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Robert M Menard - One of the best experts on this subject based on the ideXlab platform.
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single stage repair of 30 facial Cleft with bone morphogenic protein
Plastic and reconstructive surgery. Global open, 2018Co-Authors: Clifford C. Sheckter, Paul Mittermiller, Danielle Rochlin, Kay Hung, Zeshaan N Maan, Robert M MenardAbstract:Tessier #30 Clefts (median mandibular Clefts) represent a spectrum of deformities ranging from a minor Cleft in the lower lip to complete Clefts of the mandible involving the tongue, lower lip, hyoid bone, thyroid cartilages, and manubrium. Various techniques have been used to address these problems; the most common procedure involving 2 stages: an initial correction of the soft tissue followed by closure of the mandibular Cleft at a later date using bone grafting. This approach was subsequently reduced to a single operation, but still required harvesting of autologous bone graft. Here, we describe a modified single-stage operation using human recombinant bone morphogenic protein, avoiding bone graft harvest and allowing for simultaneous treatment of bone and soft tissue.
Clifford C. Sheckter - One of the best experts on this subject based on the ideXlab platform.
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single stage repair of 30 facial Cleft with bone morphogenic protein
Plastic and reconstructive surgery. Global open, 2018Co-Authors: Clifford C. Sheckter, Paul Mittermiller, Danielle Rochlin, Kay Hung, Zeshaan N Maan, Robert M MenardAbstract:Tessier #30 Clefts (median mandibular Clefts) represent a spectrum of deformities ranging from a minor Cleft in the lower lip to complete Clefts of the mandible involving the tongue, lower lip, hyoid bone, thyroid cartilages, and manubrium. Various techniques have been used to address these problems; the most common procedure involving 2 stages: an initial correction of the soft tissue followed by closure of the mandibular Cleft at a later date using bone grafting. This approach was subsequently reduced to a single operation, but still required harvesting of autologous bone graft. Here, we describe a modified single-stage operation using human recombinant bone morphogenic protein, avoiding bone graft harvest and allowing for simultaneous treatment of bone and soft tissue.
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Single Stage Repair of #30 Facial Cleft with Bone Morphogenic Protein
Wolters Kluwer, 2018Co-Authors: Clifford C. Sheckter, Paul Mittermiller, Bs ,kay Hung, Zeshaan Maan, Danielle Rochlin, Robert Menard, Md M. FacsAbstract:Summary:. Tessier #30 Clefts (median mandibular Clefts) represent a spectrum of deformities ranging from a minor Cleft in the lower lip to complete Clefts of the mandible involving the tongue, lower lip, hyoid bone, thyroid cartilages, and manubrium. Various techniques have been used to address these problems; the most common procedure involving 2 stages: an initial correction of the soft tissue followed by closure of the mandibular Cleft at a later date using bone grafting. This approach was subsequently reduced to a single operation, but still required harvesting of autologous bone graft. Here, we describe a modified single-stage operation using human recombinant bone morphogenic protein, avoiding bone graft harvest and allowing for simultaneous treatment of bone and soft tissue
George L Wehby - One of the best experts on this subject based on the ideXlab platform.
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the effects of state facial surgery mandates on timeliness of primary Cleft repair surgery in the united states
Oral Diseases, 2021Co-Authors: Tanya Wanchek, Wei Lyu, George L WehbyAbstract:OBJECTIVE This study examines the effects of state facial surgery mandates on the timeliness of primary Cleft repair surgery for privately insured children with oral Clefts in the United States. MATERIALS AND METHODS Using IBM Health MarketScan® Database from 2001 to 2017, we estimate regression models separately for age at Cleft lip repair and Cleft palate repair by having a mandate while considering child-level factors and other state differences. The sample includes 1,451 children who had primary Cleft lip repair by age 12 months, and 1,402 children who had primary Cleft palate repair by age 18 months. RESULTS A mandate was associated with earlier Cleft lip repair by 13 days (95% CI, -21.5 to -4.7 days) when controlling for state differences, regardless if the child had other birth defects. For children needing Cleft palate repair, a mandate was associated with earlier surgery by 87 days (95% CI, -136.1 to -38.4 days) only when no other birth defects were present. CONCLUSIONS State facial surgery mandates were associated with earlier Cleft lip repair for children with or without other birth defects, and earlier Cleft palate repair for children without other birth defects (besides oral Clefts). Findings suggest benefits to privately insured children with oral Clefts from state mandates to cover needed services.
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ear infection in isolated Cleft lip etiological implications
The Cleft Palate-Craniofacial Journal, 2017Co-Authors: Teresa A Ruegg, Jacqueline T. Hecht, Frederick Deleyiannis, Andrew E Czeizel, Margaret E Cooper, Elizabeth J Leslie, Matthew D Ford, George L Wehby, Mary L Marazita, Seth M WeinbergAbstract:Background and Hypothesis: Chronic ear infections are a common occurrence in children with orofacial Clefts involving the secondary palate. Less is known about the middle ear status of individuals with isolated Clefts of the lip, although several studies have reported elevated rates of ear infection in this group. The purpose of this retrospective study was to test the hypothesis that chronic ear infections occur more frequently in isolated Cleft lip cases (n = 94) compared with controls (n = 183). Methods: A questionnaire was used to obtain information on history of chronic ear infection. The association between ear infection status (present/absent) and Cleft lip status (Cleft lip case/control) was tested using both chi-square and logistic regression. Results and Conclusions: The reported occurrence of chronic ear infection was significantly greater in Cleft lip cases (31%) compared with unaffected controls (11%). After adjusting for age and sex, having a Cleft lip increased the odds of being positive...
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laterality of oral Clefts and academic achievement
Pediatrics, 2017Co-Authors: Emily R Gallagher, George L Wehby, Paul A Romitti, Brent R Collett, Sheila Barron, Timothy N AnsleyAbstract:BACKGROUND AND OBJECTIVES: Children with isolated oral Clefts have lower academic performance when compared with unaffected peers, yet few studies have examined specific attributes of Clefts that may modify this risk. Oral Clefts have nonrandom laterality, with left-sided Clefts being more common than right-sided Clefts, a pattern that may be genetically or environmentally influenced. The objective of this study was to evaluate the association between Cleft laterality and academic achievement in a population-based sample of children with and without isolated oral Clefts. METHODS: The study included 292 children with isolated unilateral Cleft lip with or without Cleft palate identified by using the Iowa Registry for Congenital and Inherited Disorders matched with 908 unaffected classmates. This group provided 1953 child-grade observations for cases and 6829 for classmates. Academic achievement was evaluated by using high-quality standardized test data on multiple academic domains as well as use of special education. RESULTS: We found that children with right-sided Clefts had similar achievement scores and usage of special education services compared with their unaffected classmates. Children with left-sided Clefts had lower reading scores than children with right-sided Clefts by nearly 7 percentiles (P CONCLUSIONS: Children with left-sided Clefts had poorer academic performance than their classmates or children with right-sided Clefts, who showed similar academic achievement compared with their unaffected classmates.
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maternal underweight and obesity and risk of orofacial Clefts in a large international consortium of population based studies
International Journal of Epidemiology, 2016Co-Authors: Hebah A Kutbi, George L Wehby, Lina Moreno M Uribe, Paul A Romitti, Suzan L Carmichael, Gary M Shaw, Andrew F Olshan, Lisa A Deroo, Sonja A RasmussenAbstract:Background Evidence on association of maternal pre-pregnancy weight with risk of orofacial Clefts is inconsistent. Methods Six large case-control studies of orofacial Clefts from Northern Europe and the USA were included in analyses pooling individual-level data. Cases included 4943 mothers of children with orofacial Clefts (Cleft lip only: 1135, Cleft palate with Cleft lip: 2081, Cleft palate only: 1727) and controls included 10 592 mothers of unaffected children. Association of orofacial Cleft risk with pre-pregnancy maternal weight classified by level of body mass index (BMI, kg/m 2 ) was evaluated using logistic regression adjusting for multiple covariates. Results Cleft palate, both alone and with Cleft lip (CP+/-CL), was associated with maternal class II+ pre-pregnancy obesity (≥ 35)compared with normal weight [adjusted odds ratio (aOR) = 1.36; 95% confidence interval (CI) = 1.16, 1.58]. CP+/-CL was marginally associated with maternal underweight (aOR = 1.16; 95% CI = 0.98, 1.36). Cleft lip alone was not associated with BMI. Conclusions In this largest population-based study to date, we found an increased risk of Cleft palate, with or without Cleft lip, in class II+ obese mothers compared with normal-weight mothers; underweight mothers may also have an increased risk, but this requires further study. These results also suggest that extremes of weight may have a specific effect on palatal development.
Alexandre R. Vieira - One of the best experts on this subject based on the ideXlab platform.
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dlx1 and mmp3 contribute to oral Clefts with and without positive family history of cancer
Archives of Oral Biology, 2015Co-Authors: Ticiana Medeiros De Saboia, Alexandre R. Vieira, Erika Calvano Kuchler, Jose Mauro Granjeiro, Maria Fernanda Reis, ângela Maria Martins, Helena Freire Romanos, Patricia Nivoloni Tannure, Leonardo Santos Antunes, Marcelo De Castro CostaAbstract:Abstract Objective It has been suggested that oral Clefts and cancer share a common genetic background. This study aimed to investigate the epidemiological and molecular association between oral Clefts and cancer. Methods One hundred forty-eight nuclear families with oral Clefts and 162 subjects with no birth defect were recruited. Data on self-reported family history of cancer among first, second, and third degree relatives of each patient were collected via a structured questionnaire. We also investigated the association between polymorphisms in the genes AXIN2 , BMP2 , BMP4 , BMP7 , DLX1 , DLX2 , and MMP3 and oral Cleft with and without history of cancer. Markers in these genes were genotyped using real time PCR. Chi-square and t -test were used to assess the differences about self-reported family history of cancer between oral Cleft and non-Cleft individuals. The transmission disequilibrium test (TDT) was used to analyze the distortion of the inheritance of alleles from parents to their affected offspring. Results Families with oral Clefts had an increased risk of having a family history of cancer ( p = 0.01; odds ratio = 1.79; 95% confidence interval, 1.07–1.87). TDT results showed an association between DLX1 and Cleft lip and palate, in which the A allele was undertransmited ( p = 0.022). For MMP3 , G was undertransmited among affected progeny ( p = 0.019) in Cleft palate subgroup. Conclusion Oral Clefts were associated with positive self-reported family history of cancer and with variants in DLX1 and MMP3 . The association between oral Clefts and cancer raises interesting possibilities to identify risk markers for cancer.
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Association of MMP3 and TIMP2 Promoter Polymorphisms with Nonsyndromic Oral Clefts
Birth defects research. Part A Clinical and molecular teratology, 2012Co-Authors: Ariadne Letra, Renato M Silva, Luise Gomes Da Motta, Susan H. Blanton, Jacqueline T. Hecht, Jose M. Granjeirol, Alexandre R. VieiraAbstract:BACKGROUND Oral Clefts are common congenital anomalies and result from defects during embryogenesis. The complex etiology is evident by the number of genes and signaling pathways involved in craniofacial development. Matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) are responsible for tissue remodeling during craniofacial development. METHODS In this study, we investigated the association of polymorphisms in 14 biologically relevant MMP and TIMP genes in 494 individuals with oral Clefts and 413 control individuals from Brazil. Genotypes were generated using Taqman chemistry. Analyses were performed using PLINK software. RESULTS Polymorphisms in MMP3 (rs522616) and TIMP2 (rs8179096) showed significant association with all Cleft types (all Clefts, Cleft lip/palate, and Cleft palate; p ≤ 0.002). An additional family-based dataset (881 case-parent trios) from the United States was used for confirmation of the association findings (p < 0.05). Analysis of gene-gene interaction suggests that MMP3 and TIMP2 may interactively contribute to a Cleft phenotype. CONCLUSIONS This study provides new evidence that variation in MMP3 may contribute to nonsyndromic oral Clefts and further supports the involvement of TIMP2 as a Cleft susceptibility gene. Although additional studies are still necessary to unveil the exact mechanism by which MMP3 and TIMP2 would contribute to a Cleft phenotype, allelic polymorphisms in these genes and their interactions may partly explain the variance of individual susceptibility to oral Clefts. Birth Defects Research (Part A) 2012. © 2012 Wiley Periodicals, Inc.
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side of dental anomalies and taurodontism as potential clinical markers for Cleft subphenotypes
The Cleft Palate-Craniofacial Journal, 2011Co-Authors: Erika Calvano Kuchler, Luise Gomes Da Motta, Alexandre R. Vieira, Jose Mauro GranjeiroAbstract:Objective: The aim of this work was to investigate in more detail the dental clinical features that could serve to define subphenotypes of oral Clefts. Design: Dental records of oral Cleft subjects from a group of 164 cases were examined, and 157 were included in this study. In addition, 65 families with two or more siblings born with Clefts and 30 control families were evaluated to determine whether dental phenotypes were sporadic. Type of oral Cleft and dental phenotypes (tooth agenesis, supernumerary teeth, taurodontism, dental transposition, and microdontia) outside the Cleft area were investigated. Association of dental anomalies with preferential subtypes of Cleft (subphenotype) was assessed. Results: A total of 74 subjects presented at least one developmental dental anomaly. Tooth agenesis was the most common dental anomaly (28.6%), followed by taurodontism (15.2%). Supernumerary teeth were associated with Cleft palate only (p = .05). The absence of maxillary left lateral incisors was significantly associated with unilateral right Cleft lip (p = .02). Bilateral Clefts were strongly associated with bilateral dental anomalies (p < 0.001). In the Cleft lip and palate group, tooth agenesis was associated with dental transposition (p = .03) and with supernumerary teeth (p = .009). Subjects with oral Clefts have a higher risk of tooth agenesis (odds ratio = 3.33; 95% confidence interval, 1.18 to 10.13) and taurodontism (odds ratio = 3.95; 95% confidence interval, 2.28 to 6.82). Tooth agenesis, microdontic upper lateral incisors, and supernumerary teeth were most commonly found in unaffected siblings and parents of children born with Clefts in comparison with families with no family history of Clefts (p = .01). Conclusion: The preferential associations between specific Cleft types with dental phenotypes suggest dental anomalies can be used as clinical markers to define the subphenotype isolated Cleft lip and palate.
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Medical Sequencing of Candidate Genes for Nonsyndromic Cleft Lip and Palate
PLOS Genetics, 2005Co-Authors: Alexandre R. Vieira, Joseph Ross Avila, Sandra Daack-hirsch, Ecaterina Dragan, Têmis Maria Félix, Fedik Rahimov, Jill Harrington, Rebecca R. Schultz, Yoriko Watanabe, Marla K. JohnsonAbstract:Nonsyndromic or isolated Cleft lip with or without Cleft palate (CL/P) occurs in wide geographic distribution with an average birth prevalence of 1/700. We used direct sequencing as an approach to study candidate genes for CL/P. We report here the results of sequencing on 20 candidate genes for Clefts in 184 cases with CL/P selected with an emphasis on severity and positive family history. Genes were selected based on expression patterns, animal models, and/or role in known human Clefting syndromes. For seven genes with identified coding mutations that are potentially etiologic, we performed linkage disequilibrium studies as well in 501 family triads (affected child/mother/father). The recently reported MSX1 P147Q mutation was also studied in an additional 1,098 Cleft cases. Selected missense mutations were screened in 1,064 controls from unrelated individuals on the Centre d'Etude du Polymorphisme Humain (CEPH) diversity cell line panel. Our aggregate data suggest that point mutations in these candidate genes are likely to contribute to 6% of isolated Clefts, particularly those with more severe phenotypes (bilateral Cleft of the lip with Cleft palate). Additional cases, possibly due to microdeletions or isodisomy, were also detected and may contribute to Clefts as well. Sequence analysis alone suggests that point mutations in FOXE1, GLI2, JAG2, LHX8, MSX1, MSX2, SATB2, SKI, SPRY2, and TBX10 may be rare causes of isolated Cleft lip with or without Cleft palate, and the linkage disequilibrium data support a larger, as yet unspecified, role for variants in or near MSX2, JAG2, and SKI. This study also illustrates the need to test large numbers of controls to distinguish rare polymorphic variants and prioritize functional studies for rare point mutations.
Paul Mittermiller - One of the best experts on this subject based on the ideXlab platform.
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single stage repair of 30 facial Cleft with bone morphogenic protein
Plastic and reconstructive surgery. Global open, 2018Co-Authors: Clifford C. Sheckter, Paul Mittermiller, Danielle Rochlin, Kay Hung, Zeshaan N Maan, Robert M MenardAbstract:Tessier #30 Clefts (median mandibular Clefts) represent a spectrum of deformities ranging from a minor Cleft in the lower lip to complete Clefts of the mandible involving the tongue, lower lip, hyoid bone, thyroid cartilages, and manubrium. Various techniques have been used to address these problems; the most common procedure involving 2 stages: an initial correction of the soft tissue followed by closure of the mandibular Cleft at a later date using bone grafting. This approach was subsequently reduced to a single operation, but still required harvesting of autologous bone graft. Here, we describe a modified single-stage operation using human recombinant bone morphogenic protein, avoiding bone graft harvest and allowing for simultaneous treatment of bone and soft tissue.
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Single Stage Repair of #30 Facial Cleft with Bone Morphogenic Protein
Wolters Kluwer, 2018Co-Authors: Clifford C. Sheckter, Paul Mittermiller, Bs ,kay Hung, Zeshaan Maan, Danielle Rochlin, Robert Menard, Md M. FacsAbstract:Summary:. Tessier #30 Clefts (median mandibular Clefts) represent a spectrum of deformities ranging from a minor Cleft in the lower lip to complete Clefts of the mandible involving the tongue, lower lip, hyoid bone, thyroid cartilages, and manubrium. Various techniques have been used to address these problems; the most common procedure involving 2 stages: an initial correction of the soft tissue followed by closure of the mandibular Cleft at a later date using bone grafting. This approach was subsequently reduced to a single operation, but still required harvesting of autologous bone graft. Here, we describe a modified single-stage operation using human recombinant bone morphogenic protein, avoiding bone graft harvest and allowing for simultaneous treatment of bone and soft tissue