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PubMed1993

Differentiation of isolated murine embryonic palatal epithelium in culture: exogenous transforming growth factor alpha modulates matrix biosynthesis in defined experimental conditions.

A novel culture technique, which supports the growth and differentiation of mouse embryonic palatal epithelial cells in the absence of either an extracellular matrix substratum or feeder layers, has been developed. Using this technique we have investigated the effects of exogenous transforming growth factor alpha (TGF alpha) and serum on extracellular matrix biosynthesis by primary cultures of mouse embryonic epithelial sheets under defined experimental conditions. In all culture treatments (chemically defined medium with and without TGF alpha or serum) the palatal epithelial sheets differentiated into three regionally distinct cell phenotypes after 36 h. Nasal and oral cells differentiated into pseudostratified, ciliated columnar, and stratified squamous keratinizing epithelium, respectively. In addition, basal medial edge epithelial (MEE) cells at the oral/nasal regional interface assumed an elongated cobblestoned phenotype. In serum-free medium, collagen types IV and V, laminin, fibronectin, and heparan sulphate proteoglycan were detected immunocytochemically throughout the entire epithelial sheet. Tenascin and collagen IX were present almost exclusively in MEE cells. Types I, II, and III collagen were completely absent. Addition of TGF alpha or serum universally increased the intensity of staining, most notably that for tenascin and collagen IX in MEE cells. These results indicate that mouse embryonic palatal epithelial sheets can be maintained under defined culture conditions during which they exhibit patterns of differentiation similar to those observed in vivo. TGF alpha, known to localize to the MEE in vivo, can modulate palatal extracellular matrix biosynthesis, particularly by the MEE, suggesting a regulatory role for this factor. The culture system is suitable for further investigating the effects of exogenous factors on mouse embryonic palatal epithelial cell bioactivity and differentiation.

Animals↗
PubMed2001

The influence of cephalometric parameters on resonance of speech in cleft lip and palate patients. An interdisciplinary study.

There are only few studies concerning the correlation between craniofacial morphology and resonance of speech in cleft palate patients. Moreover, these investigations show a considerable inhomogeneity in material and method, their basic approach was predominantly retrospective, and the statistical methods were restricted to univariate procedures. Thus, the aim of the present study was twofold: firstly to clarify the extent to which correlations exist between craniofacial morphology and resonance of speech in cleft palate patients, subject to a sufficiently large number of patients being available to ensure differentiation with regard to age and cleft type, and secondly, within a prospective longitudinal study in juvenile cleft palate patients, to investigate whether pubertal craniofacial growth changes result in changes of resonance. The collective comprised 137 cleft palate patients. The following investigations were performed: lateral cephalometry, nasometry, and standardized speech recording. Additionally, these investigations were repeated in 51 juvenile patients after a minimum time interval of 2 years. In order to analyze the complex relations between craniofacial morphology and degree of hypernasality, multivariate statistical procedures were applied. The results of the present study indicate complex correlations between cephalometric parameters and resonance of speech, requiring age-specific differentiation. In this regard, the ratios between the length of the soft palate and the sagittal depth of the nasopharyngeal airway were of prime importance. Beyond this, significant correlations were found between craniofacial growth changes and changes of resonance during puberty which might be influenced both by dentofacial orthopedics and by maxillofacial surgery.

Adolescent↗
PubMed2005

Investigation of maxillary tooth sizes in patients with palatal canine displacement.

AIM: The aim of this retrospective trial was to investigate differences in mesiodistal and vestibulo-oral crown sizes of naturally, fully-erupted permanent maxillary teeth between patients with and without palatal canine displacement. PATIENTS AND METHOD: 115 patients (mean age: 14 years 10 months; females: 77 males: 38) treated in the Department of Orthodontics, University of Munich were included in the study. 65 of the patients showed at least one palatally-displaced canine. Diagnosis and the location of the displacement were determined on the basis of standardized radiographs and confirmed by surgical documentation. Each maxillary tooth's mesiodistal and vestibulo-oral width was measured using a dial caliper on each dental cast. Excluded were partially-erupted teeth and surfaces with caries or restorations that had to be measured. An analysis of available space was made by evaluating the pre-treatment dental casts of all patients included in the study. RESULTS: Comparing the tooth widths of patients with unilateral canine displacement with the corresponding contralateral quadrants, we noted a statistically significant difference, namely that the central and lateral incisors and the canines of the affected side were narrower than those of the non-affected side in the same patient. Moreover, the displaced upper canines showed an increase in vestibulo-oral dimension. Overall tooth width (including all tooth groups) in patients with palatally-displaced canines was significantly less than that in the control group. However, when comparing the crown diameters of unilaterally- and bilaterally-affected patients, no differences in tooth-size were observed. The space-analysis showed excessive dental-arch space in patients with a palatally-displaced canine. CONCLUSION: Patients affected by palatal canine displacement showed significantly smaller maxillary tooth size.

Adolescent↗
PubMed2003

[Social orientation of parents of children with cleft lip and palate].

BACKGROUND: Cleft lip and palate are the most common malformation in the orofacial region. The type and dimension of the cleft determine the functional limitations of respiration, swallowing, speech, articulation and hearing. In addition, cosmetic and communicative restrictions influence the cognitive, social and educational progress and the wellbeing of the children affected. Their parents face a difficult and lasting task: They have to cope with their child's handicap and the current standardised treatment procedures which start in early infancy. To guarantee optimum therapeutic success parents must be included as co-therapists. Therefore more information about parents' concerns and coping strategies are required. METHOD: To assess the strain put on parents of children with cleft lip and palate as well as the parents' coping strategies, a standardised questionnaire for the German-speaking parents was used during consultation in the out-patient clinic. RESULTS. In comparison with parents of children with other handicaps, the parents of children with cleft lip and palate feel less stressed out and adopt strategies of coping such as intensification of partnership, use of social support, as well as self-respect and fulfillment. Working mothers are less preoccupied and less at risk of being focussed on the handicapped child only. In comparison, the parents of children with Orofacial clefts focus less on the handicapped child in general than those parents whose children suffer from additional behavioural disorders. DISCUSSION: Though several functional, behavioural and psychological disorders may occur in children with cleft lip and palate their parents feel comparatively little stress. They do use a variety of coping strategies and tend to adopt a rather positive approach. Certainly, additional disorders of the child lead to more parental stress and likewise requiring more attention to the child which may even accentuate existing behavioural disorders. CONCLUSION: Parents of children with cleft lip and palate experience less stress in comparison with parents of children with other handicaps. Therapeutic efforts and regular check of the child's progress might support parents' coping strategies. Therapists should also ask for additional disorders such as behavioural disorders and initiate adequate support.

Adaptation, Psychological↗
PubMed2006

Symptomatic palatal myoclonus with ear click after tick-borne meningoencephalitis.

We present a case of a 39-year-old patient, who was diagnosed and treated for a tick-borne meningoencephalitis. Three months after the treatment he started to complain of annoying, cracks-resembling, rhythmical sounds, coming from the inside of his head to both his ears. Physical examination revealed rhythmical oscillations of the soft palate with a frequency of 100-120 per minute and a clock ticking noise synchronic with the palate tremor. Electromyography revealed continuous motor unit activity at rest in the tensor veli palatini muscle. Palatal myoclonus (PM) as a result of tick-borne meningoencephalitis was diagnosed. Treatment with several medications was started with no effect, then botulinum toxin was administered under EMG guidance to both sides of the patient's soft palate with great improvement. A 5-year follow-up and continuation of botulinum toxin injections with only minor and reversible side effects proved the treatment efficacy and safety. In the article we present a case of symptomatic palatal myoclonus with ear click and shortly discuss its aetiology, types and treatment options. We also stress the efficacy and safety of PM treatment with repetitive injections of botulinum toxin.

Adult↗
PubMed1999

Mastoid pneumatization and aging in children with Pierre-Robin syndrome and in the cleft palate population out of syndrome.

We examined the characteristics of mastoid pneumatization in the Pierre-Robin syndrome (PRS) and non-PRS cleft palate population in relation to age. There were 14 patients with PRS (median age, 5 years), 7 patients with bilateral cleft lip-palates (BCLP: median age, 6 years), 29 patients with unilateral cleft lip-palates (UCLP: median age, 6 years) and 15 patients with isolated cleft palates (ICP: median age, 7 years). All had secretory otitis and ventilation tubes inserted. Pneumatization was assessed by standard computerized planimetric methods. Temporal bone (Schüller view) X-rays were obtained. Areas of bone pneumatization were outlined and measured separately for each ear. The median pneumatized area of the mastoid (MBP) in PRS patients (6.73 cm2) was significantly lower than in non-PRS cleft patients (7.29 cm2). It was also lower than in UCLP (7.35 cm2; P = 0.01) and ICP (7.19 cm2; P = 0.02). MBP did not change significantly with age in PRS (Spearman rs = 0.11) and BCLP (Spearman rs = 0.11), but did increase significantly in the ICP group (Spearman rs = 0.23; P = 0.04). Cubic regression showed the best fit in the BCLP (r2 = 0.61; P = 0.01) and ICP (r2 = 0.10; P = 0.05). It was not significant for PRS (r2 = 0.132) or UCLP (r2 = 0.049). We concluded that pneumatization in all cases increases with age, but it is statistically significant only in ICP. PRS patients have a lower area of mastoid air-cell size than the non-PRS cleft palate population. The extent of mastoid pneumatization in PRS patients does not correlate with age because of the negative influence of the mandibular hypoplasia and glossoptosis present.

Adolescent↗
PubMed1994

Effectiveness of two feeding methods in improving energy intake and growth of infants with cleft palate: a randomized study.

OBJECTIVE: To compare two feeding methods advocated for infants with cleft palate: (a) a squeezable plastic container with a narrow, long crosscut nipple (squeezable cleft palate nurser); and (b) a standard nipple with a crosscut (crosscut nipple). The effectiveness of a nutrition intervention protocol for these infants was also documented. DESIGN: Thirty-one infants (median age = 15 days) were randomized to one of two feeding methods (18 infants, squeezable cleft lip/palate nurser; 13 infants, crosscut nipple) within sex (21 boys, 10 girls) and palatal defect (22 cleft lip and palate, 9 isolated cleft palate) categories. The intervention included feeding technique instructions, nutrition counseling at each clinic visit, use of the same 20 kcal/oz standard formula for 12 months, and introduction of infant and soft table foods at 6 months. Four-day food records and growth data were obtained. MAIN OUTCOME MEASURES: Mean energy and protein intakes at 3 and 6 months of age and growth measurements during the first 18 months of life were obtained. STATISTICAL ANALYSES: A repeated measures analysis of variance for intakes was performed with time as the repeated measure and feeding method as the covariable. Similar analyses were completed for growth measures with sex and feeding method as covariates. RESULTS: Mean energy intake at 3 and 6 months of age (P = .24) and growth measurements during the first 18 months of life (P values: weight gain [grams per day], .73; weight, .21; length, .07; head circumference, .18; triceps and subscapular skinfolds and mid-arm circumference, .47, .48, and .69, respectively) were not significantly different. Both feeding methods were effective in supporting normal growth. APPLICATIONS: With adequate instruction related to the use of either feeding technique and close nutrition follow-up early in infancy, a dietitian or other health care practitioner may advise the use of either feeding method. These data support the need for feeding and nutrition education and early nutrition intervention.

Anthropometry↗
PubMed1975

Palatal growth studied on human autopsy material. A histologic microradiographic study.

The postnatal development of the hard palate was studied by conventional histologic and microradiographic means on autopsy material from thirty-three boys and twenty-seven girls aged 0 to 18 years. The findings indicated thet growth in length of the hard palate until the age of 13 to 15 was due to growth in the transverse suture and to apposition on the posterior margin of the palate. After this age the sutural growth was found to cease, whereas the apposition seemed to continue for some years. During the postnatal development the morphology of the transverse suture changed. At birth the suture was broad and slightly sinuous; later it developed into a typical squamous suture, the palatine part covering the maxillary part. During puberty the course of the suture was again slightly sinuous. The importance of this change for the vertical growth of the hard palate was discusses. It was pointed out that the lowering of the anterior part of the palate. The transverse growth of the midpalatal suture continued up to tha age of 16 in girls and 18 in boys. On the basis of morphology, the development of the median suture could be divided into three stages. In the first stage the suture was short, broad, and Y shaped; in the second the course was more sinuous; and in the third interdigitation was so heavy that a separation of the two halves of the maxilla would not be possible without fracturing the interdigitated processes.

Adolescent↗
PubMed1976

A study of the anterior portion of the palate as it relates to orthodontic therapy.

1. The anterior portion of the palate does not appear to move lingually as orthodontic forces move incisor teeth lingually. Although the alveolar bone directly supporting the teeth can be moved distally (and elongated), it does not appear possible to move the apex of the root more distally than the pretreatment position of the palatal plate. Thus, there appears to be an anatomic limitation to the distal movement of maxillary incisor teeth. 2. When incisor teeth are moved distally within the boundaries of the present alveolar process, the supporting bone does not remodel to the roots' new position; when a root which was initially positioned nearer the labial alveolar plate is moved distally against the palatal plate, there was observed no adaptation in the bone to have the root once again located near the labial alveolar plate, the root remained stable against the palatal plate. 3. When great distal movement of incisor teeth results in an alteration in position of the supporting alveolar bone, remodeling of the bone maintains a relatively constant labiolingual width of this alveolar bone. The new position of the tooth and supporting bone appears to be stable. 4. The scanty metallic implant evidence would seem to support histologic observations that alveolar processes are remodeled by apposition of bone on the cortical plate toward which the tooth is moving and resorption of the cortical plate away from which the tooth is moving. 5. There does not appear to be a statistically significant correlation between posterior facial measurements (SNMP) and the labiolingual width of the anterior palate.

Adolescent↗
PubMed1986

Effects of dibutyryl cyclic AMP and theophylline on in-vitro development of the secondary palate in the embryonic chick.

The avian secondary palate is normally cleft and does not show a rise in intracellular cyclic AMP like that of the fused mammalian palate. The secondary palate of the embryonic chick (HH stages 25-34) was exposed in vitro to dibutyryl cyclic AMP and theophylline to determine whether raising intracellular cyclic-AMP levels would alter medial-epithelial development. Differentiation of the medial epithelium was not altered but there was mucous-cell hyperplasia in nasal epithelium and inhibition of membrane-bone formation in the mesenchyme. Thus the developmental factors that cause the avian palate to be cleft and the mammalian palate to be fused are more complex than differences in intracellular cyclic-AMP levels.

Animals↗
PubMed1989

A biochemical study of glycosaminoglycans in the palatal rugae of the monkey (Macaca fascicularis).

Glycosaminoglycans (GAG) were extracted from the connective tissue of the palatal rugae, separated by electrophoresis and compared with the results obtained for the remaining palatal mucosal and gingival connective tissues. The GAG content of the rugae (3.01 mg/g defatted dry weight) was higher than in the remaining palatal mucosa (2.33 mg/g defatted dry weight) or gingiva (1.68 mg/g defatted dry weight). Dermatan sulphate was the predominant GAG in both the palatal rugae (48% of total GAG) and the remaining palatal mucosa (50%) followed by hyaluronic acid (33 and 31% respectively). The results do not support previous histochemical observations in which the rugae appeared to be rich in hyaluronic acid.

Animals↗
PubMed1994

The effect of intraperitoneal N-methyl-N-nitrosourea on hamster palatal gingiva and intermolar mucosa.

Fifty 4- to 6-week-old male random-bred golden hamsters were injected intraperitoneally with a weight-related dose (12.5 mg/kg body weight) of N-methyl-N-nitrosourea (NMU) three times a week for 4 weeks. Groups of seven animals were killed 10, 16 and 22 weeks after the first injection. The palatal gingiva from six animals and the intermolar mucosa from 21 animals was examined. Seven male age-matched untreated control animals were killed at each period. Although all NMU-treated hamsters showed dysplastic and neoplastic changes similar to those in human oral squamous-cell carcinoma, other changes such as acantholytic dyskeratosis, invading cysts, duct-like structures and basaloid islands and cords were not. The extent and severity of the changes increased with time so that by 22 weeks there was extensive involvement of the palatal bone and marrow spaces, the molar periodontal ligament and the greater palatine neurovascular bundle by neoplastic epithelium. The invading epithelium was derived from the junctional, crevicular and palatal gingival and intermolar epithelium. The latent period for the crevicular and junctional epithelia was shorter than that for the palatal gingival and intermolar epithelium. The invasive changes from the latter epithelium were often preceded by exophytic changes such as epithelial projections, papillae and papillomas. Such changes were infrequent for the gingival, crevicular and junctional epithelia. The study shows that intraperitoneal NMU acts as a complete carcinogen on the palatal gingival and intermolar epithelium in hamsters.

Animals↗
PubMed1991

Transforming growth factor-beta receptor profiles of human and murine embryonic palate mesenchymal cells.

Cell signalling in the developing mammalian palate appears to involve various growth factors and hormones. An important developmental role for the transforming growth factor-beta (TGF-beta) class of growth factors is suggested by the immunolocalization of TGF-beta 1 in the palate during its ontogeny. This study examined the effects of TGF-beta stimulation of, as well as TGF-beta receptor profiles in, murine embryonic palate mesenchymal (MEPM) and human embryonic palate mesenchymal (HEPM) cells. Results showed that TGF-beta 1 (1 ng/ml) stimulated proliferation of HEPM cells and inhibited proliferation of MEPM cells in a dose-dependent manner. The time course of 125I-TGF-beta 1 binding to specific receptors was determined by incubating cells in the presence of 170 pM 125I-TGF-beta 1 for up to 4 h. In both cell types, at 37 degrees C, the binding of 125I-TGF-beta decreased linearly over 4 h, while at 4 degrees C, binding increased with time of incubation. Incubation of both cell types at 4 degrees C for 4 h, with increasing concentrations of 125I-TGF-beta 1, resulted in binding which demonstrated saturation kinetics. Scatchard analyses revealed one class of receptors for HEPM (K 32.3 pM) and MEPM (K 26.3 pM). However, SDS-PAGE analyses of 125I-TGF-beta chemically crosslinked to specific receptor sites revealed that both cell types contained the types I (65,000 Mr) and III (230,000 Mr) TGF-beta receptors while MEPM also contained the type II (86,000 Mr) receptor. Binding studies further demonstrated the ability of platelet-derived growth factor to transmodulate TGF-beta binding. These results indicate that the HEPM cell line and primary cultures of MEPM cells, although obtained from palates at similar developmental stages, are dramatically different in their responsiveness to TGF-beta and have disparate TGF-beta receptor profiles.

Animals↗
PubMed1985

Methods taught in dental schools for determining the posterior palatal seal region.

The following conclusions summarize the results of a survey sent to the chairperson of the removable prosthodontic department of 70 dental schools regarding the concepts and techniques taught for developing the posterior palatal seal. A combination of clinical methods was most frequently taught for locating the vibrating line. The phonation of the Ah sound was the most popular single method taught for locating the vibrating line. Seventy-five percent of the dental schools taught that there is one vibrating line per person. The posterior flexion line was related to the distal termination of the maxillary denture by dental schools that teach the concept of two vibrating lines. Most dental schools (80.4%) do not use the fovea palatinae for locating the distal termination of the maxillary denture. Most dental schools (87.5%) teach students to carve the posterior palatal seal on the maxillary master cast. Most dental schools (93.9%) take the compressibility of the palatal tissue into consideration when carving the depth of the posterior palatal seal in the maxillary master cast. The butterfly pattern was most frequently described to carve the posterior palatal seal in the maxillary master cast.

Dental Impression Technique↗
PubMed1986

Identification of prostaglandin E2 receptor sites in the embryonic murine palate.

This study reports the existence and characteristics of prostaglandin E2 (PGE2) receptor sites during development of the murine embryonic palate. A radioligand binding technique utilizing [3H]-PGE2 was employed in the identification and characterization of binding sites. On day 13 of gestation, palatal PGE2 receptor sites were saturable (at 3.5 nM [3H]-PGE2) with high affinity (KD 1.6 nM) and low capacity (0.018 fmole/mg protein). Specific [3H]-PGE2 binding was completely reversible by 30 min. The rank order of prostanoid binding affinity at specific PGE2 binding sites was: E2 greater than F2 alpha greater than A2 greater than E1 = D2. The ability of embryonic palate mesenchymal cells to respond to PGE2 with dose-dependent accumulations of intracellular cAMP demonstrated the functional nature of these binding sites. Analysis of palatal PGE2 receptor characteristics during the period of palatal development also indicated significant temporal alterations in both receptor affinity and density.

Alprostadil↗
PubMedDate not supplied

Effects of anticonvulsant drugs on fetal mouse palates cultured in vitro.

Maxillary regions of day-12.5 ICR mouse fetuses were dissected and cultured in a chemically defined serumless medium, and the effects of anticonvulsant drugs on in vitro palatogenesis were studied. The explants were treated for 72 h in vitro with 50 to 200 micrograms/mL diphenylhydantoin (DPH), 200 to 800 micrograms/mL sodium phenobarbital (PB), 12.5 to 400 micrograms/mL sodium valproate (VPA), and 3 to 100 micrograms/mL diazepam (DAZ). During the culture, the secondary palatal shelves of control explants elevated, grew medially, and fused after 72-h culture in a manner similar to the palatogenetic process in vivo. The fusion of palatal shelves was inhibited dose-dependently by treatments with DPH, VPA, and DAZ. PB showed no significant inhibitory effects on palatal fusion at concentrations up to 800 micrograms/mL. The in vitro toxicity of the anticonvulsants tested appeared to correlate with the relative in vivo teratogenic potential of the drugs. The present study demonstrated that the in vitro organ culture system should be useful for screening teratogenic agents, especially those causing cleft palate, and for exploring the mechanisms of cleft palate formation.

Animals↗
PubMed1989

Ontogenetic analysis of embryonic palatal type I and type II cAMP-dependent protein kinase isozymes.

The developmental processes of cell growth and differentiation are important mechanisms regulating tissue and organ formation. These processes appear to be dependent on the ligand-receptor interactions of various hormones, growth factors, and extracellular matrix molecules. In turn, ligand-receptor interactions may elevate intracellular levels of second messengers. Among the second messengers, cyclic AMP (cAMP) is known to activate cAMP-dependent protein kinases (cAMP-dPK) by binding to two major regulatory subunit isoforms, RI and RII, of this enzyme. The present study examined the occurrence of changes in the cAMP-dPK isozyme patterns during the critical period of murine palatal ontogeny between days 12 and 14 of gestation. Cyclic AMP-dPK in cytosolic preparations (27,000 x g) of murine embryonic maxillary and palatal tissue were analyzed by DEAE chromatography and photoaffinity labelling with 8-azido-[32P]cAMP followed by SDS-PAGE and autoradiography. Both techniques indicated shifting patterns of expression of RI (45,000 Mr) and RII (52,000 Mr) regulatory subunits during palatal ontogeny. Immunohistochemical localization of RI and RII revealed more intense fluorescence in the palatal epithelial layer by days 13 and 14 with an apparent greater intensity of immunostaining on the basal aspect of the epithelial layer. These results suggest an important role for cAMP-dPK in epithelial-mesenchymal cell signalling during development of the murine palate.

Animals↗
PubMed1993

Messenger RNA phenotyping for semi-quantitative comparison of glucocorticoid receptor transcript levels in the developing embryonic mouse palate.

A specific complex of glucocorticoid and receptor interacts with responsive genes in target tissues of developing palate and controls its morphogenesis. In order to examine developmental changes in glucocorticoid receptor gene expression during embryonic palate formation, variations in transcript levels have been determined using a simple semi-quantitative reverse transcription-polymerase chain reaction (PCR) procedure. Oligo (dT)16 was used as the primer for reverse transcription, and the amount of PCR product for glucocorticoid receptor was normalized against those for glyceraldehyde 3-phosphate dehydrogenase (GAPDH) and beta-actin. We found that either GAPDH or beta-actin were suitable internal standards, and that the mRNA levels of glucocorticoid receptor undergoes a significant decrease of 30% at the developmental stage of embryonic mouse palatal shelf re-orientation. Immunolocalization of the receptor demonstrated a significant change in the distribution pattern of glucocorticoid receptor during the re-orientation stage of secondary palate formation. Our present data suggest that developmental variations in glucocorticoid receptor level control morphogenetic events of secondary palate formation.

Animals↗