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Biomedical subjects

K Mølsted

Publications and source records attributed to K Mølsted.

16 recordsLinked to original sources
PubMed1997

Craniofacial morphology in patients with Kallmann's syndrome with and without cleft lip and palate.

OBJECTIVE: Kallmann's syndrome is characterized by the association of hypogonadotropic hypogonadism and anosmia or hyposmia. The principal endocrine defect of hypogonadotropic hypogonadism is a failure to secrete luteinizing hormone-releasing hormone (LHRH), resulting in underdevelopment of the pituitary gonadotropes and an inability to synthesize and release luteinizing hormone and follicle-stimulating hormone. The purpose of the present investigation was to describe the dentition and the craniofacial morphology in patients diagnosed with Kallmann's syndrome. DESIGN: The sample consisted of 11 patients, 2 of whom also had bilateral cleft lip and palate. Radiographic investigations, including cephalometry, were performed. Comparisons were made to normal individuals and to cleft lip individuals without Kallmann's syndrome. RESULTS: Dentition: tooth agenesis occurred more frequently in patients with Kallmann's syndrome. Craniofacial morphology: Increased mandibular inclination and mandibular angulation were seen in Kallmann patients. When clefting also occurred, extreme retrognathism of both maxilla and mandible was seen, a deviation which seemingly worsened during growth. The anterior cranial base and the sphenoid bone showed an altered morphology in one of the patients with Kallman's syndrome. CONCLUSIONS: An early diagnosis of Kallmann's syndrome is very important because the prognosis for endocrine treatment thereby improves, and therefore, it is recommended that the sense of smell be evaluated in patients with the craniofacial morphology described.

Adolescent↗
PubMed1995

Cranial base in newborns with complete cleft lip and palate: radiographic study.

In a 1993 study, Mølsted and colleagues found an increased width of the spheno-occipital synchondrosis in newborns with complete clefts of the lip, alveolus, and palate compared with newborns with incomplete clefts. As the spheno-occipital synchondrosis represents remnants of the early chondrocranium that later ossifies and incorporates in the cranial base, it is possible that an inborn alteration, such as a deviant growth of cartilage, or a delayed maturation in the early development of the cartilaginous cranial base, can affect not only the length and the width of the cranial base, but also the petrous portion of the temporal bone and the nasal septum, as these structures also have a cartilaginous origin. The purpose of the present study was to measure the cranial base width, including the width of the maxilla, and to measure the bilateral angulation of the petrous portion of the temporal bone and the sphenoid bone in 3-month-old children with complete clefts and in 3-month-old children with an incomplete cleft of the lip, and to compare the two groups. Fifty-two children with complete clefts (CLP) without associated malformations comprised the test group. Forty-eight children with a minor, incomplete cleft lip (CL) constituted the control group. The results of the comparison showed marked differences between the CLP and CL groups. In the CLP children, the cranial base width and the bilateral angulation of the sphenoid bone increased. An increased angulation was also seen between left and right sides of the pars petrosa. Furthermore, increased maxillary width was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Cartilage↗
PubMed1993

A six-center international study of treatment outcome in patients with clefts of the lip and palate: evaluation of maxillary asymmetry.

This investigation was carried out by the European Cleft Lip and Palate Research Group. The purpose of this part of the investigation was to compare and evaluate maxillary asymmetry in children born with complete unilateral cleft lip and palate treated at cleft palate centers with different surgical management. Posteroanterior radiographs from three of the six participating centers were included in the investigation. Statistically significant differences were found in the symmetry of the anterior part of the maxillary complex. Children with a primary bonegrafting procedure involved in their primary treatment procedure had a more symmetric dentoalveolar development. Children from centers with primary surgical procedures including a vomer plasty and no involvement of the alveolar process had a more asymmetric development with a tilted premaxilla and a deviating inclination of the central incisors.

Analysis of Variance↗
PubMed1993

Spheno-occipital synchondrosis in three-month-old children with clefts of the lip and palate: a radiographic study.

The literature has been focused on differences in craniofacial form and dimension in cleft lip and palate patients. No attention has been given to possible alterations in the spheno-occipital synchondrosis although the synchondrosis is regarded as an important maturity and growth center. The purpose of the present investigation was to examine if the spheno-occipital synchondrosis in children born with major complete clefts differs on lateral radiographs from that of children born with minor incomplete clefts. Fifty-seven three-month-old children with complete clefts of the lip, alveolus and palate and 42 three-month-old children with minor incomplete clefts of the lip were included in the study. The results of the comparison showed that children with complete major clefts had a broader spheno-occipital synchondrosis compared to children with a minor incomplete cleft of the lip, and that the distance from the superior part of the synchondrosis to the sella point was shorter in children with complete clefts. These findings could be related to a defect or a delay in maturity in the early development of the cartilaginous cranial base in children with major clefts.

Alveolar Process↗
PubMed1993

A multicentre comparison of treatment regimens for unilateral cleft lip and palate using a multiple regression model.

The European Cleft Lip and Palate Research Group consists of specialists in orthodontics from six centres for the treatment of cleft palate in northern Europe. The purpose of this part of the multicentre study was to investigate whether differences in outcomes could be explained by specific treatment regimens. Three regimens that were assumed to influence the outcome of treatment were selected: Presurgical orthopaedics, closure of the palate, and primary bone grafting. The sample comprised 151 children with complete unilateral cleft lip and palate from the six centres. The result of multiple regression analysis showed that within that sample it was not possible to reach definite conclusions as to which factors exerted the most favourable influence on facial growth, but primary bone grafting was associated with reduced maxillary inclination and presurgical orthopedics with increased mandibular inclination.

Bone Transplantation↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 1. Principles and study design.

This article describes the design of an intercenter comparative study of treatment outcome in the treatment of children with a unilateral complete cleft of the lip and palate. The rationale and aims of this study are defined and treatment schemes of the participating centers are described. The findings are presented in a series of three papers (Parts 2, 3, and 4) dealing with the comparison of craniofacial form, dental arch relationships, and nasolabial appearance. In Part 5, conclusions and general recommendations regarding future research are discussed.

Child↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 2. Craniofacial form and soft tissue profile.

The craniofacial morphology and the soft tissue profile were evaluated in this part of the intercenter study of the European Cleft Lip and Palate Research Group. The sample was comprised of cephalometric x-rays of the full cohort of 151 cases from the six European cleft palate centers. The facial morphology in complete unilateral cleft lip and palate patients was evaluated by means of roentgen cephalometry. Approximately 25 consecutive cases from each of six European cleft palate centers were compared. Only one center showed notable and consistent differences from the others. A contributing factor for these differences may be an inconsistent treatment regimen with many surgeons involved. Analysis of the soft tissue profile between the centers showed more pronounced differences than analysis of the skeletal profile. The treatment outcome in centers with more complex or expensive programs was no better than those centers using simpler management approaches.

Analysis of Variance↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 3. Dental arch relationships.

One hundred and forty-nine dental casts of subjects with complete unilateral clefts of the lip and palate from six European cleft palate centers were assessed by means of the Goslon Yardstick. The Yardstick proved capable of discriminating between the quality of the dental arch relationships between the six centers. Two centers showed especially poor results. Three centers obtained satisfactory results although differing surgical techniques were used in these centers. One of the centers showing satisfactory dental arch relationships employed a more complex and expensive treatment program than the other two centers, which both used simpler centralized treatment regimens.

Analysis of Variance↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 4. Assessment of nasolabial appearance.

One hundred and fifteen frontal and profile photographs of the nasolabial area of subjects with complete unilateral clefts of the lip and palate from six European centers were assessed. Four components of the nasolabial area were rated separately by a panel of judges using a five-point scale of attractiveness. The Tukey multiple comparison test showed significant differences between the centers. The relative position of the six centers in this study followed a similar pattern to their respective positions in the cephalometric and dental cast studies.

Child↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 5. General discussion and conclusions.

Part 5 is the final part of a series of five articles reporting on an international, multicenter clinical audit of treatment outcome for complete UCLP. A number of recommendations for the methodology of future studies is made especially with respect to entry criteria, sample size, assumptions of homogeneity, and the reproducibility and validity of outcome measures. The findings of the present study regarding clinical procedures are presented tentatively, and improvement and extension of the methodology are required. It appears, however, that acceptable results can be achieved by different programs and ultimately clinical choices may be based on factors such as complexity, costs, and demands of treatment. Standardization, centralization, and the participation of high volume operators were associated with good outcomes, and nonstandardization and the participation of low volume operators with poor outcomes. Therapeutic factors associated with good outcomes were the employment of a vomer flap to close the anterior palate, and poor outcomes with primary bone grafting and with active presurgical orthopedics.

Bone Transplantation↗
PubMed1992

The need for long-term multicenter treatment assessment of craniofacial developmental disorders including cleft lip and palate.

There has been an increase of interest in recent years in comparing treatment outcome in patients with craniofacial anomalies, including cleft lip and palate. When a treatment result is to be evaluated, it is important that it is multifaceted, taking all aspects into account. A comparison between treatment outcome in six centers showed that those with simple procedures and few surgeons involved in the primary operations had as good treatment results as those with more complicated treatment procedures. The center that used presurgical orthopedics with extraoral strapping in its treatment program ranked low as did the center employing primary bone grafting as part of the treatment program when compared with the other centers.

Cleft Lip↗
PubMed1992

[Ceramic brackets].

Because of the many drawbacks of the hard and brittle material, ceramic brackets should not be used uncritically for orthodontic treatments. If ceramic brackets are used, the following guidelines should be observed: 1. If large and complicated tooth movements are involved, conventional bracket systems should be considered. 2. Occlusion on ceramic brackets is to be avoided. 3. Sharp instruments should be used with extreme care to avoid scratching the ceramic surface. Metal ligatures must not be used. 4. The length of the treatment is extended, probably because of the increased friction. 5. The problems connected with removing the brackets have not yet been solved. Be particularly careful of weakened teeth. 6. Esthetically, ceramic brackets function satisfactorily, but transparent elastic ligatures do not. They rapidly become discoloured and need frequent replacement. Nor are there as yet any "invisible arch wires", apart from some few, extremely flexible "white" arch wires. The ceramic bracket has no doubt come to stay, but there have been many difficulties in the "running-in" period, and the problems are far from solved yet. New ceramic brackets are coming onto the market all the time, and only future clinical studies can show whether they will become a genuine alternative to the conventional bracket.

Ceramics↗
PubMed1990

Asymmetry of the maxilla in children with complete unilateral cleft lip and palate.

Craniofacial asymmetry was analyzed in 31 children with unilateral cleft lip and palate (UCLP) and compared to a group of 24 children with incomplete clefts of the lip (CL). Symmetry was evaluated from 32 variables on posteroanterior cephalometric radiographs. Two types of asymmetry were identified: In the first, there was a positional deviation and a change of arch shape of the maxillary segment on the cleft side. The basal maxillary width was similar in the two groups. At the dentoalveolar level a decrease in width was localized to the cleft side in the UCLP group. Maxillary height of the cleft segment was reduced. The second type was related to the anterior part of the maxilla and the nasal septum. The inferior border of the bony part of the nasal septum deviated towards the cleft side. The anterior nasal spine and the midpoint between the upper central incisors deviated toward the noncleft side, but to a different degree indicating a vertical tilting of the premaxillary region.

Cephalometry↗
PubMed1987

Malocclusion in complete unilateral and bilateral cleft lip and palate. The results of a change in the surgical procedure.

In 1972 the surgical interference with the cleft in the hard palate was changed to a one-layer closure by a vomer flap. The purpose of the present investigation was to examine the effect of this change in the surgical management on the width of the maxillary dental arch and the frequency of malocclusion. Two groups of CLP children were examined: group 1 consisted of 58 children operated on before and in 1972. Group 2 consisted of 72 children operated on after 1972. All of the children had been operated on by the same surgeon. The remainder of the surgical procedures was the same in the two groups. No significant differences were observed, either in the maxillary dental arch width or in the frequency of malocclusion. A minor decrease in the frequency of mandibular overjet and crossbite was seen in the vomer group. Less need for closure of fistulas in the anterior part of the hard palate was seen in group 2.

Cleft Lip↗
PubMedDate not supplied

The prenatal development of the human nasal and vomeral bones.

The purpose of the present study was to establish normal prenatal development standards for the nasal and vomeral bones, both formed by intramembranous ossification in the membrane covering the cartilaginous nasal capsule. The study is based upon a combination of macroscopic (devisceration and radiography) and microscopic (histology) analyses on 62 normal human fetuses from spontaneous and induced abortions, ranging in gestational age from 9 to 24 weeks, representing crown-rump lengths (CRL) from 33 to 225 mm. Special attention was paid to the onset of bone formation in relation to other maturity aspects and to the growth of the bones. The very first onset of ossification of the vomeral bone is observed as two bilateral ossification centers, prior to nasal bone ossification. Later, the two bilateral ossification centers fuse caudally below the cartilaginous nasal septum, thus changing into a U-shaped bone when observed in the coronal plane. By bony apposition caudally the U-shaped vomer gradually changes into a Y-shape. The nasal bone appears as a thin bony contour ventral to the cartilaginous nasal septum in the sagittal plane, and changes gradually during growth to a wedge-shaped bone. Knowledge of the early development of the internal nose (vomeral bone) and external nose (nasal bone) is significant in understanding mid-face congenital malformations.

Face↗