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Buckley RM, Bilgen N, Harris AC, Savolainen P, Tepeli C, Erdoğan M, Serres Armero A, Dreger DL, van Steenbeek FG, Hytönen MK, Parker HG, Hale J, Lohi H, Çınar Kul B, Boyko AR, Ostrander EA. Analysis of canine gene constraint identifies new variants for orofacial clefts and stature. Genome Res 2025; 35:1080-1093. [PMID: 40127928 PMCID: PMC12047267 DOI: 10.1101/gr.280092.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Accepted: 03/10/2025] [Indexed: 03/26/2025]
Abstract
Dog breeding promotes within-group homogeneity through conformation to strict breed standards, while simultaneously driving between-group heterogeneity. There are over 350 recognized dog breeds that provide the foundation for investigating the genetic basis of phenotypic diversity. Typically, breed standard phenotypes such as stature, pelage, and craniofacial structure are analyzed through genetic association studies. However, such analyses are limited to assayed phenotypes only, leaving difficult-to-measure phenotypic subtleties easily overlooked. We investigated coding variation from over 2000 dogs, leading to discoveries of variants related to craniofacial morphology and stature. Breed-enriched variants were prioritized according to gene constraint, which was calculated using a mutation model derived from trinucleotide substitution probabilities. Among the newly found variants is a splice-acceptor variant in PDGFRA associated with bifid nose, a characteristic trait of Çatalburun dogs, implicating the gene's role in midline closure. Two additional LCORL variants, both associated with canine body size are also discovered: a frameshift that causes a premature stop in large breeds (>25 kg) and an intronic substitution found in small breeds (<10 kg), thus highlighting the importance of allelic heterogeneity in selection for breed traits. Most variants prioritized in this analysis are not associated with genomic signatures for breed differentiation, as these regions are enriched for constrained genes intolerant to nonsynonymous variation. This indicates trait selection in dogs is likely a balancing act between preserving essential gene functions and maximizing regulatory variation to drive phenotypic extremes.
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Affiliation(s)
- Reuben M Buckley
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Nüket Bilgen
- Department of Animal Genetics, Faculty of Veterinary Medicine, University of Ankara, Ankara 06110, Türkiye
| | - Alexander C Harris
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Peter Savolainen
- KTH Royal Institute of Technology, School of Chemistry, Biotechnology and Health, Science for Life Laboratory, SE-100 44 Stockholm, Sweden
| | - Cafer Tepeli
- Department of Animal Science, Faculty of Veterinary Medicine, University of Selcuk, Konya 42100, Türkiye
| | - Metin Erdoğan
- Department of Veterinary Biology and Genetics, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar 03200, Türkiye
| | - Aitor Serres Armero
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Dayna L Dreger
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Frank G van Steenbeek
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CM Utrecht, The Netherlands
| | - Marjo K Hytönen
- Department of Medical and Clinical Genetics, University of Helsinki, 00014 Helsinki, Finland
- Department of Veterinary Biosciences, University of Helsinki, 00014 Helsinki, Finland
- Folkhälsan Research Center, 00290 Helsinki, Finland
| | - Heidi G Parker
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Jessica Hale
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Hannes Lohi
- Department of Medical and Clinical Genetics, University of Helsinki, 00014 Helsinki, Finland
- Department of Veterinary Biosciences, University of Helsinki, 00014 Helsinki, Finland
- Folkhälsan Research Center, 00290 Helsinki, Finland
| | - Bengi Çınar Kul
- Department of Animal Genetics, Faculty of Veterinary Medicine, University of Ankara, Ankara 06110, Türkiye
| | - Adam R Boyko
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York 14853, USA
- Embark Veterinary, Inc., Boston, Massachusetts 02210, USA
| | - Elaine A Ostrander
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892, USA;
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Viñas MJ, Galiotto-Barba F, Cortez-Lede MG, Rodríguez-González MÁ, Moral I, Delso E, González-Meli B, Lobo F, López-Cedrún JL, Neagu D, Garatea J, Garatea A, Berenguer B, Lorca-García C, Delgado MD, Martí E, Gutiérrez JM, Hernández C, Murillo-González J, Martínez-Álvarez C, Martínez-Sanz E. Craniofacial and three-dimensional palatal analysis in cleft lip and palate patients treated in Spain. Sci Rep 2022; 12:18837. [PMID: 36336749 PMCID: PMC9637697 DOI: 10.1038/s41598-022-23584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022] Open
Abstract
Growth alterations have been described in patients operated on for oral clefts. The purpose of this work was to analyze the craniofacial and palate morphology and dimensions of young adults operated on for oral clefts in early childhood in Spain. Eighty-three patients from eight different hospitals were divided into four groups based on their type of cleft: cleft lip (CL, n = 6), unilateral cleft lip and palate (UCLP, n = 37), bilateral cleft lip and palate (BCLP, n = 16), and cleft palate only (CPO, n = 24). A control group was formed of 71 individuals. Three-dimensional (3D) digital models were obtained from all groups with an intraoral scanner, together with cephalometries and frontal, lateral, and submental facial photographs. Measurements were obtained and analyzed statistically. Our results showed craniofacial alterations in the BCLP, UCLP, and CPO groups with an influence on the palate, maxilla, and mandible and a direct impact on facial appearance. This effect was more severe in the BCLP group. Measurements in the CL group were similar to those in the control group. Cleft characteristics and cleft type seem to be the main determining factors of long-term craniofacial growth alterations in these patients. Prospective research is needed to clearly delineate the effects of different treatments on the craniofacial appearance of adult cleft patients.
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Affiliation(s)
- María José Viñas
- grid.4795.f0000 0001 2157 7667Facultad de Odontología, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Francesca Galiotto-Barba
- grid.4795.f0000 0001 2157 7667Facultad de Odontología, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - María Gabriela Cortez-Lede
- grid.419058.10000 0000 8745 438XHospital Clínico Universitario Virgen de la Arrixaca, Servicio Murciano de Salud, 30120 Murcia, Spain
| | - María Ángeles Rodríguez-González
- grid.419058.10000 0000 8745 438XHospital Clínico Universitario Virgen de la Arrixaca, Servicio Murciano de Salud, 30120 Murcia, Spain
| | - Ignacio Moral
- grid.438293.70000 0001 1503 7816Hospital Universitario Miguel Servet, Servicio Aragonés de Salud, 50009 Zaragoza, Spain
| | - Elena Delso
- grid.438293.70000 0001 1503 7816Hospital Universitario Miguel Servet, Servicio Aragonés de Salud, 50009 Zaragoza, Spain
| | - Beatriz González-Meli
- grid.410361.10000 0004 0407 4306Hospital Universitario Infantil Niño Jesús, Servicio Madrileño de Salud, 28009 Madrid, Spain
| | - Fernando Lobo
- grid.410361.10000 0004 0407 4306Hospital Universitario Infantil Niño Jesús, Servicio Madrileño de Salud, 28009 Madrid, Spain
| | - José Luis López-Cedrún
- grid.420359.90000 0000 9403 4738Complejo Hospitalario Universitario A Coruña, Servizo Galego de Saúde, 15006 A Coruña, Spain
| | - David Neagu
- grid.420359.90000 0000 9403 4738Complejo Hospitalario Universitario A Coruña, Servizo Galego de Saúde, 15006 A Coruña, Spain
| | - Joaquín Garatea
- grid.419060.a0000 0004 0501 3644Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Amaia Garatea
- grid.419060.a0000 0004 0501 3644Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Beatriz Berenguer
- grid.410361.10000 0004 0407 4306Hospital General Universitario Gregorio Marañón, Servicio Madrileño de Salud, 28009 Madrid, Spain
| | - Concepción Lorca-García
- grid.410361.10000 0004 0407 4306Hospital General Universitario Gregorio Marañón, Servicio Madrileño de Salud, 28009 Madrid, Spain
| | - María Dolores Delgado
- grid.410361.10000 0004 0407 4306Hospital Universitario 12 de Octubre, Servicio Madrileño de Salud, 28041 Madrid, Spain
| | - Eunate Martí
- grid.410361.10000 0004 0407 4306Hospital Universitario 12 de Octubre, Servicio Madrileño de Salud, 28041 Madrid, Spain
| | - José Manuel Gutiérrez
- grid.459669.10000 0004 1771 1036Hospital Universitario de Burgos, Sanidad de Castilla y León, 09006 Burgos, Spain
| | - Carlos Hernández
- grid.459669.10000 0004 1771 1036Hospital Universitario de Burgos, Sanidad de Castilla y León, 09006 Burgos, Spain
| | - Jorge Murillo-González
- grid.4795.f0000 0001 2157 7667Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Concepción Martínez-Álvarez
- grid.4795.f0000 0001 2157 7667Facultad de Odontología, Universidad Complutense de Madrid, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Elena Martínez-Sanz
- grid.4795.f0000 0001 2157 7667Facultad de Odontología, Universidad Complutense de Madrid, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Liu H, Pu L, Tsauo C, Wang X, Zheng Q, Shi B, Li C. A new congenital cleft palate New Zealand rabbit model for surgical research. Sci Rep 2021; 11:3865. [PMID: 33594140 PMCID: PMC7887234 DOI: 10.1038/s41598-021-83400-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/03/2021] [Indexed: 11/20/2022] Open
Abstract
Cleft palate repair is a challenging procedure for cleft surgeons to teach, and in research, it can be difficult to evaluate different techniques and develop new treatments. In this study, a congenital cleft palate New Zealand rabbit model has been described and could be beneficial in future studies concerning cleft palate repair. Pregnant New Zealand rabbits received 1.0 mg dexamethasone injection intramuscularly once a day from the 13th gestation day (GD13) to GD16. On GD31. Newborn rabbits were delivered by cesarean sections, fed with a standardized gastric tube feeding method, and divided into two groups. The rate of survival and the incidence of cleft palate was calculated. Weight, appearance, behavior, maxillary occlusal view, and regional anatomic and histological comparisons were recorded within 1 month after birth. Infants from the two groups with similar physiological conditions were selected for continuous maxillofacial and mandibular Micro-CT scan and three-dimensional reconstruction analysis. Ten pregnant rabbits gave birth to 48 live infants. The survival and cleft palate rates were 65.6% and 60.4% respectively. Both groups survived over 1 month with no difference in weight, appearance, and behavior. The cleft type was stable, and anatomical defects, histological characteristics, and nasal-maxillary abnormalities of the cleft were similar to those of humans. There was no statistically significant difference in maxillary and mandible development between the two groups within one month after birth. This congenital cleft palate model is considered to have more research possibilities with efficient cleft induction, reliable feeding methods, stable anatomical defects, and maxillofacial development similar to those seen in humans.
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Affiliation(s)
- Haoyue Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Lingling Pu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Chialing Tsauo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Xiaoming Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Qian Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Bing Shi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Chenghao Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China. .,Department of Cleft Lip and Palate Surgery, West China Stomatological Hospital, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, People's Republic of China.
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Freiberger K, Hemker S, McAnally R, King R, Meyers-Wallen VN, Schutte BC, Fyfe JC. Secondary Palate Development in the Dog ( Canis lupus familiaris). Cleft Palate Craniofac J 2020; 58:230-236. [PMID: 32705901 DOI: 10.1177/1055665620943771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To investigate the gestational timing of morphologic events in normal canine secondary palate development as a baseline for studies in dog models of isolated cleft palate (CP). METHODS Beagle and beagle/cocker spaniel-hybrid fetal dogs were obtained by cesarean-section on various days of gestation, timed from the initial rise of serum progesterone concentration. Morphology of fetal heads was determined by examining serial coronal sections. RESULTS On gestational day 35 (d35), the palatal shelves pointed ventrally alongside the tongue. On d36, palatal shelves were elongated and elevated to a horizontal position above the tongue but were not touching. On d37, palatine shelves and vomer were touching, but the medial epithelial seam (MES) between the apposed shelves remained. Immunostaining with epithelial protein markers showed that the MES gradually dissolved and was replaced by mesenchyme during d37-d44, and palate fusion was complete by d44. Examination of remnant MES suggested that fusion of palatal shelves began in mid-palate and moved rostrally and caudally. CONCLUSION Palate development occurs in dogs in the steps described in humans and mice, but palate closure occurs at an intermediate time in gestation. These normative data will form the basis of future studies to determine pathophysiologic mechanisms in dog models of CP. Added clinical significance is the enhancement of dogs as a large animal model to test new approaches for palate repair, with the obvious advantage of achieving full maturity within 2 years rather than 2 decades.
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Affiliation(s)
- Katharina Freiberger
- Microbiology & Molecular Genetics, 3078Michigan State University, East Lansing, MI, USA
| | - Shelby Hemker
- Microbiology & Molecular Genetics, 3078Michigan State University, East Lansing, MI, USA
| | - Ryan McAnally
- Microbiology & Molecular Genetics, 3078Michigan State University, East Lansing, MI, USA
| | - Rachel King
- Microbiology & Molecular Genetics, 3078Michigan State University, East Lansing, MI, USA
| | | | - Brian C Schutte
- Microbiology & Molecular Genetics, 3078Michigan State University, East Lansing, MI, USA.,Pediatrics & Human Development, 3078Michigan State University, East Lansing, MI, USA
| | - John C Fyfe
- Microbiology & Molecular Genetics, 3078Michigan State University, East Lansing, MI, USA
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Curtis AA, Arbour JH, Santana SE. Mind the gap: natural cleft palates reduce biting performance in bats. J Exp Biol 2020; 223:jeb.196535. [PMID: 31852754 DOI: 10.1242/jeb.196535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 12/12/2019] [Indexed: 02/03/2023]
Abstract
Novel morphological traits pose interesting evolutionary paradoxes when they become widespread in a lineage while being deleterious in others. Cleft palate is a rare congenital condition in mammals in which the incisor-bearing premaxilla bones of the upper jaw develop abnormally. However, ∼50% of bat species have natural, non-pathological cleft palates. We used the family Vespertilionidae as a model and linear and geometric morphometrics within a phylogenetic framework to (1) explore evolutionary patterns in cleft morphology, and (2) test whether cleft morphological variation is correlated with skull shape in bats. We also used finite element (FE) analyses to experimentally test how presence of a cleft palate impacts skull performance during biting in a species with extreme cleft morphology (hoary bat, Lasiurus cinereus). We constructed and compared the performance of two FE models: one based on the hoary bat's natural skull morphology, and another with a digitally filled cleft simulating a complete premaxilla. Results showed that cleft length and width are correlated with skull shape in Vespertilionidae, with narrower, shallower clefts seen in more gracile skulls and broader, deeper clefts in more robust skulls. FE analysis showed that the model with a natural cleft produced lower bite forces, and had higher stress and strain than the model with a filled cleft. In the rostrum, safety factors were 1.59-2.20 times higher in the model with a filled cleft than in the natural model. Our results demonstrate that cleft palates in bats reduce biting performance, and evolution of skull robusticity may compensate for this reduction in performance.
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Affiliation(s)
- Abigail A Curtis
- Department of Biology, University of Washington, Seattle, WA 98195-1800, USA
| | - Jessica H Arbour
- Department of Biology, University of Washington, Seattle, WA 98195-1800, USA
| | - Sharlene E Santana
- Department of Biology, University of Washington, Seattle, WA 98195-1800, USA.,Burke Museum of Natural History and Culture, University of Washington, Seattle, WA 98195-1800, USA
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Roman N, Carney PC, Fiani N, Peralta S. Incidence patterns of orofacial clefts in purebred dogs. PLoS One 2019; 14:e0224574. [PMID: 31682628 PMCID: PMC6827884 DOI: 10.1371/journal.pone.0224574] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/16/2019] [Indexed: 02/08/2023] Open
Abstract
Cleft lip (CL), cleft palate (CP) and cleft lip and palate (CLP) are the most common types of orofacial clefts in dogs. Orofacial clefts in dogs are clinically relevant because of the associated morbidity and high newborn mortality rate and are of interest as comparative models of disease. However, the incidence of CL, CP and CLP has not been investigated in purebred dogs, and the financial impact on breeders is unknown. The aims of this study were to document the incidence patterns of CL, CP and CLP in different breeds of dogs, determine whether defect phenotype is associated with skull type, genetic cluster and geographic location, and estimate the financial impact in breeding programs in the United States by means of an anonymous online survey. A total of 228 orofacial clefts were reported among 7,429 puppies whelped in the 12 preceding months. Breeds in the mastiff/terrier genetic cluster and brachycephalic breeds were predisposed to orofacial clefts. Certain breeds in the ancient genetic cluster were at increased odds of orofacial clefts. Male purebred dogs were at increased odds of CPs. Results confirm that brachycephalic breeds are overrepresented among cases of orofacial clefts. Furthermore, geographic region appeared to be a relevant risk factor and orofacial clefts represented a considerable financial loss to breeders. Improved understanding of the epidemiology of orofacial clefts (frequency, causes, predictors and risk factors) may help in identifying ways to minimize their occurrence. Information gained may potentially help veterinarians and researchers to diagnose, treat and prevent orofacial clefts.
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Affiliation(s)
- Nicholas Roman
- College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Patrick C. Carney
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Nadine Fiani
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Santiago Peralta
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
- * E-mail:
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Kobayashi-Velasco S, Salineiro FCS, Gialain IO, Cavalcanti MGP. Diagnosis of alveolar and root fractures in macerated canine maxillae: a comparison between two different CBCT protocols. Dentomaxillofac Radiol 2017; 46:20170037. [PMID: 28613920 DOI: 10.1259/dmfr.20170037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To compare two small-field-of-view (FOV) CBCT protocols with different voxel sizes and number of frames for the diagnosis of root and alveolar fractures in macerated canine maxillae. METHODS 80 incisor teeth from the canine species were inserted in 80 anterior alveolar sockets of 20 canine maxillae. An operator randomly divided each maxilla site (80 sites in total) into 4 equal groups of 20 sites: 1 (sound tooth and non-fractured alveolar socket); 2 (sound tooth and fractured alveolar socket); 3 (fractured root and non-fractured alveolar socket); and 4 (fractured root and fractured alveolar socket). The CBCT images were obtained using two different protocols: normal (N) (voxel 0.20 mm, 400 frames and radiation exposure 5.6 mGy) and high definition (HD) (voxel 0.15 mm, 500 frames and radiation exposure 7.0 mGy). RESULTS Sensitivity numbers for alveolar fractures were lower than specificity, resulting in comparable areas under the receiver operating characteristic curves (AUC) for both protocols. Sensitivity, specificity and AUC for N and HD protocols were very similar for root fractures. When comparing AUC for both N and HD protocols by submitting them to Student's t-test, the comparison among the curves produced statistically non-significant results for alveolar fractures and root fractures likewise. CONCLUSIONS Our findings demonstrated that the elected protocol for the diagnosis of root and alveolar fractures was N. This protocol allowed similar diagnosis results than HD protocol; however, with a lower amount of radiation exposure for the patient (5.6 mGy for N vs 7.0 mGy for HD).
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Affiliation(s)
| | - Fernanda C S Salineiro
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ivan O Gialain
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marcelo G P Cavalcanti
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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8
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A comparative cephalometric study for adult operated cleft palate and unoperated cleft palate patients. J Craniomaxillofac Surg 2015; 43:1218-23. [DOI: 10.1016/j.jcms.2015.04.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 03/24/2015] [Accepted: 04/22/2015] [Indexed: 11/18/2022] Open
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9
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Esmail AHA, Abdo MAA, Krentz H, Lenz JH, Gundlach KK. Centre-based statistics of cleft lip with/without alveolus and palate as well as cleft palate only patients in Aden, Yemen. J Craniomaxillofac Surg 2014; 42:297-304. [DOI: 10.1016/j.jcms.2013.05.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 03/17/2013] [Accepted: 05/27/2013] [Indexed: 10/26/2022] Open
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