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Philip Kuo Ting Chen - One of the best experts on this subject based on the ideXlab platform.

  • surgical outcomes of secondary Alveolar Bone Grafting and extensive gingivoperiosteoplasty performed at mixed dentition stage in unilateral complete cleft lip and palate
    Journal of Clinical Medicine, 2020
    Co-Authors: Yuying Chu, Frank Chunshin Chang, Chehsiung Lee, Philip Kuo Ting Chen
    Abstract:

    Secondary Alveolar Bone Grafting (SABG) is associated with donor site morbidities. We aimed to compare the outcomes of SABG and extensive gingivoperiosteoplasty (EGPP) at the mixed dentition stage. This single-blinded, randomized, prospective trial enrolled 50 consecutive patients with unilateral complete cleft lip and palate who had residual Alveolar Bone cleft, of which 44 (19 SABG, 25 EGPP) completed the study. Bone volumes before surgery, 6 months postoperatively, and 1-year postoperatively were compared using computed tomography. The Bergland scale score was recorded at 6 months postoperatively. Both groups had the same preoperative Alveolar cleft volume. On the Bergland scale, 21, 3, and 1 patient in the EGPP group and 16, 2, and 1 patient in the SABG group were classified as types I, II, and IV, respectively, which did not show significant difference. With perioperative orthodontic treatment, the 1-year residual Bone defect volume in both groups did not show significant difference (SABG 0.12 cm3 vs. EGPP at 0.14 cm3, p > 0.05). The study was not able to reveal much difference between SABG and EGPP combined with perioperative orthodontic treatment.

  • patient and parent reported outcome measures in cleft lip and palate patients before and after secondary Alveolar Bone Grafting
    Medicine, 2017
    Co-Authors: Chun Shin Chang, Philip Kuo Ting Chen, Christopher Glenn Wallace, Yen Chang Hsiao, Suehuei Chen, Fuan Chiang Chan, Jyhping Chen, Cheejen Chang, Samuel M Noordhoff
    Abstract:

    European and Northern American healthcare authorities increasingly encourage the use of Patient Reported Outcome Measures (PROMs) that complement clinical and laboratory assessments to help holistically evaluate reconstructive outcomes. This is the first study to evaluate PROMs in cleft lip/palate patients who have, or have not, undergone secondary Alveolar Bone Grafting (SABG).A PROMs study was conducted; 40 consecutive consenting cleft lip/palate children between 8 and 14 years old were included. Twenty patients did, and 20 patients did not, have SABG. PROMs scores from children and parents in the 2 groups were compared.Forty patients completed the trial. No significant differences in total score from the Chang Gung Short Form-15 (CGSF-15) were found between children and their parents. Children with SABG reported no more oral-nasal regurgitation than children without SABG, but tended to report more nasal obstruction. There were no statistically significant differences in parent reported outcomes between the 2 groups.Cleft lip/palate patients who underwent SABG reported significantly less nasal regurgitation and more nasal obstruction compared to those patients who did not undergo SABG.

  • comparative outcomes of primary gingivoperiosteoplasty and secondary Alveolar Bone Grafting in patients with unilateral cleft lip and palate
    Plastic and Reconstructive Surgery, 2016
    Co-Authors: Yi Chin Wang, Yu Fang Liao, Philip Kuo Ting Chen
    Abstract:

    BACKGROUND The role of primary gingivoperiosteoplasty in the repair of Alveolar clefts remains controversial. The aim of this study was to compare the outcomes of primary gingivoperiosteoplasty and secondary Alveolar Bone Grafting in patients with unilateral cleft lip and palate. METHODS In this prospective study, the authors analyzed the postoperative cone-beam computed tomographic scans of 50 children with complete unilateral cleft lip and palate who underwent primary gingivoperiosteoplasty (n = 25) or secondary Alveolar Bone Grafting (n = 25). These two methods of Alveolar repair were compared by measuring residual cleft defect and unsupported root ratio of cleft-adjacent central incisors on patient scans. RESULTS Patients who underwent repair by primary gingivoperiosteoplasty presented more need for additional Bone Grafting than those undergoing repair by secondary Alveolar Bone Grafting (28 percent versus 4 percent, respectively; p < 0.05). Residual cleft defect was greater in patients who underwent repair by primary gingivoperiosteoplasty than by secondary Alveolar Bone Grafting (305.8 ± 176.5 mm versus 178.6 ± 122.0 mm, respectively; p < 0.05). Patients who underwent repair by primary gingivoperiosteoplasty showed more residual palatal coronal and palatal apical defects than those who underwent repair by secondary Alveolar Bone Grafting (p < 0.05 and p < 0.001, respectively). CONCLUSIONS In patients with unilateral cleft lip and palate, primary gingivoperiosteoplasty can achieve 72 percent success. Primary gingivoperiosteoplasty results in less Bone than secondary Alveolar Bone Grafting, particularly on the palatal apical portion of the previous Alveolar cleft. Clinical success is lower with primary gingivoperiosteoplasty than with secondary Alveolar Bone Grafting. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.

  • orthopedic intrusion of premaxilla with distraction devices before Alveolar Bone Grafting in patients with bilateral cleft lip and palate
    Plastic and Reconstructive Surgery, 2004
    Co-Authors: Eric J W Liou, Philip Kuo Ting Chen, Shing C Huang, Ray Y Chen
    Abstract:

    Surgical repositioning of the downward displaced premaxilla in bilateral cleft lip and palate patients remains a controversial and perplexing issue because of its detrimental effects on the growth of the premaxilla. The purpose of this prospective clinical study was to introduce and evaluate the treatment results of an innovative technique for nonsurgically intruding the downward displaced premaxilla. Eight consecutive cases of bilateral cleft lip and palate at the age of mixed dentition were included for the correction of their premaxillary deformities. A pair of intraoral tooth-borne distraction devices was used for the orthopedic intrusion. Serial lateral and posteroanterior cephalometric radiographs were taken periodically for evaluating the growth of the premaxilla 1 year before the intrusion, changes during the intrusion, and growth/relapse up to 1 year after the intrusion. There was no overgrowth of the premaxilla or overeruption of the maxillary incisors during the 1-year observing period before the orthopedic intrusion. The treatment results revealed that the downward displaced premaxillae were all corrected within 1 month. Cephalometrically, 46 percent of the correction resulted from a true orthopedic intrusion and another 54 percent from a dentoAlveolar effect in which the maxillary incisors were intruded and the premaxillary dentoalyeolus was shortened. The cephalometric evaluations also implied that what occurred during the orthopedic intrusion was mostly the sutural contraction osteogenesis/osteolysis in the vomeropremaxillary suture combined with slightly mechanical upward displacement of the vomeronasla septum complex and nasal Bones. The orthopedic intrusion of the pretitaxilla with distraction devices is an effective nonsurgical method for collecting the downward displaced premaxilla before Alveolar Bone Grafting in patients with bilateral cleft lip and palate, and the results remained stable after 1 year.

Thikriat Aljewair - One of the best experts on this subject based on the ideXlab platform.

Letizia Perillo - One of the best experts on this subject based on the ideXlab platform.

  • secondary Alveolar Bone Grafting using autologous versus alloplastic material in the treatment of cleft lip and palate patients systematic review and meta analysis
    Progress in Orthodontics, 2019
    Co-Authors: A Scalzone, Carlos Floresmir, D Carozza, Fabrizia Dapuzzo, Vincenzo Grassia, Letizia Perillo
    Abstract:

    A systematic review assessing autologous versus alloplastic Bone for secondary Alveolar Bone Grafting in patients with cleft lip and palate was published in 2011 and included only one randomized controlled trial comparing traditional iliac Bone graft to recombinant human Bone morphogenetic protein-2 (rh-BMP2). To perform a systematic review with meta-analysis on the use of secondary Alveolar Bone Grafting (autologous Bone and rh-BMP2 graft) in order to improve Bone volume and height in patients with cleft lip and palate. An electronic search was conducted via PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CONTROL) via Cochrane Library, EMBASE via Ovid, and LILAC for studies published between January 2008 and September 2018. The systematic review registration number at PROSPERO was 42018085858. Only RCTs were included. Inclusion criteria were patients with the diagnosis of unilateral cleft lip and palate older than 5 years of age, radiographic evaluation (CT and/or CBCT) of the cleft area, and at least a 6-month follow-up. Bone formation and Bone height by radiographic CT evaluation (preoperatively, after 6 months and after 1 year of follow-up) and length of hospital stay were assessed. Four studies met strict inclusion criteria. Autologous Bone graft showed statistically significant higher Bone formation after 6-month follow-up (MD − 14.410; 95% CI − 22.392 to − 6.428; p = 0.000). No statistically significant difference was noted after a 1-year follow-up (MD 6.227; 95% CI − 15.967 to 28.422; p = 0.582). No statistically significant difference in Bone height was noted after 6-month (MD − 18.737; 95% CI − 43.560 to 6.087; p = 0.139) and 1-year follow-up (MD − 4.401; 95% CI − 30.636 to 21.834; p = 0.742). Patients who underwent rh-BMP2 graft had a statistically significant reduced hospital stay (MD − 1.146; 95% CI − 2.147 to − 0.145; p = 0.025). The main limitation is the high risk of bias among included studies. Autologous Bone and rh-BMP2 graft showed a similar effectiveness in maxillary Alveolar reconstruction in patients with unilateral cleft lip and palate assessing Bone graft volume and height although rh-BMP2 graft showed a relative shorter length of hospital stay (high uncertainty level).

  • Secondary Alveolar Bone Grafting using autologous versus alloplastic material in the treatment of cleft lip and palate patients: systematic review and meta-analysis
    SpringerOpen, 2019
    Co-Authors: A Scalzone, D Carozza, Vincenzo Grassia, C. Flores-mir, F. D’apuzzo, Letizia Perillo
    Abstract:

    Abstract Background A systematic review assessing autologous versus alloplastic Bone for secondary Alveolar Bone Grafting in patients with cleft lip and palate was published in 2011 and included only one randomized controlled trial comparing traditional iliac Bone graft to recombinant human Bone morphogenetic protein-2 (rh-BMP2). Objectives To perform a systematic review with meta-analysis on the use of secondary Alveolar Bone Grafting (autologous Bone and rh-BMP2 graft) in order to improve Bone volume and height in patients with cleft lip and palate. Data sources An electronic search was conducted via PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CONTROL) via Cochrane Library, EMBASE via Ovid, and LILAC for studies published between January 2008 and September 2018. The systematic review registration number at PROSPERO was 42018085858. Eligibility criteria Only RCTs were included. Inclusion criteria were patients with the diagnosis of unilateral cleft lip and palate older than 5 years of age, radiographic evaluation (CT and/or CBCT) of the cleft area, and at least a 6-month follow-up. Main outcome measures Bone formation and Bone height by radiographic CT evaluation (preoperatively, after 6 months and after 1 year of follow-up) and length of hospital stay were assessed. Results Four studies met strict inclusion criteria. Autologous Bone graft showed statistically significant higher Bone formation after 6-month follow-up (MD − 14.410; 95% CI − 22.392 to − 6.428; p = 0.000). No statistically significant difference was noted after a 1-year follow-up (MD 6.227; 95% CI − 15.967 to 28.422; p = 0.582). No statistically significant difference in Bone height was noted after 6-month (MD − 18.737; 95% CI − 43.560 to 6.087; p = 0.139) and 1-year follow-up (MD − 4.401; 95% CI − 30.636 to 21.834; p = 0.742). Patients who underwent rh-BMP2 graft had a statistically significant reduced hospital stay (MD − 1.146; 95% CI − 2.147 to − 0.145; p = 0.025). Limitations The main limitation is the high risk of bias among included studies. Conclusion Autologous Bone and rh-BMP2 graft showed a similar effectiveness in maxillary Alveolar reconstruction in patients with unilateral cleft lip and palate assessing Bone graft volume and height although rh-BMP2 graft showed a relative shorter length of hospital stay (high uncertainty level)

Gunvor Semb - One of the best experts on this subject based on the ideXlab platform.

  • the americleft study an inter center study of treatment outcomes for patients with unilateral cleft lip and palate part 2 dental arch relationships
    The Cleft Palate-Craniofacial Journal, 2011
    Co-Authors: Ronald R Hathaway, John Daskalogiannakis, Gunvor Semb, Kathleen Russell, Ana Mercado, Ross E Long, Marilyn Cohen, W C Shaw
    Abstract:

    OBJECTIVE: To compare maxillomandibular relationships for individuals with nonsyndromic complete unilateral cleft lip and palate using the Goslon Yardstick for dental models. DESIGN: Retrospective cohort study. SETTING: Five cleft palate centers in North America. SUBJECTS: A total of 169 subjects with repaired complete unilateral cleft lip and palate who were consecutively treated at the five centers. METHODS: Ethics approval was obtained. A total of 169 dental models of patients between 6 and 12 years old with complete unilateral cleft lip and palate were assessed using the Goslon Yardstick. Weighted kappa statistics were used to assess intrarater and interrater reliabilities; whereas, analysis of variance and Tukey-Kramer analysis was used to compare the Goslon scores. Significance levels were set at p < .05. RESULTS: Intrarater and interrater reliabilities were very good for model ratings. One center that incorporated primary Alveolar Bone Grafting showed especially poor Goslon scores that were significantly poorer than the remaining centers. The surgery protocols used by the other four centers did not include primary Alveolar Bone Grafting but involved a number of different lip and palate closure techniques. Using the Goslon Yardstick assumptions, the center with the best scores would be expected to require end-stage maxillary advancement orthognathic surgery in 20% of its patients; whereas, the center with the worst scores would be likely to require this surgery in 66% of its patients. CONCLUSIONS: The Goslon Yardstick proved capable of discriminating among the centers' dental arch relationships. Possible explanations for the differences are discussed.

  • the americleft study an inter center study of treatment outcomes for patients with unilateral cleft lip and palate part 2 dental arch relationships
    The Cleft Palate-Craniofacial Journal, 2011
    Co-Authors: Ronald R Hathaway, John Daskalogiannakis, Gunvor Semb, Kathleen Russell, Ana Mercado, Ross E Long, Marilyn Cohen, W C Shaw
    Abstract:

    Objective: To compare maxillomandibular relationships for individuals with nonsyndromic complete unilateral cleft lip and palate using the Goslon Yardstick for dental models. Design: Retrospective cohort study. Setting: Five cleft palate centers in North America. Subjects: A total of 169 subjects with repaired complete unilateral cleft lip and palate who were consecutively treated at the five centers. Methods: Ethics approval was obtained. A total of 169 dental models of patients between 6 and 12 years old with complete unilateral cleft lip and palate were assessed using the Goslon Yardstick. Weighted kappa statistics were used to assess intrarater and interrater reliabilities; whereas, analysis of variance and Tukey‐Kramer analysis was used to compare the Goslon scores. Significance levels were set at p < .05. Results: Intrarater and interrater reliabilities were very good for model ratings. One center that incorporated primary Alveolar Bone Grafting showed especially poor Goslon scores that were signifi...

  • assessment of dental arch relationships in japanese patients with unilateral cleft lip and palate
    The Cleft Palate-Craniofacial Journal, 2006
    Co-Authors: Takafumi Susami, Gunvor Semb, W C Shaw, Yuji Ogihara, Masako Matsuzaki, Miyuki Sakiyama, Tsuyoshi Takato
    Abstract:

    Objective: Evaluation of the dental arch relationships of Japanese patients with unilateral cleft lip and palate (UCLP) from the orthodontic clinic of the University of Tokyo Hospital (UTH) compared with patients treated by the Oslo Cleft Team, Norway. Design: Retrospective study and comparison with previous reports. Materials: Dental models of 24 patients with UCLP in UTH taken before orthodontic treatment and before Alveolar Bone Grafting were included. Surgeons in many hospitals performed primary surgeries. These models were matched for age and gender with 24 models from a consecutive series of patients treated by the Oslo Cleft Team as part of the Eurocran Good Practice Archive. A total of 48 models were evaluated. Main Outcome Measure: Dental arch relationship was rated with the Goslon Yardstick. The strength of agreement of rating was assessed with weighted kappa statistics. Results: Intra- and interexaminer agreements evaluated by weighted kappa statistics were high, indicating good reproducibility. Almost 60% of the patients in UTH were classified into poor or very poor categories, and the mean Goslon score was 3.50. These results show a contrast to those in Oslo and were the poorest in comparison with previous reports. Conclusion: Dental arch relationships in patients with UCLP in UTH were poor. This seemed to be attributable to surgical procedures, but a factor of racial difference in the craniofacial morphology was also considered. Further intercenter research is required to clarify this point.

  • prediction of outcomes of secondary Alveolar Bone Grafting in children born with unilateral cleft lip and palate
    European Journal of Ophthalmology, 2003
    Co-Authors: Alison Williams, Gunvor Semb, David R Bearn, W C Shaw, Jonathan R Sandy
    Abstract:

    The aim of this cross-sectional clinical outcome study using retrospective data capture of treatment histories was to examine the characteristics of children born with unilateral cleft lip and palate (UCLP) in the United Kingdom (UK) who were not grafted at the appropriate age or who had an unsuccessful secondary Alveolar Bone graft. The subjects were born with complete non-syndromic UCLP between 1.4.82 and 31.3.84 and were aged between 12.0 years and 14.7 years at the time of data collection under the care of 48 cleft teams. The success of secondary Alveolar Bone Grafting was assessed using a modification of the Bergland index. There were no independent predictors for unmet Bone Grafting need. The outcome of secondary Alveolar Bone Grafting was assessed for 164 subjects; 90 (55%) had a successful first graft. Non-Caucasian (P = 0.037) and increasing age at Grafting (P = 0.007) were risk factors for poor outcome. After adjustment for other risk factors, increased age at Grafting was independently associated with having a seriously deficient or failed graft (OR = 1.03; 95% CI 1.01-1.06 P = 0.036). All the non-Caucasians in this sample had an unsatisfactory graft. Increasing age in months at Grafting and ethnicity are predictors for poor outcome of secondary Alveolar Bone Grafting in children born with UCLP in the UK.

W C Shaw - One of the best experts on this subject based on the ideXlab platform.

  • the americleft study an inter center study of treatment outcomes for patients with unilateral cleft lip and palate part 2 dental arch relationships
    The Cleft Palate-Craniofacial Journal, 2011
    Co-Authors: Ronald R Hathaway, John Daskalogiannakis, Gunvor Semb, Kathleen Russell, Ana Mercado, Ross E Long, Marilyn Cohen, W C Shaw
    Abstract:

    OBJECTIVE: To compare maxillomandibular relationships for individuals with nonsyndromic complete unilateral cleft lip and palate using the Goslon Yardstick for dental models. DESIGN: Retrospective cohort study. SETTING: Five cleft palate centers in North America. SUBJECTS: A total of 169 subjects with repaired complete unilateral cleft lip and palate who were consecutively treated at the five centers. METHODS: Ethics approval was obtained. A total of 169 dental models of patients between 6 and 12 years old with complete unilateral cleft lip and palate were assessed using the Goslon Yardstick. Weighted kappa statistics were used to assess intrarater and interrater reliabilities; whereas, analysis of variance and Tukey-Kramer analysis was used to compare the Goslon scores. Significance levels were set at p < .05. RESULTS: Intrarater and interrater reliabilities were very good for model ratings. One center that incorporated primary Alveolar Bone Grafting showed especially poor Goslon scores that were significantly poorer than the remaining centers. The surgery protocols used by the other four centers did not include primary Alveolar Bone Grafting but involved a number of different lip and palate closure techniques. Using the Goslon Yardstick assumptions, the center with the best scores would be expected to require end-stage maxillary advancement orthognathic surgery in 20% of its patients; whereas, the center with the worst scores would be likely to require this surgery in 66% of its patients. CONCLUSIONS: The Goslon Yardstick proved capable of discriminating among the centers' dental arch relationships. Possible explanations for the differences are discussed.

  • the americleft study an inter center study of treatment outcomes for patients with unilateral cleft lip and palate part 2 dental arch relationships
    The Cleft Palate-Craniofacial Journal, 2011
    Co-Authors: Ronald R Hathaway, John Daskalogiannakis, Gunvor Semb, Kathleen Russell, Ana Mercado, Ross E Long, Marilyn Cohen, W C Shaw
    Abstract:

    Objective: To compare maxillomandibular relationships for individuals with nonsyndromic complete unilateral cleft lip and palate using the Goslon Yardstick for dental models. Design: Retrospective cohort study. Setting: Five cleft palate centers in North America. Subjects: A total of 169 subjects with repaired complete unilateral cleft lip and palate who were consecutively treated at the five centers. Methods: Ethics approval was obtained. A total of 169 dental models of patients between 6 and 12 years old with complete unilateral cleft lip and palate were assessed using the Goslon Yardstick. Weighted kappa statistics were used to assess intrarater and interrater reliabilities; whereas, analysis of variance and Tukey‐Kramer analysis was used to compare the Goslon scores. Significance levels were set at p < .05. Results: Intrarater and interrater reliabilities were very good for model ratings. One center that incorporated primary Alveolar Bone Grafting showed especially poor Goslon scores that were signifi...

  • assessment of dental arch relationships in japanese patients with unilateral cleft lip and palate
    The Cleft Palate-Craniofacial Journal, 2006
    Co-Authors: Takafumi Susami, Gunvor Semb, W C Shaw, Yuji Ogihara, Masako Matsuzaki, Miyuki Sakiyama, Tsuyoshi Takato
    Abstract:

    Objective: Evaluation of the dental arch relationships of Japanese patients with unilateral cleft lip and palate (UCLP) from the orthodontic clinic of the University of Tokyo Hospital (UTH) compared with patients treated by the Oslo Cleft Team, Norway. Design: Retrospective study and comparison with previous reports. Materials: Dental models of 24 patients with UCLP in UTH taken before orthodontic treatment and before Alveolar Bone Grafting were included. Surgeons in many hospitals performed primary surgeries. These models were matched for age and gender with 24 models from a consecutive series of patients treated by the Oslo Cleft Team as part of the Eurocran Good Practice Archive. A total of 48 models were evaluated. Main Outcome Measure: Dental arch relationship was rated with the Goslon Yardstick. The strength of agreement of rating was assessed with weighted kappa statistics. Results: Intra- and interexaminer agreements evaluated by weighted kappa statistics were high, indicating good reproducibility. Almost 60% of the patients in UTH were classified into poor or very poor categories, and the mean Goslon score was 3.50. These results show a contrast to those in Oslo and were the poorest in comparison with previous reports. Conclusion: Dental arch relationships in patients with UCLP in UTH were poor. This seemed to be attributable to surgical procedures, but a factor of racial difference in the craniofacial morphology was also considered. Further intercenter research is required to clarify this point.

  • prediction of outcomes of secondary Alveolar Bone Grafting in children born with unilateral cleft lip and palate
    European Journal of Ophthalmology, 2003
    Co-Authors: Alison Williams, Gunvor Semb, David R Bearn, W C Shaw, Jonathan R Sandy
    Abstract:

    The aim of this cross-sectional clinical outcome study using retrospective data capture of treatment histories was to examine the characteristics of children born with unilateral cleft lip and palate (UCLP) in the United Kingdom (UK) who were not grafted at the appropriate age or who had an unsuccessful secondary Alveolar Bone graft. The subjects were born with complete non-syndromic UCLP between 1.4.82 and 31.3.84 and were aged between 12.0 years and 14.7 years at the time of data collection under the care of 48 cleft teams. The success of secondary Alveolar Bone Grafting was assessed using a modification of the Bergland index. There were no independent predictors for unmet Bone Grafting need. The outcome of secondary Alveolar Bone Grafting was assessed for 164 subjects; 90 (55%) had a successful first graft. Non-Caucasian (P = 0.037) and increasing age at Grafting (P = 0.007) were risk factors for poor outcome. After adjustment for other risk factors, increased age at Grafting was independently associated with having a seriously deficient or failed graft (OR = 1.03; 95% CI 1.01-1.06 P = 0.036). All the non-Caucasians in this sample had an unsatisfactory graft. Increasing age in months at Grafting and ethnicity are predictors for poor outcome of secondary Alveolar Bone Grafting in children born with UCLP in the UK.