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PubMed2003

Facial growth and development during the pubertal period in patients with complete unilateral cleft of lip one palate.

The study is based on a long-term cephalometric follow-up of lateral X-ray films of 48 boys with complete unilateral cleft lip and palate during puberty. The configuration of the face was negatively influenced by the reduced depth of the maxilla and limited vertical growth of the upper lip. As compared with the mandible, the maxilla grew less harmoniously in many respects; on the soft profile the depth of the nose increased most intensely. Retrusion of the maxilla led to a deterioration of sagittal intermaxillary relations in almost 92% of patients. In 32% of these patients the deterioration exceeded 3 of the ANB angle, and in 27% a transition from the 1st to the 3rd skeletal class was recorded. 25% of the subjects already belonged in class III at the age of ten years. In 94% of patients during puberty, flattening of the face occurred, which was frequently associated with a sunken upper lip (63%). Due to successful orthodontic treatment it was possible to restore maxillary overjet in 46% of the patients. In subjects who had a maxillary overjet of at least 2 mm at the age of 10 years, it did not change to negative values by the age of 15 years. Patients with more severe impairment of the jaws were treated more frequently by means of fixed appliances, but they did not differ substantially from the other patients in their further development (with the exception of a significant anteinclination of the palate).

Adolescent↗

PubMed1992

Age-dependent changes in the size of the upper lip in Bulgarians.

Age-dependent changes in the width and height of the upper lip were studied in 2,300 healthy Bulgarians aged from 3 days to 102 years, for the purposes of cheiloplasty in surgery and of visual art. It has been established that at the moment of birth, the upper lip is one of the most developed organs of the human body in both sexes and that it grows in size up to the age of 80 years, completing its intensive growth during the pre-school age while in the years of puberty it does not show the growth jump characteristic of the organism as a whole. In the males, the lip remains larger during the whole period of postnatal ontogenesis except for the early childhood; the difference in the height is most expressed (3.08 mm) in the 9th decade, and in the width (5.24 mm) even later. The conclusion has been drawn that cheiloplasty can be performed at any age including the first days after birth, the dimensions obtained at the age intervals under study serving as standards.

Adolescent↗

PubMed1992

Growth and development of the face in complete unilateral cleft lip and palate during prepubertal and pubertal periods.

Roentgencephalometry was used for the assessment of the growth and development of the face during prepubertal and pubertal periods in children with complete unilateral cleft lip and palate treated with the same methods. The first series included 16 boys and 15 girls, the second series consisted of 15 boys and 15 girls examined repeatedly at the beginning and at the end of the follow-up period. There were no definite differences in the growth rate of the face between the two periods of age. Therefore, the deterioration of overjet during puberty could be due to the depletion of the compensation and adaptation mechanisms after the previous orthodontic treatment rather than to the enhanced growth rate. As compared to other facial dimensions a lower growth rate showed during both periods the length of the anterior base, the depth of the maxilla and in particular the height of the upper lip. Developmental changes of variables of shape and position proceeded similarly during both periods of age. An exception represented the rotation of the mandible and the inclination of upper incisors. During the prepubertal period the lower jaw showed a very slight posterior rotation, while during puberty an anterior growth rotation was present. A rapid improvement of the proclination of upper incisors was attained only during the prepubertal period. It was accompanied by an improvement of overjet. However, during the period of puberty there was a renewed deterioration of overjet. A marked retrusion of the maxilla developed already in the prepubertal period. During both periods occurred an identical impairment of sagittal jaw relations and of the upper lip prominence, accompanied by a flattening of the facial profile and reduction of the nasolabial angle. The prominence of the nose increased, the angle of the cranial base remained unchanged. Intersexual differences were not demonstrated in any studied characteristics.

Adolescent↗

PubMed1952

Excision of precancerous lesions of the lip.

A method of surgical treatment of precancerous lesions of the lip, by excision of the vermilion border and the advancement of the inner mucosa of the lip to cover the defect, satisfactorily removes the entire lesion and restores normal tissue to the lip surface.

Humans↗

PubMed1977

[Corrective operation of the upper lip-columella-region after closure of bilateral clefts (author's transl)].

For the correction of the retracted upper lip and columella after bilateral cleft-operations we use a submental hairbearing flap which cut as a narrow stripe of skin and subdermal tissue and autonomised is swung to the upper lip. The defect to cover results after circumcision of the scarred middle part of the upper lip used as the lower portion of the shortened columella. This method has been used with good results in 4 cases, 3 men and 1 woman.

Adult↗

PubMed1992

Densitometric evaluation of changes in the soft tissue of the chin and the lower lip during the treatment of Class III malocclusion.

The aim of this study was to use densitometry of lateral skull teleradiographs to evaluate the changes that occurred in the lower lip and chin after orthodontic or orthodontic-surgical treatment of Class III malocclusion. Forty teleradiographs from 20 patients with mandibular prognathism were made at the beginning and end of treatment. In ten of these patients the treatment was exclusively orthodontic with an edgewise appliance, and in another ten the treatment was orthodontic with a straight wire appliance combined with orthognathic and mentoplastic surgery. In the patients who were only treated orthodontically, a significant increase in density of the lower lip and the chin was found after treatment. This seemed to be related to an increase of muscular tension in these areas. Patients treated with orthognathic surgery and the straight wire appliance showed a decrease in density of the chin after treatment, but not of the lip. This can be interpreted as a consequence of muscular normalization after this procedure was accomplished.

Absorptiometry, Photon↗

PubMed2003

[Sentinel node radiolocalisation and predictive value in lip squamous cell carcinoma].

PURPOSE: Is to evaluate the role of the sentinel node (SN) radiolocalisation and its prognostic value in state T2N0M0 squamous cell carcinomas (SCC) of the lip. MATERIALS AND METHODS: Between November 1999 and June 2002 we enrolled 11 consecutive patients (8m,3f) affected with lower lip SCC (7 pts.), labio-commissure (3 pts.) and upper lip (1 pt). Lymphoscintigraphy was performed three hours before surgery. After topical anaesthesia (Lidocaine spray 10%), 30-50MBq of Nanocoll-Tc99m diluted in a 0.3 ml physiological solution was injected intradermally, divided into two peri-lesional points. Planar static acquisition began immediately after the injection in order to visual lymph drainage pathways (lateral and/or anterior view, 512x512 matrix, 5 min. pre set time, LEGP collimator). All patients underwent only selective lymph adenectomy of the SN. RESULTS: SN were visible in all patients within 5 minutes after the injection. In all patients the SNs were observed in the submandibular area (I neck level) in three patients a second SN was localized in latero cervical area (II neck level). All patients were staged SN negative. The average disease free interval for patients who underwent a selective lymph adenectomy of the SN was 20 months with continuing follow-up. CONCLUSIONS: We must stress the importance of performing an immediate exploratory dynamic or static scintigraphy within the first minutes of the radio tracer injection, in order to acquire a precise SN localisation and an accurate mapping of the tumour lymphatic pathways. SN radio localisation is especially beneficial in T2N0 stage patients where immediate lymphadenectomy is not necessary. It also saves time and cuts costs, which are specific goals in the current climate of health service management. Although our results are encouraging, a larger data base from multi centre trials with a five year follow-up would confirm the validity of our approach.

Carcinoma, Squamous Cell↗

PubMed1977

[Plastic surgery in unilateral cleft lip].

The result of cleft lip operations is judged after the external image, the complet function of circular muscle system and the unfoldable vestibulum oris. The MILLARD-plastic for wide cleft lips and the REICHERT-plastic with the own modification for narrow cleft lips are for the time the optimal methods of operation.

Cleft Lip↗

PubMed2003

[The monitoring of cleft lip with or without cleft palate in China: 1996 - 2000].

OBJECTIVE: To describe the epidemiological features of cleft lip with or without cleft palate (CL +/- P) in Chinese perinatals. METHODS: From 1996 through 2000, hospital-based cluster sampling method was adopted for collecting data. During that period all live or still births with 28 weeks of gestation or more delivered in monitoring hospitals were assessed within 7 days after birth. RESULTS: The birth prevalence rates of cleft lip (CL) and of cleft lip with cleft palate (CLP) were 5.03/10,000, 8.97/10,000 respectively, then the rate of CL +/- P was 14.0/10,000. The prevalence rates in urban and rural area, in male and female births were 13.28/10,000 and 15.57/10,000, 16.06/10,000 and 11.40/10,000 respectively. Significant difference was found among maternal-age-specific prevalence rates, and the highest one was observed in >or= 35 maternal age group. 87.25% of CL +/- P was isolated forms. No secular trend was found during that period. The perinatal fatality rate of CL +/- P was 19.04%, and the rate in isolated forms was 12.69%, but the rate in syndromic CL +/- P was as high as 62.60%. CONCLUSIONS: No decline trend in prevalence rate of CL +/- P was observed during 1996 approximately 2000. Compared with prevalence rates of CL +/- P in some foreign countries, it was higher in China during same period.

Adult↗

PubMed2004

[Effects of thermochemotherapy on immunologic function of patients with lip cancer].

OBJECTIVE: To evaluate the effects of thermochemotherapy on the immunologic function of lip cancer patients and to provide a theoretical basis for the clinical application of thermochemotherapy. METHODS: Twenty patients were heated by microwave at (42.5 +/- 0.2) degree C for 40 minutes after venoclysis of Pingyangmycin (8 mg) and Methotrexate (20 mg). Each of the patients received the therapy twice a week for 5 weeks. Venous blood was obtained before the first thermochemotherapy and after the tenth thermochemotherapy. Lymphocyte transformation index was examined by 3H-TdR method, and CD4+ and CD8+ T cells were assayed by flow cytometry. RESULTS: The tumors of the 20 patients were completely extinctive. The lymphocyte transformation index after treatment was significantly higher than that before treatment (P < 0.01). The CD4+ T cells and CD4+/CD8+ after treatment were significantly higher than those before treatment (P < 0.05); the CD8+ T cells after treatment was lower than that before treatment, but there was no statistically significant difference (P > 0.05). CONCLUSION: Thermochemotherapy can enhance the lip cancer patient's T lymphocyte immunologic function, which possibly plays an important role in the treatment of lip cancer.

Aged↗

PubMed2004

[The effect of pre-surgical orthodontics on secondary alveolar bone grafting in the patients with complete cleft lip and palate].

OBJECTIVE: To examine the effect of pre-surgical orthodontics on the outcome of the secondary alveolar bone grafting in the patients with complete cleft lip and palate. METHODS: Sixteen complete cleft lip and palate patients (9 males and 7 females) with collapsed upper arch or severe mal-positioned upper incisors were selected. The cleft was not easily grafted because of the poor access. The total cleft sites were 22 (10 patients with UCLP and 6 patients with BCLP). The age range of the patients was from 8 to 22 years. Pre-surgical orthodontic treatment was mainly to expand the collapsed upper arch and correct the mal-positioned upper incisors. After the secondary alveolar bone grafting, the patients were followed up and anterior occlusal radiograph/intraoral panograph were taken regularly. The observation period was from 6 months to 4 years. Bergland criteria were used to evaluate the interdental septal height. RESULTS: Upper arch expansion and the correction of the mal-positioned upper incisors done by the orthodontic treatment made the bone grafting procedure easier. The clinically successful rate reached 86%. CONCLUSION: The severe upper arch collapse and mal-positioned upper incisors in the patients with complete cleft lip and palate should be corrected orthodontically before the secondary alveolar bone grafting.

Abnormalities, Multiple↗

PubMed2001

Surgical treatment of squamous cell carcinoma of the lower lip.

INTRODUCTION: A controversy still exists regarding the preferable mode of treatment - surgical treatment or radiotherapy of 1st stage squamous cell carcinoma of the lower lip. That is why we have set as a PURPOSE: To compare the two methods of treatment and to propose a therapeutic approach. METHODS: A retrospective longitudinal study of patients with squamous cell carcinoma (SCC) of the lower lip from three regions in South Bulgaria (Plovdiv, Pazardjik and Smolian), who have been treated primarily with surgical operation (n=184) or by radiotherapy (n=592) was performed. RESULTS: Following up 184 patients who have undergone surgical treatment (vermilionectomy) as a primary therapeutic method for a period of 15 years, we have observed favourable results in 92.5% of the cases (n=170). We found local recurrences in 3.1% of the cases (n=6) and regional lymph-node metastases in 4.4% of the cases (n=8). Five-year overall survival rates was 81% and 10-year survival rates - 64%. The corresponding relapse-free five-year survival was 89% and ten-year survival - 82%. The results from the 592 patients treated with radiotherapy are: therapeutically cured - 90.5% of the cases (n=536), local recurrences - 4.3% of the cases (n=25) and regional lymph-node metastases (n=31.) CONCLUSIONS: Vermilionectomy is a suitable method for surgical treatment of 1st-stage SCC of the lower lip with a thickness of the tumour up to 3 mm and a size of the primary tumour up to 1.5 cm.

Carcinoma, Squamous Cell↗

PubMed2004

[Cleft palate and cleft lip. Clinical review].

UNLABELLED: The aim of this study is to do an analytical study of cleft palate and cleft lip in our hospital. PATIENTS AND METHODS: 85 clinical charts of patients attended in our hospital born between 1976 and 2001 in Aragon and Rioja were reviewed. We studied the incidence of oral cleft, associated malformations and morbidity, familial antecedents and perinatal data, phonatory disfunctions, serose otitis, growth failure and psychiatry problems. RESULTS: The mean incidence was 0.5/1000 newborns. 41.5% presented associated malformations and 19.3% were associated with a specific syndrome, being more frequent in patients affected of cleft palate and cleft lip (50%) than patients with only cleft palate (41.2%) or only cleft lip (8.8%). The most frequent malformations were: facial defects (50%), skeletal (33%), congenital cardiopathies (33%). 19% were born prematurely. The percentage of serose otitis that required control at hospital was 37.3%. 34.2% presented phonatory problems. There was a high incidence of growth failure and psychiatry problems. CONCLUSION: Oral clefts represent a complex clinical condition with a high percentage of medical complications that require a multidisciplinary treatment. The high incidence of congenital defects associated with this condition demand an exhaustive screening in the newborns affected.

Abnormalities, Multiple↗

PubMed2004

Retrospective revelations: twenty orthodontically treated individuals with unilateral cleft lip and palate.

AIM: Twenty patients with unilateral cleft lip and palate, orthodontically treated from the full primary or early transitional dentition stages until retention and dismissal, were recalled later in adult life to evaluate the status of their occlusion and facial appearance. METHODS: Cephalometric radiographs, photographs, and casts were attained as final records. In several instances, final records were obtained by orthodontic colleagues at the patient's current residence. Evaluation of the longitudinal records provided retrospective insight pertinent to the growth and positional relationships of the jaws' contiguous structures and the dentition. RESULTS: Orthodontic results are linked with observations related to the nasomaxillary complex: the anterior cranial base, tissue deficiency, the maxillary and mandibular dentition, and time modifications in skeletal facial growth. At adult ages, the patients with unilateral cleft lip and palate had acceptable facial profiles and acceptable alignment of the anterior dentition. Variances noted in mandibular pattern of growth explain attainment of acceptable relationships. In many cases, tissue deficiency in the anterior cleft region was compensated for with fixed partial dentures and removable prosthetic appliances. Posterior crossbites, although few in number, were proportionately more prevalent in this unilateral cleft lip and palate patient population than was anticipated; possible reasons are presented, taking into consideration congenital contingencies and therapeutic overlays.

Adult↗

PubMed2004

[Usefulness a buccal flaps for reconstruction tissue defects after operations cancers lip and nose].

The aim of this study was to describe methods in tissue reconstruction deficiences after operations due to upper and lower lip and nose cancer with using full thickness (musculomucosal cutaneus flap) and incomplete buccal flap (musculocutaneus). Flaps were collected bilaterally and sutured in the middle of the lips. Their usefulness was confirmed especially in total lip reconstruction.

Aged↗

PubMed2005

[Reconstruction of total lower lip or corner of mouth defects with forearm free flap suspending over fascia: report of 10 cases].

PURPOSE: To improve the contour and function of the lip and its commissure with forearm free flap suspending over fascia. METHODS: Since 2001,this method was used in 10 cases. Forearm free flap was designed according to the lip or buccal defects, then the defects were reconstructed with the flap through vascular anastomosis. The skin island for reconstruction of the intraoral lining and the skin defect was folded over the palmaris longus tendon or fascia lata. RESULTS: All the patients were followed-up for 2 years, the survival rate of the free flap was 100%, 2 patients had oral incompetence, the others had good oral function and sufficient oral competence. The flaps were helpful to expression of motion. CONCLUSION: Reconstruction of total lower lip or corner of mouth defects with forearm free flap suspending over fascia was helpful for rehabilitation of contour and oral function.

Fasciotomy↗

PubMed2005

[Combined local block anesthesia and general anesthesia in cleft lip repairing operation of infants].

OBJECTIVE: Summarizing the value and key point of combined use of local block anesthesia and general anesthesia in cleft lip repairing for infants. METHODS: Local block anesthesia and general anesthesia were combined to use in 120 cleft lip repairing operation of infants using Midazolam, Fentangl, Ketamine, Scoline (or Vecuronium) in intubation, and injecting 0.5% - 1% lidocaine of which contained 1/250 000 adrenalinum. While intubation and operation, BP, P, R, SpO2, T and ECG were observed clearly. After operation, extubation was delayed and breathing oxygen was used for infants with breathing airway infection. RESULTS: While operation, anesthesia of 120 infants was smooth. After operation, the infants regain conscious quickly and no accident occurred. CONCLUSION: For the cleft lip repairing operation to infants, as combined use of local block anesthesia and general anesthesia, anesthesia is smooth, internal environment of body is steady, bleeding is little, regaining consciousness is quick and the infants are safe.

Anesthesia↗

PubMed2005

[The effect of maxillary and mandibular lip bumper on teeth and dental arch in late mixed dentition].

PURPOSE: To study the effect of maxillary and mandibular lip bumper on tooth and dental arch in late mixed dentition. METHODS: Twelve subjects with mild or moderate crowding were selected. They were treated with maxillary and mandibular lip bumper for eight months. Analysis of cephalometrics and model measurements were done before and after treatment and paired t test were performed respectively for their changes. RESULTS: After treatment, SNA and SNB increased by 1.02 degrees and 0.97 degrees (P<0.05). Upper and lower incisor both had controlled tipping movement. The crown of incisor moved mesially and had root apex were fixed relatively. The center of rotation was close to root apex. The upper and lower molar moved differently. Upper molar was upright distally and the center of rotation was close to the crown. However, the lower molar tipped distally and the center of rotation was close to the center of resistance.The width between the first molars and length of maxillary dental arch increased by 4.12 mm and 5.09 mm (P<0.01). The width between the first molars and length of mandibular dental arch increased by 4.07 mm and 6.86 mm (P<0.01) CONCLUSION: Clinical application of lip bumper could cause transverse and vertical changes in dental arch ,which help to decrease or remove crowding.

Dental Arch↗