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Corcoran M, Karki S, Harila V, Kyngäs H, Luoto A, Ylikontiola LP, Sándor GK, Anttonen V. Oral health-related quality of life among young adults with cleft in northern Finland. Clin Exp Dent Res 2020; 6:305-310. [PMID: 32396275 PMCID: PMC7301391 DOI: 10.1002/cre2.284] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 02/01/2023] Open
Abstract
Objectives This study aimed to examine Oral Health‐related Quality of Life (OHRQoL) among patients with cleft lip with or without palate (CLP) at their final scheduled follow‐up visit at the age of 18 years. Another aim was to investigate the motivation to attend multiple follow‐up appointments and the satisfaction with care given by the cleft team using inductive qualitative analysis. Methods This cross‐sectional study was conducted among the cohort of children born with CLP who had undergone treatment at the Oulu University Hospital Cleft Lip and Palate Centre, in northern Finland since 1995. OHRQoL was assessed using the validated Finnish version of the short form of the Oral Health Impact Profile (OHIP‐14). In addition to the OHIP‐14, two open‐ended questions were also included. These questions investigated the experience of each participant concerning their motivation to attend the Oulu University Hospital Cleft Lip and Palate Centre to receive complex treatments, and their satisfaction with care provided by the cleft team. Results were presented as proportions, means, and SD. Inductive content analysis method was performed for analysis of the open‐ended questions. Results A total of 63 patients with CLP participated in this study. More than half of the participants had cleft palate. More than half of the participants reported an impact on OHRQoL (OHIP‐14 score ≥ 3). All the participants with bilateral cleft lip and palate, three fourths of the participants with unilateral cleft lip and palate, and half of the participants with cleft palate reported impact on OHRQoL. Inductive content analysis showed that one fourth of the participants reported a good outcome as a motivation to attend cleft center despite of complex procedures. All the participants reported their appreciation of the cleft team. Conclusions Despite the comprehensive treatment received by the patients born with a CLP, they still experienced lower OHRQoL, especially physical pain and psychological discomfort were more pronounced. However, good outcome, support, and oral health care being a normal routine were the motivating factors to attend a long and demanding oral health care regimen.
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Affiliation(s)
- Mirjami Corcoran
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Saujanya Karki
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Virpi Harila
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Helvi Kyngäs
- Research Unit of Nursing Science and Health Management, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - Anni Luoto
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Leena P Ylikontiola
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - George K Sándor
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Vuokko Anttonen
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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2
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Salokorpi N, Vuollo V, Sinikumpu JJ, Satanin L, Nestal Zibo H, Ylikontiola LP, Pirttiniemi P, Sándor GK, Serlo W. Increases in Cranial Volume with Posterior Cranial Vault Distraction in 31 Consecutive Cases. Neurosurgery 2018; 81:803-811. [PMID: 28383737 DOI: 10.1093/neuros/nyx125] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 02/18/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Posterior cranial vault distraction (PCVD) is a technique widely used in surgical treatment of craniosynostosis when cranial expansion is required. It has proven to be safe and to allow a significant increase of intracranial volume. OBJECTIVE To evaluate increases in intracranial volume as a result of PCVD performed in Oulu Craniofacial center using 2 different methods based on 3-dimensional (3-D) photogrammetric imaging or plain skull radiographs. METHODS All children less than 16 yr of age who were treated by PCVD (n = 31) from 2009 to 2015 at the Oulu Craniofacial Center were included. All patients were followed at outpatient clinics with plain radiographs performed for follow-up. In 5 patients, additional 3-D photogrammetric imaging was done pre- and postoperatively. RESULTS The mean intracranial volume increase was 25.0%, ranging from 16.9% to 39.4%. In 5 patients, the increase in volume was calculated from the photogrammetric 3-D images comprising a mean of 17.4%. Volume calculations from cephalograms in the same patients gave a mean of 20.8%. Whether the distraction was a primary operation or patient had undergone previous cranioplasty did not influence the achieved volumetric results. There were no statistically significant differences in the distraction results between different diagnostic groups. CONCLUSION PCVD is an effective surgical method to increase intracranial volume in a variety of clinical entities. Volumetric results of this procedure could be easily evaluated using 3-D photogrammetric imaging or plane radiographs that expose the patients to only low ionizing radiation doses.
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Affiliation(s)
- Niina Salokorpi
- Department of Neurosurgery, Oulu University Hospital, Oulu, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland.,Surgical Research Group, University of Oulu, Oulu, Finland
| | - Ville Vuollo
- Department of Orthodontics, Oral Health Sciences, Faculty of Medicine, University of Oulu, Finland
| | - Juha-Jaakko Sinikumpu
- Medical Research Center, Oulu University Hospital, Oulu, Finland.,Department of Children and Adolescent, Oulu University Hospital, Oulu, Finland.,PEDEGO Research Group, University of Oulu, Oulu, Finland
| | - Leonid Satanin
- Department of Pediatric Neurosurgery, Burdenko Institute, Moscow, Russian Federation
| | - Heleia Nestal Zibo
- Department of Maxillofacial Surgery, North Estonia Medical Centre, Tallinn, Estonia
| | - Leena P Ylikontiola
- Medical Research Center, Oulu University Hospital, Oulu, Finland.,Department of Tissue Engineering and Oral and Maxillofacial Surgery, University of Oulu, Oulu, Finland
| | - Pertti Pirttiniemi
- Medical Research Center, Oulu University Hospital, Oulu, Finland.,Department of Orthodontics, Oral Health Sciences, Faculty of Medicine, University of Oulu, Finland
| | - George K Sándor
- Medical Research Center, Oulu University Hospital, Oulu, Finland.,Department of Tissue Engineering and Oral and Maxillofacial Surgery, University of Oulu, Oulu, Finland
| | - Willy Serlo
- Medical Research Center, Oulu University Hospital, Oulu, Finland.,Department of Children and Adolescent, Oulu University Hospital, Oulu, Finland.,PEDEGO Research Group, University of Oulu, Oulu, Finland
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Abstract
Background: Autogenous bone graft harvesting from the iliac crest is associated with donor site morbidity. The aim of this report is to describe the use of piezosurgery as an attempt at morbidity reduction. Materials and Methods: A piezosurgical handpiece and its selection of tips can easily be accommodated in an iliac crest wound to osteotomize and allow the harvest and delivery of autogenous bone grafts. Results: Corticocancellous blocks or cancellous strips of autogenous bone can be readily harvested using a piezosurgical technique at the anterior iliac crest. Conclusion: Piezosurgery avoids some of the traumatic aspects of harvesting bone associated with the use of conventional rotary instruments or saws.
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Affiliation(s)
- Leena P Ylikontiola
- Department of Oral and Maxillofacial Surgery, Medical Research Center, Oulu University Hospital, Institute of Dentistry, University of Oulu, Oulu, Finland
| | - Ville Lehtonen
- Department of Oral and Maxillofacial Surgery, Medical Research Center, Oulu University Hospital, Institute of Dentistry, University of Oulu, Oulu, Finland
| | - George K Sándor
- Department of Oral and Maxillofacial Surgery, Medical Research Center, Oulu University Hospital, Institute of Dentistry, University of Oulu, Oulu, Finland; BioMediTech, Institute of Bioscience and Technology, University of Tampere, Tampere, Finland
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4
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Abstract
BACKGROUND The harvesting of a tooth as a candidate for tooth autotransplantation requires that the delicate dental tissues around the tooth be minimally traumatized. This is especially so for the periradicular tissues of the tooth root and the follicular tissues surrounding the crown. The aim of this report is to describe the use of piezosurgery as an attempt at morbidity reduction in the harvesting of teeth for autotransplantation. METHODS A piezosurgical handpiece and its selection of tips were easily adapted to allow the harvesting and delivery of teeth for autotransplantation purposes. RESULTS Twenty premolar teeth were harvested using a piezosurgical device. The harvested teeth were subsequently successfully autotransplanted. All twenty teeth healed in a satisfactory manner without excessive mobility or ankyloses. CONCLUSIONS Piezosurgery avoids some of the traumatic aspects of harvesting teeth and removing bone which are associated with thermal damage from the use of conventional rotary instruments or saws. Piezosurgery can be adapted to facilitate the predictable harvesting of teeth for autotransplantation purposes.
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Affiliation(s)
- Leena P Ylikontiola
- Department of Oral and Maxillofacial Surgery, Medical Research Center, Oulu University Hospital, Institute of Dentistry, University of Oulu, Oulu, Finland
| | - George K Sándor
- Department of Oral and Maxillofacial Surgery, Medical Research Center, Oulu University Hospital, Institute of Dentistry, University of Oulu, Oulu, Finland; BioMediTech, Institute of Bioscience and Technology, University of Tampere, Tampere, Finland
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5
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Lappalainen OP, Karhula S, Haapea M, Kyllönen L, Haimi S, Miettinen S, Saarakkala S, Korpi J, Ylikontiola LP, Serlo WS, Sándor GK. Bone healing in rabbit calvarial critical-sized defects filled with stem cells and growth factors combined with granular or solid scaffolds. Childs Nerv Syst 2016; 32:681-8. [PMID: 26782995 DOI: 10.1007/s00381-016-3017-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 01/06/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE In pediatric neurosurgery, decompressive craniectomy and correction of congenital cranial anomalies can result in major cranial defects. Corrective cranioplasty for the repair of these critical-sized defects is not only a cosmetic issue. The limited availability of suitable autogenous bone and the morbidity of donor site harvesting have driven the search for new approaches with biodegradable and bioactive materials. This study aimed to assess the healing of rabbit calvarial critical-sized defects filled with osteogenic material, either with bioactive glass scaffolds or tricalcium phosphate granules in various combinations with adipose stem cells or bone marrow stem cells, BMP-2, BMP-7, or VEGF to enhance osteogenesis. METHODS Eighty-two bicortical full thickness critical-sized calvarial defects were operated. Five defects were left empty as negative control defects. The remaining 77 defects were filled with solid bioactive glass scaffolds or tricalcium phosphate granules seeded with adipose or bone marrow derived stem cells in combination with BMP-2, BMP-7, or VEGF. The defects were allowed to heal for 6 weeks before histologic and micro-CT analyses. RESULTS Micro-CT examination at the 6-week post-operative time point revealed that defects filled with stem cell-seeded tricalcium phosphate granules resulted in new bone formation of 6.0 %, whereas defects with bioactive glass scaffolds with stem cells showed new bone formation of 0.5 to 1.7 %, depending on the growth factor used. CONCLUSIONS This study suggests that tricalcium phosphate granules combined with stem cells have osteogenic potential superior to solid bioactive glass scaffolds with stem cells and growth factors.
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Affiliation(s)
- Olli-Pekka Lappalainen
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital and Medical Research Center, University of Oulu, Oulu, Finland
| | - Sakari Karhula
- Research Group of Medical Imaging, Physics and Technology, Infotech Doctoral Program, University of Oulu, Oulu, Finland
| | - Marianne Haapea
- Department of Diagnostic Radiology, University of Oulu, Oulu, Finland
| | - Laura Kyllönen
- BioMediTech, Institute of Biosciences and Medical Technology, University of Tampere, Tampere, Finland
| | - Suvi Haimi
- BioMediTech, Institute of Biosciences and Medical Technology, University of Tampere, Tampere, Finland
| | - Susanna Miettinen
- BioMediTech, Institute of Biosciences and Medical Technology, University of Tampere, Tampere, Finland
| | - Simo Saarakkala
- Research Group of Medical Imaging, Physics and Technology, Infotech Doctoral Program, Department of Diagnostic Radiology, Medical Research Center, University of Oulu, Oulu, Finland
| | - Jarkko Korpi
- Department of Otolaryngology, Head and Neck Surgery, Oulu University Hospital, Oulu, Finland
| | - Leena P Ylikontiola
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital and Medical Research Center, University of Oulu, Oulu, Finland
| | - Willy S Serlo
- Department of Children and Adolescents, Division of Pediatric Surgery, Oulu University Hospital, Medical Research Center, PEDEGO Research Center, University of Oulu, Oulu, Finland
| | - George K Sándor
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital and Medical Research Center, University of Oulu, Oulu, Finland.
- BioMediTech, Institute of Biosciences and Medical Technology, University of Tampere, Tampere, Finland.
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6
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Abstract
BACKGROUND Cleft lip and palate patients often have a retruded maxilla with a severely narrowed deficient maxillary arch. This report aims to describe the management of severe maxillary retrusion and constriction in cleft lip and palate patients using distraction osteogenesis applied in serial sequence in two directions perpendicular to each other. MATERIALS AND METHODS Two adult male cleft lip and palate patients were treated with maxillary distraction osteogenesis in two stages. In the first stage, surgically assisted rapid palatal expansion with a tooth-borne device was performed to significantly expand the maxillary arch in the transverse dimension. After the teeth were orthodontically aligned, the horizontal distraction of the maxilla was made by two internal maxillary distraction devices. RESULTS In the first patient, the maxilla was initially widened by 11 mm and then distracted forward by 20 mm. Despite the breakage of the shaft of one of the two distractors at the end of distraction, a satisfactory occlusion was found at the time of distractor device removal. The maxillary position has remained stable through 8 years of follow-up. In the second patient, the palate was widened by 14 mm and the maxilla was distracted forward by 22 mm. The maxillary position has remained stable through 3 years of follow-up. CONCLUSION Sequential serial distraction of maxilla in two planes perpendicular to each other is a safe and stable approach for the treatment of cleft lip and palate patients with severe transverse and anteroposterior discrepancies.
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Affiliation(s)
- Leena P Ylikontiola
- Department of Oral and Maxillofacial Surgery, Medical Research Centre, Oulu University Hospital, Institute of Dentistry, University of Oulu, Oulu, Finland
| | - George K Sándor
- Department of Oral and Maxillofacial Surgery, Medical Research Centre, Oulu University Hospital, Institute of Dentistry, University of Oulu, Oulu, Finland; BioMediTech, Institute of Bioscience and Technology, University of Tampere, Tampere, Finland
| | - Virpi Harila
- Department of Oral Development and Orthodontics, Oral Health Sciences Research Group, Medical Research Centre, Oulu University Hospital, University of Oulu, Oulu, Finland
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Lehtonen V, Anttonen V, Ylikontiola LP, Koskinen S, Pesonen P, Sándor GK. Dental anomalies associated with cleft lip and palate in Northern Finland. Eur J Paediatr Dent 2015; 16:327-332. [PMID: 26637260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM Despite the reported occurrence of dental anomalies of cleft lip and palate, little is known about their prevalence in children from Northern Finland with cleft lip and palate. The aim was to investigate the prevalence of dental anomalies among patients with different types of clefts in Northern Finland. MATERIALS AND METHODS Design and Statistics: patient records of 139 subjects aged three years and older (with clefts treated in Oulu University Hospital, Finland during the period 1996-2010 (total n. 183) were analysed for dental anomalies including the number of teeth, morphological and developmental anomalies and their association with the cleft type. The analyses were carried out using Chi-square test and Fisher's exact test. Differences between the groups were considered statistically significant at p values < 0.05. RESULTS More than half of the patients had clefts of the hard palate, 18% of the lip and palate, and 13% of the lip. At least one dental anomaly was detected in 47% of the study population. Almost one in three (26.6%) subjects had at least one anomaly and 17.9% had two or three anomalies. The most common type of anomaly in permanent teeth were missing teeth followed by supernumerary teeth. Supernumerary teeth were significantly more apparent when the lip was involved in the cleft compared with palatal clefts. Missing teeth were less prevalent among those 5 years or younger. The prevalence of different anomalies was significantly associated with the cleft type in both age groups. CONCLUSIONS Dental anomalies are more prevalent among cleft children than in the general population in Finland. The most prevalent anomalies associated with cleft were missing and supernumerary teeth.
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Affiliation(s)
- V Lehtonen
- University of Oulu, Institute of Dentistry, Department of Paedodontics, Cariology and Endodontology, Oulu, Finland
| | - V Anttonen
- University of Oulu, Institute of Dentistry, Department of Paedodontics, Cariology and Endodontology. Oulu University Hospital, Oulu, Finland
| | - L P Ylikontiola
- University of Oulu, Institute of Dentistry, Department of Oral and Maxillofacial Surgery. Oulu University Hospital, Oulu, Finland
| | | | - P Pesonen
- University of Oulu, Institute of Dentistry, Department of Paedodontics, Cariology and Endodontology, Oulu, Finland
| | - G K Sándor
- University of Oulu, Institute of Dentistry, Department of Oral and Maxillofacial Surgery. Oulu University Hospital, Oulu, Finland
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8
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Lithovius RH, Lehtonen V, Autio TJ, Harila V, Anttonen V, Sándor GK, Ylikontiola LP. The association of cleft severity and cleft palate repair technique on hearing outcomes in children in northern Finland. J Craniomaxillofac Surg 2015; 43:1863-7. [PMID: 26421466 DOI: 10.1016/j.jcms.2015.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 07/29/2015] [Accepted: 08/18/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The consequences of cleft lip and palate include scaring, dental malformations, tooth misalignment, speech problems, and hearing loss. Otitis media with effusion causing hearing loss is a problem for many cleft palate patients. METHODS This study examines the association among cleft severity, palate repair technique, and hearing outcomes in children from northern Finland with clefts, aged 3-9 years. The study included 90 cleft patients who were treated at the Oulu University Hospital Cleft Lip and Palate Center between 1998 and 2011. The severity of the cleft, the surgical technique used to repair the palate, audiogram configuration data, and the need for ventilation tube placement were determined retrospectively from patient records. RESULTS Only 3.3% of cleft patients had an abnormal pure tone average hearing threshold representing abnormal hearing. Neither the surgical technique used to repair the cleft palate nor the severity of the cleft was a significant factor related to hearing loss or to the number of ventilation tubes required. Hearing improved significantly with increasing age over a span of 6 years. CONCLUSIONS Continuous follow-up with proactive placement of ventilation tubes before or at the time of palatoplasty results in hearing outcomes in cleft children that are similar to those reported in non-cleft children.
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Affiliation(s)
- Riitta H Lithovius
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Ville Lehtonen
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Oulu, Oulu University Hospital, Oulu, Finland; Department of Cariology, Paedodontics and Endodontology, University of Oulu, Oulu, Finland
| | - Timo J Autio
- Department of Otolaryngology, Faculty of Medicine, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Virpi Harila
- Department of Oral Development and Orthodontics, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Vuokko Anttonen
- Department of Cariology, Paedodontics and Endodontology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - George K Sándor
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Oulu, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland.
| | - Leena P Ylikontiola
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Oulu, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
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Kortelainen T, Tolvanen M, Luoto A, Ylikontiola LP, Sándor GK, Lahti S. Comparison of Oral Health-Related Quality of Life Among Schoolchildren With and Without Cleft Lip and/or Palate. Cleft Palate Craniofac J 2015; 53:e172-6. [PMID: 26171571 DOI: 10.1597/14-180] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim was to compare the oral health-related quality of life among 11- to 14-year-old patients with cleft lip and/or palate (CLP) and schoolchildren without CLP. The validity and reliability of the Finnish Child Perception Questionnaire designed for 11- to 14-year-olds (CPQ11-14) was also assessed. DESIGN AND SUBJECTS Participants in this cross-sectional questionnaire survey study were children aged 11 to 14 years from two groups. The CLP sample included all children of this age who had had CLP selected from the regional treatment register (N = 51). The school sample included children from four school classes (N = 82). Informed consent from parents was obtained. Ethical clearance and parental informed consent were obtained. MAIN OUTCOME MEASURES Oral health-related quality of life was measured with the CPQ11-14. RESULTS The CPQ11-14 total and oral symptoms, functional limitations, emotional well-being, and social well-being subscores were poorer among patients with CLP than among schoolchildren without CLP (mean scores: 55.5 versus 15.0; 11.9 versus 5.1; 14.0 versus 2.8; 12.6 versus 4.2; and 17.1 versus 2.9, respectively; all P < .001 for Mann-Whitney tests). Cronbach alpha value was 0.97 for total scale and between 0.81 and 0.94 for subscales. Among all children in the school sample, intraclass correlation coefficient was 0.79 for total scale and varied between 0.65 and 0.74 for subscales. CONCLUSION The oral health-related quality of life of Finnish children with CLP was considerably poorer than that of their peers in overall and all dimensions, especially social well-being. The CPQ11-14 showed appropriate reliability and validity.
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10
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Lehtonen V, Sándor GK, Ylikontiola LP, Koskinen S, Pesonen P, Harila V, Anttonen V. Dental treatment need and dental general anesthetics among preschool-age children with cleft lip and palate in northern Finland. Eur J Oral Sci 2015; 123:254-9. [DOI: 10.1111/eos.12195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Ville Lehtonen
- Department of Cariology, Paedodontics and Endodontology; Institute of Dentistry; University of Oulu; Oulu Finland
| | - George K. Sándor
- Department of Oral and Maxillofacial Surgery; Institute of Dentistry; University of Oulu; Oulu Finland
- Medical Research Center Oulu; Oulu University Hospital and University of Oulu; Oulu Finland
| | - Leena P. Ylikontiola
- Department of Oral and Maxillofacial Surgery; Institute of Dentistry; University of Oulu; Oulu Finland
- Medical Research Center Oulu; Oulu University Hospital and University of Oulu; Oulu Finland
| | | | - Paula Pesonen
- Institute of Dentistry; University of Oulu; Oulu Finland
| | - Virpi Harila
- Medical Research Center Oulu; Oulu University Hospital and University of Oulu; Oulu Finland
- Department of Oral Development and Orthodontics; Institute of Dentistry; University of Oulu; Oulu Finland
| | - Vuokko Anttonen
- Department of Cariology, Paedodontics and Endodontology; Institute of Dentistry; University of Oulu; Oulu Finland
- Medical Research Center Oulu; Oulu University Hospital and University of Oulu; Oulu Finland
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11
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Harila V, Ylikontiola LP, Sándor GK. Dental arch relationships assessed by GOSLON Yardstick in children with clefts in Northern Finland. Eur J Paediatr Dent 2014; 15:389-391. [PMID: 25517586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Our purpose was to evaluate the dental arch relationships using the GOSLON Yardstick in children with cleft lip and or cleft palate in Northern Finland. MATERIALS AND METHODS The subjects consisted of 62 Finnish patients (36 girls and 26 boys) with clefts born between 1995-2005 in the Northern Ostrobothnia Hospital District of Finland. There were 36 patients with cleft palate, 9 with unilateral cleft lip and palate, 6 with cleft in soft palate, 5 with bilateral cleft lip and palate, 2 with cleft lip and 4 with submucous clefts. The study casts were obtained at the mean age of 6.3 years (5.8-7.8 years) and the cases were selected randomly. The dental arch relationships were assessed by the GOSLON Yardstick method by one calibrated researcher. RESULTS After the assessment, 77.1% of cases were allocated to categories 1 and 2 (excellent and good), 10.4% category 3 (fair), and 12.5% categories 4 and 5 (poor and very poor). Patients with cleft palate had good prognosis in 84.6% of the cases. Of the patients with soft palate clefts and unilateral cleft lip and palate, 66.7% were allocated to categories 1 and 2. Bilateral cleft lip and palate patients had the poorest prognosis. Patients with submucous cleft and cleft lip had all good prognosis. CONCLUSION The GOSLON Yardstick is a useful method for assessing dental arch relationships and treatment prognosis not only in cleft lip and palate patients, but also in cleft palate patients.
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Affiliation(s)
- V Harila
- Institute of Dentistry, University of Oulu, Department of Oral Development and Orthodontics, Oulu University Hospital Oulu, Finland
| | - L P Ylikontiola
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Institute of Dentistry, University of Oulu, Oulu, Finland
| | - G K Sándor
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Institute of Dentistry, University of Oulu, Oulu, Finland
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12
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Lithovius RH, Ylikontiola LP, Sándor GKB. Incidence of palatal fistula formation after primary palatoplasty in northern Finland. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:632-6. [PMID: 25283164 DOI: 10.1016/j.oooo.2014.07.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 06/28/2014] [Accepted: 07/01/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this retrospective study was to determine the incidence of palatal fistulas after primary cleft palate repair. STUDY DESIGN The study included 136 patients who were treated at the Oulu University Hospital cleft lip and palate center between 1998 and 2011. All patients were treated by the same surgeons with 1-stage palatoplasty closing the hard and soft palate concurrently. RESULTS The overall frequency of postoperative fistula was 9.6% of patients. Patients with cleft lip and palate (20.0%) were more likely to develop postoperative palatal fistulas than patients with cleft palate (6.6%). Surgical technique and cleft severity were not significant factors for the development of palatal fistulas. CONCLUSIONS The majority of patients undergoing primary palatal repair do not develop palatal fistulas.
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Affiliation(s)
- Riitta H Lithovius
- PhD candidate, Institute of Dentistry, University of Oulu, Oulu, Finland
| | - Leena P Ylikontiola
- Director of Cleft Lip and Palate Program, Oulu University Hospital, Institute of Dentistry, University of Oulu, Oulu, Finland
| | - George K B Sándor
- Professor of Oral and Maxillofacial Surgery, University of Oulu; Consultant, Oulu University Hospital; Professor of Tissue Engineering, BioMediTech, Institute of Biosciences and Medical Technology, University of Tampere, Tampere, Finland.
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13
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Abstract
OBJECTIVE The aim of this study was to determine the incidence of cleft lip and/or cleft palate in a population uniquely from Northern Finland. MATERIALS AND METHODS The records of a total of 214 cleft patients treated between 1998-2011 at the Oulu Cleft Lip and Palate Center at the University of Oulu were assessed on a retrospective basis. Data regarding cleft type, sex and side of cleft was collected and analyzed. Family history of clefting was investigated. RESULTS Cleft palate (68.7%) was most frequently found, followed by cleft lip and palate (18.7%) and cleft lip with or without alveolus (12.6%). Cleft palate occurred more frequently in females (63.3%) and cleft lip and palate was more frequently found in males (62.5%). The left side was more frequently affected in both male and female patients. Left-sided clefts were observed in 82% of patients compared to right-sided clefts in 18%. A family history of clefting was detected in 20.1% of patients. CONCLUSION The incidence of clefts in Northern Finland is higher than the corresponding incidence in other European countries. Cleft palate was the most frequent cleft type and it was more frequent in females. In males, cleft lip and palate was more frequent. The left side was more frequently affected in both genders. One fifth of the patients had a family history of clefts.
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Affiliation(s)
- Riitta H Lithovius
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Oulu, Oulu Cleft Lip and Palate Center, Oulu University Hospital , Oulu , Finland
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Lithovius RH, Ylikontiola LP, Sándor GK. Frequency of pharyngoplasty after primary repair of cleft palate in northern Finland. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:430-4. [DOI: 10.1016/j.oooo.2013.12.409] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 11/30/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022]
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Abstract
OBJECTIVE The aim of this study was to examine the maxillary arch dimensions in cleft lip and/or palate infants in Northern Finland before surgery. MATERIALS AND METHODS The subjects consisted of 70 Finnish cleft patients born between 1997-2004 in Northern Ostrobothnia Hospital District in Finland. The study casts were obtained before surgery at the mean age of 5.6 months (SD = 2.2). There were 42 children with cleft palate (CP) (26 girls/16 boys), 13 with unilateral cleft lip and palate (UCLP) (eight girls/five boys), eight children with cleft lip (CL)(two girls/six boys) and seven with bilateral cleft lip and palate (BCLP) (two girls/five boys). Conventionally-used landmarks were marked on study casts and cleft width, arch circumference, anterior and posterior arch width and arch length were measured with a digital sliding calliper. The statistical method was ANOVA. RESULTS The prevalence of CP in this study, 60% of all clefts, is higher than the average standards. There were statistically significant differences in cleft width, posterior and anterior arch width, arch length and arch circumference, when different cleft groups were compared. When differences between girls and boys were compared, boys had larger cleft size and arch dimensions generally, but the results were not statistically significant. CONCLUSIONS The results show the large variation in the severity of cleft lip and/or palate deformity at birth and in maxillary arch dimensions between different cleft types. It also demonstrates the effect of phenotypic variability within the groups of cleft lip and/or palate.
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Affiliation(s)
- Virpi Harila
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Oulu, Oulu Cleft Lip and Palate Center, Oulu University Hospital, Oulu, Finland.
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16
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Abstract
BACKGROUND Craniosynostosis compromises the cranial vault volume, severely impede growth, and may lead to increased intracranial pressure (ICP). Posterior cranial vault (PCV) distraction osteogenesis (DO) offers an excellent treatment opportunity for this condition. This article intends to describe the outcomes of PCV DO. MATERIALS AND METHODS Nine males and seven female children indicated for PCV DO were included in the study. The single vector distraction devices with quick-disconnect distraction rods, a type of miniaturized hardware, was used in all cases. RESULT Seven of the 16 patients had a history of one or more prior cranioplasty. All reoperations in this series were performed for the indication of raised ICP including five of the scaphocephaly patients and the syndromic patients. Clinical signs of raised ICP were present in all patients with either measured raised intracranial pressure or those with clinical signs of raised ICP preoperatively. There was substantial decrease in the ICP postoperatively. DISCUSSION The outcomes of this study were encouraging. Placing the distractor stems as flat as possible against the outer layer of the cranial bone seems to be a very important maneuver. This keeps the distractor stem less proud and less likely to sustain future trauma. Removal of the distractor stems keeps the devices further away from the risk of later traumatic dislodgement. Moreover, miniaturized distractors allow precise control of the rate and the amount of distraction.
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Affiliation(s)
- Leena P Ylikontiola
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland
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Sándor GK, Korpi JT, Ylikontiola LP, Salokorpi N, Katisko J, Kumpulainen T. Navigation-Assisted Le Fort I Osteotomy With Midpalatal Split to Treat Compressive Pathologies of the Craniovertebral Junction. J Oral Maxillofac Surg 2013; 71:e120-5. [DOI: 10.1016/j.joms.2012.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 09/25/2012] [Accepted: 09/26/2012] [Indexed: 10/27/2022]
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Affiliation(s)
- George K B Sándor
- Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, Ontario, Canada.
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Abstract
Asymmetries of the craniofacial region encompass a multitude of diverse and potentially complex abnormalities that may be the result of numerous causes. The expression and degree of asymmetry for a given condition, although a highly variable process, is the ultimate determinant of the nature of its treatment. This article highlights some of the key features and treatment strategies for various common facial asymmetries.
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Affiliation(s)
- George K B Sándor
- Graduate Program in Oral and Maxillofacial Surgery and Anesthesia, University of Toronto, Toronto, Ontario, Canada.
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Serlo WS, Ylikontiola LP, Vesala AL, Kaarela OI, Iber T, Sándor GKB, Ashammakhi N. Effective correction of frontal cranial deformities using biodegradable fixation on the inner surface of the cranial bones during infancy. Childs Nerv Syst 2007; 23:1439-45. [PMID: 17901962 DOI: 10.1007/s00381-007-0470-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE Fixation of cranial bones in pediatric craniofacial surgery with biodegradable materials has developed into an accepted method. However, placing the fixation material on the outer surface of the cranial bone at the frontal cranium in infants can result in suboptimal cosmetic outcomes, as the plates and screws can be palpable. The placement of resorbable fixation devices on the inner surface of the skull would allow for less obvious fixation beneath the skin with a potentially superior cosmetic result. The authors report the use of such resorbable fixation devices on the inner or endocranial aspect of the cranium which appears to be novel. MATERIALS AND METHODS Ten patients with the mean age of 14 months (range 7-35 months) were treated with cranial remodeling using poly(lactide-co-glycolide) (PLGA) biodegradable fixation on the inner surface of the cranial bones. Five patients had trigonocephaly, four plagiocephaly, and one brachycephaly. All patients had 3D computed tomography (CT) and clinical photographs done preoperatively and postoperatively at follow-up. The outcome was judged at follow-up by clinical evaluation, photographs, 3D CT, and interview of the parents. The mean follow-up time was 3.5 years (range 0.5-6 years). RESULTS The primary recovery was uneventful in all cases. No wound infection occurred, but one patient had a minor skin necrosis which required a single revision operation to correct. The cosmetic outcome was scored as excellent, good, fair, or poor. There was no case with delayed union. Seven out of ten cases were judged as excellent and three as good, none as fair or poor. CONCLUSIONS The use of resorbable PLGA fixation devices on the inner aspect of the skull appears to provide a satisfactory cosmetic result in this small preliminary group of pediatric patients. Further long-term study of these materials in this specific location in a larger patient group is needed.
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Affiliation(s)
- Willy S Serlo
- Department of Surgery and Paediatrics, Division of Pediatric Surgery, Oulu University, Oulu, Finland
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Sàndor GKB, Ylikontiola LP. Patient evaluation of outcomes of external rhinoplasty for unilateral cleft lip and palate. Int J Oral Maxillofac Surg 2006; 35:407-11. [PMID: 16513323 DOI: 10.1016/j.ijom.2006.01.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2005] [Revised: 10/24/2005] [Accepted: 01/16/2006] [Indexed: 11/18/2022]
Abstract
Thirty-five patients (range 16-59 years) with cleft-lip nasal deformity treated by external rhinoplasty were evaluated for satisfaction and perception of outcomes. Treatment involved alar base relocation and augmentation of the asymmetric nasal tip with auricular cartilage grafts. The patients completed a satisfaction survey and interview at the 2-year follow-up visit. A visual analogue scale (VAS) numbered 0-10 was also used by the patients to grade outcome compared to preoperative appearance at 4 anatomic sites. Prior to surgery, the nasal tip was perceived as being most deformed (15/35), followed by alar position (12/35) and nasal apertures (8/35). The site on the nose most improved by surgery was the tip (15), followed by alar position (10), symmetry of nostrils (6) and dorsum (4). The highest VAS score was for the tip (8.32), followed by alar position (7.59), dorsum (7.41) and symmetry of nostrils (6.73). No patients suffered long-term pain for more than 2 months following surgery. All patients were prepared to undergo such procedure for a second time, if necessary. The unilateral cleft-lip nasal deformity can be improved in the eyes of the patient, using the combination of external rhinoplasty with alar base relocation, where necessary, and auricular cartilage augmentation of the nasal tip.
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Affiliation(s)
- G K B Sàndor
- University of Toronto, Mount Sinai Hospital, Bloorview MacMillan Children's Centre, The Hospital for Sick Children, S-525, 555 University Avenue, Toronto, Canada M5G 1X8.
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