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Soğukpınar M, Utine GE, Boduroğlu K, Şimşek-Kiper PÖ. A spectrum of TP63-related disorders with eight affected individuals in five unrelated families. Eur J Med Genet 2024; 68:104911. [PMID: 38281558 DOI: 10.1016/j.ejmg.2024.104911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 11/08/2023] [Accepted: 01/20/2024] [Indexed: 01/30/2024]
Abstract
TP63-related disdorders broadly involve varying combinations of ectodermal dysplasia (sparse hair, hypohydrosis, tooth abnormalities, nail dysplasia), cleft lip/palate, acromelic malformation, split-hand/foot malformation/syndactyly, ankyloblepharon filiforme adnatum, lacrimal duct obstruction, hypopigmentation, and hypoplastic breasts and/or nipples. TP63-related disorders are associated with heterozygous pathogenic variants in TP63 and include seven overlapping phenotypes; Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome (AEC), Ectrodactyly-ectodermal dysplasia-cleft lip/palate syndrome 3 (EEC3), Limb-mammary syndrome (LMS), Acro-dermo-ungual-lacrimal-tooth syndrome (ADULT), Rapp-Hodgkin syndrome (RHS), Split-hand/foot malformation 4 (SHFM4), and Orofacial cleft 8. We report on five unrelated families with 8 affected individuals in which the probands presented with varying combinations of ectodermal dysplasia, cleft lip/palate, split-hand/foot malformation, lacrimal duct obstruction, and ankyloblepharon filiforme adnatum. The clinical diagnosis involved AEC syndrome (2 patients), EEC3 syndrome (2 patients), and a yet hitherto unclassified TP63-related disorder. Sanger sequence analysis of the TP63 gene was performed revealing five different variants among which four were novel and three were de novo. The identificated TP63 variants co-segregated with the other affected individuals in the families. The abnormalities of ectoderm derived structures including hair, nails, sweat glands, and teeth should alert the physician to the possibility of TP63-related disorders particularly in the presence of orofacial clefting.
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Affiliation(s)
- Merve Soğukpınar
- Department of Pediatric Genetics, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
| | - Gülen Eda Utine
- Department of Pediatric Genetics, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Koray Boduroğlu
- Department of Pediatric Genetics, Hacettepe University, Faculty of Medicine, Ankara, Turkey
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de Vries ME, Carpinelli MR, Fuller JN, Sutton Y, Partridge DD, Auden A, Anderson PJ, Jane SM, Dworkin S. Grainyhead-like 2 interacts with noggin to regulate tissue fusion in mouse. Development 2024; 151:dev202420. [PMID: 38300806 PMCID: PMC10946436 DOI: 10.1242/dev.202420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/29/2024] [Indexed: 02/03/2024]
Abstract
Defective tissue fusion during mammalian embryogenesis results in congenital anomalies, such as exencephaly, spina bifida and cleft lip and/or palate. The highly conserved transcription factor grainyhead-like 2 (Grhl2) is a crucial regulator of tissue fusion, with mouse models lacking GRHL2 function presenting with a fully penetrant open cranial neural tube, facial and abdominal clefting (abdominoschisis), and an open posterior neuropore. Here, we show that GRHL2 interacts with the soluble morphogen protein and bone morphogenetic protein (BMP) inhibitor noggin (NOG) to impact tissue fusion during development. The maxillary prominence epithelium in embryos lacking Grhl2 shows substantial morphological abnormalities and significant upregulation of NOG expression, together with aberrantly distributed pSMAD5-positive cells within the neural crest cell-derived maxillary prominence mesenchyme, indicative of disrupted BMP signalling. Reducing this elevated NOG expression (by generating Grhl2-/-;Nog+/- embryos) results in delayed embryonic lethality, partial tissue fusion rescue, and restoration of tissue form within the craniofacial epithelia. These data suggest that aberrant epithelial maintenance, partially regulated by noggin-mediated regulation of BMP-SMAD pathways, may underpin tissue fusion defects in Grhl2-/- mice.
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Affiliation(s)
- Michael E. de Vries
- Department of Medicine, Monash University Central Clinical School, Prahran, Victoria 3004, Australia
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Marina R. Carpinelli
- Department of Medicine, Monash University Central Clinical School, Prahran, Victoria 3004, Australia
| | - Jarrad N. Fuller
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Yindi Sutton
- Department of Medicine, Monash University Central Clinical School, Prahran, Victoria 3004, Australia
| | - Darren D. Partridge
- Department of Medicine, Monash University Central Clinical School, Prahran, Victoria 3004, Australia
| | - Alana Auden
- Department of Medicine, Monash University Central Clinical School, Prahran, Victoria 3004, Australia
| | - Peter J. Anderson
- Australian Craniofacial Unit, Women and Children's Hospital, Adelaide, SA 5005, Australia
- Faculty of Health Sciences, University of Adelaide, Adelaide, SA 5005, Australia
- School of Basic Medical Sciences, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Stephen M. Jane
- Department of Medicine, Monash University Central Clinical School, Prahran, Victoria 3004, Australia
| | - Sebastian Dworkin
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Melbourne, Victoria 3086, Australia
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Alayyash A, Alam MK, Rashid ME, Mathew A, Di Blasio M, Ronsivalle V, Cicciù M, Minervini G. Prenatal incidence of cleft lip/palate and cocaine abuse in parents: a systematic review and meta-analysis. BMC Oral Health 2024; 24:185. [PMID: 38317147 PMCID: PMC10840297 DOI: 10.1186/s12903-024-03884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/10/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The study aimed to investigate the association between maternal cocaine abuse during pregnancy and the prevalence of cleft lip/palate (CL/P) in offspring, synthesizing existing evidence through a systematic review and meta-analysis. CL/P is a congenital craniofacial anomaly with complex etiology, and prior research has suggested potential links between maternal cocaine use and CL/P. However, these associations remain inconclusive. METHODS A comprehensive literature search was conducted to identify relevant studies published up to the study's cutoff date in September 2021. Several databases were systematically searched using predefined search terms. Inclusion criteria were set to encompass studies reporting on the prevalence of CL/P in infants born to mothers with a history of cocaine use during pregnancy, with a comparison group of non-cocaine-using mothers. Data were extracted, and a meta-analysis was performed using a random-effects model to calculate pooled odds ratios (OR) and relative risks (RR) with their respective 95% confidence intervals (CI). RESULTS The review included data from 4 studies that met the inclusion criteria. The combined OR from two studies was 0.05 (95% CI: 0.00, 4.41), which does not suggest a statistically significant association between prenatal cocaine exposure and the incidence of CL/P due to the confidence interval crossing the null value. Additionally, the combined RR was 0.17 (95% CI: 0.04, 0.66), indicating a statistically significant decrease in the risk of CL/P associated with prenatal cocaine exposure. These results, with an OR that is not statistically significant and an RR suggesting decreased risk, should be interpreted with caution due to considerable heterogeneity and variability among the included studies' findings. Further research is needed to clarify these associations. CONCLUSION The findings from this systematic review and meta-analysis suggest that maternal cocaine use during pregnancy is not a statistically significant independent risk factor for the development of CL/P in offspring. These results underscore the multifactorial nature of CL/P etiology and emphasize the importance of considering other genetic, environmental, and nutritional factors in understanding the condition's origins. While the study provides important insights, limitations such as data heterogeneity and potential confounders should be acknowledged. Future research should adopt rigorous study designs and explore a broader range of potential risk factors to comprehensively elucidate CL/P development.
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Affiliation(s)
- Afnan Alayyash
- Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Mohammad Khursheed Alam
- Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia.
- Department of Dental Research Cell, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Chennai, 600077, India.
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, 1207, Bangladesh.
| | - Mohammed Enamur Rashid
- Department of Oral Basic and Clinical Sciences, College of Dentistry, Taibah University, Al Madinah, Al Munawara, Kingdom of Saudi Arabia
| | - Asok Mathew
- Clinical Science Department, Center of Medical and Bioallied Health Sciences Research, Ajman University, Ajman, UAE
| | - Marco Di Blasio
- University Center of Dentistry, Department of Medicine and Surgery, University of Parma, 43126, Parma, Italy.
| | - Vincenzo Ronsivalle
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, Luigi Vanvitelli, 80138, Naples, Italy
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Zahedipour F, Khorram Khorshid HR, Esmaeilzadeh E, Kamali K, Ebadifar A. Association of MMP2 and MMP9 gene polymorphisms with nonsyndromic cleft lip/palate in an Iranian population. J Dent Res Dent Clin Dent Prospects 2023; 17:149-153. [PMID: 38023796 PMCID: PMC10676531 DOI: 10.34172/joddd.2023.40640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background Cleft lip/palate (CL/P) is a prevalent congenital disorder. Matrix metalloproteinases (MMPs) play a role in palatogenesis and have been proposed to be associated with nonsyndromic CL/P development. This study aimed to examine the association of MMP2 (rs243866) and MMP9 (rs3918242) gene polymorphism with nonsyndromic CL/P in an Iranian population. Methods Blood samples were collected from 120 nonsyndromic CL/P patients and 140 healthy newborns in this case-control study. DNA extraction was performed by the salting-out method, and the samples underwent polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP), using Pag and SphI enzymes, for genotyping MMP2 and MMP9 gene polymorphisms. Statistical analysis was performed with SPSS 11.5. Univariate and multivariate logistic regression models were used to calculate the odds ratios and 95% confidence intervals (CIs). The level of statistical significance was set at P<0.05. Results No significant association was found between MMP2 gene polymorphism and nonsyndromic CL/P. However, the MMP9 gene polymorphism had a significant association with nonsyndromic CL/P, with a higher prevalence of the T allele and TT genotype in the case group than the control group. Conclusion This study indicated a potential link between MMP9 gene polymorphism and nonsyndromic CL/P in an Iranian population. Future investigations with greater sample diversity and larger sample sizes are required to obtain more comprehensive and robust evidence. In-depth analyses and studies involving different ethnic groups can further enhance our understanding of the genetic underpinnings of CL/P.
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Affiliation(s)
- Fatemeh Zahedipour
- Department of Orthodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Koorosh Kamali
- Department of Public Health, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Asghar Ebadifar
- Dentofacial Deformities Research Center, Research Institute of Dental Sciences, Department of Orthodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Idso S, Holloway J, Patel P, Zhao L, Forbes D, Liu D. Airway changes in patients with unilateral cleft lip/palate (UCL/P) after maxillary advancement. Angle Orthod 2023; 93:727-735. [PMID: 37319320 PMCID: PMC10633796 DOI: 10.2319/110722-764.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/01/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVES To assess the effect on the retropalatal airway (RPA), retroglossal airway (RGA), and total airway (TA) volumes and cephalometrics (SNA, SNB, ANB, PP-SN, Occl-SN, N-A, A-TVL, B-TVL) after maxillary advancement orthognathic surgery in patients with unilateral cleft lip/palate (UCL/P) using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT scans of 30 patients (13 males and 17 females, 17-20 years old) with UCL/P were evaluated at two time points: preoperative (T1) and postoperative (T2). The interval between T1 and T2 ranged from 9-14 weeks, except for two patients in whom the interval was 24 weeks. Intraexaminer reliability was measured with an intraclass correlation coefficient test. A paired t-test was used to compare the airway and cephalometric measurements between T1 and T2, with a P value of .05 being considered significant. RESULTS From T1 to T2, significant increases were found in the volumes of RPA (from 9574 ± 4573 to 10,472 ± 4767, P = .019), RGA (from 9736 ± 5314 to 11,358 ± 6588, P = .019), and TA (from 19,121 ± 8480 to 21,750 ± 10,078, P = .002). In addition, the RGA (from 385 ± 134 to 427 ± 165, P = .020) and TA (from 730 ± 213 to 772 ± 238, P = .016) sagittal area increased significantly. For minimal cross-sectional area (MCA), only the RPA increased significantly (from 173 ± 115 to 272 ± 129, P = .002). All cephalometric changes were statistically significant between T1 and T2 except for SNB. CONCLUSIONS Maxillary advancement in patients with UCL/P produces statistically significant increases in the retropalatal (volumetric and MCA), retroglossal (volumetric and sagittal), and total (volumetric and sagittal) airways based on data from CBCT imaging.
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Affiliation(s)
| | | | | | | | | | - Dawei Liu
- Corresponding author: Dr Dawei Liu, Department of Developmental Sciences/Orthodontics, Marquette University School of Dentistry, 1801 West Wisconsin Ave, Milwaukee, WI 53233, USA (e-mail: )
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Alshammari AK, AlDakhayel S, Alsulaiman G, Alzoori F, Alghurayes A, Alshammari T, Algharbi M, Siddiqui AA. Impact of Orofacial Clefts on Oral Health Quality of Life: A Cross-sectional Survey Study in Saudi Arabia. J Contemp Dent Pract 2023; 24:655-659. [PMID: 38152938 DOI: 10.5005/jp-journals-10024-3531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIM To evaluate the effect of facial clefts on the dental health quality of life of affected individuals, and to determine whether age and gender affect the oral health quality of life differently. MATERIALS AND METHODS The cross-sectional survey included 50 participants (32 females and 18 males) from the northern region of Saudi Arabia, using a reliable and validated questionnaire, the Child Oral Health Impact Profile (COHIP), which measured self-reported oral health-related quality of life (OHRQoL) in children and adults using a five-point Likert scale. Statistical analysis was performed, and results were considered significant if the p-value was less than 0.05. RESULTS The highest scores in the oral health domain were related to bad breath and reluctance in speaking or reading aloud in class within the school environment domain, with mean scores of 3.44 ± 1.3 and 3.52 ± 1.2, respectively. Most patients showed apprehension regarding necessary dental treatments (mean = 1.44 ± 0.07). The study found a non-statistically significant difference in tooth discomfort between age groups (p = 0.092), with individuals aged from 20 to 29 experiencing higher levels of discomfort than other age groups surveyed. CONCLUSION The two topics with the highest mean scores in the oral health domain and the school environment domain were bad breath and not wanting to speak or read aloud in class. Females reported more discomfort, and there was a substantial association between gender and tooth pain/sensitivity. CLINICAL SIGNIFICANCE Understanding the difficulties cleft patients face is crucial, as doing so will enable dentists to encourage and handle these issues more effectively.
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Affiliation(s)
- Abdulrahman K Alshammari
- Department of Preventive dentistry, College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia, Phone: +966 598092207, e-mail:
| | - Safanah AlDakhayel
- Dental Intern, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | | | - Fatemah Alzoori
- Dental Intern, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | | | - Taif Alshammari
- Dental Intern, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | - Muteb Algharbi
- Department of Preventive dentistry, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | - Ammar A Siddiqui
- Department of Preventive dentistry, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
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Sander AK, Grau E, Bartella AK, Kloss-Brandstätter A, Neuhaus M, Zimmerer R, Lethaus B. Dental anomalies and their therapeutic implications: retrospective assessment of a frequent finding in patients with cleft lip and palate. BMC Oral Health 2022; 22:553. [PMID: 36457084 PMCID: PMC9714158 DOI: 10.1186/s12903-022-02606-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 11/18/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Orofacial clefts are characterized by a frequent occurrence of dental anomalies. Numerous studies demonstrate the high prevalence of dental aplasia, supernumerary teeth, and hypoplastic teeth in patients with cleft lip with/without cleft palate (CL/P), yet the therapeutic consequences are rarely discussed. This study explores prevalence, localization, and association between primary and secondary dentition in a large European collective and begins to evaluate the significance of dental anomalies in the therapeutic course of patients with CL/P. METHODS The medical reports of 1070 patients with different entities of CL/P who presented to our clinic within a 15-year investigation period were evaluated retrospectively. Dental anomalies were classified into three different diagnostic groups: dental aplasia, supernumerary teeth and hypoplastic teeth. The statistical analyses included studies of the frequency and localization of dental anomalies in different cleft entities as well as of the association between primary and secondary dentition and the therapeutic consequences. RESULTS Uni- or bilateral cleft lip and palate (CLP) (47.5%) occurred most frequently, followed by cleft palate only (CPO) (32.9%) and cleft lip with or without alveolus (CL ± A) (19.6%). Dental anomalies were found significantly more often on the side of the cleft. Aplastic permanent teeth were mostly found in patients with CLP (54.8%), while supernumerary permanent teeth occurred primarily in patients with CL ± A (21.7%). Patients with CPO presented dental aplasia but no patient with CPO showed supernumerary teeth. The occurrence of dental aplasia in the primary dentition significantly increases the probability of aplastic teeth in the permanent dentition. Dental anomalies, in particular dental aplasia, significantly increase patients' need for subsequent orthodontic therapy and orthognathic surgery. CONCLUSION Dental aplasia and hypoplasia are common in patients with CL/P not only in the cleft area but in the whole dentition. In the event of dental aplasia in the primary dentition, the frequency of aplastic teeth in the permanent dentition is significantly higher. Additionally, the need for therapeutic interventions, especially concerning orthognathic surgery, seems to be significantly higher in patients with CL/P who are affected by dental anomalies. Clinicians should take this into account when creating long-term treatment plans.
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Affiliation(s)
- A. K. Sander
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - E. Grau
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - A. K. Bartella
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - A. Kloss-Brandstätter
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - M. Neuhaus
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - R. Zimmerer
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - B. Lethaus
- grid.411339.d0000 0000 8517 9062Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
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Coste MC, Huby M, Neiva-Vaz C, Soupre V, Picard A, Kadlub N. Evaluation of prenatal breastfeeding workshop to inform and support mother with antenatal diagnosis of cleft lip/palate. J Stomatol Oral Maxillofac Surg 2022; 123:e1002-e1006. [PMID: 35760311 DOI: 10.1016/j.jormas.2022.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/08/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION To support mother with antenatal diagnosis of cleft lip/palate (CL/P), we implement an antenatal breastfeeding workshop to promote breastfeeding and its continuation. The aim of this study was to evaluate patient satisfaction after this workshop and efficiency of this workshop on breastfeeding rates and duration. MATERIALS AND METHODS We conducted a prospective study from February 2018 to April 2022. Patients received two surveys after the workshop and after birth, to evaluate their satisfaction. A prospective breastfeeding follow-up were pursued by email, at 1-3-6 and 12 months to determine if the breastfeeding had been continued or stopped. RESULTS We included 124 pregnant women who participated to the workshop. After the workshop, most participants (114/124) answered to the first survey. Amongst the 114 participants who answered to the first survey, 45 participated to a face-to-face workshop; and 69 to a teleworkshop. Participants were globally satisfied or very satisfied from the workshop; and felt more capable to breastfeed their child. 95/124 participants answered to the second survey. Most of the participants considered that the workshop had help them carry on a maternal milk feeding to their child Breastfeeding was pursued 1 month at 90%, 3 months at 62.5%, 6 months at 41.9%, after 6 months at 18.4%. Duration of breastfeeding were not statistically different, depending on the cleft type(p = 0.022). CONCLUSION The prenatal information helped the future mothers and met their requests and needs. The satisfaction rate reflected the importance of informing and supporting mothers in their feeding choices for their infants. The rate of breastfeeding at birth of a cleft-infant, whatever its type, for mothers who participated in the breastfeeding workshop, was over 90%.
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Affiliation(s)
- Marie-Camille Coste
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, 146 rue de Sèvres, Paris 75015, France; Facial Cleft and Malformation National Network, Paris, France
| | - Marine Huby
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, 146 rue de Sèvres, Paris 75015, France; Facial Cleft and Malformation National Network, Paris, France
| | - Cécilia Neiva-Vaz
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, 146 rue de Sèvres, Paris 75015, France; Facial Cleft and Malformation National Network, Paris, France
| | - Véronique Soupre
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, 146 rue de Sèvres, Paris 75015, France; Facial Cleft and Malformation National Network, Paris, France
| | - Arnaud Picard
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, 146 rue de Sèvres, Paris 75015, France; Facial Cleft and Malformation National Network, Paris, France; University of Paris, France
| | - Natacha Kadlub
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, 146 rue de Sèvres, Paris 75015, France; Facial Cleft and Malformation National Network, Paris, France; University of Paris, France.
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Parisi L, Rihs S, La Scala GC, Schnyder I, Katsaros C, Degen M. Discovery and characterization of heterogeneous and multipotent fibroblast populations isolated from excised cleft lip tissue. Stem Cell Res Ther 2022; 13:469. [PMID: 36076255 PMCID: PMC9461253 DOI: 10.1186/s13287-022-03154-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 06/23/2022] [Accepted: 08/22/2022] [Indexed: 11/21/2022] Open
Abstract
Background Regularly discarded lip tissue obtained from corrective surgeries to close the cleft lip represents an easily accessible and rich source for the isolation of primary fibroblasts. Primary fibroblasts have been described to show compelling similarities to mesenchymal stem cells (MSCs). Hence, cleft lip and palate (CLP) lip-derived fibroblasts could be thought as an intriguing cell source for personalized regenerative therapies in CLP-affected patients. Methods Initially, we thoroughly characterized the fibroblastic nature of the lip-derived mesenchymal outgrowths by molecular and functional assays. Next, we compared their phenotype and genotype to that of bone marrow-mesenchymal stem cells (BM-MSCs) and of human lung-derived fibroblasts WI38, by assessing their morphology, surface marker expression, trilineage differentiation potential, colony-forming (CFU) capacity, and immunomodulation property. Finally, to better decipher the heterogeneity of our CLP cultures, we performed a single cell clonal analysis and tested expanded clones for surface marker expression, as well as osteogenic and CFU potential. Results We identified intriguingly similar phenotypic and genotypic properties between CLP lip fibroblasts and BM-MSCs, which makes them distinct from WI38. Furthermore, our own data in combination with the complex anatomy of the lip tissue indicated heterogeneity in our CLP cultures. Using a clonal analysis, we discovered single cell-derived clones with increased levels of the MSC markers CD106 and CD146 and clones with variabilities in their commitment to differentiate into bone-forming cells and in their potential to form single cell-derived colonies. However, we were not able to gain clones possessing superior MSC-like capacities when compared to the heterogeneous parental CLP population. Additionally, all clones could still generate contractile forces and retained robust levels of the fibroblast specific marker FSP1, which was not detectable in BM-MSCs. Conclusions Our results suggest that we isolate heterogeneous populations of fibroblasts from discarded CLP lip tissue, which show a prominently multipotent character in their entirety avoiding the need for elaborate subpopulation selections in vitro. These findings suggest that CLP lip fibroblasts might be a novel potential cell source for personalized regenerative medicine of clinical benefit for CLP patients. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-022-03154-x.
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Affiliation(s)
- Ludovica Parisi
- Laboratory for Oral Molecular Biology, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Silvia Rihs
- Laboratory for Oral Molecular Biology, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Giorgio C La Scala
- Division of Pediatric Surgery, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - Isabelle Schnyder
- University Clinic for Pediatric Surgery, Bern University Hospital, Bern, Switzerland
| | - Christos Katsaros
- Laboratory for Oral Molecular Biology, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Martin Degen
- Laboratory for Oral Molecular Biology, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland.
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Tsang JMK, Yu WS, Tuomainen J, Sell D, Lee KYS, Tong MCF, Pereira VJ. The Impact of Maxillary Osteotomy on Fricatives in Cleft Lip and Palate: A Perceptual Speech and Acoustic Study. Folia Phoniatr Logop 2021; 74:271-283. [PMID: 34644700 PMCID: PMC9501750 DOI: 10.1159/000520080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Abnormal facial growth is a recognized outcome in cleft lip and palate (CLP), resulting in a concave profile and a class III occlusal status. Maxillary osteotomy (MO) is undertaken to correct this facial deformity, and the surgery can impact speech articulation, although the evidence remains limited and ill-defined for the CLP population. AIMS The aim of the study was to investigate the impact of MO on the production of the fricatives /f/ and /s/, using perceptual and acoustic analyses, and to explore the nature of speech changes. METHODS Twenty participants with CLP were seen 0-3 months pre-operatively (T1) and 3 months (T2) and 12 months (T3) after MO. A normal group (N = 20) was similarly recruited. Perceptual speech data was collected according to a validated framework and ratings made on audio and audio-video recordings (VIDRat). Spectral moments were centre of gravity (CG), standard deviation (SD), skewness (SK) and kurtosis (KU). Reliability studies were carried out for all speech analyses. RESULTS For the CLP group, VIDRat identified dentalization/interdentalization as the main type of pre-operative error for /s/ with a statistically significant improvement over time, χ2(2) = 6.889, p = 0.032. Effect sizes were medium between T1 and T3 (d = 0.631) and small between T2 and T3 (d = 0.194). For the acoustic data, effect sizes were similarly medium between T1 and T2 (e.g., SK, /f/ d = 0.579, /s/ d = 0.642) and small between T1 and T3 across all acoustic parameters. Independent t tests showed mainly statistically significant differences between both groups at all time points with large effect sizes (e.g., T2 CG, t = -4.571, p < 0.001, d =1.581), indicating that /s/ was not normalized post-operatively. For /f/, differences tended to be at T1 with large effect sizes (e.g., CG, t = -2.307, p = 0.028, d = 0.797), reflecting normalization. CONCLUSIONS AND IMPLICATIONS This is the first speech acoustic study on /f/ for individuals with CLP undergoing MO. The surgery has a positive impact on /f/ and /s/, which appear to stabilize 3 months post-operatively. Speech changes are an automatic and a direct consequence of the physical changes brought about by MO, effecting articulatory re-organization. The results of the study have direct clinical implications for the clinical care pathway for patients with CLP undergoing MO.
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Affiliation(s)
- Joy M K Tsang
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China
| | - Wilson S Yu
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China
| | - Jyrki Tuomainen
- Speech, Hearing and Phonetic Sciences, Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Debbie Sell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Kathy Y S Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China.,Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China
| | - Michael C F Tong
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China.,Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China
| | - Valerie J Pereira
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China.,Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China
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11
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Lecourtois-Amézquita MG, Cuevas-Córdoba B, Santiago-García J. Homozygous deletion of glutathione S-transferase theta 1 and mu 1 increase the risk of non-syndromic oral clefts in a Mexican population. Arch Oral Biol 2021; 130:105246. [PMID: 34454376 DOI: 10.1016/j.archoralbio.2021.105246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/01/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate whether null variants of Glutathione S-transferase Mu 1 (GSTM1) and GST Theta 1 (GSTT1) in infants and mothers, as well as maternal exposures to environmental factors, contribute to the risk of non-syndromic cleft lip with or without palate (NSCL/P) in a Mexican population. DESIGN We performed a matched pair case-control study, including 98 cases and 98 controls and their mothers. Sociodemographic information and environmental exposures were collected by a questionnaire. Null variants of GSTM1 and GSTT1 were assessed by multiplex Polymerase Chain Reaction (PCR). Odds ratios (OR) and their 95 % confidence intervals (CI) were calculated to estimate risks. The interaction of genetic variables with smoking and adjusted ORs were evaluated by binary logistic regression. RESULTS Homozygous null GSTM1 was associated with the risk of NSCL/P when present in mothers (OR = 2.45, 95 % CI 1.23-4.86) or infants (OR = 2.98, 95 % CI 1.45-6.14). A higher risk was also found when children carried the homozygous null GSTT1 (OR = 4.89, 95 % CI 2.42-9.87). In mothers, this variant showed a crude risk of 9.17 (95 % CI 3.95-21.29), which increased to OR = 13.81 (95 % CI 1.63-117.09) upon interaction with frequent passive smoking (5-7 days/week). Sociodemographic and other environmental exposures were not significantly associated with the risk of NSCL/P. CONCLUSIONS Maternal and infant GSTT1 and GSTM1 homozygous null genotypes were associated with a higher risk of NSCL/P, and the results suggest an interaction of the maternal GSTT1-null/null genotype with frequent passive smoking.
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Affiliation(s)
- Mariana G Lecourtois-Amézquita
- Programa de Doctorado en Ciencias de la Salud, Universidad Veracruzana, Luis Castelazo S/N. Xalapa, Veracruz, 91190, Mexico; Instituto de Investigaciones Biológicas, Universidad Veracruzana, Luis Castelazo S/N. Xalapa, Veracruz, 91190, Mexico
| | - Betzaida Cuevas-Córdoba
- Instituto de Investigaciones Biológicas, Universidad Veracruzana, Luis Castelazo S/N. Xalapa, Veracruz, 91190, Mexico
| | - Juan Santiago-García
- Instituto de Investigaciones Biológicas, Universidad Veracruzana, Luis Castelazo S/N. Xalapa, Veracruz, 91190, Mexico.
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12
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Ozkan HB, Kulak Kayikci ME, Gunaydin RO, Ozgur FF. Comparing the Temporal Aspects of Velopharyngeal Closure in Children with and without Cleft Palate. Folia Phoniatr Logop 2021; 74:153-166. [PMID: 34274924 DOI: 10.1159/000517296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/20/2020] [Accepted: 05/18/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Children with cleft palate exhibit differences in the 4 temporal components of nasalization (nasal onset and offset intervals, nasal consonant duration, and total speech duration), with various patterns having been noted based on different languages. Thus, the current study aimed to examine the temporal aspects of velopharyngeal closure in children with and without cleft palate; this is the first study to do so in the Turkish language. METHODS This study evaluated and compared the 4 temporal characteristics of velopharyngeal closure in children (aged 6-10 years) with (n = 28) and without (n = 28) cleft palate using nonword consonant and vowel speech samples, including the bilabial nasal-to-stop combination /mp/ and the velar nasal-to-stop combination /ηk/. Acoustic data were recorded using a nasometer, after which acoustic waveforms were examined to determine the 4 temporal components of nasalization. Flexible nasoendoscopy was then used to evaluate velopharyngeal closure patterns. RESULTS With regard to the 4 closure patterns, significant differences in the nasal offset interval (F4-25 = 10.213, p = 0.04; p < 0.05) and the nasal consonant duration ratio (F4-25 = 12.987, p = 0.02; p < 0.05) were observed for only /ampa/. The coronal closure pattern showed the longest closure duration (0.74 s). Children with cleft palate showed prolonged temporal parameters in all 4 characteristics, reflecting oral-nasal resonance imbalances. In particular, the low vowel sound /a/ was significantly more prolonged than the high vowel sounds /i/ and /u/. CONCLUSIONS The examined temporal parameters offer more accurate characterizations of velopharygeal closure, thereby allowing more accurate clinical assessments and more appropriate treatment procedures. Children with cleft palate showed longer nasalization durations compared to those without the same. Thus, the degree of hypernasality in children with cleft palate may affect the temporal aspects of nasalization.
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Affiliation(s)
- Hilal Burcu Ozkan
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Mavis Emel Kulak Kayikci
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Riza Onder Gunaydin
- Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Fatma Figen Ozgur
- Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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13
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El-Sibai M, El Hajj J, Al Haddad M, El Baba N, Al Saneh M, Daoud Khatoun W, Helaers R, Vikkula M, El Atat O, Sabbagh J, Abou Chebel N, Ghassibe-Sabbagh M. Dysregulation of Rho GTPases in orofacial cleft patients-derived primary cells leads to impaired cell migration, a potential cause of cleft/lip palate development. Cells Dev 2021; 165:203656. [PMID: 34024335 DOI: 10.1016/j.cdev.2021.203656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/20/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Abstract
Cleft lip and/or palate are a split in the lip, the palate or both. This results from the inability of lip buds and palatal shelves to properly migrate and assemble during embryogenesis. By extracting primary cells from a cleft patient, we aimed at offering a better understanding of the signaling mechanisms and interacting molecules involved in the lip and palate formation and fusion. With Rho GTPases being indirectly associated with cleft occurrence, we investigated the role of the latter in both. First, whole exome sequencing was conducted in a patient with cleft lip and palate. Primary fibroblastic cells originating from the upper right gingiva region were extracted and distinct cellular populations from two individuals were obtained: a control with no cleft phenotype and a patient with a cleft lip and palate. The genetic data showed three candidate variables in ARHGEF18, EPDR1, and CUL7. Next, the molecular data showed no significant change in proliferation rates between healthy patient cells and CL/P patient cells. However, CL/P patient cells showed decreased migration, increased adhesion and presented with a more elongated phenotype. Additionally, RhoA activity was upregulated in these cells, whereas Cdc42 activity was downregulated, resulting in loss of polarity. Our results are suggestive of a possible correlation between a dysregulation of Rho GTPases and the observed phenotype of cleft lip and palate patient cells. This insight into the intramolecular aspect of this disorder helps link the genetic defect with the observed phenotype and offers a possible mechanism by which CL/P occurs.
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Affiliation(s)
- Mirvat El-Sibai
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
| | - Joelle El Hajj
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
| | - Maria Al Haddad
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
| | - Nada El Baba
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
| | - Mounir Al Saneh
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
| | - Wassim Daoud Khatoun
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
| | - Raphaël Helaers
- Laboratory of Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium.
| | - Miikka Vikkula
- Laboratory of Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium.
| | - Oula El Atat
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
| | - Joseph Sabbagh
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon.
| | - Naji Abou Chebel
- Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Michella Ghassibe-Sabbagh
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
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14
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Yilmaz HN, Hatipoglu S, Erdem B, Can B, Kadir T. Adherence frequency of CANDIDA ALBICANS on nasoalveolar molding (NAM) appliances. J Stomatol Oral Maxillofac Surg 2020; 121:473-477. [PMID: 32835859 DOI: 10.1016/j.jormas.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND METHOD The aim of this prospective study was to evaluate the adherence frequency of Candida albicans and non-albicans Candida species in newborn babies with Cleft Lip and Palate (CLP) who receive presurgical orthopedic therapy with Nasoalveolar Molding (NAM) appliances. This study comprised of 25 CLP newborns including 8-right unilateral, 8-left unilateral and 7-bilateral CLP. First swab samples were taken from the hard palate when the baby was referred and renewed after 3 days. Following the 7th day of delivery of NAM appliance, the swab samples were retaken from both the hard palate and the NAM appliance. Samples were renewed with 2-month intervals. The last swab samples were taken one month after the surgery. Oral swabs were cultured on CHROMagar Candida medium for the growth of yeasts. RESULTS There were no statistically significant differences between the time points regarding C. albicans proliferation frequency and severity rates on the palate. No significant difference was found due to the type of cleft and sex in terms of candidal colonization. A constant increase in proliferation frequency of non-albicans on the palatal mucosa was observed between all of the time points. Although the results were insignificant, there was a constant increase in C. albicans proliferation which presented a decrease following primary lip surgery. CONCLUSION The appliance might not only cause an increase in the colonization of C. albicans but also provide the continuation of the colonization. Therefore, mouth cleaning is important even after primary lip surgery.
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Affiliation(s)
- Hanife Nuray Yilmaz
- Department of Orthodontics, Faculty of Dentistry, Marmara University, Basibuyuk Street 9/3, 34854, Basibuyuk, Maltepe, Istanbul, Turkey.
| | - Sirin Hatipoglu
- Department of Orthodontics, Faculty of Dentistry, Beykent University, Cumhuriyet Mahallesi, Beykent, Buyukcekmece / Istanbul, Turkey
| | - Buket Erdem
- Private Practice, Valikonagi Cad. Nuribey Is Merkezi 65/5 K 5 Nisantasi, 34371 Sisli/Istanbul, Turkey
| | - Banu Can
- Department of Microbiology, Faculty of Dentistry, Marmara University, Basibuyuk Street 9/3, 34854, Basibuyuk, Maltepe, Istanbul, Turkey
| | - Tanju Kadir
- Department of Microbiology, Faculty of Dentistry, Marmara University, Basibuyuk Street 9/3, 34854, Basibuyuk, Maltepe, Istanbul, Turkey
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15
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Denadai R, Seo HJ, Lo LJ. Persistent symptomatic anterior oronasal fistulae in patients with Veau type III and IV clefts: A therapeutic protocol and outcomes. J Plast Reconstr Aesthet Surg 2019; 73:126-133. [PMID: 31196804 DOI: 10.1016/j.bjps.2019.05.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 01/20/2019] [Revised: 04/25/2019] [Accepted: 05/15/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND The anterior oronasal fistulae neighboring the alveolar cleft could persist or reappear after the alveolar reconstruction with cancellous bone grafting. The persistent symptomatic anterior oronasal fistulae need to be repaired, but surgery remains a challenge in cleft care. Surprisingly, this issue has rarely been reported in the literature. The purpose of this long-term study was to report a single surgeon experience with a therapeutic protocol for persistent symptomatic anterior oronasal fistula repair. METHODS This is a retrospective study of consecutive patients with Veau type III and IV clefts and persistent symptomatic anterior oronasal fistulae managed according to a therapeutic protocol from 1997 to 2018. Depending on fistula size, patients were treated with local flaps associated with an interpositional graft or two-stage tongue flaps (small/medium or large fistulae, respectively). The surgical outcomes were classified as "good" (complete fistula closure with no symptoms), "fair" (asymptomatic narrow fistula remained), or "poor" (failure with persistent symptoms). RESULTS Forty-four patients with persistent symptomatic anterior oronasal fistulae were reconstructed with local flaps associated with interpositional fascia or dermal fat grafting (52.3%) or two-stage tongue flaps (47.7%). Most of patients (93.2%) presented "good" outcomes, ranging from 87% to 100% (local and tongue flaps, respectively). Three (6.8%) patients presented symptomatic residual fistula ("poor" outcomes). CONCLUSIONS For the repair of persistent symptomatic anterior oronasal fistulae, this therapeutic protocol provided satisfactory outcome with low fistula recurrence rate.
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Affiliation(s)
- Rafael Denadai
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei Shan, Taoyuan 333, Taiwan
| | - Hyung Joon Seo
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei Shan, Taoyuan 333, Taiwan
| | - Lun-Jou Lo
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei Shan, Taoyuan 333, Taiwan.
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16
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Nicot R, Rotten D, Opdenakker Y, Kverneland B, Ferri J, Couly G, Levaillant JM. Fetal dental panorama on three-dimensional ultrasound imaging of cleft lip and palate and other facial anomalies. Clin Oral Investig 2018; 23:1561-1568. [PMID: 30132143 DOI: 10.1007/s00784-018-2586-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 08/15/2017] [Accepted: 08/17/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Craniofacial deformities have a high psychosocial impact. The aim of this paper is to improve obstetric ultrasonography and prenatal detection of facial anomalies by providing a new fetal dental panorama. MATERIAL AND METHODS The present study describes a new modality to visualize the fetal tooth germs and an easy step-by-step diagnostic approach. Image acquisition was performed between 23 and 32 weeks of gestation using a Voluson E10 GE ultrasound machine with an RM6C transducer (GE Medical Systems, Zipf, Austria). Reconstruction was performed using Omniview from the axial image. Volume contrast imaging (VCI) was used with a thickness of 20 mm, and a render mode that combined "Rx mode" and "surface texture." RESULTS The resulting imaging allows a more precise visualization of the fetal dental arch and can be obtained between 14 and 28 weeks of gestation. The presence of dental anomalies can be a clue for the diagnosis of various congenital defects, in particular conditions with a shortage of other physical abnormalities, such as ectodermal dysplasia and Binder syndrome. CONCLUSIONS The creation of a precise fetal dental panorama allows an improved detection of facial deformities. CLINICAL RELEVANCE With the current paper, we want to increase prenatal diagnostics facial anomalies, and help to establish a tailored multidisciplinary treatment plan. This paper should be of interest to readers who are currently treating patients with craniofacial malformations and readers who are performing diagnostic prenatal sonography.
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Affiliation(s)
- Romain Nicot
- Center for Woman and Fetal Imaging, F-59800, Lille, France. .,Department of Oral and Maxillofacial Surgery and Stomatology, CHU Lille, F-59000, Lille, France.
| | - Daniel Rotten
- Department of Gynecology and Obstetrics, Hôpital Delafontaine, F-93200, Saint-Denis, France
| | - Yasmin Opdenakker
- Department of Oral and Maxillofacial Surgery, University Hospital Ghent, B-9000, Ghent, Belgium
| | - Bothild Kverneland
- Department of Maxillofacial Surgery, Necker Enfants Malades University Hospital, F-75015, Paris, France
| | - Joël Ferri
- Department of Oral and Maxillofacial Surgery and Stomatology, CHU Lille, F-59000, Lille, France.,International Association of Oral and Maxillofacial Medicine (IAOMM), F-59650, Villeneuve dAscq, France
| | - Gérard Couly
- Center for Woman and Fetal Imaging, F-59800, Lille, France
| | - Jean-Marc Levaillant
- Center for Woman and Fetal Imaging, F-59800, Lille, France.,Hôpital Privé Armand Brillard, Groupe Ramsay Générale de Santé, F-94130, Nogent-sur-Marne, France
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17
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Rodriguez N, Maili L, Chiquet BT, Blanton SH, Hecht JT, Letra A. BRCA1 and BRCA2 gene variants and nonsyndromic cleft lip/palate. Birth Defects Res 2018; 110:1043-1048. [PMID: 29921024 DOI: 10.1002/bdr2.1346] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 03/05/2018] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Nonsyndromic cleft lip with or without cleft palate (NSCL/P) is a debilitating condition that not only affects the individual, but the entire family. The purpose of this study was to investigate the association of BRCA1 and BRCA2 genes with NSCL/P. METHODS Twelve polymorphisms in/nearby BRCA1 and BRCA2 were genotyped using Taqman chemistry. Our data set consisted of 3,473 individuals including 2,191 nonHispanic white (NHW) individuals (from 151 multiplex and 348 simplex families) and 1,282 Hispanic individuals (from 92 multiplex and 216 simplex families). Data analysis was performed using Family-Based Association Test (FBAT), stratified by ethnicity and family history of NSCL/P. RESULTS Nominal associations were found between NSCL/P and BRCA1 in Hispanics and BRCA2 in NHW and Hispanics (p < .05). Significant haplotype associations were found between NSCL/P and both BRCA1 and BRCA2 (p ≤ .004). CONCLUSIONS Our results suggest a modest association between BRCA1 and BRCA2 and NSCL/P. Further studies in additional populations and functional studies are needed to elucidate the role of these genes in developmental processes and signaling pathways contributing to NSCL/P.
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Affiliation(s)
- Nicholas Rodriguez
- Center for Craniofacial Research, UTHealth School of Dentistry at Houston, Houston TX, USA
| | - Lorena Maili
- Department of Pediatrics, UTHealth McGovern Medical School, Houston TX, USA.,Pediatric Research Center, UTHealth McGovern Medical School, Houston TX, USA
| | - Brett T Chiquet
- Center for Craniofacial Research, UTHealth School of Dentistry at Houston, Houston TX, USA.,Department of Pediatric Dentistry, UTHealth School of Dentistry at Houston, Houston TX, USA.,Pediatric Research Center, UTHealth McGovern Medical School, Houston TX, USA
| | - Susan H Blanton
- Department of Human Genetics and John P. Hussman Institute of Human Genomics, University of Miami Miller School of Medicine, Miami FL, USA
| | - Jacqueline T Hecht
- Center for Craniofacial Research, UTHealth School of Dentistry at Houston, Houston TX, USA.,Department of Pediatrics, UTHealth McGovern Medical School, Houston TX, USA.,Pediatric Research Center, UTHealth McGovern Medical School, Houston TX, USA
| | - Ariadne Letra
- Center for Craniofacial Research, UTHealth School of Dentistry at Houston, Houston TX, USA.,Department of Diagnostic and Biomedical Sciences, UTHealth School of Dentistry at Houston, Houston TX, USA.,Pediatric Research Center, UTHealth McGovern Medical School, Houston TX, USA
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18
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Losa M, Risolino M, Li B, Hart J, Quintana L, Grishina I, Yang H, Choi IF, Lewicki P, Khan S, Aho R, Feenstra J, Vincent CT, Brown AMC, Ferretti E, Williams T, Selleri L. Face morphogenesis is promoted by Pbx-dependent EMT via regulation of Snail1 during frontonasal prominence fusion. Development 2018; 145:dev157628. [PMID: 29437830 PMCID: PMC5868993 DOI: 10.1242/dev.157628] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 01/24/2018] [Indexed: 12/17/2022]
Abstract
Human cleft lip with or without cleft palate (CL/P) is a common craniofacial abnormality caused by impaired fusion of the facial prominences. We have previously reported that, in the mouse embryo, epithelial apoptosis mediates fusion at the seam where the prominences coalesce. Here, we show that apoptosis alone is not sufficient to remove the epithelial layers. We observed morphological changes in the seam epithelia, intermingling of cells of epithelial descent into the mesenchyme and molecular signatures of epithelial-mesenchymal transition (EMT). Utilizing mouse lines with cephalic epithelium-specific Pbx loss exhibiting CL/P, we demonstrate that these cellular behaviors are Pbx dependent, as is the transcriptional regulation of the EMT driver Snail1. Furthermore, in the embryo, the majority of epithelial cells expressing high levels of Snail1 do not undergo apoptosis. Pbx1 loss- and gain-of-function in a tractable epithelial culture system revealed that Pbx1 is both necessary and sufficient for EMT induction. This study establishes that Pbx-dependent EMT programs mediate murine upper lip/primary palate morphogenesis and fusion via regulation of Snail1. Of note, the EMT signatures observed in the embryo are mirrored in the epithelial culture system.
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Affiliation(s)
- Marta Losa
- Program in Craniofacial Biology, Institute of Human Genetics, Eli and Edyth Broad Center of Regeneration Medicine & Stem Cell Research, Departments of Orofacial Sciences and Anatomy, University of California, San Francisco, 513 Parnassus Avenue, HSW 710, San Francisco, CA 94143, USA
| | - Maurizio Risolino
- Program in Craniofacial Biology, Institute of Human Genetics, Eli and Edyth Broad Center of Regeneration Medicine & Stem Cell Research, Departments of Orofacial Sciences and Anatomy, University of California, San Francisco, 513 Parnassus Avenue, HSW 710, San Francisco, CA 94143, USA
| | - Bingsi Li
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - James Hart
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Laura Quintana
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Irina Grishina
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Hui Yang
- Departments of Craniofacial Biology and Cell and Developmental Biology, University of Colorado at Denver, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Irene F Choi
- Departments of Craniofacial Biology and Cell and Developmental Biology, University of Colorado at Denver, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Patrick Lewicki
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Sameer Khan
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Robert Aho
- Program in Craniofacial Biology, Institute of Human Genetics, Eli and Edyth Broad Center of Regeneration Medicine & Stem Cell Research, Departments of Orofacial Sciences and Anatomy, University of California, San Francisco, 513 Parnassus Avenue, HSW 710, San Francisco, CA 94143, USA
| | - Jennifer Feenstra
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
- Karolinska Institute, Department of Physiology and Pharmacology, Nanna svartz väg 2, 17177 Stockholm, Sweden
| | - C Theresa Vincent
- Karolinska Institute, Department of Physiology and Pharmacology, Nanna svartz väg 2, 17177 Stockholm, Sweden
- Department of Physiology and Biophysics, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA
| | - Anthony M C Brown
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Elisabetta Ferretti
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Trevor Williams
- Departments of Craniofacial Biology and Cell and Developmental Biology, University of Colorado at Denver, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Licia Selleri
- Program in Craniofacial Biology, Institute of Human Genetics, Eli and Edyth Broad Center of Regeneration Medicine & Stem Cell Research, Departments of Orofacial Sciences and Anatomy, University of California, San Francisco, 513 Parnassus Avenue, HSW 710, San Francisco, CA 94143, USA
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
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Soghani B, Ebadifar A, Khorram Khorshid HR, Kamali K, Hamedi R, Aghakhani Moghadam F. The study of association between reduced folate carrier 1 ( RFC1) polymorphism and non-syndromic cleft lip/palate in Iranian population. ACTA ACUST UNITED AC 2017; 7:263-268. [PMID: 29435434 PMCID: PMC5801538 DOI: 10.15171/bi.2017.31] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 09/23/2017] [Revised: 11/22/2017] [Accepted: 11/23/2017] [Indexed: 12/26/2022]
Abstract
Introduction: Cleft lip/palate is one of the most common congenital defects and is supposed to have multifactorial etiology, including a complex interaction between genetics and environment. Reduced folate carrier 1 (RFC1) gene takes part in folate transportation within the cells. In this study, the association of A80G polymorphism in the RFC1 gene with the non-syndromic cleft lip/palate (nsCL/P) was investigated in Iranian infants for the first time. Methods: In this case-control survey, 122 Iranian infants with nsCL/P and 164 healthy infants were investigated for RFC1 polymorphism by PCR and RFLP methods. The results were statistically compared with control group, odds ratios with 95% CI were estimated by univariate and multivariate logistic regression model and a P <0.05 was considered statistically significant. Results: The RFC1 G allele was significantly higher (P=0.001; OR=7, 95% CI: 4.7-10.2) in the cases (60.3%) compared with the controls (17.9%). Not only the RFC1 AG genotype was significantly higher (P<0.001; OR=44, 95% CI: 14.6-133) in cases (67.8%) than the controls (27.4%), but also GG genotype (P<0.001; OR=85, 95% CI: 20.5-352) was much higher in cases (26.4%) than the controls (4.3%). Conclusion: Our study indicated that the RFC1 (A80G) polymorphism was associated with the nsCL/P in Iranian population. Moreover, 80GG homozygosity was significant in the cases. The presence of G allele can be considered as a risk factor for the nsCL/P. Infants with the GG and AG genotypes were more prone to cleft lip/palate as compared to the AA ones. This finding emphasizes the role of RFC1 gene and the intracellular levels of folate.
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Affiliation(s)
- Behnoosh Soghani
- Dentofacial Deformities Research Center Research Institute of Dental Sciences, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asghar Ebadifar
- Dentofacial Deformities Research Center Research Institute of Dental Sciences, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Orthodontic, Faculty of Dentistry, Shahid Behehsti University of Medical Sciences, Tehran, Iran
| | | | - Koorosh Kamali
- Department of Public Health, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Roya Hamedi
- Dental Carries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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20
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Broder HL, Wilson-Genderson M, Sischo L. Oral health-related quality of life in youth receiving cleft-related surgery: self-report and proxy ratings. Qual Life Res 2017; 26:859-867. [PMID: 27699557 PMCID: PMC5336514 DOI: 10.1007/s11136-016-1420-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE This paper evaluated the impact of cleft-related surgery on the oral health-related quality of life (OHRQoL) of youth with cleft over time. METHODS Data were derived from a 5-year, multi-center, prospective, longitudinal study of 1196 youth with cleft lip and/or palate and their caregivers. Eligible youth were between 7.5 and 18.5 years old, spoke English or Spanish, and were non-syndromic. During each observational period, which included baseline, and 1- and 2-year post-baseline follow-up visits, youths and their caregivers completed the Child Oral Health Impact Profile, a validated measure of OHRQoL. Multilevel mixed-effects models were used to analyze the effects of receipt of craniofacial surgery on OHRQoL over time. RESULTS During the course of this study a total of 516 patients (43 %) received at least one surgery. Youth in the surgery recommendation group had lower self- (β = -2.18, p < 0.05) and proxy-rated (β = -2.92, p < 0.02) OHRQoL when compared to non-surgical self- and proxy-rated OHRQoL at baseline. Both surgical and non-surgical youth (β = 3.73, p < 0.001) and caregiver (β = 1.91, p < 0.05) ratings of OHRQoL improved over time. There was significant incremental improvement (time × surgery interaction) in self-reported OHRQoL for youth postsurgery (β = 1.04, p < 0.05), but this postsurgery increment was not seen in the caregiver proxy ratings. CONCLUSIONS Surgical intervention impacts OHRQoL among youth with cleft. Youth who were surgical candidates had lower baseline self- and caregiver-rated OHRQoL when compared to non-surgical youth. Youth who underwent cleft-related surgery had significant incremental improvements in self-rated but not caregiver (proxy)-rated OHRQoL after surgery.
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Affiliation(s)
- Hillary L Broder
- Department of Cariology and Comprehensive Care, New York University College of Dentistry, 137 E. 25th Street, 5th Floor, New York, NY, 10010, USA.
| | | | - Lacey Sischo
- Department of Cariology and Comprehensive Care, New York University College of Dentistry, 137 E. 25th Street, 5th Floor, New York, NY, 10010, USA
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21
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Saket M, Saliminejad K, Kamali K, Moghadam FA, Anvar NE, Khorram Khorshid HR. BMP2 and BMP4 variations and risk of non-syndromic cleft lip and palate. Arch Oral Biol 2016; 72:134-137. [PMID: 27591802 DOI: 10.1016/j.archoralbio.2016.08.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 11/10/2015] [Revised: 05/29/2016] [Accepted: 08/19/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Non-syndromic cleft lip with or without cleft palate (CL/P) is one of the most common congenital anomalies and arises from the interaction of environmental and genetic factors. The objective of this study was to investigate the association between the BMP2 (bone morphogenetic protein 2) and BMP4 (bone morphogenetic protein 4) polymorphisms with non-syndromic CL/P to clarify the potential role of these genes in the etiology of CL/P in Iranian population. DESIGN The allelic and genotypic frequencies of BMP2 rs235768 A>T and BMP4 rs17563 T>C polymorphisms were determined in 107 unrelated Iranian subjects with non-syndromic CL/P and 186 control subjects using PCR and RFLP methods, and the results were compared with healthy controls. A p-value of <0.05 was considered statistically significant. RESULTS The BMP2 rs235768 AT genotype was significantly higher (P=0.009, OR=3, 95% CI=1.3-7.0) in the CL/P (59.8%) than the control group (33.3%). Similarly, the BMP4 rs17563 TC genotype were significantly higher (P=0.008, OR=3.7, 95% CI=1.4-9.9) in the CL/P (70.0%) than the control group (44.6%). CONCLUSION The BMP2 rs235768 A>T and BMP4 rs17563 T>C polymorphisms could be considered as the risk factor for non-syndromic CL/P in Iranian population.
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Affiliation(s)
- Mitra Saket
- Department of Genetics, Islamic Azad University, Damghan Branch, Damghan, Iran
| | - Kioomars Saliminejad
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Koorosh Kamali
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | | | - Nazanin Esmaeili Anvar
- Genetic Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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22
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Abstract
In a child with cleft lip and/or palate, nutrition is the first priority as for any other child. These children have specific physical limitations. To fulfill their nutritional requirement, these children need modifications in order to thrive and grow. Failure to adjust to these needs could place the children into a potential life-threatening situation. One of the immediate problems to be addressed in a newborn with cleft lip/palate is difficulty in feeding. Nasal regurgitation and choking are common because of inability of the palate to separate the nasal and oral cavities. The case presented here discusses the management of feeding problem in the infant with cleft lip/palate. How to cite this article: Goswami M, Jangra B, Bhushan U. Management of feeding Problem in a Patient with Cleft Lip/ Palate. Int J Clin Pediatr Dent 2016;9(2):143-145.
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Affiliation(s)
- Mridula Goswami
- Professor and Head, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Babita Jangra
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Urvashi Bhushan
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, New Delhi, India
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Abstract
In this issue of the Biomedical Journal, we highlight a review revealing that the effect of autophagy, reactive oxygen species, and antioxidants in cancer may be a question of timing and context. We also discuss original research showing that the prevalence of cleft lip with or without palate in Taiwan has declined over the past 20 years, and what this might mean in terms of trends in abortion. Finally, we also learn about risk factors for recurrent hospital-acquired infection with multi-drug resistant bacteria, and the value of dental screening for patients with tinnitus.
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Affiliation(s)
- Emma Louise Walton
- Staff Writer at the Biomedical Journal, 56 Dronningens Gate, 7012 Trondheim, Norway.
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Mukhopadhyay P, Greene RM, Pisano MM. Cigarette smoke induces proteasomal-mediated degradation of DNA methyltransferases and methyl CpG-/CpG domain-binding proteins in embryonic orofacial cells. Reprod Toxicol 2015; 58:140-8. [PMID: 26482727 DOI: 10.1016/j.reprotox.2015.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 11/24/2014] [Revised: 08/18/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022]
Abstract
Orofacial clefts, the most prevalent of developmental anomalies, occur with a frequency of 1 in 700 live births. Maternal cigarette smoking during pregnancy represents a risk factor for having a child with a cleft lip and/or cleft palate. Using primary cultures of first branchial arch-derived cells (1-BA cells), which contribute to the formation of the lip and palate, the present study addressed the hypothesis that components of cigarette smoke alter global DNA methylation, and/or expression of DNA methyltransferases (Dnmts) and various methyl CpG-binding proteins. Primary cultures of 1-BA cells, exposed to 80μg/mL cigarette smoke extract (CSE) for 24h, exhibited a >13% decline in global DNA methylation and triggered proteasomal-mediated degradation of Dnmts (DNMT-1 and -3a), methyl CpG binding protein 2 (MeCP2) and methyl-CpG binding domain protein 3 (MBD-3). Pretreatment of 1-BA cells with the proteasomal inhibitor MG-132 completely reversed such degradation. Collectively, these data allow the suggestion of a potential epigenetic mechanism underlying maternal cigarette smoke exposure-induced orofacial clefting.
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Affiliation(s)
- Partha Mukhopadhyay
- University of Louisville Birth Defects Center, Department of Molecular, Cellular and Craniofacial Biology, ULSD, University of Louisville, Louisville, KY 40202, United States
| | - Robert M Greene
- University of Louisville Birth Defects Center, Department of Molecular, Cellular and Craniofacial Biology, ULSD, University of Louisville, Louisville, KY 40202, United States.
| | - M Michele Pisano
- University of Louisville Birth Defects Center, Department of Molecular, Cellular and Craniofacial Biology, ULSD, University of Louisville, Louisville, KY 40202, United States
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25
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Gamba BF, Rosenberg C, Costa S, Richieri-Costa A, Ribeiro-Bicudo LA. Cleft lip/palate, short stature, and developmental delay in a boy with a 5.6-mb interstitial deletion involving 10p15.3p14. Mol Syndromol 2015; 6:39-43. [PMID: 25852446 DOI: 10.1159/000371404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2014] [Indexed: 11/19/2022] Open
Abstract
The chromosome interval 10p15.3p14 harbors about a dozen genes. This region has been implicated in a few well-known human phenotypes, namely HDR syndrome (hypoparathyroidism, sensorineural deafness, and renal dysplasia) and DGS2 (DiGeorge syndrome 2), but a number of variable phenotypes have also been reported. Cleft lip/palate seems to be a very unusual finding within the clinical spectrum of patients with this deletion. Here, we report a male child born with short stature, cleft lip/palate, and feeding problems who was found to have a 5.6-Mb deletion at 10p15.3p14.
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Affiliation(s)
- Bruno F Gamba
- Department of Genetics, Institute of Biosciences, São Paulo, Brazil
| | - Carla Rosenberg
- Department of Genetics and Evolutionary Biology, Institute of Biosciences, São Paulo, Brazil
| | - Silvia Costa
- Department of Genetics and Evolutionary Biology, Institute of Biosciences, São Paulo, Brazil
| | - Antonio Richieri-Costa
- Department of Syndromology Division, Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paolo, São Paulo, Brazil
| | - Lucilene A Ribeiro-Bicudo
- Department of Genetics, Institute of Biosciences, São Paulo, Brazil ; Department of Genetics, Institute of Biosciences, Federal University of Goias, Goiânia, Brazil
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Ebadifar A, Hamedi R, Khorram Khorshid HR, Saliminejad K, Kamali K, Aghakhani Moghadam F, Esmaeili Anvar N, Ameli N. Association of Transforming Growth Factor Alpha Polymorphisms with Nonsyndromic Cleft Lip and Palate in Iranian Population. Avicenna J Med Biotechnol 2015; 7:168-72. [PMID: 26605011 PMCID: PMC4629459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Cleft lip with or without cleft palate (CL/P) is one of the most common congenital anomalies and the etiology of orofacial clefts is multifactorial. Transforming growth factor alpha (TGFA) is expressed at the medial edge epithelium of fusing palatal shelves during craniofacial development. In this study, the association of two important TGFA gene polymorphisms, BamHI (rs11466297) and RsaI (rs3732248), with CL/P was evaluated in an Iranian population. METHODS The frequencies of BamHI and RsaI variations were determined in 105 unrelated Iranian subjects with nonsyndromic CL/P and 218 control subjects using PCR and RFLP methods, and the results were compared with healthy controls. A p-value of <0.05 was considered statistically significant. RESULTS The BamHI AC genotype was significantly higher (p=0.016) in the patients (12.4%) than the control group (5.0%). The BamHI C allele was significantly higher (p=0.001; OR=3.4, 95% CI: 1.6-7.4) in the cases (8.0%) compared with the control group (2.5%). CONCLUSION Our study showed that there was an association between the TGFA BamHI variation and nonsyndromic CL/P in Iranian population.
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Affiliation(s)
- Asghar Ebadifar
- Dentofacial Deformities Research Center, Research Institute of Dental Sciences, Department of Orthodontic, Faculty of Dentistry, Shahid Behehsti University of Medical Sciences, Tehran, Iran
| | - Roya Hamedi
- Department of Orthodontic, Dentofacial Deformities Research Center, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding author: Roya Hamedi, Ph.D., Department of Orthodontic, Dentofacial Deformity Research Center, Faculty of Dentistry, Shahid Behehsti University of Medical Sciences, Tehran, Iran, Tel: +98 9125576105, E-mail:
| | | | - Kioomars Saliminejad
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Koorosh Kamali
- Department of Public Health, Faculty of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Nazanin Esmaeili Anvar
- Genetic Research Centre, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nazilla Ameli
- Department of Orthodontic, Faculty of Dentistry, Semnan University of Medical Sciences, Semnan, Iran
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27
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Silvestre J, Tahiri Y, Paliga JT, Taylor JA. Incidence of positive screening for obstructive sleep apnea in patients with isolated cleft lip and/or palate. Plast Surg (Oakv) 2014; 22:259-63. [PMID: 25535465 DOI: 10.4172/plastic-surgery.1000886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To determine the incidence of obstructive sleep apnea (OSA) in children with isolated cleft lip and/or palate (CL/P). METHODS The present prospective study was performed at a pediatric tertiary care centre. Consecutive patients evaluated at the cleft clinic from January 2011 to August 2013 were identified. Patients' families prospectively completed the Pediatric Sleep Questionnaire (PSQ), a validated tool used to predict moderate to severe OSA. Patients with CL/P and an underlying syndrome or other craniofacial diagnosis were excluded. A positive OSA screen was recorded if the ratio of positive to total responses was >0.33. Risk factors associated with a positive screen were identified using the Student's t or ANOVA test. RESULTS A total of 867 patients completed the PSQ, 489 of whom with isolated CL/P met inclusion criteria. The mean age was 8.4 years. The overall incidence of positive screening was 14.7%. The most commonly reported symptoms among positive screeners were 'fidgets with hands or feet' (73.6%), 'interrupts others' (69.4%) and 'mouth breather during the day' (69.4%). The most sensitive items were 'stops breathing during the night' and 'trouble breathing during sleep', with positive predictive values of 0.78 and 0.67, respectively. Sex, body mass index, ancestry and cleft type were not significantly associated with increased risk for positive screening. CONCLUSION One in seven children with isolated CL/P screened positively for OSA according to the PSQ. This finding highlights the potential importance of routine screening in this at-risk group.
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Affiliation(s)
- Jason Silvestre
- Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Youssef Tahiri
- Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - J Thomas Paliga
- Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jesse A Taylor
- Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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28
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Green RM, Feng W, Phang T, Fish JL, Li H, Spritz RA, Marcucio RS, Hooper J, Jamniczky H, Hallgrímsson B, Williams T. Tfap2a-dependent changes in mouse facial morphology result in clefting that can be ameliorated by a reduction in Fgf8 gene dosage. Dis Model Mech 2014; 8:31-43. [PMID: 25381013 PMCID: PMC4283648 DOI: 10.1242/dmm.017616] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Failure of facial prominence fusion causes cleft lip and palate (CL/P), a common human birth defect. Several potential mechanisms can be envisioned that would result in CL/P, including failure of prominence growth and/or alignment as well as a failure of fusion of the juxtaposed epithelial seams. Here, using geometric morphometrics, we analyzed facial outgrowth and shape change over time in a novel mouse model exhibiting fully penetrant bilateral CL/P. This robust model is based upon mutations in Tfap2a, the gene encoding transcription factor AP-2α, which has been implicated in both syndromic and non-syndromic human CL/P. Our findings indicate that aberrant morphology and subsequent misalignment of the facial prominences underlies the inability of the mutant prominences to fuse. Exencephaly also occured in some of the Tfap2a mutants and we observed additional morphometric differences that indicate an influence of neural tube closure defects on facial shape. Molecular analysis of the CL/P model indicates that Fgf signaling is misregulated in the face, and that reducing Fgf8 gene dosage can attenuate the clefting pathology by generating compensatory changes. Furthermore, mutations in either Tfap2a or Fgf8 increase variance in facial shape, but the combination of these mutations restores variance to normal levels. The alterations in variance provide a potential mechanistic link between clefting and the evolution and diversity of facial morphology. Overall, our findings suggest that CL/P can result from small gene-expression changes that alter the shape of the facial prominences and uncouple their coordinated morphogenesis, which is necessary for normal fusion.
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Affiliation(s)
- Rebecca M Green
- Department of Craniofacial Biology, University of Colorado Denver, 12801 East 17th Avenue, Aurora, CO 80045, USA
| | - Weiguo Feng
- Department of Craniofacial Biology, University of Colorado Denver, 12801 East 17th Avenue, Aurora, CO 80045, USA
| | - Tzulip Phang
- Department of Pharmacology, University of Colorado Denver, 12801 East 17th Avenue, Aurora, CO 80045, USA
| | - Jennifer L Fish
- University of California San Francisco, Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, San Francisco, CA 94110, USA
| | - Hong Li
- Department of Craniofacial Biology, University of Colorado Denver, 12801 East 17th Avenue, Aurora, CO 80045, USA
| | - Richard A Spritz
- Human Medical Genetics and Genomics Program, University of Colorado School of Medicine, 12800 East 17th Avenue, Aurora, CO 80045, USA
| | - Ralph S Marcucio
- University of California San Francisco, Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, San Francisco, CA 94110, USA
| | - Joan Hooper
- Department of Cell and Developmental Biology, University of Colorado Denver, 12801 East 17th Avenue, Aurora, CO 80045, USA
| | - Heather Jamniczky
- McCaig Institute for Bone and Joint Health, Department of Cell Biology & Anatomy, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N3Z6, Canada
| | - Benedikt Hallgrímsson
- McCaig Institute for Bone and Joint Health, Department of Cell Biology & Anatomy, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N3Z6, Canada. Alberta Children's Hospital Research Institute, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N3Z6, Canada
| | - Trevor Williams
- Department of Craniofacial Biology, University of Colorado Denver, 12801 East 17th Avenue, Aurora, CO 80045, USA. Human Medical Genetics and Genomics Program, University of Colorado School of Medicine, 12800 East 17th Avenue, Aurora, CO 80045, USA. Department of Cell and Developmental Biology, University of Colorado Denver, 12801 East 17th Avenue, Aurora, CO 80045, USA.
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29
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François-Fiquet C, Dupouy M, Daoud S, Poli-Merol ML. [Cleft lip and palate: Health-related quality of life (French VSP-A scale) for patients and their family. About 51 families]. ANN CHIR PLAST ESTH 2014; 60:192-200. [PMID: 25218967 DOI: 10.1016/j.anplas.2014.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 07/06/2014] [Accepted: 08/08/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE, OBJECTIVE The aim of our study was to investigate the quality of life of patients undergoing cleft lip or cleft lip and palate as well as the perception of quality of life of patients perceived by their parents slot. PATIENTS AND METHODS Fifty-one adolescents and young adults (29 boys and 22 girls) who underwent cleft lip (FL 22) or lip and palate (CLP 29) and their parents have received psychological and surgical joint consultation. The minimum age for inclusion was 10 years (mean age 15.5 years). A quality of life questionnaire (VSP-A) "children" was given between 10 and 11 years and a questionnaire "adolescents" beyond. Parents have them answered a questionnaire of perceived quality of life of their children. The results were analyzed and compared to a control population (Statistics Student test). Perceived parents lived in relation to their children was obtained through the study of linear regression curves. RESULTS The response rate to the questionnaires was 66.7% for parents, 85.7% for children and 63.6% for teenagers. The quality of life of the patients was assessed by the patients to 65.1/100 on average. The index of overall quality of life was superimposed on the control population (p=0.66). Perceived quality of life of patients by their parents was fairly close to the quality of life described by patients (66.5). On the areas of family, education, recreation, quality index was proportionately less than for other areas. For each of these areas, parents overestimated the quality of life of their child. Compared to the control group the fields of education, leisure, vitality quality index were significantly lower in the/FL population P.
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Affiliation(s)
- C François-Fiquet
- Chirurgie pédiatrique, pôle mère enfant, American Memorial Hospital, CHU de Reims, 47, rue Cognaq-Jay, 51092 Reims cedex, France; Chirurgie plastique, reconstructrice et esthétique, pôle locomoteur, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France; EA 3801, université de Reims Champagne Ardenne, URCA, SFR CAP santé, 51, rue Cognacq-Jay, 51100 Reims, France.
| | - M Dupouy
- Chirurgie pédiatrique, pôle mère enfant, American Memorial Hospital, CHU de Reims, 47, rue Cognaq-Jay, 51092 Reims cedex, France
| | - S Daoud
- Chirurgie pédiatrique, pôle mère enfant, American Memorial Hospital, CHU de Reims, 47, rue Cognaq-Jay, 51092 Reims cedex, France
| | - M-L Poli-Merol
- Chirurgie pédiatrique, pôle mère enfant, American Memorial Hospital, CHU de Reims, 47, rue Cognaq-Jay, 51092 Reims cedex, France
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30
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Abstract
Context: Cleft palate repair is preferentially completed between 6 and 18 months of age, facilitating essential speech and language development along with swallowing and feeding reflexes, and avoiding otitis media and hearing loss. In Mongolia patients often present in early adulthood for cleft lip and/or palate management. Wider defects are associated with older age groups and have higher rates of fistula formation and wound dehiscence. These complications encouraged a modified surgical technique for improved outcomes. Aims: Objectives of this study were to compare the efficacy of three established palatoplasty techniques with our mongolian technique. Materials and Methods: A retrospective review of all palatoplasty cases, in non-syndromic cleft lip and/or palate patients, between January 1992 and November 2008 in Ulaanbaatar, Mongolia was performed. Exclusion criteria included those suffering from an acute or chronic respiratory illness at presentation or in the recovery period. We compared three established techniques with our modified technique. Outcome measures were duration of surgery, length of hospital stay and fistula rate. Statistical Analysis Used: Discrete data are reported as n (%), while continuous data are summarised as mean±SD. Differences in demographic, surgical and postoperative data were tested by independent t-test (continuous data) and Fisher's exact test (discrete data). Results: Palatoplasty was performed on 436 patients with an average age of 60 months. The modified palatoplasty technique had reduced surgical time (P value <0.01) and hospital stay (P value <0.01) and a 96% complication free wound recovery, compared with established techniques. Cleft lip and/or palate patients aged 42 months or older were more likely to be from the countryside. Conclusions: 86.9% of patients presenting for cleft palate repair had palatoplasty later than the recommended age. Geographical predilection for children older than six years, were more likely to have cleft palate repair complications. We have shown the modified palatoplasty technique is a more efficient time saving surgical procedure with lower complication rates.
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Affiliation(s)
- N Ayanga Gongorjav
- Department of Maxillofacial Surgery, Maternal and Child Health Research Centre, Ulaanbaatar, Mongolia
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Gopakumar M, Hegde AM. Parental Attitude towards the Provision of Nonsurgical Oral Health Care to Children with Oral Clefts: An Epidemiological Survey. Int J Clin Pediatr Dent 2010; 3:35-7. [PMID: 27625554 PMCID: PMC4955042 DOI: 10.5005/jp-journals-10005-1051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 09/12/2009] [Accepted: 10/02/2009] [Indexed: 11/25/2022] Open
Abstract
Aim To evaluate the attitudes of parents of 3 to 8 years old children with cleft lip and palate towards the provision of pediatric dental health care and assess the experience of dentistry in general dental practice. Materials and methods A questionnaire was distributed to parents of 100 children in the age group of 3 to 8 years old with cleft lip and palate who visited the cleft lip and palate center in KS Hegde Medical Academy, Mangalore. Results Out of the hundred patients, 66% of the patients registered directly at the cleft center for their deformity. Only 20% of these children visited a local dental practitioner for their dental health care. 42% had neither undergone any dental treatment nor received any dietary or oral hygiene advices. Regarding the provision of the dental treatment, 74% wanted a pediatric dentist to provide dental check-up and treatment at the cleft center, whereas, 24% preferred a dental practitioner close to their home and 2% does not want treatment anywhere. Conclusion The survey indicates that there is parental support for the pediatric dental assessment at the cleft center with subsequent arrangement of dental treatment with their local dental practitioners. The majority wanted a pediatric dentist to provide the dental check-up and treatment at the cleft center.
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Affiliation(s)
- Manju Gopakumar
- Reader, Department of Pedodontics and Preventive Children Dentistry, AB Shetty Memorial Institute of Dental Sciences Mangalore, Karnataka, India
| | - Amitha M Hegde
- Professor and Head, Department of Pedodontics and Preventive Children Dentistry, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
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