PubMed · 4870371
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J A Tolmeijer. 1968. [Prostheses for defects].. https://pubmed.ncbi.nlm.nih.gov/4870371/
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Measurements on X-ray films were used for the assessment of facial development in 24 individuals with complete unilateral cleft lip and palate, ranging in age from 10 to 11 years and operated upon in two stages. The suture of the velum was performed simultaneously with cheiloplasty at the age of 7 months, the suture of the hard palate followed at the age of 6 years. They were compared with a series of 27 individuals with the same type of cleft who were subjected to one-stage closure of the palate at the age of 4 years. But for the more favourable occlusion of incisors after two-stage palatoplasty, which was due to the more intense orthodontic therapy, these two series showed no differences in facial growth and development. The delay of surgical repair of the hard palate by two years did not improve the growth and development of jaws. However, it is not possible to exclude favourable effects of a delay of the suture of hard palate into a substantially more mature age.
BACKGROUND: The risk of recurrent neural-tube defects is decreased in women who take folic acid or multivitamins containing such during the periconceptional period. The extent to which folic acid supplementation can reduce the first occurrence of defects is not known. METHODS: We conducted a randomized, controlled trial of periconceptional multivitamin supplementation to test the efficacy of this treatment in reducing the incidence of a first occurrence of neural-tube defects. Women planning a pregnancy (in most cases their first) were randomly assigned to receive a single tablet of a vitamin supplement (containing 12 vitamins, including 0.8 mg of folic acid; 4 minerals; and 3 trace elements) or a trace-element supplement (containing copper, manganese, zinc, and a very low dose of vitamin C) daily for at least one month before conception and until the date of the second missed menstrual period or later. RESULTS: Pregnancy was confirmed in 4753 women. The outcome of the pregnancy (whether the fetus or infant had a neural-tube defect or congenital malformation) was known in 2104 women who received the vitamin supplement and in 2052 who received the trace-element supplement. Congenital malformations were significantly more prevalent in the group receiving the trace-element supplement than in the vitamin-supplement group (22.9 per 1000 vs. 13.3 per 1000, P = 0.02). There were six cases of neural-tube defects in the group receiving the trace-element supplement, as compared with none in the vitamin-supplement group (P = 0.029). The prevalence of cleft lip with or without cleft palate was not reduced by periconceptional vitamin supplementation. CONCLUSIONS: Periconceptional vitamin use decreases the incidence of a first occurrence of neural-tube defects.
The Danish Register of Congenital Malformations at the National Board of Health is used for surveillance and research. More than 10% of all patients registered have oral cleft diagnoses. This report evaluates the completeness of the Register of Congenital Malformations as regards registration of oral cleft patients born in Denmark in the period 1983-1987. The register is limited to congenital anomalies diagnosed in hospitals in the child's first year of life. The investigation shows, that the register is suitable for surveillance of clefts, because the completeness of registration was constant during the five-year period 1983-1987. The completeness was more than 90% of all known cases, and probably higher for severe clefts and cases with associated anomalies. Identical diagnosis was found in 93% of all patients registered in The Register of Congenital Malformations with at least one other source of ascertainment. In addition, the investigation disclosed misclassification of a small oral-cleft-subgroup and the need for an additional diagnosis in the coding. The register can only be used for surveillance and research in congenital anomalies, which are usually diagnosed in the child's first year of life.