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At least 91 records · Page 5Linked to original sources
PubMed1987

Development of the object permanence concept in cleft lip and palate and noncleft lip and palate infants.

Studies of language acquisition in cleft lip and palate infants have not investigated the development of specific cognitive concepts, such as object permanence, which may be related to early linguistic skills. This study obtained comparative data on the development of the object permanence concept in cleft lip and palate and noncleft lip and palate infants to determine whether there were significant differences in rate or sequence of development. Infants were tested for the object permanence concept from 12 through 18 months of age. Results revealed significant improvement in all infants' scores with age, indicating progressive development of the concept. Further, while scores were not significantly different between the cleft lip and palate groups, scores for these groups were significantly better than scores for noncleft lip and palate infants. Superior performance of the cleft lip and palate infants may have resulted from increased environmental stimulation provided by their parents. Implications for intervention and future research in this area are presented.

Attention↗
PubMed1996

The effect of cleft lip repair on maxillary morphology in patients with unilateral complete cleft lip and palate.

This study was performed to investigate the isolated effects of cleft lip repair on maxillary morphology in patients with complete unilateral cleft lip and palate. We compared 10 adult patients with unilateral cleft lip and palate who had only lip repair in childhood and no palatal repair (group 1) with 30 adult patients with unilateral cleft lip and palate who had both their lip and palate repaired in childhood (group 2). Both groups of patients also were compared with 24 adult individuals who had normal occlusion and no cleft anomalies. Evaluation of lateral cephalograms showed that both group 1 and group 2 had significant degrees of maxillary retrusion compared with normal individuals. The magnitude of maxillary retrusion was not increased by cleft palate repair, and none of the cephalometric measurements were significantly different between groups 1 and 2.

Adult↗
PubMed1982

Lip and jaw interaction during speech: responses to perturbation of lower-lip movement prior to bilabial closure.

Electrical stimulation was used to produce unexpected, involuntary depression of the lower lip in three normal young adults. Stimulation was timed to begin 500 to 40 ms prior to voice offset in [aep] and (Ip]. Upper lip, lower lip, and jaw movements were measured with a strain gauge system. Movements in 104 syllables with lower-lip stimulation were compared to the preceding normal syllable. Both the jaw and upper lip compensated for the involuntary perturbations in lower-lip movement. Compensatory movements did not occur as additional, discrete gestures following stimulation onset, but appeared as an increase in the size of closing movements. Bilabial closure was produced at the typical time (within - 10 to + 20 ms of voice offset) in 68% of the perturbed syllables, but it was delayed (a mean of 61 ms) in the remaining 32%. Neither the incidence nor the magnitude of this delay appeared to be related to the jaw position at stimulation onset or to the time between stimulation onset and voice offset.

Adult↗
PubMed1994

Lip-larynx coordination in speech: effects of mechanical perturbations to the lower lip.

This experiment investigates the coordination between the larynx and the lips and jaw in voiceless consonant production using an experimental paradigm where a mechanical perturbation is applied to an articulator. Three subjects received unexpected perturbations to the lower lip during the transition between the first vowel and the first stop in /i'pip/. Movements of the upper articulators (lips and jaw) were recorded using an optoelectronic technique. Laryngeal responses were monitored using transillumination; intraoral pressure and the acoustic signal were also recorded. Results showed that laryngeal abduction was delayed following lip perturbation and that the duration of the laryngeal adduction gesture was lengthened. The oral movements toward closure of two of the subjects were modified and all subjects showed modification of the oral release movements in the perturbed conditions. All subjects showed an increased movement velocity and displacement of the upper lip, lower lip, and jaw in the oral opening phase. First trial compensation, however, was not observed in two of the three subjects. The results are discussed with respect to the speech perturbation literature and the notion of coordinative structures.

Biomechanical Phenomena↗
PubMed2002

The importance of the level of the lip line and resting lip pressure in Class II, Division 2 malocclusion.

Many clinicians hypothesize that retroclination of the maxillary central incisors in Class II, Division 2 malocclusion is caused by increased resting lip pressure against these teeth. The purpose of this study was (1) to verify this assumption by means of simultaneous lip-pressure measurements at two different levels on the maxillary central incisor crowns, and (2) to examine factors that could possibly contribute to the increased resting lip pressure. This is the first study to prove that individuals with Class II, Division 2 malocclusion (n = 21) have the upper central incisors exposed to significantly higher lip pressure than those with Class I malocclusion (n = 21). Our statistical evaluation revealed that this is primarily attributed to a high lip line and not to a hypertonic peri-oral musculature. We concluded that orthodontic treatment of Class II, Division 2 cases should include intrusion of the maxillary incisors, to eliminate the non-physiologically high pressure exerted by the lower lip on these teeth and, consequently, to reduce the high risk of a post-orthodontic relapse.

Adult↗
PubMed1994

Palatal changes after lip surgery in different types of cleft lip and palate.

This study concerns palatal development during 6 months following primary lip closure. The sample consisted of 75 children with different forms of cleft lip and palate and 51 noncleft children. The palate was measured at 3 months of age, just before lip surgery, after surgery at 6 months, and again at 9 months of age. The results showed that lip closure has a strong effect in the anterior alveolar region. This effect was restricted to 3 months after surgery. The changes in complete clefts were more explicit than in incomplete cleft forms. Furthermore, the data showed that arch depth reduction due to lip surgery was compensated for by continued anteroposterior palatal growth. Early orthopedics appeared to prevent major palatal collapse immediately after lip surgery. Finally simultaneous closure of the alveolar cleft at the nasal side resulted in continued reduction of anterior cleft width.

Case-Control Studies↗
PubMed2003

Influence of lip repair on craniofacial morphology of patients with complete bilateral cleft lip and palate.

OBJECTIVE: The aim of this study was to compare two groups of adult male patients with complete bilateral cleft lip and palate (BCLP) on the basis of lateral cephalometric radiographs. PATIENTS: The first group of adult male patients with complete BCLP was comprised of 13 unoperated patients with an average age of 21 years. The second group was comprised of 14 patients with an average age of 21 years 7 months, who had been operated only on the lip prior to 2 years of age. DESIGN: The following measurements were evaluated: angle and length of cranial base; maxillary spatial positioning and length; mandibular spatial positioning; morphology and length; maxillomandibular relationship; vertical facial length; dental positioning; interdental arch relationship; and soft profile. RESULTS: The results suggest that lip repair has a significant influence on certain areas of the craniofacial complex, mainly the premaxilla and the upper incisors. CONCLUSIONS: The most significant findings consequent to lip repair consisted of reduction of the premaxillary anterior projection and lingual tipping of the upper incisors. Retropositioning of the premaxilla, especially in the alveolar part, is a desired effect of lip repair in complete BCLP. Such effect on the projected premaxilla is usually beneficial, except when the exceedingly severe lip pressure, unfavorable growth pattern, or both retropositions the midface profile beyond acceptable sagittal limits.

Adolescent↗
PubMed1996

[Repair of bilateral cleft lip with unilateral composite lip flap: report 19 patients].

To repair bilateral cleft lip seems to be more difficult than that of unilateral one. In order to correct insufficiency of fore-lip, we have applied the composite lip flap of the thicker side for bilateral cleft lip in 19 patients. Overall results were satisfactory. There was no peculiar appearance indicating that fore-lip is too long or tension in the postoperative follow up from six months to four and half years. In this article, the methods of rotating repair were described in detail. The advantage and key points of the teehnique were discussed. So it may be regarded as one of the ideal measures for repairing bilateral cleft lip.

Child, Preschool↗
PubMed2006

Nasolabial symmetry following Tennison-Randall lip repair: a three-dimensional approach in 10-year-old patients with unilateral clefts of lip, alveolus and palate.

AIM: To assess the degree of facial symmetry in patients suffering from unilateral cleft lip, alveolus and palate (UCLAP) by determining differences between the cleft and the non-cleft hemifaces from 3D surface data. PATIENTS AND METHODS: In twenty-two 10-year-old UCLAP patients, who had the lip repaired using the Tennison-Randall technique and did not undergo further revisional surgery, differences were determined between landmarks, surface areas of the upper lip vermilion and nostrils and virtual volumes of midface, nose and upper lip for cleft and non-cleft sides, separately, after having established a plane of symmetry calculated from optical 3D facial surface data. RESULTS: Statistically significant differences could be found between cleft and non-cleft sides for the nasal landmarks G(lat), G(sup) and La(med), the nostril angle and the virtual volume of the nose (p(Glat)=0.011, p(Gsup)<0.0005, p(Lamed)=0.002, p(nostril angle)=0.036 and p(nose volume)<0.0005, resp.). CONCLUSION: Analysis of 3D data shows that complete nasal symmetry is difficult to achieve with Tennison-Randall's lip repair without revisional surgery. Further trials on larger populations of patients will allow a more comprehensive and consistent analysis of the consequence of different methods for cp repair in order to identify the techniques with the best outcome in terms of facial symmetry.

Cephalometry↗
PubMed1991

The contour lines of the upper lip and a revised method of cleft lip repair.

Many techniques for cleft lip repair have been reported, but these techniques do not consider the contour lines of the upper lip and, in fact, destroy them. The upper lip has complicated contour lines including the vermilion free margin, vermilion border, upper lip horizontal groove (upper lip groove), philtrum (dimple and columns), nostril sills, and nasolabial grooves. Incision lines should be designed so that the postoperative scars do not cross these contour lines. We feel that our incision lines and postoperative scars provide better aesthetic results and diminish hypertrophic scar formation.

Child, Preschool↗
PubMed2005

The central lip flap and nasal mucosal rotation advancement: important aspects of composite correction of the bilateral cleft lip nose deformity.

The columella, nasal tip, lip relationship in the secondary bilateral cleft deformity remains an enigma and a great challenge for the cleft surgeon. A subset of patients with bilateral cleft lip still require columellar lengthening and nasal correction, despite the advances in preoperative orthopedics and primary nasal corrections. An approach to correct this deformity is described. This consists of (1) lengthening the columella by a central lip advancement flap; (2) open rhinoplasty, allowing definitive repositioning of lower lateral cartilages, ear cartilage grafting to the tip and columella when necessary; (3) nasal mucosal advancement; (4) alar base narrowing; and (5) reconstruction of the orbicularis oris as required. Depending on the individual assessment of the patients, some of these steps were not performed, leaving the nasal mucosal advancement the most important aspect of the reconstruction. In a consecutive series of 72 patients with repaired bilateral cleft lip and palate, 17 patients have been treated with nasal mucosal rotation advancement and followed up for a maximum period of 10 years. With the use of this technique, the secondary bilateral cleft lip nose deformity has been successfully corrected.

Adolescent↗
PubMed1999

Upper lip measurements at the time of surgery and follow-up after modified rotation-advancement flap repair in unilateral cleft lip patients.

The purpose of this prospective study was to determine whether unilateral cleft lip repaired by the rotation-advancement flap will grow short on the repaired side. This study involved 56 patients with nonsyndromic unilateral cleft lip (31 with complete and 25 with incomplete cleft lip) who underwent a rotation-advancement flap repair by a single surgeon between 1989 and 1997. Eleven patients were lost to follow-up. Forty-five patients have been followed for a varying period of between 8 and 84 months (mean = 37 months). The upper lip was measured immediately after the lip repair and follow-up using calipers. The growth ratios of vertical, horizontal, and nostril sill dimensions were compared between the cleft side and the noncleft side of the same face. Statistical analysis was performed to compare the growths between the cleft and noncleft sides. There was not a significant difference in the growth ratios of vertical (Wilcoxon signed rank test, p = 0.85) and horizontal dimensions (Student's t test, p = 0.18) between the cleft and noncleft sides. There was, however, a statistically significant difference in the growth ratios of nostril sill width between the cleft and noncleft sides (Student's t test, p = 0.02). Our findings indicated that a repaired unilateral cleft retained the vertical and horizontal dimensions determined at the time of the initial repair.

Cleft Lip↗
PubMed2006

Aesthetic upper lip reconstruction with vermilion submucosal-pedicle cross-lip flap.

The localized cutaneous amyloidosis occurring on the upper lip of a 48-year-old man was surgically treated and aesthetically reconstructed with vermilion submucosal pedicle partial-thickness cross-lip flap. The reconstruction of the upper lip following the tumor resection or trauma with Abbe flap or its modified methods may not be always satisfactory because it leaves parallel scars extending to the free vermilion margin and trapdoor deformity. We considered that the replacement of free margin of the upper vermilion with that of the lower vermilion might be responsible for it. When significant vermilion is lost, some surgeons may discard its free margin additionally or convert this defect to a through-and-through defect for easier repair. We believe that surgeon should preserve a continuity of the free margin of upper-lip if possible. Our modified Abbe flap can be applied for a various defects of the upper lip so far as the free margin of the vermilion can be preserved.

Amyloidosis↗
PubMed1993

Dental cast study of adult patients with untreated unilateral cleft lip or cleft lip and palate in indonesia compared with surgically treated patients in The Netherlands.

To determine differences in maxillary and dentoalveolar relationships between untreated and treated patients having unilateral clefts of the lip and alveolus (UCLA) or lip and palate (UCLP), dental cast assessments were done on 70 untreated adult Indonesian patients (UCLA-I, UCLP-I) and 67 Dutch patients, surgically treated in infancy (UCLA-D, UCLP-D). The Indonesian group consisted of 44 UCLA-I and 26 UCLP-I patients, and the Dutch group of 24 UCLA-D and 43 UCLP-D patients. In the UCLA-I patients, deformities occurred in that part of the dentoalveolar complex that surrounds the cleft. Lip repair in the UCLA-D group more frequently caused deformities in the incisor and buccal areas on the cleft side. In the UCLP-I patients, deformities were present in the incisor and cuspid areas on the cleft side. The buccal segments showed collapse both on the cleft and noncleft sides. Lip and palate repair in the UCLP-D group caused significantly more deformities in the incisor, cuspid, and buccal areas up to the level of the first molars, both on the cleft and noncleft sides. Surgical treatment seems to cause maxillary and dentoalveolar deformities up to the first molars more frequently, but these are not as pronounced as one would expect: following the practiced surgical regimen, the deformities were usually mild. Negative effects of surgical intervention seem to be antagonized by the restored integrity of the lip and palate leading to orientation of maxillary parts and correction of tongue position, which in turn has a molding effect on the maxilla and mandible.

Adolescent↗
PubMed1993

[Correction of naso-labial disfigurement subsequent to bilateral cleft lip repair with combined upper lip flap and Abbe flap].

Anomalies of the nose and lip after repair of bilateral cleft lip and palate is a psychological injury to the patients affecting their social intercourse. The author has designed an operative method using a flap of the fore-lip combined with Abbe flap of the lower lip to repair the anomaly with successful result. In two patients, free Abbe lip flap was used, with one complete success and partial necrosis of the other.

Adolescent↗
PubMed1984

Effect of oral screen treatment on dentition, lip morphology, and function in children with incompetent lips.

The effect of treatment with an oral screen was studied in sixteen children with incompetent lips who were compared with a control group of sixteen children who also had incompetent lips. The period of observation was 1 year. The treatment brought about retroclination of proclined maxillary incisors with a resulting decrease in overjet, in the diastema between the incisors, and in arch length. The mandibular incisors proclined somewhat. No change in general intermaxillary relation or in arch width was observed with the treatment. Neither lip morphology nor the electromyographically recorded function of the lips was affected by the treatment. The maximum force that the lips could exert to resist an external force was increased substantially by the treatment. Whether this is of value for the stability of the orthodontic treatment result is not known.

Activator Appliances↗
PubMed2002

[Early repair for infants with cleft lip. Retrospective study of 263 cleft lip repairs].

This study attempts to define the effect of early repair on the surgical procedure and immediate outcome of cleft lip surgery. The first part deals with 263 consecutive cleft lip repairs (218 infants) categorized retrospectively by age at operation. 123 patients (150 cleft lips) were operated on during the first 4 weeks of life; a subgroup of 40 infants was operated on at a week or less of age; 95 patients (113 cleft lips) were operated at an older age (1 to 12 months). There were no significant difference in immediate surgical result between the groups and there was no apparent difference in the operative results as defined by whether or not the child needed subsequent revision. We are currently encouraging early repair in the full-term baby as the optimum method of management of newborns with cleft lip.

Age Factors↗
PubMed1991

A technique for measurement of intraoral lip pressures with lip bumper therapy.

One of the reported effects of functional appliance therapy is muscular adaptation achieved through the use of vestibular shields. To develop a method for measuring these effects, 10 children with Class I molar occlusion in the late mixed-dentition stage underwent lip bumper therapy for 8 months. Semiconductor pressure transducers mounted on Tru-Tain stents in the mandibular midline and left canine areas were used to measure lip pressures with the patient at rest and during five functional exercises. Resting and speaking lip pressures for the midline transducer showed significant increases 1 month after lip bumper placement and then decreased to near or below pretreatment levels, possibly an adaptive response. Left-side resting pressures also showed a gradual decrease. In contrast, left-side speaking pressures showed no significant changes over time. The swallowing pressures were not replicable because of excessive background fluctuations. The results of this study indicate that this method has potential for improving clinical diagnosis. The preliminary data also suggest an adaptive response of lip muscles that varies according to anatomic location.

Activator Appliances↗