Search PubMed⌕ Search

Biomedical subjects

R Ranta

Publications and source records attributed to R Ranta.

At least 37 records · Page 2Linked to original sources

Taurodontism in twins with cleft lip and/or palate.

The aims of this study were to determine the frequency of taurodontism of the first and second permanent molars in twins discordant or concordant for clefts, the frequency for each type of cleft in twins, and the concordance-discordance ratio in mono- and dizygotic twins. Thirty-nine pairs of twins (13 monozygotic, 26 dizygotic) between the ages of 7 and 23 yrs were investigated. Taurodontism and hypodontia were determined from orthopantomograms of the dentition. Of the 39 pairs of twins investigated, 16 (41%) had taurodontism, equally in mono- and dizygotic pairs. The highest frequency of the trait was noted in subjects with isolated cleft palate and the lowest in cleft lip subjects. Four of 13 monozygotic pairs with taurodontism were concordant for the trait, as were 9 of 12 dizygotic pairs. Taurodontism was symmetric in 91% of the affected molar pairs. Concomitant taurodontism and hypodontia was observed in 8 of 16 taurodontic twin pairs. We conclude that the etiology of clefting in our group of twins seems to have an effect on the frequency of taurodontism. A high concordance for taurodontism and a high symmetry of the trait may indicate a strong genetic etiology of taurodontism.

Adolescent↗

Quality of speech correlated to craniofacial characteristics of cleft palate patients with the Pierre Robin sequence.

The present study aims at examining the relationship between cephalometric craniofacial dimensions and speech performance in 30 young adult cleft palate patients with a Pierre Robin (PR) sequence. Speech was analyzed from tape-recorded speech samples and by using nasalance measurements. Veloparyngeal closure was assessed by using videonasendoscopy. Various cephalometric dimensions reflecting facial vertical height and sagittal nasopharyngeal length were measured and compared to speech data. The results indicated that the sagittal bony nasopharyngeal depth (AD1-PNS, AD2-PNS) is significantly related to speech impairment in terms of the need for velopharyngoplasty. After comparing the present results to those obtained from patients with isolated cleft palate without a PR sequence we concluded that the cleft patients with a PR sequence require more often velopharyngeal flaps to eliminate persisting signs of velopharyngeal insufficiency.

Adolescent↗

Craniofacial morphology in twins with cleft lip and palate.

The craniofacial morphology of 11 pairs of monozygotic (MZ) and 28 pairs of dizygotic (DZ) Finnish twins, discordant or concordant for cleft of the lip (CL), unilateral cleft lip and palate (UCLP), or cleft palate only (CP) were investigated by means of lateral cephalometric radiographs. The results were compared to those of age-, sex-, and cleft-type matched single-birth cleft subjects, and also with normative data from the Nordic population. The co-twins with no cleft lip or palate (NONC) showed only slightly more obtuse gonial and steeper mandibular angles compared to normative data. Twins with CL, UCLP or CP had a more retrusive mandible, a wider cranial base and mandibular angle, and a wider angle between the maxilla and mandible than did the single-birth cleft subjects. Comparison of the noncleft twin group with the CL, UCLP, and CP twin groups for the CL twins showed no significant differences. For the UCLP twins, a more retrusive and down- and backward rotation of both jaws, a wider gonial angle, and a wider cranial base angle was seen. The CP twins had their maxillae slightly retrusive, the down- and backward rotation of both jaws was apparent, and the gonial angle was more obtuse. A comparison between the noncleft MZ and noncleft CDZ twins showed no significant differences. The MZ CP twins had a more retrusive mandible and more down- and backward rotation of both jaws than did DZ CP twins. It thus can be suggested that twinning itself does not seem to have an effect on maxillofacial morphology, but the features of the mandibular structure, the cranial base angulation, and the inclination of the jaws are at least partly genetically induced.

Adolescent↗

Occurrence of the Carabelli trait in twins discordant or concordant for cleft lip and/or palate.

The frequency and expression of the Carabelli trait among 36 twin pairs discordant or concordant for cleft lip and/or palate were investigated. Four of 10 monozygotic (MZ) and 24 of 26 dizygotic (DZ) pairs of twins were discordant for clefts. The frequency of the trait on the first upper molars of the noncleft subjects was 79%. It varied from 54% to 61% in the subjects with clefts, and the frequency of the trait decreased with increasing extension of the cleft. The occurrence of the trait was bilateral in more than 90% of the MZ and the DZ subjects. MZ twins had a higher concordance rate for the corresponding molar comparisons and for cross-twin comparisons than did the DZ pairs. The corresponding polychoric correlations for MZ twin pairs were estimated to be 1.0, and for the DZ twin pairs estimates ranged from 0.4 to 0.5. Thus, genetic factors appear to control the Carabelli trait, and the heritability seems to be high even in our cleft lip and/or palate twins.

Adolescent↗

Effect of timing and method of closure of isolated cleft palate on development of dental arches from 3 to 6 years of age.

Development of the dental arches from 3 to 6 years of age was followed in 120 children with isolated cleft palate (ICP) and in 50 non-cleft (NONC) children. In 60 of the ICP children the palate had been repaired at the age of 1.8 years (SD = 0.2) and in the other 60 at the age of 1.1 years (SD = 0.1). In both groups the one-stage soft and hard cleft palate closure had been performed using the mucoperiosteal palatal V to Y push-back technique (Veau-Wardill-Kilner) or the Cronin modification. The purpose of this study was to compare the effect of the two different ages and the two different methods of palatal repair on the development of dental arches. The growth increment in maxillary canine and molar width, and posterior palatal height during the 3-year period was greater in the group with late palatal repair. In children with no secondary palatal repair, when the primary repair had been done with the V to Y method, the increase in maxillary canine width was greater than with the Cronin modification. On the other hand, when the V to Y technique was used, velopharyngoplasties were more frequent. The means of maxillary canine and molar width decreased in children with velopharyngoplasties, and increased in the others. Dental arches of ICP children were significantly smaller than those of NONC children, and the discrepancy increased during the period from 3 to 6 years of age, and increased more in the maxilla than in the mandible.

Age Factors↗

Hypodontia in twins discordant or concordant for cleft lip and/or palate.

The aims of this study were to determine the frequency of hypodontia of permanent teeth in twins discordant or concordant for clefts in each type of cleft, to determine the concordance of hypodontia in mono- and dizygotic twins, and to compare the findings with some earlier data. Thirty-nine pairs of twins between 7 and 23 yr of age were investigated. Six of 13 monozygotic and 24/26 dizygotic pairs were discordant for clefts. Orthopantomograms of the dentition, treatment records, and anamnestic data were studied. Twenty-three pairs of twins (59%) had at least one twin with hypodontia: 9/13 (69%) monozygotic and 14/26 (54%) dizygotic. The prevalence of hypodontia was 37% for monozygotic and 32.7% for dizygotic twins, 16.7% in the noncleft and cleft lip groups, 41.1% in the cleft palate group, and 64.3% in the cleft lip and palate group. All these were above the values observed earlier in the noncleft twins and in the Finnish normal and cleft group populations. Four of 13 pairs of monozygotic twins had no hypodontia, 8/9 pairs were discordant, and only 1/9 was concordant for hypodontia. The corresponding figures for the 26 dizygotic pairs were: 12/26, 11/14, and 3/14 pairs. Maxillary second premolars were the most frequently absent teeth, followed in order of frequency by the maxillary lateral incisors and the mandibular second premolars. Hence, for this sample of twins, the genetic component seems to be weak.

Adolescent↗

Growth in children with Pierre Robin sequence and isolated cleft palate.

Postnatal height and weight growth were assessed in 50 children (20 boys) with Pierre Robin sequence and in 58 children (27 boys) with isolated cleft palate, born in 1967-86. The height and weight measurements from birth to 12 years were collected retrospectively from child health centers and schools. The current Finnish relative weight and SD scores for height were used for growth assessment. The birth size of children with Pierre Robin sequence did not differ from those with isolated cleft palate or from healthy children, on the basis of Finnish norms. During the first year after birth, children with Pierre Robin sequence were shorter and lighter than those with isolated cleft palate but later caught up with them and the Finnish norms. Children with Pierre Robin sequence born prematurely or with associated anomalies showed more deficient growth.

Body Height↗

One-stage closure of isolated cleft palate with the Veau-Wardill-Kilner V to Y pushback procedure or the Cronin modification. II. Height, weight and comparison of dental arches.

The body height and weight, and sizes of dental arches in 116 patients with isolated cleft palate were evaluated at 16.9-20.6 years of age. One-stage closure of the soft and hard palate had been done at a mean age of 1.8 years using the Veau-Wardill-Kilner or the Cronin mucoperiosteal palatal V-Y pushback technique. The height attained in both the boys (177.6 cm) and the girls (165.7 cm) was similar to that in the general adult population, even though half of the boys had not reached their final height. The median relative weight for height and sex was 6%. There were no significant differences in dental arch measurements depending on the method of operation but the more palatal operations done the shorter the maxillary and mandibular dental arch widths. The extent of cleft made a significant difference, larger clefts having narrower palatal intercanine widths. Dental arch dimensions were consistently larger in boys than in girls.

Adolescent↗

One-stage closure of isolated cleft palate with the Veau-Wardill-Kilner V-Y push-back method or the Cronin modification. Cephalometric comparison of nasopharynx.

The craniofacial structure of 116 consecutive patients with isolated cleft palate was studied by lateral cephalograms at 17-20 years of age. One-stage soft- and hard-palate closure had been done with the Veau-Wardill-Kilner or the Cronin mucoperiosteal palatal V-Y push-back method at the mean age of 1.8 years. The patients treated with the Veau-Wardill-Kilner method showed larger sagittal depths of the bony nasopharynx and nasopharyngeal airway but smaller thickness of the soft tissue on the posterior nasopharyngeal wall. The sagittal depth of the nasopharyngeal airway was larger in patients who had had secondary palatal operations. The effect of sex was significant, males having larger dimensions.

Cephalometry↗

One-stage closure of isolated cleft palate with the Veau-Wardill-Kilner V to Y pushback procedure or the Cronin modification. III. Comparison of lateral craniofacial morphology.

The craniofacial morphology of 116 consecutive patients with isolated cleft palate was studied by means of lateral cephalograms at 17 to 20 years of age. One-stage hard- and soft-palate closure had been carried out at the mean age of 1.8 years by using the Veau-Wardill-Kilner or the Cronin mucoperiosteal palatal V-Y pushback technique. In the Veau-Wardill-Kilner group the cranial base was longer, the cranial base angle was larger, and the mandible longer and its ramus higher but less backward rotated. The patients with originally the most extensive clefts showed the most marked deviations in craniofacial morphology at adult age.

Adolescent↗

One-stage closure of isolated cleft palate with the Veau-Wardill-Kilner V to Y pushback procedure or the Cronin modification. I. Comparison of operative results.

The long term operative results of one-stage closure of isolated cleft palate with either the Veau-Wardill-Kilner V to Y pushback procedure or the Cronin modification were evaluated and compared retrospectively. A total of 116 consecutive patients with isolated cleft palate who had been operated on at the age of 18-24 months were followed up until 17-20 years of age. Twenty-four of the patients needed one or more additional operations on the palate, mainly pharyngeal flaps (20%) and repair of fistulas (10%). There was no significant difference in the number of patients who needed further operations, either between the two different operations or between the sexes, but the patients who presented with the most extensive clefts required the most operations.

Adolescent↗

Sizes of dental arches and general body growth up to 6 years of age in children with isolated cleft palate.

Development of the dental arches and height and weight at the ages of 3 yr and 6 yr were studied longitudinally in 60 children with isolated cleft palate (CP) and in 50 noncleft (NONC) children. Retrospective comparisons were also made in the CP group with arch size at the age of 0.2 yr and 1.8 yr. Anterior width at 0.2 yr of age was associated with canine width at the age of 3 yr (r = 0.70) and 6 yr (r = 0.60). Change in maxillary posterior width from 3 yr to 6 yr of age was related to the extension of the cleft, so that in the group with total cleft this dimension diminished. Measured in standard deviation scores (SDS), the means of maxillary width at canines and primary second molars in CP children varied from -1.0 to -2.0 and mandibular dimensions from -0.6 to -1.4. Discrepancy in arch depth diminished with age. Body size differed less from normal than the size of the dental arches. At 3 yr of age the height was -0.4 SDS in CP boys and -0.5 SDS in CP girls, but at 6 yr of age only -0.1 SDS in both boys and girls. Correlations between body size and the size of the dental arches were generally low (r less than 0.20) both in CP and NONC children. The small size of the dental arches in CP children does not seem to be merely a reflection of the overall smaller size of CP children.

Body Constitution↗

Hypernasality and the nasopharyngeal space. A cephalometric study.

In the present study cephalometric measurements reflecting the nasopharyngeal space were traced on lateral cephalometric X-rays in 59 young adults with an isolated cleft palate. The distribution of the measurements AD1-PNS, AD2-PNS, AD1-BA, AD2-SO and PNS-BA and the magnitude of the hypernasality were analyzed with the ANOVA procedure and Duncan's multiple range test. The degree of hypernasality was assessed in terms of the hypernasality index. The results showed that AD1-PNS and AD2-PNS measurements were significantly related to the hypernasality index at the risk level of 0.03 and 0.05 per cent, respectively. The patients with the shortest sagittal depth of the nasopharynx had normal resonance in their speech, while the patients with the longest measurements demonstrated hypernasality. The thickness of the posterior pharyngeal wall in terms of AD2-SO was not clearly significant for speech, although the patients with the longest measurements tended to speak without hypernasal resonance. The other cephalometric measurements, i.e. AD1-BA and PNS-BA were not significantly related to the occurrence of hypernasality. It was concluded that the cephalometric measurements reflecting nasopharyngeal space are correlated with the occurrence of hypernasality, but the relationship is by no means simple and linear, and therefore it requires further study.

Adolescent↗

Cephalometric analysis of the obstructive sleep apnea syndrome.

The cephalometric measurements of 33 Finnish OSAS patients showed a fairly normal relationship between the base of the skull and the maxilla (SNA 82.3), whereas the mandible was slightly smaller than average (SNB 78.0). In 58% of the patients the mandible was significantly retrognathic and/or small in relation to the maxilla, even if dental occlusion was satisfactory. The sagittal lengths of the anterior cranial base and the maxilla were fairly normal. The hyoid bone was constantly situated more inferiorly and posteriorly than on average (MP-H 32.6). UPPP, genioplasty and advancement of the floor of the mouth and hyoid suspension were found to be effective in severe OSAS. The changes caused by the operation could best be verified cephalometrically by a more anterior position of the hyoid bone (average change of 11.1 mm).

Adult↗

Mandibular distraction. An experimental study on sheep.

In a series of 17 growing sheep (aged 13.5-19 weeks) the recently developed external fixation frame permitting gradual distraction, was tested. The frame gives good stability during distraction. Mandibular osteotomy was performed transversely in the middle of the ramus, under general anaesthesia, with an oscillating saw. Using distraction by approximately 1 mm per day, lengthening of the mandibular ramus was achieved. X-ray analysis showed all the distracted osteotomies to have healed in 25 days, showing new bone formation in the distraction gap. The pattern of radiological healing was graded according to the phase of consolidation. With this method it appears to be possible to lengthen the mandible without transplantation of additional bone.

Animals↗

Effect of timing and method of cleft palate repair on dental arches at the age of three years.

The purpose of this study was to compare the influence of two different ages at the time of palatal closure and two surgical methods on the size of the dental arches at the age of 3 years in children, with CP, UCLP, and BCLP. In 88 children the one-stage palatal closure had been performed at the age of 1.8 years and in 92 children at the age of 1.1 years. In both groups palatal surgery had been performed with a V to Y push back procedure (Veau-Wardill-Killner) or with the Cronin modification. Dimensions of the maxillary arch in both groups at age 3 were smaller than in noncleft children, but the timing of palatal closure did not affect arch dimensions in children with CP, UCLP, or BCLP. Arch dimensions at 3 years of age were not related to the method used in palatal closure.

Age Factors↗