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Rocha F, Lopes Salomão S, Gerk A, Kim A, Telles L, Laus Pereira Lima B, Melo de Carvalho M, Martins Rocha C, Alonso N. Timely Access for Orofacial Cleft Repairs in a Brazilian Amazon Center. J Craniofac Surg 2024:00001665-990000000-01847. [PMID: 39194252 DOI: 10.1097/scs.0000000000010553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Accepted: 07/14/2024] [Indexed: 08/29/2024] Open
Abstract
Orofacial clefts are the most common congenital craniofacial anomalies worldwide, and if not managed in a timely manner, can lead to significant complications. We aim to examine surgical timing at one of the few cleft care centers in the North region of Brazil since its foundation in 2016. This retrospective, descriptive study analyzed medical records from 2016 to 2023. We calculated the age at surgery for each time period and each primary surgery performed. We also evaluated the number of procedures performed outside the recommended age . Of the 1439 procedures performed from 2016 to 2023, 713 procedures met our inclusion criteria. Among these, 66.67% (n=188) of primary cheiloplasties, 67.80% (n=40) of primary lip adhesions, and 54.57% (n=203) of palatoplasties were performed outside the recommended time frame. Of the surgeries performed, 45.16% (n=322) were between 2016 and 2019, while 54.84% (n=391) were from 2020 to 2023. Considering procedures performed within the ideal recommended age groups, only 32.92% (n=106) were done between 2016 and 2019, in contrast to 45.01% (n=176) between 2020 and 2023. In conclusion, since the inception of the specialized center, there has been an increase in surgical volume and an improvement in their timing. However, many surgeries are still being conducted outside the recommended time frame.
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Affiliation(s)
- Franklin Rocha
- Department of Pediatric Plastic Surgery, Foundation Santa Casa de Misericórdia of Pará
| | - Sarah Lopes Salomão
- Postgraduation Program in Sciences of Rehabilitation of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP). Bauru, São Paulo, Brasil
| | - Ayla Gerk
- Harvard Medical School, Program in Global Surgery and Social Change; Boston, MA
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Ana Kim
- São Camilo University Center, São Paulo, SP, Brazil
| | - Luiza Telles
- Medical Education Institute (IDOMED), Rio de Janeiro, Brazil
| | | | | | - Cynthia Martins Rocha
- Department of Pediatric Plastic Surgery, Foundation Santa Casa de Misericórdia of Pará
| | - Nivaldo Alonso
- Department of Plastic Surgery, Faculty of Medicine of the University of São Paulo (FMUSP), São Paulo, São Paulo, Brazil
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Peixoto AP, Miranda F, de Oliveira Pinto R, Ribeiro TTDC, Lara FSS, Machado FMDC, Garib D. Maxillary arch dimensions in bilateral cleft lip and palate in the age 0-5 months. Orthod Craniofac Res 2024. [PMID: 39003677 DOI: 10.1111/ocr.12836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 06/07/2024] [Accepted: 07/04/2024] [Indexed: 07/15/2024]
Abstract
INTRODUCTION The complete bilateral cleft lip and palate (BCLP) divides the maxillary arch into three segments, separated from each other, resulting in abnormal growth of the alveolar arch. This study evaluated the maxillary arch dimensions in BCLP and compared them with neonates without craniofacial anomalies. METHODS This retrospective study was conducted in a tertiary cleft centre. Sixty-six neonates aged 0-5 months were divided into two groups: cleft group-children with BCLP (23 boys and 18 girls) and control group-children without craniofacial deformities (15 boys and 10 girls). The dental models were processed by a 3D scanner. Landmarks were marked to achieve inter-canine distance, inter-tuberosity distance and arch length measurements. t-Tests were used for intergroup comparisons (p < .05). RESULTS The maxillary cleft arch was demonstrated to be wider and longer in the posterior region compared to the control group. The inter-canine distance did not present differences between the cleft and controls. The inter-canine distance of the control group was the only measurement influenced by the variable sex. CONCLUSIONS The cleft significantly interfered with the arch posterior width and arch sagittal length, making them larger. There was no statistical difference in the measurements between sex in the cleft group.
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Affiliation(s)
- Adriano Porto Peixoto
- Department of Orthodontics, Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - Felicia Miranda
- Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | | | - Tiago Turri de Castro Ribeiro
- Department of Orthodontics, Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | | | | | - Daniela Garib
- Department of Orthodontics, Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
- Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
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Neves MC, Nogueira VO, Sforza C, Oliveira Valarelli TM, Neppelenbroek KH, Soares S. Quantitative Assessment of Lip Morphology in Patients With and Without Cleft Lip and Palate Using 3-Dimensional Stereophotogrammetry. J Craniofac Surg 2024:00001665-990000000-01758. [PMID: 38976511 DOI: 10.1097/scs.0000000000010467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 06/10/2024] [Indexed: 07/10/2024] Open
Abstract
This study aimed to assess and quantify the morphologic characteristics of the lips and the lower third of the face in cleft and noncleft patients, utilizing three-dimensional (3D) stereophotogrammetry. Sixty patients were included in the study, comprising 30 unilateral cleft lip and palate patients (G1, 24 female, 6 male; aged 20 to 60 y, mean age 44.0±12.0 y) and 30 noncleft patients (G2, 23 female, 7 male; aged 20 to 59 y, mean age 43.5±12.0 y). Anthropometric landmarks were identified on the facial surface. Three-dimensional stereophotogrammetry was employed to capture images. Statistical analysis was conducted to compare the groups, with a significance level set at 0.05. The comparative analysis revealed statistically significant differences in 5 linear and 6 angular measurements. Linear measurements such as philtrum width, upper and lower cutaneous lip height, mandibular ramus length, and midfacial depth exhibited significant differences between cleft and noncleft patients. Similarly, angular measurements, including upper lip angle, Cupid's bow angle, lower/medium face convexity, lip seal, nasolabial angle, and left gonial angle, displayed statistically significant disparities. These findings underscore the ongoing surgical challenges in the comprehensive rehabilitation of patients with clefts, highlighting the critical need for continued advancements in treatment strategies.
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Affiliation(s)
- Maria Carolina Neves
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - Vanessa Ota Nogueira
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Thaís Marchini Oliveira Valarelli
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - Karin Hermana Neppelenbroek
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Simone Soares
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
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Rando GM, Ambrosio ECP, Jorge PK, Sforza C, Menezes M, de Almeida ALPF, Soares S, Dalben GS, Tonello C, Carrara CFC, Machado MAAM, Oliveira TM. Three-Dimensional Anthropometric Analysis of the Effect of Lip Reconstructive Surgery on Children with Cleft Lip and Palate at Three Different Times. CHILDREN (BASEL, SWITZERLAND) 2024; 11:824. [PMID: 39062273 PMCID: PMC11276499 DOI: 10.3390/children11070824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/12/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES This investigation aimed to assess the optimal timing for lip repair in children with cleft lip and palate via 3D anthropometric analysis to evaluate their maxillofacial structures. METHODS The sample comprised 252 digitized dental models, divided into groups according to the following timing of lip repair: G1 (n = 50): 3 months; G2 (n = 50): 5 and 6 months; G3 (n = 26): 8 and 10 months. Models were evaluated at two-time points: T1: before lip repair; T2: at 5 years of age. Linear measurements, area, and Atack index were analyzed. RESULTS At T1, the intergroup analysis revealed that G1 had statistically significant lower means of I-C', I-C, C-C', and the sum of the segment areas compared to G2 (p = 0.0140, p = 0.0082, p = 0.0004, p < 0.0001, respectively). In addition, there was a statistically significant difference when comparing the cleft area between G2 and G3 (p = 0.0346). At T2, the intergroup analysis revealed that G1 presented a statistically significant mean I-C' compared to G3 (p = 0.0461). In the I-CC' length analysis, G1 and G3 showed higher means when compared to G2 (p = 0.0039). The I-T' measurement was statistically higher in G1 than in G2 (p = 0.0251). In the intergroup growth rate analysis, G1 and G2 showed statistically significant differences in the I-C' measurement compared to G3 (p = 0.0003). In the analysis of the Atack index, there was a statistically significant difference between G1 and the other sample sets (p < 0.0001). CONCLUSION Children who underwent surgery later showed better results in terms of the growth and development of the dental arches.
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Affiliation(s)
- Gabriela Mendonça Rando
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | | | - Paula Karine Jorge
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru 17012-900, Brazil
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Functional Anatomy Research Center, Faculty of Medicine and Surgery, University of Milan, 20133 Milano, Italy
| | - Márcio Menezes
- School of Health Science, State University of Amazonas, Manaus 69065-001, Brazil
| | - Ana Lúcia Pompeia Fraga de Almeida
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru 17012-900, Brazil
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Simone Soares
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru 17012-900, Brazil
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Gisele Silva Dalben
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru 17012-900, Brazil
| | - Cristiano Tonello
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru 17012-900, Brazil
- Bauru School of Medicine, University of São Paulo, Bauru 17012-901, Brazil
| | | | | | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru 17012-900, Brazil
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Gifalli M, Antonio CT, Aparecida Pezzato da Silva V, Aroteia Capone F, Capelato Prado P, Trettene ADS. Adolescents with orofacial clefts: understanding their experiences. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2024; 42:e2023131. [PMID: 38716994 PMCID: PMC11073468 DOI: 10.1590/1984-0462/2024/42/2023131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/18/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To understand the experience of young people with orofacial clefts regarding life as an adolescent. METHODS Descriptive, qualitative study, developed in a Brazilian public and tertiary hospital, a reference center in the care of patients with craniofacial anomalies and related syndromes, between February and April 2019. The sample was defined by theoretical saturation. The following inclusion criteria were established: age between ten and 19 years old and having previously operated on orofacial cleft (lip and/or palate). Individuals with fissure associated with syndromes or other malformations were excluded. Data collection was performed through semi-structured interviews, which were audio recorded and transcribed in full. The trigger element was: how has it been for you to experience your adolescence? For the construction of the results, content analysis was used in the thematic modality. RESULTS Seventeen adolescents participated. From the speeches, three categories were revealed: interacting socially, feeling supported, and experiencing and facing prejudice. CONCLUSIONS The biopsychosocial and conflicting complexity that adolescents with orofacial clefts experience was noticed, as well as the importance of receiving support and establishing modalities of situational coping.
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Akdemir G, Gorucu-Coskuner H. Comparison of different maxillary advancement protocols in patients with unilateral cleft lip and palate: a finite element analysis. Clin Oral Investig 2024; 28:260. [PMID: 38642152 PMCID: PMC11032273 DOI: 10.1007/s00784-024-05633-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/23/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate the stress distributions and possible amount of movement in the maxillofacial region resulting from different maxillary advancement protocols in patients with unilateral cleft lip and palate. MATERIALS AND METHODS A unilateral cleft lip and palate model (CLP model) with Goslon score 4 was created for finite element analysis. Three different protocols were compared: Group 1: usage of a face mask with elastics placed at a 30? angle to the occlusal plane over a conventional acrylic plate; Group 2: usage of a face mask with elastics placed at a 30? angle to the occlusal plane over miniplates placed in the infrazygomatic crest region; Group 3: usage of elastic from the menton plate placed in the mandible to the infrazygomatic plates in the maxilla. RESULTS Dental effects were greater in the maxillary protraction protocol with a face mask over a conventional acrylic plate (Von Misses Stress Values; Group 1?=?cleft side:0.076, non-cleft side:0.077; Group 2?=?cleft side:0.004, non-cleft side: 0.003; Group 3?=?cleft side:0.0025; non-cleft side:0.0015), whereas skeletal effects were greater in maxillary protraction protocols with face mask using skeletal anchorage (Von Misses Stress Values; Group 1:0.008; Group 2:0.02; Group 3:0.0025). The maximum amount of counterclockwise rotation of the maxilla as a result of protraction was observed in traditional acrylic plate face mask protocol, and the minimum amount was observed by using elastics between infrazygomatic plates and menton plate. CONCLUSIONS In individuals with unilateral cleft lip and palate with Goslon score 4, it was observed that the skeletally anchored face mask caused more skeletal impact and displacement than both the traditional acrylic plate face mask model and the pure skeletally supported maxillary protraction model. CLINICAL RELEVANCE When planning maxillary protraction treatment in patients with cleft lip and palate, it should be considered that more movement in the sagittal plane might be expected on the cleft side than the non-cleft side, and miniplate and screws on the cleft side are exposed to more stress when using infrazygomatic plates as skeletal anchorage.
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Loureiro NB, Marzano-Rodrigues MN, Trindade-Suedam IK, D Aquino A, Trindade SHK. Assessment of Internal Nasal Dimensions of Individuals With Cleft Lip and Palate and Obstructive Sleep Apnea Syndrome by Computed Tomography. Cleft Palate Craniofac J 2024; 61:574-583. [PMID: 36330652 DOI: 10.1177/10556656221133606] [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: 02/17/2024] Open
Abstract
To evaluate nasal cavity (NC) dimensions of individuals with cleft lip and/or palate (CL/P), obstructive sleep apnea (OSA), and primary snoring, by tomographic image analysis, compared to individuals with OSA without CL/P (N-CL/P). Cross-sectional and retrospective. Tertiary referral center. Patients were divided into 2 groups: (G1) CL/P + OSA or primary snoring, n = 11; (G2) N-CL/P + OSA, n = 13. NC tomographic images were reconstructed using ITK-SNAP software, and measurements were obtained from these three-dimensional models using SpaceClaim software. Total NC volumes, right and left NC volumes, and volumes of the nostril to the nasal valve (V1) and from the nasal valve to the superior limit of the nasopharynx (V2), cross-sectional areas, and perimeters. NC volumes (total, right, and left sides), V1, and V2, though smaller in the CL/P + OSA, did not differ significantly from the N-CL/P + OSA. Cross-sectional areas and perimeters of the superior limit of the nasopharynx, in the CL/P + OSA, presented significantly higher values compared to the N-CL/P + OSA (P ≤ .05). The internal nasal dimensions of patients with CL/P do not seem to be part of the etiopathogenesis, nor constitute a risk factor for OSA with greater severity, in this special group of patients.
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Affiliation(s)
- Natalia Bortotti Loureiro
- Sleep Studies Unit/Laboratory of Physiology/Hospital for Rehabilitation of Craniofacial Anomalies - HRAC, University of São Paulo, Brazil
| | - Maria Noel Marzano-Rodrigues
- Sleep Studies Unit/Laboratory of Physiology/Hospital for Rehabilitation of Craniofacial Anomalies - HRAC, University of São Paulo, Brazil
| | - Ivy Kiemle Trindade-Suedam
- Sleep Studies Unit/Laboratory of Physiology/Hospital for Rehabilitation of Craniofacial Anomalies - HRAC, University of São Paulo, Brazil
| | - Alessandro D Aquino
- Sleep Studies Unit/Laboratory of Physiology/Hospital for Rehabilitation of Craniofacial Anomalies - HRAC, University of São Paulo, Brazil
| | - Sergio Henrique Kiemle Trindade
- Sleep Studies Unit/Laboratory of Physiology/Hospital for Rehabilitation of Craniofacial Anomalies - HRAC, University of São Paulo, Brazil
- Otolaryngology Section/Hospital for Rehabilitation of Craniofacial Anomalies - HRAC, University of São Paulo, Brazil
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Ambrosio ECP, Jorge PK, Carrara CFC, Machado MAAM, Oliveira TM. Research on Cleft Lip and Palate: What Is New? CHILDREN (BASEL, SWITZERLAND) 2023; 11:25. [PMID: 38255339 PMCID: PMC10813963 DOI: 10.3390/children11010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024]
Abstract
Craniofacial development begins during the fourth week of intrauterine life (IUL) [...].
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Affiliation(s)
- Eloá Cristina Passucci Ambrosio
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Silvio Marchione 3-20, Bauru 17012-900, SP, Brazil; (E.C.P.A.)
| | - Paula Karine Jorge
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Silvio Marchione 3-20, Bauru 17012-900, SP, Brazil; (E.C.P.A.)
| | - Cleide Felício Carvalho Carrara
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Silvio Marchione 3-20, Bauru 17012-900, SP, Brazil; (E.C.P.A.)
| | - Maria Aparecida Andrade Moreira Machado
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla 9-75, Bauru 17012-901, SP, Brazil
| | - Thais Marchini Oliveira
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Silvio Marchione 3-20, Bauru 17012-900, SP, Brazil; (E.C.P.A.)
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla 9-75, Bauru 17012-901, SP, Brazil
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Campos LD, Trindade IEK, Trindade SHK, Pimenta LAF, Kimbell J, Drake A, Marzano-Rodrigues MN, Trindade-Suedam IK. Effects of 3D Airway Geometry on the Airflow of Adults with Cleft Lip and Palate and Obstructive Sleep Apnea: A Functional Imaging Study. Sleep Sci 2023; 16:e430-e438. [PMID: 38197022 PMCID: PMC10773502 DOI: 10.1055/s-0043-1776868] [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] [Received: 06/25/2022] [Accepted: 02/09/2023] [Indexed: 01/11/2024] Open
Abstract
Objective Individuals with cleft lip and palate (CLP) are at a high risk of developing obstructive sleep apnea (OSA). Hypothetically, the severity of OSA might be associated with the morphology of the upper airway (UAW) and the characteristics of the airflow. Thus, the present study aimed to assess and compare, in adults with CLP and skeletal class-III discrepancy, with or without OSA, simulations of airflow resistance and pressure according to the geometrical characteristics of the UAW and cephalometric parameters. Materials and Methods According to the results of type-I polysomnography tests, the sample ( n = 21) was allocated in 2 groups: 1) without OSA (N-OSA; n = 6); and 2) with OSA (OSA; n = 15). Cephalometric measurements were performed on the cone-beam computed tomography (CBCT) scans of the groups. After three-dimensional (3D) reconstructions, the volume (V) and minimal cross-sectional area (mCSA) of the UAW were generated. Computational fluid dynamics (CFD) simulations were used to assess key airflow characteristics. The results were presented at a significance level of 5%. Results The UAW pressure values and airway resistance did not differ between the groups, but there was a tendency for more negative pressures (26%) and greater resistance (19%) in the OSA group. Volume and mCSA showed a moderate negative correlation with resistance and pressure. The more inferior the hyoid bone, the more negative the pressures generated on the pharyngeal walls. Conclusion The position of the hyoid bone and the geometry of the UAW (V and mCSA) exerted effects on the airway-airflow resistance and pressure. However, key airflow characteristics did not differ among subjects with CLP, were they affected or not by OSA.
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Affiliation(s)
- Leticia Dominguez Campos
- Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
| | - Inge Elly Kiemle Trindade
- Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
- School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Biological Sciences, School of Dentistry, Universidade de São Paulo, Bauru, SP, Brazil
| | - Sergio Henrique Kiemle Trindade
- Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
- Department of Pediatric Dentistry, Orthodontics and Public Health, School of Medicine, Universidade de São Paulo, Bauru, SP, Brazil
| | - Luiz André Freire Pimenta
- Department of Biological Sciences, School of Dentistry, Universidade de São Paulo, Bauru, SP, Brazil
| | - Julia Kimbell
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Amelia Drake
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Maria Noel Marzano-Rodrigues
- Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
| | - Ivy Kiemle Trindade-Suedam
- Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
- School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Biological Sciences, School of Dentistry, Universidade de São Paulo, Bauru, SP, Brazil
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Chepernate Vieira Dos Santos C, Gonçalves MG, Souza Campos Costa M, da Silva Costa SM, Ferreira Santiago Junior J, de Almeida ALPF. Survival Rate of Dental Implants in the Cleft Area: A Cross-Sectional Retrospective Study. J Craniofac Surg 2023; 34:2146-2148. [PMID: 37594045 DOI: 10.1097/scs.0000000000009625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/15/2023] [Indexed: 08/19/2023] Open
Abstract
This study aimed to evaluate the survival rate of osseointegrated implants installed in the cleft area. An extensive data survey was conducted using the medical records of individuals who had implants installed in the cleft area between 1999 and 2020. The variables assessed were age, sex, implant follow-up time, implantation procedures, and rehabilitation with implant-supported prostheses. Data were analyzed in terms of implant survival time, correlating with the factors: age, sex, execution, or no-execution of bone regrafting, the time interval between secondary alveolar bone grafting and regrafting, the time interval between regrafting and implant installation, and the time interval between implant installation and provisional and definitive prosthesis. Data were analyzed with respect to implant survival. χ 2 and Student t tests were used with a 5% significance level. A total of 1295 medical records were analyzed, of which 688 reported implants in cleft areas (56.1% in females, 43.9% in males) with a success rate of 92.73% and a mean follow-up time of 53.2 (±45.0) months. There were no statistically significant differences in the correlation between the survival rate and sex ( P = 0.895, χ 2 test), between the implant survival rate and regrafted area ( P = 0.904, χ 2 test), or between the survival rate and patient age ( P = 0.246, Student t test). The survival rate of implants in the cleft area was 92.73%. Age, sex, and the need for regrafting did not influence the survival rate of implants installed in the cleft area. Clinical studies that evaluate the survival rate of implants installed in patients with cleft maxilla are of great relevance to the dental field.
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Affiliation(s)
| | - Maiara Gabriela Gonçalves
- Sector of Periodontics Hospital for the Rehabilitation of Craniofacial Anomalies, University of São Paulo
| | | | | | | | - Ana Lúcia Pompéia Fraga de Almeida
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, and Hospital for the Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
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Felício Carvalho Carrara C, Jorge PK, Costa B, Machado MAAM, Oliveira TM, da Silva Dalben G. Customized Tray for Impression Taking in Children With Cleft Lip and Palate. Cleft Palate Craniofac J 2023; 60:1168-1171. [PMID: 35466698 DOI: 10.1177/10556656221095713] [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: 11/17/2022] Open
Abstract
The assessment of rehabilitation outcomes requires a patient documentation protocol, including records obtained at standardized ages, to compare different types of surgeries, their effects, as well as between different rehabilitation centers. The aim of this paper was to present proper trays for babies with different types of cleft lip and palate, which are used in the outpatient routine at Hospital of Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP). The customized trays are made with self-curing acrylic resin. The tray must have suitable depth to copy the buccal sulcus, and wax is usually applied to contour the tray edge, and the adjustment of the tray to the fornix, making the tray specific for each child. The impression precludes the utilization of dental casts for diagnosis, treatment plan, and research measurements. In the clinical practice at HRAC-USP, it was observed that customized trays increased the quality of impression, accurately reproducing anatomical features of dental arches of babies with oral clefts.
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Affiliation(s)
- Cleide Felício Carvalho Carrara
- Pediatric Dentistry, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Paula Karine Jorge
- Pediatric Dentistry, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Beatriz Costa
- Pediatric Dentistry, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Thais Marchini Oliveira
- Pediatric Dentistry, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry - University of São Paulo, Bauru, São Paulo, Brazil
| | - Gisele da Silva Dalben
- Pediatric Dentistry, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
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Ambrosio ECP, Furiatto AP, Coutinho MS, Quagliato DR, Carrara CFC, Machado MAAM, Oliveira TM, Jorge PK. What Are the Effects on Palate of Early Lip Surgery in Children With Cleft Lip and Palate? Cross-Sectional Evaluation From 5-Year-Old. J Craniofac Surg 2023; 34:1748-1751. [PMID: 37418613 DOI: 10.1097/scs.0000000000009501] [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: 09/06/2022] [Accepted: 05/16/2023] [Indexed: 07/09/2023] Open
Abstract
This study aimed to evaluate the postsurgical effects from 5 years on the palate after surgical repair of the lip at 3 or 9 months of age in children with cleft lip and palate. Eighty-four digitized dental impressions were divided into the following groups: group 1 (G1): lip surgery at 3 months of life; group 2 (G2): lip surgery at 9 months of life; group 3 (G3): without orofacial cleft. Five angular (C'IC, ICM, IC'M', CMM', and C'M'M) and 3 linear parameters (C-C', c-c', and M-M') were evaluated. Statistical analysis was applied with α=5%. Intraclass Correlation Coefficient was significantly smaller in G1 than in G3 ( P =0.005), while IC'M' was significantly smaller in G3 than in G1 ( P <0.001). C'M'M was significantly smaller in G1 than in G2 and G3 ( P <0.001). The distances C-C' and c-c' were significantly smaller in G1 than in G2 and G3 ( P <0.001). There was a statistically significant difference in both G1 and G2 ( P <0.001, in all) in the analysis of palatal symmetry. Linear regression analysis showed that the, 11.2% of outcomes determined by c-c' distance can be explained by the age of lip repair ( P =0.013). In conclusion, lip surgery at 3 months of life showed a tendency toward more restriction in 5-year postsurgery palate development. The age of cheiloplasty is one of the factors that can influence palatal development; however, other factors may be associated and should be studied.
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Affiliation(s)
| | - Arthur P Furiatto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru/SP, Brazil
| | - Marcelli S Coutinho
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru/SP, Brazil
| | - Débora R Quagliato
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru/SP, Brazil
| | | | | | - Thais M Oliveira
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru/SP, Brazil
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru/SP, Brazil
| | - Paula K Jorge
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru/SP, Brazil
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Jorge PK, Ambrosio ECP, Mello-Peixoto YCT, Carrara CFC, Soares S, Almeida ALPFD, Machado MAAM, Oliveira TM. Current Perspectives on Cleft Lip and Palate and Children's Health. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050857. [PMID: 37238405 DOI: 10.3390/children10050857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023]
Abstract
Orofacial clefts are the most prevalent craniofacial congenital anomalies, affecting the lip, with or without involvement of the palate, or solely the palate [...].
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Affiliation(s)
- Paula Karine Jorge
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Silvio Marchione 3-20, Bauru 17012-900, Brazil
| | - Eloá Cristina Passucci Ambrosio
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Silvio Marchione 3-20, Bauru 17012-900, Brazil
| | - Yana Cosendey Toledo Mello-Peixoto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla 9-75, Bauru 17012-901, Brazil
| | - Cleide Felício Carvalho Carrara
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Silvio Marchione 3-20, Bauru 17012-900, Brazil
| | - Simone Soares
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Silvio Marchione 3-20, Bauru 17012-900, Brazil
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla 9-75, Bauru 17012-901, Brazil
| | - Ana Lucia Pompeia Fraga de Almeida
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Silvio Marchione 3-20, Bauru 17012-900, Brazil
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla 9-75, Bauru 17012-901, Brazil
| | - Maria Aparecida Andrade Moreira Machado
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla 9-75, Bauru 17012-901, Brazil
| | - Thais Marchini Oliveira
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Silvio Marchione 3-20, Bauru 17012-900, Brazil
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla 9-75, Bauru 17012-901, Brazil
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Villela MJCDS, Franzolin SDOB, Bom GC, dos Santos EAMC, da Cunha GFM, Trettene ADS. Smoking in adolescents with cleft lip and/or palate: prevalence and associated factors. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2021316. [PMID: 36921164 PMCID: PMC10014026 DOI: 10.1590/1984-0462/2023/41/2021316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/30/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To assess the prevalence and factors associated with smoking in adolescents with cleft lip and/or palate. METHODS This is a cross-sectional study, developed in a Brazilian public and tertiary hospital between November 2018 and August 2019. Adolescents aged between 12 and 19 years old, previously submitted to cheiloplasty and/or palatoplasty surgeries were included. Data collection was carried out through interviews, guided by questionnaires referring to sociodemographic issues, use and factors associated with smoking. For statistical analysis, Fisher's Exact Test, Chi-square, Student's t test and bivariate logistic regression were used, all with a significance level of 5% (p≤0.05). RESULTS 102 adolescents participated. The prevalence of smoking was 20.6% (n=21). Having cleft lip and palate was associated with smoking (p=0.012). The bivariate analysis showed that not dating (p=0.001; OR=0.19) and owning a home (p=0.032; OR=0.33) were configured as protective factors for the act of being a smoker, while believing that smoking facilitates interaction with young people or with the group of friends (p=0.043; OR=2.95), having friends who use alcoholic beverages (p=0.002; OR=8.40), having friends who use drugs, except cigarettes (p=0.002; OR=5.33), use alcoholic beverages (p<0.001; OR=10.67) and sexual initiation (p<0.001; OR=7.00), were associated with being a smoker. CONCLUSIONS From the knowledge of the profile of adolescents most vulnerable to tobacco use, it is possible to plan and implement educational and preventive actions.
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Trevizan ACDS, Gonçales AGB, Centurion Pagin BS, Pagin O, Neves LTD. Rare and Multiple Hypodontia in Van der Woude Syndrome: Case Report. Cleft Palate Craniofac J 2023; 60:243-248. [PMID: 34787023 DOI: 10.1177/10556656211058265] [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: 01/18/2023] Open
Abstract
Van der Woude syndrome (VWS) is a rare syndrome of genetic etiology, commonly occasioned by mutations in the IRF6 gene and that causes disorders in craniofacial development. VWS is characterized by the presence of paramedian fistulas in the lower lip and cleft lip and / or cleft palate. Although some dental phenotypes have been reported in this syndrome, multiple and rare hypodontias were not described. Through this case report, we present a case of Van der Woude Syndrome (VWS) with rare and multiple hypodontia in which clinical data and radiographic exams were evaluated. The patient presented hypodontia of eight permanent teeth (lateral incisors, second premolars and second molars). So, when the dentist recognizes multiple and/or rare hypodontias, for an accurate diagnosis, detailed examination of the lower lip is indicated, as well as a survey of the family history and referral for genetic counseling, since the syndrome presents high penetrance. The patient is expected to be rehabilitated to have a good quality of life. Rehabilitation in these cases requires alveolar bone graft, orthodontics and prosthesis to replace missing teeth.
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Affiliation(s)
- Aline Cristina da Silva Trevizan
- Rehabilitation Sciences, Hospital for Rehabilitation of Craniofacial Anomalies, 344933University of São Paulo (HRAC/USP), São Paulo, Brazil
| | - Andréa Guedes Barreto Gonçales
- Rehabilitation Sciences, Hospital for Rehabilitation of Craniofacial Anomalies, 344933University of São Paulo (HRAC/USP), São Paulo, Brazil
| | - Bruna Stuchi Centurion Pagin
- Department of Oral Diagnosis, Hospital for Rehabilitation of Craniofacial Anomalies, 42466University of São Paulo (HRAC/USP), São Paulo, Brazil
| | - Otávio Pagin
- Department of Oral Diagnosis, Hospital for Rehabilitation of Craniofacial Anomalies, 42466University of São Paulo (HRAC/USP), São Paulo, Brazil
| | - Lucimara Teixeira das Neves
- Department of Biological Sciences, Bauru School of Dentistry, 42466University of São Paulo and Post-Graduation Program in Rehabilitation Sciences, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), São Paulo, Brazil
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Chandwani N, Nandan M, Jadhav G, Pawar AM, Karobari MI, Marya A. Single visit rehabilitation of 12-day neonate with cleft palate using modified feeding spoon impression technique: A case report. Clin Case Rep 2023; 11:e7008. [PMID: 36860725 PMCID: PMC9969763 DOI: 10.1002/ccr3.7008] [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] [Received: 09/08/2022] [Revised: 02/04/2023] [Accepted: 02/14/2023] [Indexed: 03/02/2023] Open
Abstract
The rehabilitation of the cleft requires a multidisciplinary approach involving a pediatrician, surgeon, otolaryngologist, speech therapist, orthodontist, prosthodontist, and psychologist. The present case report illustrates the rehabilitation of a 12-day-old neonate with a cleft palate. Since the palatal arch of the neonate was very small, a feeding spoon was innovatively modified to obtain the impression. The obturator was fabricated on the same day and delivered in one appointment.
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Affiliation(s)
- Neelam Chandwani
- Department of DentistryAll India Institute of Medical SciencesNagpurIndia
| | - Monika Nandan
- Department of DentistryAll India Institute of Medical SciencesNagpurIndia
| | - Ganesh Jadhav
- Department of DentistryAll India Institute of Medical SciencesNagpurIndia
| | | | | | - Anand Marya
- Department of Orthodontics, Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- Center for Transdisciplinary Research, Saveetha Dental College, Saveetha Institute of Medical and Technical ScienceSaveetha UniversityChennaiIndia
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da Silva VAP, Gifalli M, Capone FA, Farinha FT, Prado PC, Trettene ADS. Prenatal diagnosis of orofacial clefts: unveiling the parents' experience. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2022004. [PMID: 36700568 PMCID: PMC9869735 DOI: 10.1590/1984-0462/2023/41/2022004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/06/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To understand the experience of parents regarding prenatal diagnosis of orofacial cleft in their children. METHODS Descriptive study with a qualitative approach, carried out in a Brazilian public tertiary hospital between January and March 2019. Parents who were accompanying their children during hospitalization for primary surgeries and who had received the diagnosis of malformation during pregnancy were included in this study. Data was collected through semi-structured interviews, which were audio-recorded and transcribed in full. To prepare the results, Content Analysis was used in the Thematic modality. RESULTS The sample had 17 participants: 16 mothers and one father. From the speeches, three categories were unveiled: dealing with the unknown, assimilating the diagnosis, and positive and negative implications of prenatal diagnosis. CONCLUSIONS We learned how complex and conflicting it was for parents to receive the diagnosis of malformation in their children, and that family and professional support was essential to the process of assimilation and coping. The findings point to the need for planning and implementing interventions, protocols and/or public policies aimed at assisting these parents in this period.
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AMBROSIO ECP, PUCCIARELLI MGR, SFORZA C, SOARES S, MENEZES MD, CARRARA CFC, MACHADO MAAM, OLIVEIRA TM. Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study. Braz Oral Res 2023; 37:e021. [PMID: 37018803 DOI: 10.1590/1807-3107bor-2023.vol37.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/23/2022] [Indexed: 04/05/2023] Open
Abstract
This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.
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Batista NT, Martinez AF, Bom GC, Farinha FT, Prado PC, Trettene ADS. Correlation between burden and sleep quality in informal caregivers of infants with orofacial cleft. REVISTA PAULISTA DE PEDIATRIA 2023; 41:e2021352. [DOI: 10.1590/1984-0462/2023/41/2021352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/13/2022] [Indexed: 11/16/2022]
Abstract
Abstract Objective: To evaluate the correlation between burden and sleep quality in caregivers of infants with cleft lip and/or palate. Methods: This descriptive cross-sectional study was carried out in a Brazilian tertiary public hospital between March and September 2020. The sample included the main informal, literate caregivers of infants with cleft lip and/or palate, aged 18 years or older. The instruments used were the Burden Interview Scale and the Pittsburgh Sleep Quality Index. Data were collected during the infants’ hospitalization. Statistical analysis adopted Pearson and Spearman correlations, with a 5% significance level. Results: A total of 31 informal caregivers participated in the study, most of them mothers (n=28; 90%), with a mean age of 30 years (standard deviation – SD=7.5), low socioeconomic status (n=20; 64%), who completed high school (n=19; 61%), were married (58%), had two children (n=15; 48%), and no employment relationship (n=18; 58%). A moderate correlation was found between sleep quality and burden (r=0.39; p=0.032) and between burden and subjective sleep quality (r=0.39; p=0.029), sleep latency (r=0.43; p=0.017), and daytime dysfunction (r=0.49; p<0.001). Conclusions: The study showed that the higher the burden, the lower the sleep quality. The findings indicate the need to plan and implement interventions to minimize the burden experienced by these informal caregivers in order to improve their sleep quality.
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Silveira DMMLD, Martelli DRB, Dias VO, Silveira MSCD, Almeida ILF, Martelli Júnior H. Surgical rehabilitation of cleft lip and/or palate: evaluation of the Brazilian public health system. Braz J Otorhinolaryngol 2022; 88 Suppl 5:S126-S132. [PMID: 35717308 PMCID: PMC9801040 DOI: 10.1016/j.bjorl.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 05/05/2022] [Accepted: 05/30/2022] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To evaluate the surgical rehabilitation of cleft lip and/or palate by the Brazilian public health system. METHODS Retrospective, analytical and comparative ecological study, with information on hospital procedures performed on individuals with cleft lip and/or palate in Centers authorized by the Brazilian public health system, between the years 2008 and 2020. The information was collected in databases Ministry of Health data. RESULTS Between 2008 and 2020, there was an increase of 8 (36.4%) qualified Centers in Brazil, currently having 30 Centers in 100% of the geographic regions. The surgical procedures performed totaled 68,716; with multiple surgeries being the most frequent. Complete cleft lip and palate was the most frequent type in hospital admissions. The public financial resources invested in the surgical rehabilitation of cleft lip and palate in the qualified Lip and Palate Malformation Treatment Centers were US$ 39,693 million, making an average value per procedure of US$ 577.64. CONCLUSIONS In Brazil, public health system performed and financed, over the years 2008 and 2020, an important volume of surgical procedures for cleft lip and/or palate, which presented a polarization in the Southeast region but with a slight tendency expansion to other regions of the country. The most performed surgical procedures were multiple surgeries and mostly for individuals with cleft lip and palate. The amounts paid showed a heretogeneous distribution in the national territory. LEVEL OF EVIDENCE Level 5: Report containing program evaluation data.
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Affiliation(s)
- Denise Maria M L da Silveira
- Universidade Estadual de Montes Claros (Unimontes), Programa de Pós-Graduação em Cuidado Primário em Saúde, Montes Claros, MG, Brazil; Secretaria de Saúde do Estado de Minas Gerais, Superintendência Regional de Saúde de Montes Claros, Montes Claros, MG, Brazil.
| | - Daniella Reis B Martelli
- Universidade Estadual de Montes Claros (Unimontes), Programa de Pós-Graduação em Cuidado Primário em Saúde, Montes Claros, MG, Brazil; Universidade Estadual de Montes Claros (Unimontes), Curso de Odontologia, Montes Claros, MG, Brazil
| | - Verônica Oliveira Dias
- Universidade Estadual de Montes Claros (Unimontes), Curso de Odontologia, Montes Claros, MG, Brazil
| | | | | | - Hercílio Martelli Júnior
- Universidade Estadual de Montes Claros (Unimontes), Programa de Pós-Graduação em Cuidado Primário em Saúde, Montes Claros, MG, Brazil; Universidade Estadual de Montes Claros (Unimontes), Curso de Odontologia, Montes Claros, MG, Brazil
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Silvestre CMR, Silva AMC, Ferreira da Silva RCG, Bittencourt WS, Borba AM, Fernandes V, da Silva CAL. Environmental Factors at the Periconceptional Period and the Occurrence of Cleft Lip and Palate in a Midwest Brazil Population: A Case-Control Study. J Occup Environ Med 2022; 64:e751-e756. [PMID: 36069817 DOI: 10.1097/jom.0000000000002689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate the association between periconceptional environmental exposures and the occurrence of cleft lips and palates. METHODS This case-control study analyzed 150 mothers of children with cleft lips and palates living in the same city as 250 mothers whose children did not present with this malformation (controls). Environmental exposure data were gathered through a questionnaire (Latin American Collaborative Study of Congenital Malformations methodology). RESULTS Multivariate analysis revealed that monthly income below minimum wage, having another malformed child, other diseases in the first gestational trimester (urinary infection), use of pesticides in home gardens, and pesticide use in farms close to the home were risk factors associated with the malformation, whereas taking vitamins was a protective factor. CONCLUSION Maternal and paternal exposure to pesticides is associated with cleft lip and palate in Mato Grosso State, Brazil.
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Affiliation(s)
- Carla Meliso R Silvestre
- From the University of Cuiabá, Cuiabá, Mato Grosso, Brazil (Ms Silvestre, Dr Silva, Dr R.C.G. da Silva, Dr Bittencourt, Dr Borba, Dr Fernandes, Dr C.A.L. da Silva); General Hospital of Cuiabá, Cuiabá, Mato Grosso, Brazil (Ms Silvestre, Dr R.C.G. da Silva, Dr Borba, Dr Fernandes, Dr C.A.L. da Silva)
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Fernandes VM, Mondelli MFCG, José MR, Gomide MR, Lauris JRP, Feniman MR. Salivary Cortisol and Sustained Auditory Attention in Children with and without Cleft Lip and Palate. Int Arch Otorhinolaryngol 2022; 26:e605-e614. [PMID: 36405466 PMCID: PMC9668409 DOI: 10.1055/s-0041-1735130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/07/2021] [Indexed: 10/19/2022] Open
Abstract
Introduction Cortisol is a hormone involved in the response to stress. Attention is a function that can change due to exposure to stress. Objectives To verify the correlation between the level of salivary cortisol and sustained auditory attention in children with cleft lip and palate, as well as to compare the results of the variables analyzed between female and male patients. Methods In total, 103 children aged 6 to 11 years, were divided into 2 groups: those with cleft lip and palate (experimental group, EG; n = 69) and the control group (CG; n = 34). The Sustained Auditory Attention Ability Test (SAAAT) and salivary cortisol levels, measured by an enzyme immunoassay kit (Salimetrics, Stage College, PA, US), were calculated and compared regarding the two groups. The statistical tests used were the Mann-Whitney test and the Spearman correlation. Results The median level of salivary cortisol was of 0.03615 µl/dL and 0.18000 µl/dL respectively for the EG and CG, with a significant difference between the groups ( p = 0.000). Absence of statistical significance (total error score = 0.656; vigilance decrement = 0.051) was observed the for SAAAT among the EG (median total error score = 12.00; 25th percentile [25%] = 7.00; 75th percentile [75%] = 21.00; and vigilance decrement = 1.00; 25% = 0.00; 75% = 2.50) and the CG (median total error score = 12.00; 25% = 6.00; 75% = 24.00; and vigilance decrement = 0.00; 25% = -1.00; 75% = 2.00). Conclusion All children had median levels of salivary cortisol and scores for sustained auditory attention within normal parameters. A significant correlation between the level of salivary cortisol and the ability to sustain auditory attention was observed in children without cleft lip and palate. There were no differences regarding the SAAAT and salivary cortisol between female and male patients.
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Affiliation(s)
- Viviane Mendes Fernandes
- Postgraduate Program in Rehabilitation Sciences, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | | | - Maria Renata José
- Programa de Pós-Graduação em Distúrbios da Comunicação, Universidade de Tuiuti do Paraná, Curitiba, Paraná, Brasil
| | - Márcia Ribeiro Gomide
- Postgraduate Program in Rehabilitation Sciences, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | - José Roberto Pereira Lauris
- Departament of Speech Therapy, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brasil
| | - Mariza Ribeiro Feniman
- Departament of Speech Therapy, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brasil
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Ambrosio ECP, Sartori IC, Jorge PK, Carrara CFC, Valarelli FP, Machado MAAM, Oliveira TM. Six-year post-surgical evaluation in the treatment protocols in the dental arches of children with oral cleft: longitudinal study. J Appl Oral Sci 2022; 30:e20220120. [PMID: 35920507 PMCID: PMC9586431 DOI: 10.1590/1678-7757-2022-0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Oral cleft surgical repairs are performed using different techniques worldwide. To evaluate and compare the development of the dental arches of children with unilateral cleft lip and palate before and after the primary surgeries performed with different techniques at the first months and six years of life. METHODOLOGY This is a retrospective longitudinal study. The sample comprised 56 dental casts divided int the following groups: Group 1 (G1) - cheiloplasty (Millard technique) at three months and one-step palatoplasty (von Langenbeck technique) at 12 months; and Group 2 (G2) - cheiloplasty (Millard technique) and two-step palatoplasty: anterior hard palate closure (Hans Pichler technique) at three months and posterior soft palate closure (Sommerlad technique) at 12 months. The digitized dental casts were evaluated at three months - pre-surgical (T1) and six years of life- post-surgical (T2). The following linear measurements were analyzed: intercanine (C-C'), intertuberosity (T-T') distances; anterior dental arch (I-CC'), anterior intersegment (I-C'), and total arch (I-TT') lengths. The palate area was also measured. Parametric and non-parametric tests were applied (p<0.05). RESULTS In G1, the intragroup comparison showed statistically significant smaller I-CC' and I-C' at T2 (p=0.001 and p<0.001, respectively), while T-T', I-TT', and area comparisons were significantly greater (p<0.001, p=0.002, and p<0.001, respectively). In G2, the intragroup comparison exhibited statistically significant smaller C-C' and I-C' at T2 (p=0.004, for both), whereas T-T', I-TT' and area comparisons were significantly greater (p<0.001, p=0.004, and p<0.001, respectively). At T2, the intergroup analysis revealed that G1 had a statistically significant smaller I-CC' (p=0.014). The analysis of the intergroup differences (∆=T2-T1) showed that G1 had a statistically smaller I-CC' (p=0.043). CONCLUSION The two-step palatoplasty showed a more favorable prognosis for the maxillary growth than one-step palatoplasty in children with oral clefts.
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Affiliation(s)
- Eloá Cristina Passucci Ambrosio
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | - Isabela Castro Sartori
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | - Paula Karine Jorge
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | | | | | - Maria Aparecida Andrade Moreira Machado
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | - Thais Marchini Oliveira
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
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López Ramos RP, Blanco Victorio DJ, Ramos GT, Pajuelo MJ, Abanto J. Changes in the Oral Health-Related Quality of Life in Infants With Cleft Lip and/or Palate Before and After Surgical Treatment. Cleft Palate Craniofac J 2022; 59:47-53. [PMID: 33626895 PMCID: PMC9904395 DOI: 10.1177/1055665621993282] [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: 01/26/2023] Open
Abstract
OBJECTIVE To assess oral health-related quality of life (OHRQoL) changes before and after the primary surgical treatment in infants with cleft lip and/or palate (CL/P). DESIGN Quasi-experimental study. METHODS A total of 106 infants with CL/P younger than 2 years undergoing primary surgical treatment in the Plastic Surgery Service of the Instituto Nacional de Salud del Niño in Peru. The parent/caregiver answered a questionnaire about OHRQoL named the Peruvian version of the Early Childhood Oral Health Impact Scale (P-ECOHIS) in the pretreatment (baseline) and follow-up post-treatment. The total score of P-ECOHIS and their 2 sections (child impact and family impact) in the baseline and each follow-up period post-treatment scores were assessed. As well as, the type of the CL/P on OHRQoL, standardized effect sizes (ES) based on mean total change scores (difference between baseline and 12th month) were analyzed. RESULTS Improvements in infant's OHRQoL after treatment were reflected in each follow-up period P-ECOHIS score compared to the baseline score. The total P-ECOHIS scores decreased significantly from 28.07 (baseline) to 7.7 (12th month; P < .0001), as did the individual domain scores (P < .0001). There were significant differences in the baseline and follow-up post-treatment scores of infants who reported improvement of the OHRQoL (P < .0001). The ES was large (3.79). The cleft lip had an improvement in the OHRQoL at 12th month post-treatment (P < .0001). CONCLUSIONS Primary surgical post-treatment resulted in significant improvement of the infant's OHRQoL with CL/P.
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Affiliation(s)
| | | | | | - Mónica J. Pajuelo
- School of Science and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jenny Abanto
- Department of Pediatric Dentistry, APCD Dental School, São Paulo, Brazil
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25
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Jain N, Pilmane M. Evaluating the Expression of Candidate Homeobox Genes and Their Role in Local-Site Inflammation in Mucosal Tissue Obtained from Children with Non-Syndromic Cleft Lip and Palate. J Pers Med 2021; 11:jpm11111135. [PMID: 34834487 PMCID: PMC8618679 DOI: 10.3390/jpm11111135] [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] [Received: 09/30/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 11/16/2022] Open
Abstract
Craniofacial development including palatogenesis is a complex process which requires an orchestrated and spatiotemporal expression of various genes and factors for proper embryogenesis and organogenesis. One such group of genes essential for craniofacial development is the homeobox genes, transcriptional factors that are commonly associated with congenital abnormalities. Amongst these genes, DLX4, HOXB3, and MSX2 have been recently shown to be involved in the etiology of non-syndromic cleft lip and palate. Hence, we investigated the gene and protein expression of these genes in normal and cleft affected mucosal tissue obtained from 22 children, along with analyzing their role in promoting local-site inflammation using NF-κB. Additionally, we investigated the role of PTX3, which plays a critical role in tissue remodeling and wound repair. We found a residual gene and protein expression of DLX4 in cleft mucosa, although no differences in gene expression levels of HOXB3 and MSX2 were noted. However, a significant increase in protein expression for these genes was noted in the cleft mucosa (p < 0.05), indicating increased cellular proliferation. This was coupled with a significant increase in NF-κB protein expression in cleft mucosa (p < 0.05), highlighting the role of these genes in promotion of pro-inflammatory environment. Finally, no differences in gene expression of PTX3 were noted.
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Sousa GFTD, Roncalli AG. [Factors associated with the delay in primary surgical treatment of cleft lip and palate in Brazil: a multilevel analysis]. CIENCIA & SAUDE COLETIVA 2021; 26:3505-3515. [PMID: 34468646 DOI: 10.1590/1413-81232021269.2.23592019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 10/13/2019] [Indexed: 11/22/2022] Open
Abstract
This study analyzed the delay in the primary surgical treatment of patients with cleft lip and palate in Brazil performed under the Unified Health System (SUS), and the effect of the sociodemographic context and municipal socioeconomic indicators on access to this treatment (2009-2013). Data from the Decentralized Hospital Information System relating to all hospital authorization forms paid for primary cleft lip and/or palate surgeries and socioeconomic data (2010) was used. The ages recommended by the American Cleft Palate-Craniofacial Association (12 months for lip surgeries and 18 months for palate surgeries) were used as parameters. The prevalence of delay observed in primary lip surgeries was 66.4% and in palate surgeries was 71.2%. The North and Northeast regions had the worst percentages of delay. Non-whites had a greater prevalence of delay in cleft lip surgeries with PR = 1.40 (1.30-1.50) and cleft palate surgeries with PR = 1.27 (1.21-1.33). The multilevel analysis identified the influence of self-reported skin color and Human Development Index (HDI) on the delay of primary lip surgery, and of HDI on the delay of palate surgery. The importance of social determination on the access to primary cleft lip and palate surgeries was evident.
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Affiliation(s)
- Giselle Firmino Torres de Sousa
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte. Av. Sen. Salgado Filho 1787, Lagoa Nova. 59056-000. Natal RN Brasil.
| | - Angelo Giuseppe Roncalli
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte. Av. Sen. Salgado Filho 1787, Lagoa Nova. 59056-000. Natal RN Brasil.
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Ambrosio ECP, Sforza C, de Menezes M, Carrara CFC, Soares S, Machado MAAM, Oliveira TM. Prospective cohort 3D study of dental arches in children with bilateral orofacial cleft: Assessment of volume and superimposition. Int J Paediatr Dent 2021; 31:606-612. [PMID: 32970887 DOI: 10.1111/ipd.12731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/25/2020] [Accepted: 09/15/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cohort studies have evaluated dental arches of children. AIM To evaluate the volumetric, linear, palatal surface area, and the dental arch superimposition of participants with bilateral complete cleft lip (BCL) and bilateral cleft lip and palate (BCLP) surgically treated in a specialized hospital. DESIGN One hundred and thirty six digitized dental models evaluated before cheiloplasty (T1), after cheiloplasty (T2), and after palatoplasty (T3). The stereophotogrammetry software analysed the volume, palate superimposition, linear, and area measurements. RESULTS In BCL group, at T2, C-C', T-T', area, and volume significantly increased (P = .000, P < .000, P = .010 e P = .003, respectively). In BCLP group, the comparison T3 × T1 showed that C-C' decreased, whereas T-T' and the area increased (P < .000, P < .000, P = .000). The volume increased at T2, but decreased at T3 (P < .000) in participants with BCLP. The intergroup analysis revealed that C-C', T-T', I-C', and I-C were significantly smaller in participants with BCLP (P < .000, P = .016, P = .001 e P = .020, respectively), whereas the volume, superimposition, and area were statistically similar between groups (P > .05). CONCLUSION The comparison between bilateral orofacial clefts showed reduction in the transversal and anteroposterior linear measurements, but not in the area and volume, which was confirmed by the superimposition of the dental arches.
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Affiliation(s)
- Eloá Cristina Passucci Ambrosio
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Chiarella Sforza
- Human Anatomy, Department of Biomedical Sciences for Health, Faculty of Medicine and Surgery, Functional Anatomy Research Center (FARC), University of Milan, Milan, Italy
| | - Márcio de Menezes
- Restorative Dentistry, School of Health Science, State University of Amazonas, Manaus, Brazil
| | | | - Simone Soares
- Department of Prosthesis, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.,Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | | | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.,Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
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28
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Arch Asymmetry in Patients With Cleft Lip and Palate After Rehabilitation Treatment Using Stereophotogrammetry. J Craniofac Surg 2021; 32:e501-e504. [PMID: 33481468 DOI: 10.1097/scs.0000000000007460] [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
ABSTRACT Arch asymmetry in cleft patients is a current problem that interdisciplinary treatment aims to solve. This research proposed to analyze the final rehabilitation, according to the arch symmetry of these patients. Thirty-five patients aged between 18 and 30 years, rehabilitated with a fixed partial denture or implants in the cleft area. The analysis was performed using digitalized dental casts with a laser model scanner (R700TM; 3Shape A/S, Holmens Kanal 7, 1060, Copenhagen/Denmark), analyzed with a Vectra Analysis Module software program (VECTRA H1; Canfield Scientific, 4 Wood Hollow Road, Parsippany, NJ 07054). Three linear measurements were evaluated, incisal-canine, canine-molar, and incisal-molar distance. The Student t test was applied to test the significance (P = 0.05) of an observed sample by correlation coefficient test (r-value). Female patients showed a significant correlation in arch symmetry. According to the rehabilitation treatment, patients who received implants showed a high correlation and significant symmetry at all maxillary distances. Finally, according to the cleft side in the maxillary dimensions, even though the majority of patients had clefts on the left side, only patients with a cleft on the right side showed symmetry in this area. Patients rehabilitated with implants in the cleft area showed a more symmetrical maxillary arch than those restored with fixed partial dentures.
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Cunha GFMD, Manso MMFG, Villela MJCDS, Bom GC, Mondini CCDSD, Trettene ADS. Religiosity, spirituality, and self-esteem in adolescents with cleft lip and palate: a correlational study. Rev Esc Enferm USP 2021; 55:e03782. [PMID: 34190897 DOI: 10.1590/s1980-220x2020030503782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/24/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the correlation between religiosity, spirituality, and self-esteem in adolescents with uni- and bilateral cleft lip and palate. METHOD Correlational and cross-sectional study developed in a public and tertiary hospital in Brazil between July 2018 and February 2019. The sample comprised 100 adolescents divided into two groups: G1 (unilateral cleft, 50 participants) and G2 (bilateral cleft, 50 participants). For data collection, three instruments were used: Sociodemographic Questionnaire, DUREL Religion index, Rosenberg self-esteem scale. Statistical analysis was performed with the tests Chi-squared, Mann-Whitney, Pearson Correlation, and analysis of linear correlation strength, with a 5% significance level (p ≥ 0.05). RESULTS Only organizational religiosity was higher in G1 when compared with G2 (p = 0.03). The overall self-esteem was satisfactory for both groups; however, there was no significant difference between them (p = 0.34). No correlation between religiosity and spirituality with self-esteem were identified for G1 and G2. CONCLUSION The adolescents with uni- or bilateral cleft lip and palate presented high levels of religiosity, spirituality, and self-esteem. However, no correlation between these variables was identified.
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Affiliation(s)
- Gabriela Fávaro Marques da Cunha
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Programa de Pós-Graduação em Ciências da Reabilitação, Bauru, SP, Brasil
| | - Maila Meryellen Ferreira Garcia Manso
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Programa de Pós-Graduação em Ciências da Reabilitação, Bauru, SP, Brasil
| | - Maria Júlia Costa de Souza Villela
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Programa de Pós-Graduação em Ciências da Reabilitação, Bauru, SP, Brasil
| | - Gesiane Cristina Bom
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Programa de Pós-Graduação em Ciências da Reabilitação, Bauru, SP, Brasil
| | | | - Armando Dos Santos Trettene
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Programa de Pós-Graduação em Ciências da Reabilitação, Bauru, SP, Brasil
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Feitosa MCP, Garib D, de Cássia Moura Carvalho Lauris R, Herkrath APQ, Vettore MV. The impact of orthognathic surgery on quality of life in individuals with oral clefts. Eur J Orthod 2021; 44:170-177. [PMID: 34173641 DOI: 10.1093/ejo/cjab039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES To evaluate the relationships between individual, environmental, clinical factors and oral health-related quality of life (OHRQoL) in patients with cleft lip and palate (CLP) following orthognathic surgery. MATERIALS AND METHODS A follow-up study was conducted involving 69 adults with unilateral and bilateral CLP under orthodontic treatment. Interviews and oral examinations were conducted prior to orthognathic surgery (T0) to evaluate age, gender, psychological well-being, dental caries, malocclusion, social support, social networks, family income and education and OHRQoL. All participants were reviewed after 6 months (T1) to re-assess psychological well-being, malocclusion and OHRQoL. Structural equation modeling estimated the associations between the variables. RESULTS OHRQoL total scores reduced following orthognathic surgery, from 11.7 to 6.9 (P < 0.01). Occlusal characteristics and psychological well-being improved between T0 and T1. In the structural equation modeling, reduction of malocclusion (β = 0.02) between T0 and T1 directly predicted poor OHRQoL at T1. Improvement of psychological well-being between T0 and T1 was associated with better OHRQoL at T1 (β = -0.07). Dental caries and malocclusion at T0 were indirectly linked to poor OHRQoL at T1 (β = 0.02). LIMITATIONS The short follow-up period of 6 months after orthognathic surgery. CONCLUSIONS/IMPLICATIONS This represents the first prospective study examining the interrelationships of predictors of OHRQoL in patients with CLP after orthognathic surgery. OHRQoL and psychological well-being improved after orthognathic surgery. Clinical and psychological characteristics were important determinants of OHRQoL. These findings suggest the importance of the biopsychosocial model of health and the patient-centered approach in oral health care in individuals with CLP.
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Affiliation(s)
- Mariana Chaves Petri Feitosa
- Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Daniela Garib
- Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.,Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | | | | | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
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31
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Silva CM, Pereira MCDM, Queiroz TBD, Neves LTD. Family history in non-syndromic orofacial clefts: Is there a pattern? Oral Dis 2021; 28:2194-2203. [PMID: 34146367 DOI: 10.1111/odi.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/11/2021] [Accepted: 06/02/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To survey the frequency and pattern of family history for non-syndromic orofacial clefts (NSOFC). Initial hypothesis: more complex forms have a higher frequency of positive family history. MATERIALS AND METHODS A retrospective study was carried with 2,668 subjects with three different types of clefts (CL Group (cleft lip), CLP Group (cleft lip and palate), and CP group (cleft palate)); family history information was collected. The Chi-square (X2 ) and Z-test were used. RESULTS A positive family history was found in 31% of the sample. The CLP Group had highest percentage and highest proportion of affected relatives, being these factors statistically significant when compared to the CP Group. Comparisons between the CLP Male and CL Male with CP Male were statistically significant. First-degree kinship was the most frequently found. CONCLUSIONS The initial hypothesis was confirmed, subjects with CLP had the highest percentage of positive family history, the highest proportion of affected relatives and had more affected relatives in comparison with CP. It is more common to find affected relatives in the CLP Male and CL Male groups when compared with CP Male. CLP and CP groups present a pattern of occurrence of the type of cleft in the family.
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Affiliation(s)
- Carolina Maia Silva
- Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo (Post-Graduation Program in Rehabilitation Sciences-HRAC/USP), Bauru, Brazil
| | - Maria Carolina de Moraes Pereira
- Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo (Post-Graduation Program in Rehabilitation Sciences-HRAC/USP), Bauru, Brazil
| | - Thaís Bernardes de Queiroz
- Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo (Post-Graduation Program in Rehabilitation Sciences-HRAC/USP), Bauru, Brazil
| | - Lucimara Teixeira das Neves
- Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo (Post-Graduation Program in Rehabilitation Sciences-HRAC/USP), Bauru, Brazil.,Bauru School of Dentistry, University of Sao Paulo, (Department of Biological Science - FOB/USP), Bauru, Brazil
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32
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Adults With Unilateral Cleft Lip and Palate Present Reduced Internal Nasal Volumes: Findings of a Three-Dimensional Morphometric Assessment in Cone-Beam Computed Tomography Scans. J Craniofac Surg 2021; 32:e15-e19. [PMID: 33278248 DOI: 10.1097/scs.0000000000006820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The main purpose was to assess and compare nasal cavity (NC) volumes among adults with unilateral (UCLP) and bilateral cleft lip and palate (BCLP) and in noncleft controls (CON), by means of cone-beam computed tomography (CBCT) three-dimensional reconstructions. Forty-five scans of individuals with class III skeletal pattern, matched by age, were gathered in 3 groups: UCLP (n = 15), BCLP (n = 15) and (CON) (n = 15). The NC volume was assessed three-dimensionally, using Dolphin 11.8 software. Descriptive normally distributed data was presented as mean (±SD). Comparisons of NC volume among groups was performed using ANOVA test (P ≤ 0.05). The NC mean volumes corresponded to 14.7(±2.2) cm3 (UCLP), 17.1(±2.2) cm3 (BCLP) and 18.1(±3.8) cm3 (CON), respectively. UCLP individuals presented a significantly reduced NC volume when compared to controls (P = 0.006). No differences were observed between UCLP versus BCLP or BCLP versus CON. The intraclass correlation coefficient suggested a high intra- and inter-examiners agreement (>.075). Individuals with unilateral cleft lip and palate presented reduced NC when compared to individuals without cleft lip and palate. CBCT scans can be considered a highly accurate tool for morphometric assessments of craniofacial structures.
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Siqueira VDS, Mateo-Castillo JF, Pinto LDC, Garib D, Pinheiro CR. Etiological factors commonly related to the need of endodontic treatment in individuals with orofacial clefts. J Clin Exp Dent 2021; 13:e580-e585. [PMID: 34188764 PMCID: PMC8223154 DOI: 10.4317/jced.57980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/20/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Dental treatment is fundamental in the rehabilitation of individuals with orofacial clefts, due to their oral condition; when indicated, endodontic therapy allows elimination of infection of the root canal system. Aim: To analyze, by a retrospective study, the most prevalent type of orofacial cleft, the etiological factors most commonly related to the endodontic treatment need, as well as their success and failure rates. MATERIAL AND METHODS This study analyzed data from 136 records (76 females and 60 males) with mean age of 19 years and 7 months, who met the inclusion criteria. Data were collected including the type of cleft, etiological factors that led to the need of endodontic treatment, as well as their success and failure rates. The statistical analysis was performed by the chi-square, Kruskal-Wallis, Fisher's Exact and Batista Pike tests. RESULTS Among the etiological factors, were pulp involvement due to caries, endodontic treatment for prosthetic rehabilitation, tooth resorptions, for orthodontic movement, dental trauma and indication of internal tooth bleaching; the most prevalent factor was pulp involvement due to caries. Among all data analyzed, cleft lip and palate presented the highest percentage, and there was predominance of treatment success compared to failure. CONCLUSIONS The well-conducted root canal treatment is necessary for dental rehabilitation, maintaining the masticatory function and esthetic harmony of these individuals. Key words:Cleft lip, Cleft palate, Endodontics.
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Affiliation(s)
- Viviane-da Silva Siqueira
- Endodontics Sector, Dentistry Department, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/ USP), Bauru, São Paulo, Brazil
| | - José-Francisco Mateo-Castillo
- Endodontics Sector, Dentistry Department, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/ USP), Bauru, São Paulo, Brazil
| | - Lidiane-de Castro Pinto
- Endodontics Sector, Dentistry Department, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/ USP), Bauru, São Paulo, Brazil
| | - Daniela Garib
- Orthodontics Sector, Dentistry Department, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/ USP), Bauru, São Paulo, Brazil
| | - Claudia-Ramos Pinheiro
- Endodontics Sector, Dentistry Department, Specialization in Endodontics, Postgraduate Center for Dentistry - CPO Uningá, Bauru, São Paulo, Brazil
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34
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Henrique T, Banhara FL, Silva NFD, Farinha FT, Manso MMFG, Trettene ADS. Orthognathic surgery: doubts from patients with orofacial fissures regarding the immediate postoperative period. Rev Bras Enferm 2021; 74:e20200089. [PMID: 34037141 DOI: 10.1590/0034-7167-2020-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 12/21/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to identify the main doubts regarding the immediate postoperative care of patients with orofacial clefts undergoing orthognathic surgery. METHODS cross-sectional, quantitative study, developed in a public and tertiary hospital, between November 2017 and May 2018. Data collection occurred through interviews during the preoperative nursing consultation. An instrument was used to describe doubts, which later were grouped according to the subject. RESULTS 48 patients participated. The doubts referred to sun exposure (56%), food/mastication (48%), the relationship between intermaxillary block-breathing-vomiting (48%), oral hygiene (31%), physical activity restriction (27%), nasopharyngeal cannula, removal of surgical stitches, hospitalization time and speech/communication (23%), bleeding, cryotherapy, facial massage, aesthetic and functional results, healing, edema/ecchymosis, postoperative pain, and changes in facial sensitivity (21%). CONCLUSIONS the doubts were related to food, the period of convalescence, care for the surgical wound, postoperative complications, and medications.
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Affiliation(s)
- Tatiane Henrique
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais. Bauru, São Paulo, Brazil
| | - Fábio Luiz Banhara
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais. Bauru, São Paulo, Brazil
| | - Natiele Favarão da Silva
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais. Bauru, São Paulo, Brazil
| | - Francely Tineli Farinha
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais. Bauru, São Paulo, Brazil
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Hassegawa CA, Garcia-Usó MA, Yatabe-Ioshida MS, Trindade IEK, Fukushiro AP, Carreira DGG, Trindade-Suedam IK. Internal nasal dimensions of children with unilateral cleft lip and palate and maxillary atresia: comparison between acoustic rhinometry technique and cone-beam computed tomography. Codas 2021; 33:e20200099. [PMID: 34037161 DOI: 10.1590/2317-1782/20202020099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/24/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To compare the nasal cavity geometry of children and teenagers with cleft lip and palate and maxillary atresia by two methods: cone-beam computed tomography, considered the gold standard, and acoustic rhinometry. METHODS Data on cone-beam computed tomography and acoustic rhinometry examinations of 17 children and teenagers with cleft lip and palate and maxillary atresia, previously obtained for orthodontic planning purposes, were evaluated prospectively. Using Dolphin Imaging 11.8 software, the nasal cavity was reconstructed by two evaluators, and the internal nasal volumes were obtained. Using rhinometry, the volumes of regions V1 and V2 were measured. The values of each examination were then compared at a significance level of 5%. RESULTS Statistical analysis showed high intra- and inter-rater reproducibility in the cone-beam computed tomography analysis. The mean internal nasal volumes (± standard deviation) obtained using acoustic rhinometry and cone-beam computed tomography corresponded to 6.6 ± 1.9 cm3 and 8.1 ± 1.5 cm3, respectively. The difference between the examinations was 17.7%, which was considered statistically significant (p = 0.006). CONCLUSION The nasal volumes measured via the two methods were different; that is, they presented discrepancies in the measurements. The gold standard technique identified larger volumes than acoustic rhinometry in the nasal cavity. Therefore, determining which test reflects clinical reality is an essential future step.
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Affiliation(s)
- Caroline Akemi Hassegawa
- Programa de Pós-graduação, Laboratório de Fisiologia, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo - HRAC USP - Bauru (SP), Brasil
| | | | - Marília Sakayo Yatabe-Ioshida
- Departemento de Ortodontia e Odontopediatria, School of Dentistry, University of Michigan - UM - Ann Arbor (MI), USA
| | - Inge Elly Kiemle Trindade
- Laboratório de Fisiologia, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo - HRAC USP - Bauru (SP), Brasil.,Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo - FOB USP - Bauru (SP), Brasil
| | - Ana Paula Fukushiro
- Laboratório de Fisiologia, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo - HRAC USP - Bauru (SP), Brasil.,Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru, Universidade de São Paulo - FOB USP - Bauru (SP), Brasil
| | - Daniela Gamba Garib Carreira
- Setor de Ortodontia, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo - HRAC USP - Bauru (SP), Brasil.,Departamento de Ortodontia, Faculdade de Odontologia de Bauru - FOB USP - Bauru (SP), Brasil
| | - Ivy Kiemle Trindade-Suedam
- Laboratório de Fisiologia, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo - HRAC USP - Bauru (SP), Brasil.,Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo - FOB USP - Bauru (SP), Brasil
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Three-dimensional imaging technique to compare digital impression CEREC Omnicam intraoral camera (CAD) and tri-dimensional cone-beam computed tomography, to measure maxillary casts: Unilateral and bilateral cleft lip and palate up to 6 months of age, applied in nanotechnology. APPLIED NANOSCIENCE 2021. [DOI: 10.1007/s13204-021-01846-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bueno PM, Kiemle Trindade PA, Medeiros LH, Silva MM, Scomparin L, Garcia-Usó M, Trindade-Suedam IK. Bite force assessment before and after orthognathic surgery in individuals with repaired cleft lip and palate. J Oral Biol Craniofac Res 2021; 11:138-142. [PMID: 33537185 PMCID: PMC7838730 DOI: 10.1016/j.jobcr.2020.12.005] [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: 09/02/2020] [Revised: 12/16/2020] [Accepted: 12/19/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To evaluate the impact of orthognathic surgery on the masticatory system of individuals with repaired cleft lip and palate (CLP) by means of bite force (BF) assessment. MATERIAL AND METHODS Forty individuals were prospectively divided into 2 groups: 1) Control group (CON): 20 individuals without CLP (10 males, 10 females, 23.7y±7.4), 2) Cleft lip and palate group (CLP): 20 individuals with complete CLP with indication for orthognathic surgery (OS) (11 males, 9 females, 23.6y±5.6; 10 unilateral CLP; 10 bilateral CLP). The BF was evaluated in the immediate preoperative period (PRE), 3 months postoperatively (POST3M) and 6 months postoperatively (POST6M), using a gnathodynamometer (IDDK Kratos, Cotia-SP, Brazil). RESULTS The BF of the CLP group was significantly lower than that of the CON in all evaluated periods. The BF of individuals with CLP was significantly lower in POST3M compared to PRE. Also, a significant increase in BF was observed between POST3M and POST6M. Though not significant, the BF was increased in POST6M when compared to PRE. The BF of unilateral and bilateral CLP individuals were statistically similar. Males presented a BF almost twice as high as females. CONCLUSION Cleft lip and palate negatively impacts BF. Although there was a tendency for BF values to increase 6 months after OS, it was still significantly reduced when compared to controls, not reaching normative values.
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Affiliation(s)
- Patricia Martins Bueno
- Postgraduate Program in Rehabilitation Sciences, Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Paulo Alceu Kiemle Trindade
- Oral and Maxillofacial Surgeon, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, University of São Paulo, Bauru, SP, Brazil
| | - Laís Hollara Medeiros
- Postgraduate Program in Rehabilitation Sciences, Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Mariana Mendes Silva
- Postgraduate Program in Rehabilitation Sciences, Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Leandro Scomparin
- Postgraduate Program in Rehabilitation Sciences, Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Michele Garcia-Usó
- Professor Department of Biological Sciences, Discipline of Physiology, Ourinhos Dental School UNIFIO, Ourinhos, SP, Brazil
| | - Ivy Kiemle Trindade-Suedam
- Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
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Möller LH, Pradel W, Gedrange T, Botzenhart UU. Prevalence of hypodontia and supernumerary teeth in a German cleft lip with/without palate population. BMC Oral Health 2021; 21:60. [PMID: 33573652 PMCID: PMC7879655 DOI: 10.1186/s12903-021-01420-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/27/2021] [Indexed: 11/16/2022] Open
Abstract
Background The distribution of dental abnormalities among cleft patients concerning cleft type frequently poses ambiguity wherefore the aim of this study was to evaluate the prevalence of hypodontia and supernumerary teeth in an exemplary German cleft population dependent on the cleft type. Methods Radiographs and dental records of cleft patients, which had been treated and followed up in the Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus Campus, Dresden, Germany (investigation period of 22 years) were evaluated concerning hypodontia and supernumerary teeth dependent on the cleft type. Out of 386 records, 108 patients met the inclusion criteria: non-syndromic cleft of the alveolus with or without palate (CL/P), at least one clear panoramic x-ray, sufficient dental records. Statistical analysis was performed using x-square and binominal test (p ≤ 0.05). Results Hypodontia was more frequent (54/50%) than supernumerary teeth (36/33.3%) and was more common in bilateral clefts of the lip and palate (BCLP) (70.1%) than in unilateral clefts of the lip and palate (UCLP) (51.6%) or clefts of the lip and alveolus (CLA) (34.5%) (p << 0.001). There was an average of 0.9 missing teeth per patient, thereof the upper lateral incisor was most often affected (23.2%). In contrast, supernumerary teeth were more frequent in CLA (51.7%; p = 0.014) than UCLP (29.0%) and BCLP patients (17.6%). Conclusion The prevalence for numerical dental anomalies was significantly different among the cleft types. Hypodontia significantly increased with the extend of the cleft, whereas the prevalence of supernumerary teeth decreased.
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Affiliation(s)
- Liesa Heidi Möller
- Department of Orthodontics, Carl Gustav Carus Campus TU Dresden, Fetscherstrasse 74, Haus 28, 01307, Dresden, Germany
| | - Winnie Pradel
- Department of Oral and Maxillofacial Surgery, Dresden University Hospital, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Tomasz Gedrange
- Department of Orthodontics, Carl Gustav Carus Campus TU Dresden, Fetscherstrasse 74, Haus 28, 01307, Dresden, Germany
| | - Ute Ulrike Botzenhart
- Department of Orthodontics, Carl Gustav Carus Campus TU Dresden, Fetscherstrasse 74, Haus 28, 01307, Dresden, Germany.
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Cleft lip and palate cause large variations in size and location of the posterior superior alveolar canal. Clin Oral Investig 2021; 25:4451-4458. [PMID: 33417062 DOI: 10.1007/s00784-020-03757-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the posterior superior alveolar canal (PSAC) in patients with cleft lip and palate (CLP) as compared to patients with no cleft lip and palate (NC) using cone-beam computed tomography (CBCT). MATERIALS AND METHODS This was a retrospective multicenter study based on two steps: (1) evaluating intra- and inter-calibration and (2) detecting the presence or absence of PSAC and its location, diameter, and anastomosis with anterior superior alveolar canal. RESULTS A total of 300 patients were selected for the study, out of which 150 were categorized as CLP (75 men, 75 women; mean age: 29.8 years) and 150 were categorized as NC (75 men, 75 women; mean age: 40.3 years). PSAC in patients with CLP and NC was visible in 100% of the cases, in men and women, bilaterally. PSAC location in CLP was middle and upper third of the maxillary sinus as compared to NC (lower third) (chi-squared < 0.001). PSAC mean diameter in CLP was 1.12 mm. It was larger compared to 0.6 mm in NC (t-test < 0.0001). CONCLUSION PSAC location in patients with CLP was predominantly in the middle and upper third of the maxillary sinus, compared with NC. PSAC mean diameter in CLP was 1.12 mm. It was larger compared to that of 0.6 mm in NC. CLINICAL RELEVANCE These anatomical variations in CLP are important and should be acknowledged by surgeons for the following reasons: (1) to perform pre-surgical planning, (2) to avoid bleeding, and (3) to avoid neurosensory alterations.
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Carvalho NO, Matos MFS, Belchior IFC, Araújo MB, Rocha CT, Neves BG. Parents' Emotional and Social Experiences of Caring a Child with Cleft Lip and/or Palate. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Guerra MS, Franchi V, Novaes BA, Favero M, Pirana S. Cleft lip and palate: Relationship between phonological awareness and audiological characteristics in children. JOURNAL OF CLEFT LIP PALATE AND CRANIOFACIAL ANOMALIES 2021. [DOI: 10.4103/jclpca.jclpca_45_20] [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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Bom GC, Prado PC, Farinha FT, Manso MMFG, Dutka JDCR, Trettene ADS. STRESS, OVERLOAD AND QUALITY OF LIFE IN CAREGIVERS OF CHILDREN WITH/WITHOUT OROFACIAL CLEFT AND DYSPHAGIA. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2020-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to analyze the correlation between stress, overload and quality of life of informal caregivers of children with and without orofacial cleft and dysphagia. Method: a cross-sectional, case-control study carried out in a public and tertiary hospital, located in the inland of São Paulo, Brazil, which encompassed two groups: case and comparative. The case group consisted of 30 informal caregivers of children with orofacial cleft and dysphagia, using a feeding tube, while the comparative group consisted of 30 informal caregivers of children without orofacial cleft, fed orally. For data collection, the Bourden Interview Scale, Inventory of Stress Symptoms for Adults and the World Health Organization Quality of Life Bref were used. For statistical analysis, the following tests were used: chi-square, Student's t, Mann-Whitney and Pearson's correlation, all with a 5% significance level. Analysis of the linear correlation forces was also used. Results: in the case group, stress presented a moderate correlation with the overall quality of life (r=-0.41; p=0.025) and satisfaction with health (r=-0.42; p=0.021). Also in the case group, referring to quality of life, the Physical and Psychological domains presented a strong correlation with overload (r=-0.54, p=0.002; r=-0.55, p=0.002, respectively). In the comparative group, no correlations were identified. Conclusion: among the informal caregivers of children with orofacial cleft and dysphagia, there was a correlation between stress and the perception of global quality of life and satisfaction with health, as well as between overload and quality of life, in the physical and psychological dimensions.
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Mahardawi B, Boonsiriseth K, Pairuchvej V, Wongsirichat N. Alveolar cleft bone grafting: factors affecting case prognosis. J Korean Assoc Oral Maxillofac Surg 2020; 46:409-416. [PMID: 33377466 PMCID: PMC7783176 DOI: 10.5125/jkaoms.2020.46.6.409] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/17/2020] [Accepted: 06/05/2020] [Indexed: 12/31/2022] Open
Abstract
Objectives The goal of this retrospective study was to determine the significance and impact of several factors on the alveolar cleft bone grafting procedure. Materials and Methods The medical records were reviewed. In addition, x-rays were checked. The size of every cleft was measured in this retrospective study. The analyzed factors included sex, age, type of cleft, size of the cleft, and the type of flap used in surgery. The patients were characterized into group A (no complications, Bergland scale 1 or 2), group B (complications or Bergland scale 3), or group C (failure cases). Statistical analysis was performed with a P-value set at 0.05. Results There were 32 cases in group A, 26 in group B, and 9 in group C. Multinomial logistic regression showed an association between the type of the cleft and the size of the cleft, with the presence of complications, or achieving type 3 on the Bergland scale, with odds ratios of 5.118 and 6.000, respectively. The type of cleft was related to failure with an odds ratio of 4.833. Given a small sample, statistical analysis could not be performed to evaluate the relationship between the size of the cleft and group C. Age, sex, and the type of the flap were not significant factors. Conclusion The cleft size of more than 10 mm and bilateral clefts were listed regarding their effect on the procedure. Clinicians should not overlook these factors. In addition, patients must be informed of any risks that are present.
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Affiliation(s)
- Basel Mahardawi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kiatanant Boonsiriseth
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Verasak Pairuchvej
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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de Rezende Barbosa GL, Pimenta LA, Tyndall DA, Allareddy TV, Sousa Melo SL. Three-Dimensional Assessment of Cervical Vertebrae Anomalies in Patients With Cleft Lip and Palate. Cleft Palate Craniofac J 2020; 58:1102-1109. [PMID: 33349034 DOI: 10.1177/1055665620980226] [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: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate the occurrence of cervical vertebrae anomalies (CVA) in patients with unilateral (UCLP) and bilateral cleft lip and palate (BCLP) using cone beam computed tomography (CBCT) examinations. DESIGN Retrospective assessment of CBCT images. Descriptive statistics were calculated. Fisher exact test or χ2 test was performed to evaluate the differences among each CVA between sex and type of cleft. SETTING School of Dentistry. PARTICIPANTS One hundred fifty-one patients with cleft lip and palate (103 UCLP/48 BCLP). INTERVENTIONS No relevant intervention. MAIN OUTCOME MEASURES Cone beam computed tomography images were assessed for the presence or absence of 12 most commonly observed CVA: spina bifida, dehiscence, cleft of the posterior arch, cleft of the anterior arch, fusion between cervical vertebrae, block fusion, occipitalization, narrowing of the intervertebral space, posterior ponticle, os odontoideum, ossiculum terminale, and subdental cartilaginous remnants. RESULTS The presence of subdental cartilaginous remnants was the most frequently observed alteration-found in 81.45% of the sample-and it was the only CVA with statistically significant frequencies in the individuals with BCLP. Considering only the other CVA, 22.51% presented 1 and 5.29% presented 2 or more CVA. CONCLUSIONS Patients with cleft lip and palate may present an overall high incidence of CVAs. However, when comparing the distribution of the CVAs among sex and types of cleft, the only significant difference noted was a higher incidence of subdental cartilaginous remnants among patients with BCLP.
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Affiliation(s)
| | - Luiz A Pimenta
- Division of Comprehensive Oral Health, School of Dentistry, 2331University of North Carolina. Chapel Hill, NC, USA
| | - Donald A Tyndall
- Department of Diagnostic Sciences, School of Dentistry, 2331University of North Carolina. Chapel Hill, NC, USA
| | - Trishul V Allareddy
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, 4083The University of Iowa, Iowa City, IA, USA
| | - Saulo L Sousa Melo
- Department of Integrative Biomedical and Diagnostic Sciences, School of Dentistry, 6684Oregon Health and Science University. Portland, OR, USA
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Iurovschi R, Joaquim CR, de Faveri M, de Miranda TS, Feres M, de Figueiredo LC. Evaluation of the Microbiological Profile of Alveolar Residual Screws and Cleft-Adjacent Teeth in Individuals With Complete Unilateral Fissures. Cleft Palate Craniofac J 2020; 57:1182-1189. [PMID: 32748644 DOI: 10.1177/1055665620945568] [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: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the microbiota profile of residual alveolar slits and teeth adjacent to the cleft in fissured individuals. DESIGNS This study used a cross-sectional design. PARTICIPANTS Twenty individuals, aged 14 to 24 years, who had a residual fissure in the maxillary alveolar ridge region were selected. MAIN OUTCOME MEASURES Three sites per individual were selected for microbiological collection (the site of the residual cleft and the 2 nearest teeth). The samples were analyzed using the Checkerboard DNA-DNA hybridization technique for 73 species of bacteria. RESULTS All the species analyzed were found in the 2 niches (slits and teeth). The bacterial species present in the largest number in the residual cracks were Prevotella melaninogenica, Prevotella nigrescens, and Streptococcus mitis. With regard to the bacterial profiles in the mesial and distal faces, the most prevalent species were P nigrescens, Veillonella parvula, and Fusobacterium nucleatum sp vicentii. The analysis of all the collected samples demonstrated very similar profiles for the mesial and distal faces, with these 2 sites even presenting the same species in greater frequencies. Higher counts of 20 bacterial species (Wilcoxon test) were observed in the dental niche, in relation to the fissure, particularly, P nigrescens, V parvula, F nucleatum sp vicentii, and Neisseria mucosa. CONCLUSION Some species were significantly more prevalent in the residual alveolar fissures and in adjacent teeth. The comparison between the profiles of the 2 niches demonstrated large differences in the most frequent species in the teeth, and no qualitative differences with regard to specific pathogens.
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Affiliation(s)
- Ronaldo Iurovschi
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Claudia Regina Joaquim
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Marcelo de Faveri
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | | | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
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Almeida MSC, Lacerda RHW, Leal KB, Figueiredo CHMDC, Santiago BM, Vieira AR. Analysis of permanent second molar development in children born with cleft lip and palate. J Appl Oral Sci 2020; 28:e20190628. [PMID: 32520078 PMCID: PMC7299560 DOI: 10.1590/1678-7757-2019-0628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/21/2020] [Accepted: 04/04/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The study of dental development in individuals born with cleft lip and palate (CLP) serves to determine when orthodontic intervention should start. To evaluate the permanent second molar development in children born with cleft lip and palate according to Demirjian's and Nolla's methods. METHODOLOGY Out of a total of 513 digital panoramic radiographs, 113 pairs of children aged 3 to 16 years were selected. The exams were from children born with or without cleft lip and palate, of the same sex, with an age difference of up to 30 days. The images were analyzed by three examiners and reliability was checked through intra-examiner agreement by the Kappa test. The data were analyzed by Wilcoxon's and Mann-Whitney tests according to each dataset. RESULTS The findings indicated delayed development of the permanent second molars in children with CLP (P<0.001). The development of the right permanent second molar was delayed compared to the left molar in children with CLP. Moreover, mandibular teeth showed significantly earlier development than maxillary teeth in both the case and control groups. There was no significant difference in the development of permanent second molars between sexes. CONCLUSION Children with CLP presented delay in the development of permanent second molars.
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Affiliation(s)
| | | | | | | | | | - Alexandre Rezende Vieira
- Universidade Federal da Paraíba , João Pessoa , Paraíba , Brasil
- University of Pittsburgh , Pittsburgh , Pennsylvania , United States of America
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Rezende Pucciarelli MG, de Lima Toyoshima GH, Marchini Oliveira T, Marques Honório H, Sforza C, Soares S. Assessment of dental arch stability after orthodontic treatment and oral rehabilitation in complete unilateral cleft lip and palate and non-clefts patients using 3D stereophotogrammetry. BMC Oral Health 2020; 20:154. [PMID: 32460814 PMCID: PMC7254638 DOI: 10.1186/s12903-020-01143-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although arch stability has been studied in patients without a cleft, evidence for patients with a cleft is sparse. Therefore, we compared the dimensions and stability of dental arches in cleft lip and palate patients and those without a cleft. METHODS Forty participants, 20 with a complete unilateral cleft lip and palate and 20 non-cleft patients aged from 18 to 30 years, with anterior and/or posterior crossbite and receiving orthodontic treatment were evaluated retrospectively. Eighty gypsum casts were digitized using a laser model scanner casts for both groups made immediately after the orthodontic treatment was completed (T1). Also, for the Cleft Lip and Palate group, casts were obtained and digitized 1 year after implant-supported rehabilitation (T2) and for the Non-Cleft Lip and Palate group, 1 year after the conclusion of the orthodontic treatment (T2). The formula: Δ = T2-T1 evaluated the stability of dental arches for inter-canine distances (C-C'), inter-molar distances (M-M'), arch length (I-M), palate surface and volume. The dimensions of the dental arches were measured digitally. The independent t test was used for statistical analysis (α = 0.05). RESULTS A statistical difference was found in the stability of the groups for inter-canine (cleft area) measurement. At the times T1 and T2, a statistically significant difference was found in the arch length, surface and volume. CONCLUSIONS This study concluded that in the Cleft Lip and Palate group, the maxillary dimensions were not stabilized after 1 year of orthodontic and prosthodontic treatment (mainly for the inter-canine linear measurement) and that the transverse arch dimensions were smaller compared with those of non-cleft patients.
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Affiliation(s)
- Maria Giulia Rezende Pucciarelli
- Bauru School of Dentistry/Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry and Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Chiarella Sforza
- Faculty of Medicine and Surgery, Department of Biomedical Sciences for Health, Functional Anatomy Research Center (FARC), Università degli Studi di Milano, Milan, Italy
| | - Simone Soares
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry and Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil.
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Mecarini F, Fanos V, Crisponi G. Anomalies of the oral cavity in newborns. J Perinatol 2020; 40:359-368. [PMID: 31925320 DOI: 10.1038/s41372-019-0585-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/06/2019] [Accepted: 12/21/2019] [Indexed: 11/09/2022]
Abstract
Examination of the oral cavity should be an essential part of the newborn assessment. Early detection of congenital disorders is essential to begin appropriate medical or surgical therapy and to prevent complications that could profoundly affect a child's life. The present review aims to describe the main anomalies of the oral cavity in infants and provide images in order to help the physician in current clinical practice.
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Affiliation(s)
- Federico Mecarini
- Neonatal Intensive Care Unit, AOU Cagliari, University of Cagliari, Cagliari, Italy.
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, AOU Cagliari, University of Cagliari, Cagliari, Italy
| | - Giangiorgio Crisponi
- Neonatal Intensive Care Unit, AOU Cagliari, University of Cagliari, Cagliari, Italy
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Silva NFD, Beluci ML, Banhara FL, Henrique T, Manso MMFG, Trettene ADS. Patients and informal caregivers’ questions about alveolar bone graft post-operative care. Rev Bras Enferm 2020; 73:e20190403. [DOI: 10.1590/0034-7167-2019-0403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/18/2019] [Indexed: 01/01/2023] Open
Abstract
ABSTRACT Objectives: to identify patients’ and informal caregivers’ questions related to alveolar bone graft post-operative care. Methods: analytical and cross-sectional study, developed in a public and tertiary hospital between October 2017 and February 2018. The sample consisted of 46 participants. Data collection occurred during the preoperative nursing consultation through interview. The doubts were described in a form prepared by the researchers and later grouped by similarity of the subject. Results: doubts referred to diet (type of food, consistency, temperature and time period), surgical wound care (oral hygiene, graft rejection, removal of surgical points), post-operative complications (bleeding and edema), convalescence period (sun exposure, physical effort, time away from activities, length of stay) and medications. Conclusions: identifying the doubts allowed planning and implementing nursing care focused on the real needs of the clientele, favoring the rehabilitation process.
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Campos LD, Trindade IEK, Yatabe M, Trindade SHK, Pimenta LA, Kimbell J, Drake AF, Trindade-Suedam IK. Reduced pharyngeal dimensions and obstructive sleep apnea in adults with cleft lip/palate and Class III malocclusion. Cranio 2019; 39:484-490. [DOI: 10.1080/08869634.2019.1668997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Leticia Dominguez Campos
- Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, SP, Brazil
| | - Inge Elly Kiemle Trindade
- Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, SP, Brazil
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | | | - Luiz Andre Pimenta
- Craniofacial Center and Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julia Kimbell
- Department of Otolaryngology/Head and Neck Surgery (A.F.D.), School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amelia F. Drake
- Craniofacial Center, Department of Otolaryngology/Head and Neck Surgery (A.F.D.), School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ivy Kiemle Trindade-Suedam
- Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, SP, Brazil
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