Unilateral Cleft Lip

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Yu-fang Liao - One of the best experts on this subject based on the ideXlab platform.

  • 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.

  • Vomer flap for hard palate repair is related to favorable maxillary growth in Unilateral Cleft Lip and palate
    Clinical oral investigations, 2013
    Co-Authors: Yu-fang Liao, Ying-hsin Lee, Ruby Wang, Chiung Shing Huang, Philip Kuo-ting Chen, Yu Ray Chen
    Abstract:

    Objective Vomer flap repair is assumed to improve maxillary growth because of reduced scarring in growth-sensitive areas of the palate. Our aim was to evaluate whether facial growth in patients with Unilateral Cleft Lip and palate was significantly affected by the technique of hard palate repair (vomer flap versus two-flap).

  • two stage palate repair with delayed hard palate closure is related to favorable maxillary growth in Unilateral Cleft Lip and palate
    Plastic and Reconstructive Surgery, 2010
    Co-Authors: Yu-fang Liao, Ruby Wang, Iying Yang, Claudia Yun, Chiung Shing Huang
    Abstract:

    Background Two-stage palate repair with delayed hard palate closure is generally advocated because it allows the best possible postoperative maxillary growth. Nevertheless, in the literature, it has been questioned whether maxillary growth is better following use of this protocol. The authors therefore aimed to investigate whether stage of palate repair, one-stage versus two-stage, had a significant effect on facial growth in patients with Unilateral Cleft Lip and palate. Methods Seventy-two patients with nonsyndromic complete Unilateral Cleft Lip and palate operated on by two different protocols for palate repair, one-stage versus two-stage with delayed hard palate closure, and their 223 cephalometric radiographs were available in the retrospective longitudinal study. Clinical notes were reviewed to record treatment histories. Cephalometry was used to determine facial morphology and growth rate. Generalized estimating equations analysis was performed to assess the relationship between (1) facial morphology at age 20 and (2) facial growth rate, and the stage of palate repair. Results Stage of palate repair had a significant effect on the length and protrusion of the maxilla and the anteroposterior jaw relation at age 20, but not on their growth rates. Conclusions The data suggest that in patients with Unilateral Cleft Lip and palate, two-stage palate repair has a smaller adverse effect than one-stage palate repair on the growth of the maxilla. This stage effect is on the anteroposterior development of the maxilla and is attributable to the development being undisturbed before closure of the hard palate (i.e., hard palate repair timing specific).

  • intraoral photographs for rating dental arch relationships in Unilateral Cleft Lip and palate
    The Cleft Palate-Craniofacial Journal, 2009
    Co-Authors: Yu-fang Liao, Chiung Shing Huang
    Abstract:

    Abstract Background and Purpose: The Goslon Yardstick is one of the most commonly used methods to assess dental arch relationships of patients with Unilateral Cleft Lip and palate. This system was originally applied to dental casts. For reasons of economy and convenience, we aimed to determine whether intraoral photographs could substitute for dental casts for rating dental arch relationships. Methods: Records of 58 patients with nonsyndromic complete Unilateral Cleft Lip and palate from the Chang Gung Craniofacial Center, Taipei, Taiwan, were used in this study. A set of dental casts and digital intraoral photographs taken at around 9 years of age were available for all patients. An experienced examiner rated the dental casts using the Goslon Yardstick to provide the reference scores. The other three examiners rated the intraoral photographs and repeated the rating 1 week later to calculate inter- and intraexaminer reliability. The photographic scores for each examiner were then compared with the referen...

David M Fisher - One of the best experts on this subject based on the ideXlab platform.

  • permanent tooth agenesis and maxillary hypoplasia in patients with Unilateral Cleft Lip and palate
    Plastic and Reconstructive Surgery, 2015
    Co-Authors: Gregory S Antonarakis, David M Fisher
    Abstract:

    BACKGROUND: Maxillary growth in patients with Clefts is highly variable. The authors' aim was to investigate whether severity of maxillary hypoplasia is associated with the presence of permanent tooth agenesis in children with complete Unilateral Cleft Lip and palate. METHODS: Fifty children with complete Unilateral Cleft Lip and palate were divided into two groups of 25 children. One group had tooth agenesis of the Cleft maxillary lateral incisor, whereas the other did not. Panoramic radiographs, lateral cephalometric radiographs, and dental casts were available for all children in the mixed dentition phase before preparation for alveolar bone grafting. The Modified Huddart/Bodenham scoring system was used to determine dental arch relationships on dental casts. Lateral cephalometric radiographs were traced and analyzed. Differences between groups were investigated using independent samples t tests. RESULTS: Children with complete Unilateral Cleft Lip and palate and tooth agenesis presented with more negative Modified Huddart/Bodenham scores (-12.4 ± 5.2) than those without tooth agenesis (-5.4 ± 3.5) (p < 0.001), representing more severe arch constriction. These children also presented cephalometrically with reduced basal maxillary length (2.2 mm shorter; p = 0.043), alveolar maxillary length (2.9 mm shorter; p = 0.009), and alveolar maxillary protrusion (2.9 degrees less; p = 0.049) compared to those without tooth agenesis. CONCLUSIONS: Individuals with complete Unilateral Cleft Lip and palate and tooth agenesis demonstrate more deficient maxillary growth than those without tooth agenesis. This is evident in both the sagittal and vertical dimensions, and when looking at the dentoalveolar intermaxillary relationships. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.

  • objective measurements for grading the primary Unilateral Cleft Lip nasal deformity
    Plastic and Reconstructive Surgery, 2008
    Co-Authors: David M Fisher, Raymond Tse, Jeffrey R Marcus
    Abstract:

    Background:The purpose of this prospective study was to develop and validate an objective means of grading the presurgical Unilateral Cleft Lip nasal deformity. Our hypotheses are that expert Cleft surgeons can reliably rank patients according to their subjective assessment of the degree of unilater

  • Unilateral Cleft Lip repair an anatomical subunit approximation technique
    Plastic and Reconstructive Surgery, 2005
    Co-Authors: David M Fisher
    Abstract:

    Background:A technique of Unilateral Cleft Lip repair is described. The repair draws from a variety of previously described repairs and adheres to a concept of anatomical subunits of the Lip. Cases from within the spectrum of the deformity have been chosen from a series of 144 consecutive cases to d

Chiung Shing Huang - One of the best experts on this subject based on the ideXlab platform.

  • Vomer flap for hard palate repair is related to favorable maxillary growth in Unilateral Cleft Lip and palate
    Clinical oral investigations, 2013
    Co-Authors: Yu-fang Liao, Ying-hsin Lee, Ruby Wang, Chiung Shing Huang, Philip Kuo-ting Chen, Yu Ray Chen
    Abstract:

    Objective Vomer flap repair is assumed to improve maxillary growth because of reduced scarring in growth-sensitive areas of the palate. Our aim was to evaluate whether facial growth in patients with Unilateral Cleft Lip and palate was significantly affected by the technique of hard palate repair (vomer flap versus two-flap).

  • two stage palate repair with delayed hard palate closure is related to favorable maxillary growth in Unilateral Cleft Lip and palate
    Plastic and Reconstructive Surgery, 2010
    Co-Authors: Yu-fang Liao, Ruby Wang, Iying Yang, Claudia Yun, Chiung Shing Huang
    Abstract:

    Background Two-stage palate repair with delayed hard palate closure is generally advocated because it allows the best possible postoperative maxillary growth. Nevertheless, in the literature, it has been questioned whether maxillary growth is better following use of this protocol. The authors therefore aimed to investigate whether stage of palate repair, one-stage versus two-stage, had a significant effect on facial growth in patients with Unilateral Cleft Lip and palate. Methods Seventy-two patients with nonsyndromic complete Unilateral Cleft Lip and palate operated on by two different protocols for palate repair, one-stage versus two-stage with delayed hard palate closure, and their 223 cephalometric radiographs were available in the retrospective longitudinal study. Clinical notes were reviewed to record treatment histories. Cephalometry was used to determine facial morphology and growth rate. Generalized estimating equations analysis was performed to assess the relationship between (1) facial morphology at age 20 and (2) facial growth rate, and the stage of palate repair. Results Stage of palate repair had a significant effect on the length and protrusion of the maxilla and the anteroposterior jaw relation at age 20, but not on their growth rates. Conclusions The data suggest that in patients with Unilateral Cleft Lip and palate, two-stage palate repair has a smaller adverse effect than one-stage palate repair on the growth of the maxilla. This stage effect is on the anteroposterior development of the maxilla and is attributable to the development being undisturbed before closure of the hard palate (i.e., hard palate repair timing specific).

  • The effect of gingivoperiosteoplasty on facial growth in patients with complete Unilateral Cleft Lip and palate.
    The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association, 2010
    Co-Authors: Cindy Hsin-yi Hsieh, Phil K T Chen, Chiung Shing Huang
    Abstract:

    Abstract Objective: Gingivoperiosteoplasty performed at the time of Lip repair of Cleft patients is one kind of alveolar repair. The purpose of this retrospective study was to evaluate the effect of gingivoperiosteoplasty on facial growth of patients with complete Unilateral Cleft Lip and palate (UCLP). Design: Retrospective study. Patients: Sixty-two consecutive patients with nonsyndromic complete Unilateral Cleft Lip/palate with 5-year-olds' record were included in this retrospective study. Interventions: All the patients had received nasoalveolar molding treatment before cheiloplasty at the age of 3 to 6 months. Twenty-six patients had gingivoperiosteoplasty performed at the time of cheiloplasty and function as the GPP group. Thirty-six patients did not have gingivoperiosteoplasty at the time of cheiloplasty and function as the non-GPP group. Main Outcome Measures: Cephalometry was used to evaluate the facial growth at 5 years of age in the two groups of patients. Results: Gingivoperiosteoplasty had si...

  • intraoral photographs for rating dental arch relationships in Unilateral Cleft Lip and palate
    The Cleft Palate-Craniofacial Journal, 2009
    Co-Authors: Yu-fang Liao, Chiung Shing Huang
    Abstract:

    Abstract Background and Purpose: The Goslon Yardstick is one of the most commonly used methods to assess dental arch relationships of patients with Unilateral Cleft Lip and palate. This system was originally applied to dental casts. For reasons of economy and convenience, we aimed to determine whether intraoral photographs could substitute for dental casts for rating dental arch relationships. Methods: Records of 58 patients with nonsyndromic complete Unilateral Cleft Lip and palate from the Chang Gung Craniofacial Center, Taipei, Taiwan, were used in this study. A set of dental casts and digital intraoral photographs taken at around 9 years of age were available for all patients. An experienced examiner rated the dental casts using the Goslon Yardstick to provide the reference scores. The other three examiners rated the intraoral photographs and repeated the rating 1 week later to calculate inter- and intraexaminer reliability. The photographic scores for each examiner were then compared with the referen...

John B. Mulliken - One of the best experts on this subject based on the ideXlab platform.

  • the changing nasolabial dimensions following repair of Unilateral Cleft Lip an anthropometric study in late childhood
    Plastic and Reconstructive Surgery, 2016
    Co-Authors: Zena L Knight, Ingrid M Ganske, Curtis K Deutsch, John B. Mulliken
    Abstract:

    Background:Repair of Unilateral Cleft Lip and nasal deformity in three dimensions requires anticipation of changes in the fourth dimension that can be determined by periodic and objective assessment.Methods:Fifty patients with Unilateral Cleft Lip with or without Cleft palate underwent primary repai

  • resorbable internal splint an adjunct to primary correction of Unilateral Cleft Lip nasal deformity
    Plastic and Reconstructive Surgery, 2002
    Co-Authors: Granger B Wong, Ram Burvin, John B. Mulliken
    Abstract:

    There is usually some relapse in position of the alar cartilage after primary repair of Unilateral Cleft Lip. Therefore, preoperative or postoperative external splinting has been recommended to supplement either closed or open suspension of the alar cartilage. The authors present a method using a resorbable internal nostril splint to shield the positioned alar cartilage from deformational forces caused by scar, and thus avoiding the problems associated with external splinting. An internal nasal splint was placed in 15 infants during repair of Unilateral complete Cleft Lip and nasal deformity. The nasal morphology was compared with that of 15 control patients who had the same nasolabial procedure without internal splinting. Average follow-up time was 20.4 months (range, 4 to 30 months). Photogrammetric analysis showed that asymmetry of the alar contours averaged 8.6 percent in the splinted patients, as compared with 23 percent for controls (p < 0.01). Thus, alar asymmetry was decreased two-thirds in the splinted group. An internal resorbable nasal splint is an adjunct to open alar suspension in primary repair of the Unilateral Cleft Lip nasal deformity. An internal nasal splint protects the corrected alar cartilage longer than an external splint and eliminates drawbacks, such as necrosis, cutaneous depression of the nostril sill, and patient non-compliance. This strategy of temporary internal support of healing cartilage has other applications.

Jeffrey R Marcus - One of the best experts on this subject based on the ideXlab platform.

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