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At least 1,657 records · Page 92Linked to original sources
PubMed1987

Orofacial clefts in Czechoslovakia. Incidence, genetics and prevention of cleft lip and palate over a 19-year period.

The precise value of incidence was calculated based on the sample of 3,660 probands with orofacial clefts born in Bohemia between 1964-1982, as all cases born in this region and time were registered. For non-syndromic cases, the incidence of cleft lip was 0.4396 per 1,000 live birth, 0.7684 for cleft lip and palate and 0.6024 for isolated cleft palate. The sample of 4,950 of our older probands born between 1886-1963 was added and the whole sample of 8,250 individuals was evaluated with respect to sex-ratio, laterality, clinical severity, seasonal incidence and age of parents. The risk of recurrence and value of heritability were calculated as well. Based on these evaluations, a four-threshold multifactorial model for cleft lip and palate was suggested and also confirmed by our results of primary prevention of orofacial clefts using periconceptional supplementation with vitamins and folic acid.

Cleft Lip↗
PubMed1987

The effect of form and dimension on the management of the maxillary arch in unilateral cleft lip and palate conditions.

Over the past 28 years, a series of studies at the West Midlands Regional Plastic Unit has compared the maxillary arches at birth and 4 months of 30 normal children and two groups of children with unilateral cleft lip and palate, one of which had presurgical maxillary orthopaedic treatment and the other which did not. Other studies have compared the area of palatal mucosa at birth with the overall size of the arch at 5 years of age and have also assessed the long term effect of simultaneous lip and palate repair and presurgical treatment on the profile, occlusion and speech of the older patient. The paper summarises the findings of the investigations and considers how they have contributed to an understanding of the unilateral cleft lip and palate problem particularly with regard to the long term management of such cases and the provision of a suitable treatment protocol.

Cleft Lip↗
PubMed1987

Facial morphology and occlusion at the stage of early mixed dentition in cleft lip and palate patients treated with delayed closure of the hard palate.

Cephalometric radiographs and dental study casts were analyzed in a group of 23 seven-year-old cleft lip and palate patients, 16 with unilateral and 7 with bilateral cleft. The patients' primary surgical procedures had been completed except for closure of the cleft in the hard palate. For comparison, similar records from another group of patients, 18 with unilateral and 8 with bilateral cleft lip and palate, were studied. In these cases the cleft of the hard palate had been repaired in infancy, using a vomer flap procedure. The results indicated that midfacial growth and dental occlusion of the unilateral cleft sample was significantly better in patients whose closure of the hard palatal cleft had been delayed to the stage of mixed dentition than where repair had been performed with a vomer flap in infancy. No differences were found, however, between similar subgroups with bilateral cleft lip and palate.

Cephalometry↗
PubMed1987

Cleft lip: aesthetic results following a different skin incision.

In a revision of the cleft lip cases repaired in the past 20 years using the most common techniques, the most significant observation that has emerged is the alteration of lip anatomy due to the abnormal dislocation of tissue masses and scar direction. These may have negative consequences on the final development of the lip. In an effort to avoid some of these inconveniences the authors propose a very flexible technique that recalls Pfeiffer's concepts, consisting of a vertical line of incision interrupted at various points so as to obtain angles of different degrees. The method has been named the W-technique with variably sized angles.

Cleft Lip↗
PubMed2003

A case of focal acantholytic dyskeratosis occurring on both the lip and the anal canal.

Focal acantholytic dyskeratosis has a distinctive histological pattern that is associated with various clinical expressions. It rarely occurs on the lip or the perianal area. We report a patient with focal acantholytic dyskeratosis occurring on both the upper lip and the anal canal. Histopathologically, the lesions showed hyperkeratosis, suprabasilar clefting, epidermal acantholysis and dyskeratosis. This case represents the first report of a focal acantholytic dyskeratosis occurring on both the lip and the anal canal.

Acantholysis↗
PubMed1978

The effects of zero population growth on the incidence of cleft lip and palate in Western Australia.

A total of 613 cases of cleft lip, cleft palate, and combinations of both (CLP(P)) has been ascertained in the period from 1958 to 1975 in Western Australia. Near-total ascertainment of cases during this period was obtained from multiple sources. There has been a significant decline in the total incidence and the cleft lip and palate (CLP) incidence in males. The hypothesis is presented that these changes are linked to the changing fertility pattern throughout Australia (as technological improvements are made in the simplicity and efficacy of birth control), and abortion (as social attitudes change); and as the birthrate drops towards zero population growth (ZPG). The paper presents two critical observations: (i) the link between CLP(P) incidence, and demographic changes; (ii) in differing behaviour of cleft lip (CL) and CLP, which were previously regarded as linked conditions.

Australia↗
PubMed2006

Improving cleft palate/cleft lip antenatal diagnosis by 3-dimensional sonography: the "flipped face" view.

OBJECTIVE: Three-dimensional sonography has enhanced the diagnosis of congenital anomalies in the early stages of pregnancy. Both cleft lip and palate remain a diagnostic challenge for the sonographer because of the variable size of the defects as well as their location. Recently, a technique described by Campbell et al (Ultrasound Obstet Gynecol 2003; 22:552-554, 2005; 25:12-18) demonstrated an improved method called the "reverse face" view, which appears to assist in the diagnosis of clefts involving the palate. METHODS: The fetal face was initially examined with the fetus in the supine position. Using 3-dimensional sonography, a static volume was acquired. Following acquisition of the volume, it was rotated 90 degrees so that the cut plane was directed in a plane from the chin to the nose. The volume cut plane was then scrolled from the chin to the nose to examine in sequential order the lower lip, mandible, and alveolar ridge; tongue; upper lip, maxilla, and alveolar ridge; and hard and soft palates. RESULTS: This approach identified the full length and width of the structures of the mouth and palates and allows the examiner to identify normal anatomy as well as clefts of the hard and soft palates. CONCLUSIONS: The fetal hard and soft palates of the mouth can be accessed using a new technique, which we call the "flipped face" maneuver, when an adequate volume of the face can be obtained.

Cleft Lip↗
PubMed1998

Premaxillary size and craniofacial growth in patients with cleft lip and palate.

BACKGROUND: Premaxillary size in individuals with cleft lip and palate is variable, ranging from a mere nubbin to a large protuberance. The purpose of this study was to evaluate the effect of premaxillary size on craniofacial growth in cleft lip and palate patients. MATERIALS AND METHODS: Premaxillary size was measured using 181 dental casts of bilateral complete cleft lip and palate (BCLP) infants. The infants had no associated systemic malformations, and were approximately one year of age. Data were obtained from the files of the Chang Gung Craniofacial Center. The mean size (mean = 19.3 mm) of the premaxilla and standard deviation (SD = 2.0 mm) were calculated. A sample of 55 subjects was divided into three groups: large premaxilla; [LP; 15 boys, 5 girls; mean age 5.2 years; premaxillary size > (19.3 + 2.0) mm; mean size 22.6 mm]; small premaxilla [SP; 15 boys, 5 girls; mean age = 5.1 years; premaxillary size < (19.3-2.0) mm; mean size = 16.5 mm] and bilateral-median facial dysplasia [B-MFD; 6 boys, 9 girls; mean age 5.1 years; mean size 10.5 mm]. They all had a bilateral cheiloplasty at about 3 months of age and palatoplasty at about one year of age. Lateral cephalograms were taken at about 5 years of age to compare the craniofacial complex among the three groups. RESULTS: The LP group tended to have a longer maxilla, longer anterior maxillary height and more protruded maxilla, producing a better interjaw relation and larger overjet. The opposite phenomena were observed in the B-MFD group, and the SP group had results between those of the LP group and the B-MFD group. CONCLUSION: BCLP patients with large premaxilla had superior maxillary growth (in depth and anterior height) as compared to those with small premaxilla.

Child↗
PubMed1976

Geographic lip: a variant of geopgraphic tongue.

The following aspects of the classic geographic tongue are discussed: clinical polymorphism with the appearance of annulus migrans, histological appearacne of the spongiform pustule, frequent association with pustular psoriasis and related diseases, and its relationship to psoriasis buccalis. Two cases of geographic lip are described in which annulus migrans was present. In one case, the geographic lip was associated with a plicated lip, a labial form of plicated tongue.

Adolescent↗
PubMed1999

Full-thickness skin graft in the secondary repair of bilateral cleft lip. A case report.

A 13-week-old boy with bilateral complete cleft lip and palate is presented. He had three attempted repairs of his lip elsewhere over a period of four weeks, and all of these broke down. Consequently, a substantial amount of his prolabium became necrotic. After a preoperative orthodontic realignment of the cleft segments, a secondary lip/nose repair was performed. The mucosa was reconstructed by advancement flaps. The orbicularis muscle was dissected out from its abnormal insertion and reconstructed in the midline. The philtrum was reconstructed with a full-thickness skin graft from the right postauricular area. The six-month postoperative result was satisfactory. This technique could be considered as an alternative to primary Abbé flap in secondary reconstruction of the cleft lip, although long-term follow-up must be obtained.

Cleft Lip↗
PubMed1999

Cleft of the lip and palate in twins.

BACKGROUND: Cleft lip and palate is one of the most common congenital anomalies in Taiwan. Its etiology remains unknown for the majority of the patients. The study of twins is a classic method for evaluating the relative roles of genetic and environmental factors in the formation of the anomaly. METHODS: In this study, 37 pairs of twins and one set of triplets with cleft lip and palate were evaluated. Clinical data were collected for zygosity determination and analysis of etiologic factors. The concordance rate and heritability index were assessed. RESULTS: The results showed that the concordance rate was 26% for all twins and 57% among the monozygotic pairs, which is higher than those rates for the Caucasian population. The heritability index was 53%, higher than the other reports as well. The influence of the environment could not be ruled out. CONCLUSION: The results confirm a strong genetic role in the etiology of clefts in our patients. Environmental factors were acting as well. The findings in this study support the multifactorial threshold model in the development of cleft lip and palate.

Adolescent↗
PubMed1999

Prosthetic reconstruction in the cleft lip and palate patient with an extracoronal resilient attachment retained removable partial overdenture: case report.

There are still some difficulties in prosthetic reconstruction of cleft lip and palate patients with conventional prostheses or implant retained prostheses. The most common difficulties are insufficient alveolar bone quality and quantity, inadequate soft tissue, and abutment teeth. The patient we report on was a 23-year-old man with a clinical diagnosis of right incomplete cleft lip and palate combined with midface dysplasia. The maxillary six anterior teeth were reconstructed. The maxillary right central incisor and canine were used as abutments for an extracoronal resilient attachment (ERA) retained removable partial overdenture. The STERN ERA SYSTEM is a hinged resilient attachment with an ideal stress breaking characteristic, a good retentive function, and easy chairside replacement. The 2-year follow-up examination revealed an adequate esthetic appearance with good retention and stability of the prosthesis. A removable partial overdenture using the teeth adjacent to the cleft area as abutments with an adequate attachment design is an alternative method for prosthetic reconstruction of cleft lip and palate deformity.

Adult↗
PubMed1999

Prevention and detection of lip cancer--the dentist's role.

With their attention to the oral area, dentists are in an excellent position not only to diagnose lip cancer, but also to counsel patients in its prevention. Patients need to be educated on the dangers of ultraviolet radiation and the measures available to decrease exposure to it. This article discusses the circumstances that increase the chance of developing lip cancer, the variety of ways to decrease that chance, and the recognition and treatment of premalignant and malignant lip lesions.

Dentists↗
PubMed1975

The effects of clefting on crown-root length, eruption, height and weight in twins discordant for cleft of lip and/or palate.

Within-twin differences for crown-root length and eruption of the mandibular buccal teeth were examined for 14 DZ and 14 MZ like-sexed twins discordant for cleft of lip and/or palate. The differences were found to be greater between DZ twins than between MZ and seldom statistically significant. Relatively large variances associated with the differences are attributed to widely varying levels of postnatal care for this sample. The within-twin differences were also analyzed according to type of cleft. Cleft of lip only was found to have a lesser effect on root-crown length and percent eruption differenes than cleft or palate (or cleft of lip and palate) although again not a statistically significant difference. Height and weight were found to follow a similar pattern including large variances associated with the within-twin differences. It is therefore concluded that a dysmorphogenic effect of clefting on crown-root length, eruption, height and weight cannot be demonstrated in this sample because of large associated variances due in turn to varying levels of post-natal health care and multiple other aspects of the syndrome.

Adolescent↗
PubMed1976

Secondary correction of nasal abnormalities associated with cleft lip.

Approximately 30% of patients will require a second operation for correction of nasal abnormalities associated with unilateral cleft lip. In a single second operation, the following steps seem to give the most satisfactory correction: repositioning the nasal septum in the midline; altering the contour of the alar cartilage on the cleft side; and rotation of the axis of the external naris on the cleft side. The usual result following this combination of procedures is moderate but not complete correction of the abnormality. About 50% of the patients will need a second operation for correction of nasal abnormalities associated with bilateral cleft lip. Satisfactory correction of the bilateral cleft lip nasal deformity is usually obtained by lengthening the columella (which secondarily corrects a flat nasal tip) and narrowing the width of the nose at the level of the alae. Satisfactory restoration to normal is usually obtained by the aforementioned procedure.

Cleft Lip↗
PubMed1975

[Oblique oval deformation of the upper dental arch and arciform deviation of the face in unilateral cleft lip].

Abnormal muscular equilibrium due to unilateral cleft-lip is responsable for deviation of the center of the face and of the outline of the upper lip towards the healthy side. This deviation is constant but is variable in intensity. By taking precautions in the neonate it can be attenuated, particularly by orientation of the bottle. The degree of perfection of muscular suturing in the region of the nasal threshold is the basis of reestablishment of early normal muscular equilibrium. The quality of the primary treatment decreases the degree of importance of facial sequelae but risks aggravating the contraction of the upper lip if not followed-up pre- and post-operatively with orthodontic treatment.

Cleft Lip↗
PubMed1976

Facial and dental relationships of individuals with unoperated clefts of the lip and/or palate.

Twelve individuals with unoperated unilateral clefts of the lip and palate and eight with unoperated unilateral clefts of thelip and alveolus were examined clinically and cephalometrically. The two groups were compared to each other and to a matched sample of normal individuals. All subjects were examined in their native India. Based on the findings of this investigation, it is suggested that, in general, the cranial base and skeletal face are not extensively malrelated in individuals with either unoperated unilateral clefts of the lip and palate or of the lip and alveolus when compared to matched normals. Yet, there are distinct differences in dentoalveolar and skeletal relations between both cleft groups and normals and between the two cleft groups.

Alveolar Process↗
PubMed1976

Treatment principles for the changing arch form in children with complete unilateral cleft lips and palates.

Data on maxillary growth for 62 normal and 87 complete unilateral cleft lip and palate subjects presented in 1975 is supplemented and extended. The children ranged in age from six months to four years and were evaluated at four developmental stages. In order to clarify the character of the maxillary arch deformity, measurements of depth, width, height, and length were made and analyzed statistically. Prior to lip repair, cleft and normal subjects showed similar patterns of maxillary growth. This similarity was not apparent by age two. Anterior-posterior growth inhibition of the maxilla appeared to occur after lip repair and to remain a problem by age four. The authors discuss possible ways of minimizing these differences by management techniques.

Alveolar Process↗