recurrent aphthous stomatitis in children: clinical effectiveness and parental satisfaction. Med Oral Patol Oral Cir Bucal 2020; 25:e549-e553. [PMID: 32388522 PMCID: PMC7338059 DOI: 10.4317/medoral.23573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/10/2020] [Indexed: 01/26/2023] Open
Abstract
Background This study aims to evaluate the effectiveness of the photobiomodulation therapy (PBMT) in the treatment of minor recurrent aphthous stomatitis (MiRAS) in children, in terms of pain relief, lesion size reduction and the parental satisfaction of the therapy.
Material and Methods This randomized controlled study was carried out on 60 children with clinical diagnosis of MiRAS. Patients were randomized into two groups: group A receiving laser therapy and group B receiving sham therapy (placebo). Laser therapy (diode laser, λ: 645 nm) was administered on day 1 (T0) for three consecutive days. Patients were evaluated also on day 4 (T1), on day 7 (T2) and on day 10 (T3). Oral aphthous lesions size was assessed through a periodontal probe to measure the diameter length (mm); pain was evaluated through the Visual Analogue Scale (VAS); parental satisfaction was assessed through a questionnaire.
Results The difference in the reduction of ulcers diameters between the two groups resulted statistically significant at T1 and at T2 (p<0.05). A statistically significant difference in pain reduction between two groups was found at T1 (p<0.05). No statistically significant difference between the two groups of parents was found as concerns the parental acceptance of the procedure and the discomfort for the need of multiple appointments.
Conclusions PBMT is to be considered effective in the treatment of MiRAS in children and well- accepted by the parents of the children themselves. Key words:Ulcers, children, lasers
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Affiliation(s)
- E Bardellini
- Dental Clinic, p.le Spedali Civili n.1 25133 Brescia
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Ribeiro EC, Lacerda RHW, da Silva LGM, Santiago BM, da Costa CHM, Almeida MSC. An analysis of third molar mineralization in Brazilian patients with cleft lip and palate. Acta Odontol Scand 2020; 78:384-389. [PMID: 32096419 DOI: 10.1080/00016357.2020.1731594] [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: 10/24/2022]
Abstract
Purpose: This study investigated the third molar mineralization in patients with cleft lip and palate.Materials and methods: From a total of 253 digital panoramic radiographs from patients with cleft lip and palate within the age range of 7-21 years, 97 radiographs were selected (cleft group). A control group was formed from same sex individuals, without malformation and chronological age matched within 30 days. The analysis of third molar mineralization was carried out by three calibrated examiners using Demirjian's and Nolla's methods. McNemar and Wilcoxon test for paired samples were used for pairwise comparisons between the groups. The Likelihood Ratio test was used to check for an association between the type of cleft and tooth calcification.Results: In both methods, the mineralization means were smaller in the case group than in the control, with significant differences for all third molars (p < .05). The type of cleft affected dental mineralization. There was no significant difference when comparing the left or right sides, but maxillary molars showed earlier mineralization.Conclusions: A significant delay in third molar mineralization was observed in patients with cleft lip and palate according to Demirjian's and Nolla's methods.
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Affiliation(s)
- Esther Carneiro Ribeiro
- Academic Center for Biological Sciences, School of Dentistry, Federal University of Campina Grande, Patos, Brazil
| | | | | | - Bianca Marques Santiago
- Department of Clinics and Social Dentistry, Federal University of Paraíba, João Pessoa, Brazil
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Siegenthaler M, Bettelini L, Brudnicki A, Rachwalski M, Fudalej PS. Early versus late alveolar bone grafting in unilateral cleft lip and palate: Dental arch relationships in pre-adolescent patients. J Craniomaxillofac Surg 2018; 46:2052-2057. [PMID: 30416034 DOI: 10.1016/j.jcms.2018.09.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/30/2018] [Accepted: 09/25/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To evaluate the dental arch relationship in preadolescent children with complete unilateral cleft lip and palate after early secondary alveolar bone grafting (E-ABG) by comparing to late bone grafting (L-ABG). MATERIAL AND METHODS Two raters blindly assessed the dental arch relationship with the modified Huddart-Bodenham (HB) Index for 2 groups: E-ABG group (36 children, mean age 9.6 years) and L-ABG group (56 children, mean age 11.1 years). The groups differed with respect to age at which alveolar bone grafting was performed: between 1.4 and 4.1 years (mean 2.2 years, E-ABG group) and after 8 years (L-ABG group). T-test was run to compare scores between 2 groups. Regression analysis was carried out to evaluate gender, age at cleft repair, age at ABG, and age at assessment with the HB index. RESULTS The overall HB scores were -6.77 and -4.25 in the E-ABG and L-ABG groups, respectively (p = 0.025). Regression analysis showed that only the age at cleft repair influenced the HB scores. CONCLUSION ABG carried out between 2 and 4 years of age does not seem to negatively affect the dental arch relationship at the age of 10 years in comparison to L-ABG.
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Affiliation(s)
| | - Lisa Bettelini
- Private Practice, Winkelstrasse 22, 1716 Plaffeien, Switzerland
| | - Andrzej Brudnicki
- Department of Paediatric Surgery (Head of the Department: Prof. Ewa Sawicka), Institute of Mother and Child, Kasprzaka 17a, 01-211 Warsaw, Poland
| | - Martin Rachwalski
- Department of Maxillofacial and Plastic Surgery (Head of the Department: Prof. Arnaud Picard), National Reference Center for Cleft Lip and Palate, Hôpital Universitaire Necker-Enfants Malades, 149 Rue de Sèvres, 75015 Paris, France
| | - Piotr S Fudalej
- Department of Orthodontics (Head of the Department: Doc. Milos Spidlen), Institute of Dentistry and Oral Sciences, Palacky University Olomouc, Palackeho 12, 771 00 Olomouc, Czech Republic; Department of Orthodontics and Dentofacial Orthopaedics (Head of the Department: Prof. Christos Katsaros), University of Bern, Freiburgstrasse 9, 3010 Bern, Switzerland.
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Early Orthopaedic Treatment of Hemifacial Microsomia. Case Rep Dent 2018; 2017:7318715. [PMID: 29387494 PMCID: PMC5745710 DOI: 10.1155/2017/7318715] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/01/2017] [Indexed: 11/17/2022] Open
Abstract
The aim of this paper is to report treatment effects of functional therapy in a growing patient affected by hemifacial microsomia (HM). According to Kaban's classification, the patient was classified as grade IIa as she presented all mandibular and temporomandibular joint components and a normal shaped, hypoplastic mandible. The therapeutic approach included the use of an asymmetrical functional activator (AFA) to stimulate the growth of the affected side and consequently to improve symmetry of the mandible and maxillary deficiency. Further effects were the lengthening of the mandibular ramus, restoration of occlusion, and expansion of soft tissues.
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