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PubMed1975

Growth and changes in maxillary arch form in complete unilateral cleft lip and cleft palate children.

This study aims at the comparison of growth changes of the maxillary arch of 62 normals and 87 complete unilateral cleft lip and cleft palate subjects. This is achieved by measuring their maxillo-facial models, which will aid in clarifying such questions as: when and where the maxillary growth inhibition will occur, and the several aspects of growth-change. Patients with complete unilateral cleft lip and cleft palate were classified into four stages: 1) six month old infants before lip and palatal closure; 2) two year old children, lip repair at six months of age; 3) three year old children, lip repair at six months and palatal closure at two years; 4) four year old children, with repairs as in stage 3. Normal subjects were also classified into four stages, to match the cleft group by age and body weight. Impressions were taken for each patient's upper jaw and upper face simultaneously under general anesthesia, and the maxillo-facial model was made. Results obtained were as follows: (1) In the normal group, the forward and downward growth of the anterior alveolar region increased considerably between stages 1 and 2 and stages 3 and 4. The growth of the anterior alveolar arch was slight during all four stages. The depth and width of the retromolar point increased gradually through all four stages, and measured the growth of the posterior alveolar region. (2) In the cleft group: at stage 1 the anterior end of the larger segment was protruded and both the larger and smaller segments, especially in the anterior region, were laterally dislocated. The height of the anterior alveolar region was found to be noticeably less than that of the normal group. At stage 2 the growth inhibition in depth and height was noted in all the alveolar points of the cleft group, especially in the anterior alveolar region, in comparison to the normal group. At stage 3 the depths in all alveolar points decreased, but no significant difference was found when compared to stage 2. However, the increase in heights was marked. At stage 4 the depths and heights of alveolar points in the cleft group were found to be smaller than those of the normal group.

Child, Preschool↗

PubMed2000

Analysis of the candidate genes responsible for non-syndromic cleft lip and palate in Japanese people.

In order to assess the association of alleles for candidate genes with non-syndromic cleft lip and palate, DNA samples from 43 Japanese patients were compared with those from 73 control subjects with respect to the genes encoding transforming growth factor alpha (TGFalpha), TGFbeta and gamma-aminobutyric acid type A receptor beta3 (GABRB3). The restriction fragment length polymorphisms of the 3'-non-coding region of the TGFalpha gene K-primer region were observed after digestion with NcoI and HinfI. Allele 4 was the most common among cases of cleft lip with or without cleft palate, whereas allele 2 was the most common among controls. A significant difference was found in this region between groups with cleft lip (with or without cleft palate) and controls (chi2=10.190; P=0.017). Three alleles of the TGFbeta2 gene were tested, and allele 2 was the most common in both cases and controls. The proportion of allele 2 in the case group was greater than that in the control group, showing a significant difference between cases of cleft lip (with or without cleft palate) and controls (chi(2)=19.208; P<0.0001). No significant differences in variants of TGFbeta3 or GABRB3 between case and control populations were observed. Thus it is concluded that TGF genes play a role in craniofacial development, and that alleles of TGFalpha or/and TGFbeta2 are associated with cleft lip and cleft palate in Japanese populations.

Adolescent↗

PubMed2001

Lip cancer in South Australia, 1977-1996.

Lip cancer (140 ICD-9, C00 ICD-10) is a form of oral cancer occurring at the junction between the oral cavity and the skin. Lip cancer has a distinctive global epidemiology that is notably different from cancer occurring at other intraoral sites. This study reviews and analyses the epidemiological data for lip cancer from the South Australian Central Cancer Registry between 1977 and 1996. During this 20-year period, 2716 cases of lip cancer (2095 male, 621 female) and 35 deaths from this disease (23 males, 12 females) were reported. The average age of diagnosis was 58.3 years in males and 66.0 years in females. Very high age-standardised incidence rates (over 15.0 per 100000 per annum in males and 4.0 per 100000 per annum in females) were found, giving the South Australian population amongst the highest incidence of lip cancer in the world. Also of considerable concern was the finding that, contrary to global trends, these rates showed a significant increase over the 20-year period in both sexes. Possible reasons for these findings are discussed.

Adolescent↗

PubMed2001

[Incidence of the cleft lip and palate in the University of Chile Maternity Hospital and in maternity Chilean participating in the Latin American Collaborative Study of Congenital Malformations (ECLAMC)].

BACKGROUND: ECLAMC is a registry, aimed to assess the incidence of congenital malformations, that started in 1967 and Chile incorporated to it in 1969. AIM: To report the incidence of cleft lip/palate, updated to 1999 in the University of Chile Maternity Hospital and other Chilean hospitals participating in the ECLAMC. PATIENTS AND METHODS: A review of the ECLAMC database that registers all births or stillbirths of more than 500 g. RESULTS: The incidence of orofacial cleft, at the University of Chile Maternity Hospital, in the period 1991-1999 was 17.8 per 10,000 (12.6 for cleft lip and 5.2 for cleft palate). The incidence in the rest of participating hospitals was 12.04 and 4.6 respectively. Males had a higher incidence of cleft lip and 80% of children with cleft palate, had other malformations, most of them as part of a syndrome (13 and 18 trisomy, holoproscencephalia, Pierre Robin, Apert en EE syndromes, anencephaly etc). In three of 12 children with cleft lip but without cleft palate, there was a relative with the same malformation. CONCLUSIONS: It is proposed that both entities, cleft lip with or without cleft palate and cleft palate without cleft lip, are two etiopathogenically different conditions.

Chi-Square Distribution↗

PubMed2002

Superficial mycosis superimposing on isolated lichen planus of the lip: a case report and review of the literature.

We report a case of superficial mycosis superimposing on isolated lichen planus (LP) of the lower lip that was successfully treated. A 36-year-old woman had 2 ulcerated, scaling, erythematous plaques on the lower lip for several months with mild painful sensation. Results of histologic study showed typical features of LP, but fungal hyphae were found in the horny layer. The lesion healed with only very mild residual erythema after 6 weeks of treatment. A review of the literature shows only one noted case of tinea of the lip, which was reported in 1968 by a dental practitioner, and only several cases of isolated LP of the lip. The possible mechanism of coexistence of tinea and LP of the lip is reviewed.

Adult↗

PubMed2002

[Analysis of 5459 cleft lip and palate cases].

OBJECTIVE: To analyse the constitution of 5459 cleft lip and palate cases and to review the development of surgical treatment to them. METHODS: The data of the 5459 cleft lip and palate cases were collected and classified. The ratio of sex and disease pattern were calculated and analyzed statistically. Also, by means of classification of the disease pattern, the operation methods and the operation time, the change of the surgical methods and the first operation age were analyzed. RESULTS: In the cleft lip and palate cases, the sex ratio is different. There were obvious differences in the first operative ages in different periods. The main repair methods for cleft lip and palate changed with time. CONCLUSION: The male is more than the female in the cleft lip and palate patients. The average first operation age has been decreased and the main repair methods have changed since 1980.

China↗

PubMed1999

[A study of individual operation designs for unilateral cleft lip repair].

OBJECTIVE: To formulate a reasonable and effective individual operation design that can be adaptable to various forms of deformity of unilateral cleft lip. METHODS: The unilateral deformity of unilateral cleft lip was classified into four types (Type I, II, III, IV) according to the distances from the midpoint of the base of columella and the points of alar bases respectively to cupid's bow peaks of both sides. Furthermore, according to the characteristics of deformity, four types of operation were designed respectively under the standard of making both cupid's bow peaks along cleft drop in the same levels, and the essentials were restoring and making the distances from the midpoint of the base of columella and the points of alar bases to both cupid's bow peaks symmetric. RESULTS: Type I operation was almost the same as the Millard's operation design, and the basic designs of Type II and Type IV operation were also the same as the Millard's operation design, but were combined with the Tennison's operation design. Type III operation was a new operation design of unilateral cleft lip repair. CONCLUSION: The individual operation design in unilateral cleft lip repair should be definitely according to the characteristics of cleft lip deformity.

Cleft Lip↗

PubMed2001

[Factors involved in intelligent development of children with cleft lip and palate].

OBJECTIVE: The objective of this study was to investigate the possible factors involved in intelligent development of children with cleft Lip and palate. METHODS: The intelligence quotient (IQ) and developmental quotient (DQ) of 152 children with cleft lip and palate under 14 years old were conducted, and the control group was made up of 80 healthy children. The considered factors included degrees of deformation, situation of perinatal period, way of feeding, psychological conditions of the children, general situation of their parents and education of these children. The data were statistically analyzed and compared. RESULTS: The IQ value of these children generally was normal, but the mean value was still lower than that of the control group (P < 0.01). The mean IQ value of the group of children with only cleft lip or cleft palate was higher than that of the group with both cleft lip and cleft palate, and the mean IQ value of these children with II degree deformity was higher than that of children with III degree deformity. The mean IQ value of these children feed with mother's milk was higher than that of those feed with artificial milk. These children more than 5 years old were disturbed psychologically, and their parents were also with pressure. CONCLUSION: The intelligent development of children with cleft lip and palate is affected by many factors, including types and degrees of deformity, feeding ways, illnesses and social psychological factors in different periods of development. Therefore, it is very important to take steps before 5 years old, including correctly feeding, repairing the deformity as early as possible, preventing the illnesses, necessary psychological treatment, improving social environment.

Adolescent↗

PubMed2003

[Application of the nasal lining flap to correct the wide unilateral complete cleft lip].

OBJECTIVE: To study use of nasal lining flap in correction of the wide complete unilateral cleft lip. METHODS: 78 patients with wide complete cleft lip were. operated, firstly to be sure. That the lip length on both sides was equal. Then the nasal lining flap was used to enhance the height of the lip on cleft side for keeping symmetry with the non-cleft side. The rest of procedures was the same as "Millard" method. RESULTS: 84.6 percent of patients had good appearance at one and half years after surgery. CONCLUSIONS: It is an effective way to take advantage of the nasal lining flap to correct the wide complete unilateral cleft lip.

Cleft Lip↗

PubMed1992

Permanent lip augmentation employing polytetrafluoroethylene grafts.

There is a paucity of literature regarding aesthetic enhancement of the lips. This is due to the lack of reliable techniques employing autogenous tissue and the reluctance on the part of surgeons to use an alloplastic implant in this anatomic region, which is superficial, subject to trauma, and must conform to innumerable geometric shapes. The ideal lip augmentation procedure should provide for a predictable, permanent enlargement without visible scars or donor-site deformity, can be customized to the particular patient's anatomy, and can be reversed if so desired. A series of 21 alloplastic lip implants employing polytetrafluoroethylene with a mean follow-up of 14.33 months is presented. The overall complication rate was 9.52 percent. Permanent lip augmentation can be achieved with alloplastic sheet grafts of polytetrafluoroethylene in a safe and predictable fashion. Stiffness of the lips develops with progressive thickness of the grafts. Grafts exceeding 3 mm in thickness should be avoided.

Adolescent↗

PubMedDate not supplied

Congenital maxillary double lip: review of the literature and report of a case.

A double lip is an anomaly that may be either congenital or acquired. It occurs most often in the upper lip, although both upper and lower lips are occasionally involved. Surgical intervention (simple excision) produces good functional and cosmetic results. In this report, we describe a case of congenital double upper lip, present a review of the literature and discuss the differential diagnosis. Double lip is of special interest in dentistry because the general practitioner is often the first professional to detect and establish the diagnosis of this uncommon condition.

Adult↗

PubMed2001

Lower lip cancer morbidity in three regions in South Bulgaria for a period of 15 years (1985-1999).

INTRODUCTION: In most of the countries lower lip cancer in men varies from 1.0 case per 100 000 (in England) to 8.9 cases per 100 000 (in Hungary). We have set as a PURPOSE: To follow the dynamics in lower lip cancer morbidity in three regions in South Bulgaria. MATERIALS AND METHODS: A cohort study of lower lip cancer is performed for a period of 15 years. RESULTS: In 1985 lower lip cancer morbidity for the three regions was 4.3 cases per 100 000 and in 1999 it was 3.49 cases per 100 000. Morbitdity retains a comparatively high level. In 1985 morbidity in men was 8.5 cases per 100 000 and in women it was 0.7 cases per 100 000. In 1999 the incidence of morbidity in men decreased to 4.9 cases per 100 000, while in women it increased to 2.1 cases per 100 000. The incidence of morbidity rises with age. The factor that most influences morbidity is smoking. A definite role plays also poor condition of the teeth (carious teeth, bad prostheses and crowns, dental calculus). CONCLUSION: The incidence of morbidity in lower lip cancer in men is 4 times as high as that in women.

Bulgaria↗

PubMed2003

A surgical simulator for cleft lip planning and repair.

The objective of this project was to develop a computer-based surgical simulation system for cleft lip planning and repair. This system allows the user to interact with a virtual patient to perform the traditional steps of cleft-lip repair. The system interfaces to force-feedback (haptic) devices to track the user's motion and provide feedback during the procedure, while performing real-time soft-tissue simulation. An eleven-day old unilateral cleft-lip and palate patient was previously CT scanned for ancillary diagnostic purposes using standard imaging protocols and 1mm slices. High-resolution 3D meshes were automatically generated from this data using the ROVE software created in our lab. The resulting 3D meshes of bone and soft-tissue were instilled with physical properties of soft tissues for purposes of simulation. Once these preprocessing steps were completed, the patient's bone and soft-tissue data are presented on the computer screen in stereo and the user can freely view, rotate, and otherwise interact with the patient's data in real-time. The user is prompted to select anatomical landmarks on the patient data for preoperative planning purposes, then their locations are compared against that of a "gold standard" and a score, derived from their deviation from that standard and time required, is generated. The user can then move a haptic stylus and guide the motion of the virtual cutting tool. The soft tissues can thus be incised using this virtual cutting tool, moved using virtual forceps, and fused in order to perform any of the major procedures for cleft-lip repair. Real-time soft tissue deformation of the mesh realistically simulates normal tissues and haptic-rate (>1kHz) force-feedback is provided. The surgical result of the procedure can then be immediately visualized and the entire training process can be repeated at will. A short evaluation study was also performed. Two groups (nonmedical and plastic surgery residents) of six-people each performed the anatomical marking task of the simulator four times. Results showed that the plastic surgery residents scored consistently better than the people without medical background. Every person's score increased with practice, and the length of time needed to complete the eleven markings decreased. The data was compiled and showed which specific markers consistently took users the longest to identify as well as which locations were hardest to accurately mark. Our findings suggest that the simulator is a valuable training tool, giving residents a way to practice anatomical identification for cleft lip surgery without the risks associated with training on a live patient. Educators can also use the simulator to examine which markers are consistently problematic, and modify their training to address these needs.

Cleft Lip↗

PubMed2004

Relationship between lip position and drooling in children with cerebral palsy.

AIM: This was to determine whether there is any relationship between lip position and drooling in children with cerebral palsy (CP). METHODS: One hundred and sixty individuals with CP (aged 4-18 years) agreed to take part in the study. The following data were collected in two ways. Firstly the presence or absence of drooling, the dental age, the incisal relationship and lip position were obtained by direct observation of the children. Secondly other data for age, sex, learning disability and type of CP were collected using a questionnaire/form. STATISTICS: This was by simple Chi squared analysis. RESULTS: A significantly greater number of CP children who drooled had incompetent lips (p<0.002). When comparing CP children with drooling (mild + moderate + severe) and those without drooling there was a clear difference in distribution of it between those with and those without competent lips. This difference was found to be highly significant (p<0.005). CONCLUSION: Lip position and oral seal share a potentially important association with drooling.

Adolescent↗

PubMed2004

Congenital lower lip pits: a case report.

The Van der Woude syndrome is a rare autosomal-dominant condition typically comprising cleft lip or cleft palate and distinctive pits of the lower lips. The degree to which individuals carrying the gene are affected varies widely, even within families. The variable manifestations include lip pits alone, absent teeth, and isolated cleft lip and palate of varying degrees of severity. Other associated anomalies have also been described. We report a case of Van der Woud syndrome manifesting with isolated lower lip pits in an adolescent female with similarly affected family members.

Adolescent↗

PubMed2005

[Analysis of psychological condition of parents with cleft lip and/or palate children].

OBJECTIVE: To evaluate the psychological situations of cleft lip and/or palate children's parents, to discuss the relationship between psychological situations and cleft types, and to provide clinical treatment to improve the psychological situations of these parents. METHODS: 100 parents whose children were proceeded the primary surgery treatment were selected as the study group, and other 34 parents whose children were normal as the control group. All parents were inquired and tested by the life event scale (LES) and self-rating anxiety scale (SAS). RESULTS: The LES total scores of the cleft lip and/or palate patients' parents were significantly high compared with the normal (P < 0.05). The SAS total scores of the cleft lip and/or palate patients' parents had no significant difference with the control group (P > 0.05). The scores of cleft lip and/or palate patients' parents were the highest and the scores of cleft palate patients' parents were the lowest. CONCLUSION: Most of the cleft lip and/or palate patients' parents were disturbed by a negative psychological situation. Some kind of negative psychological situation may manifest some body symptoms. Meanwhile,the three subgroups' data had the significant difference, which indicated that parents may much more care about the appearance abnormality.

Child↗

PubMed2005

Fixed presurgical orthopaedics for bilateral cleft lip and palate.

BACKGROUND: Presurgical orthopaedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. It is accepted that presurgical orthopaedic plates facilitate lip repair and balanced orofacial growth. AIMS: The aims of this retrospective study of newborns with bilateral cleft lip and palate were two-fold: to describe the use of a fixed appliance to reposition the displaced fragments, and to determine if the magnitude of the palatal changes was age-related. METHODS: Study models of 12 infants with bilateral cleft lip and palate were used. The models recorded the condition prior to expansion (2-3 weeks after birth) and at the end of retention (at the time of lip surgery). The intercanine width, intertuberosity width, palatal length, palatal depth and intercanine arch length were measured. RESULTS: As a result of the expansion the intercanine width and intertuberosity width increased, and the palatal length and intercanine arch length decreased. These changes were not age-related. CONCLUSIONS: Fixed presurgical orthopaedic expansion appliances can be used to expand the upper facial skeleton in newborns.

Age Factors↗

PubMed2006

Comparison of lip positions in ancient Buddhas with Japanese adults.

OBJECTIVES: To compare the lip positions found in two ancient Buddha statues with the lip positions in contemporary Japanese adults. METHODS: The facial profiles of Yakushi-ji temple Sho Kannon (male) and Chugu-ji temple Bodhisattva (female), generally considered to be two of the most beautiful Buddha statues in existence, were compared with the facial profiles of 30 Japanese dental students. Profiles of the statues were measured on photographs and profiles of the adults on cephalometric radiographs. The adults comprised 15 men between 22 and 26 years of age (Mean age: 23.8+/-1.3 years) and 15 women between 22 to 25 years of age (Mean age: 22.9+/-1.0 years). RESULTS: The Buddha statues had retrusive lips compared with the lip positions in contemporary Japanese adults. CONCLUSION: Flat profiles may be favoured by Japanese adults who, typically, have protrusive lips.

Adult↗