scholarly journals The Challenge of 3D Bioprinting of Composite Natural Polymers PLA/Bioglass: Trends and Benefits in Cleft Palate Surgery

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1553
Author(s):  
Damien Brézulier ◽  
Louis Chaigneau ◽  
Sylvie Jeanne ◽  
Ronan Lebullenger
Keyword(s):  
Cleft Palate ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Host Cells ◽  
Poly Lactic Acid ◽  
Autogenous Bone ◽  
Natural Polymers ◽  
Bone Harvesting ◽  
Facial Clefts ◽  
Computer Aided

Cleft lip and palate is the fourth most common congenital malformation. Its prevalence is about 1 in 750 to 1 in 2000 live births. The consequences of this malformation are major: maxillary growth deficit, unaesthetic appearance, phonation disorders, difficulty in eating, and psycho-social disorders. Cleft palate repair establishes the division between the oral and nasal cavities. The alveolar bone graft is a key step. Different sites of autogenous bone harvesting are used, the most common being the iliac crest. Nevertheless, the large number of complications associated with harvesting has led to the use of substitute biomaterials. Bioactive glasses, discovered in 1969, are a group of synthetic silica-based materials with bone-bonding properties. Although 45S5 granular composition is commonly used in bone surgery to repair critical defects, it is only rarely used in the repair of cleft palates because this galenic form is only moderately adapted. However, advances in bone tissue engineering allow the shaping of three-dimensional scaffolds, which support colonization by host cells. Recent advances in computer-aided design/computer-aided manufacturing (CAD/CAM) have even led to the 3D printing of scaffolds combining 45S5 bioglass with a natural and biocompatible poly-lactic acid matrix. The shape of the parts is customized and adapted to the particular shape of the critical bone defects. The objective of this literature review is to highlight the particularities of alveolar defects subsequent to facial clefts, then to detail the characteristics of the materials and technologies used to elaborate 3D matrices by bioprinting. Finally, we will explore research directions regarding their use in reconstructive surgery of cleft palates.

Hospitalization, Breast-Milk Feeding, and Growth in Infants with Cleft Palate and Cleft Lip and Palate Born in Denmark

2008 ◽  
Vol 45 (6) ◽  
pp. 628-632 ◽  
Author(s):  
Lisa H. V. Smedegaard ◽  
Dorthe R. N. Marxen ◽  
Jette H. V. Moes ◽  
Eva N. Glassou ◽  
Cand Scientsan
Keyword(s):  
Breast Milk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Year ◽  
Health Visitors ◽  
Facial Clefts ◽  
Growth References ◽  
First Year Of Life ◽  
Milk Feeding

Objective: To evaluate if the duration of postpartum hospitalization, duration of breast-milk feeding, and growth during the first year of life in infants with cleft lip and palate (CLP) and cleft palate (CP) are comparable to infants without facial clefts. Design: Prospective data collection using a registration chart developed by the authors. Setting: Special health care of infants with CLP/CP born in Denmark. Participants: All mature infants with CLP/CP born in 2003 and 2004 were included. Of 165 infants, 115 participated in the study. Intervention: In Denmark, parents of children with CLP/CP receive counseling. This counseling is managed by specially trained health visitors/nurses and is initiated at birth. The counseling seeks to support parents’ confidence in having an infant with CLP/CP and to initiate a relationship between the infant and the parents. Main Outcome Measures: Duration of postpartum hospitalization, duration of breast-milk feeding, and weight and length at birth, 5 months of age, and 12 months of age. Results: Hospitalization was 4 days and comparable to that of infants without CLP/CP. The infants with CLP/CP received breast milk but for a shorter period compared with infants without CLP/CP. Weights at birth, 5 months of age, and 12 months of age were identical with Danish growth references. Conclusion: The authors find the results satisfactory and believe that the counseling provided by the health visitors/nurses plays a part in the results.

scholarly journals Evaluation of alveolar bone grafting in unilateral cleft lip and palate patients using a computer-aided diagnosis system

2012 ◽  
Vol 42 (4) ◽  
pp. 225 ◽  
Author(s):  
Pipop Sutthiprapaporn ◽  
Keiji Tanimoto ◽  
Takashi Nakamoto ◽  
Supaporn Kongsomboon ◽  
Saowaluck Limmonthol ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Computer Aided Diagnosis ◽  
Diagnosis System ◽  
Alveolar Bone Grafting ◽  
Computer Aided ◽  
Aided Diagnosis

scholarly journals Improving the efficiency of prenatal diagnosis of cleft lip and palate

2020 ◽  
pp. 36-42
Author(s):  
A. N. Chukanov
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Obstetric Care ◽  
Ultrasound Elastography ◽  
Fetal Head ◽  
Sensitivity Indices ◽  
Facial Clefts ◽  
Diagnostic Criterion

Objective: to identify the most effective and affordable method to diagnose various types of fetal cleft lip and palate, the use of which is possible in the majority of specialized obstetric care facilities. Material and methods. The study included the results of ultrasound examination of fetuses (59 cases) in various modes with cleft lip and palate of various types within gestational periods from 16 to 36 weeks. Results. The sensitivity indices of the generally accepted method of two-dimensional B-mode ultrasound have been determined for diagnosing all types of clefts, which amounted to 81.3 %, and the sensitivity for diagnosing cleft palate and cleft lip and palate amounted to 80.3 %. The sensitivity indices of the newly developed diagnostic method (ultrasound elastography of the palate) have been determined, which amounted to 89.8 % in the diagnosis of all types of clefts, and 90.2 % in the diagnosis of cleft palate and cleft lip and palate (46/51). Demonstration of the image of the fetal face obtained during the three-dimensional B-mode reconstruction to its future parents helps the family to make a more balanced and correct decision on further pregnancy tactics. In cases of cleft palate, a new visualization diagnostic criterion has been defined - tongue bifurcation. MRI of the fetal head is not an effective and affordable method for the diagnosis of facial clefts, which can be widely used in practice. Conclusion: It is advisable and necessary to conduct an obligatory study of the karyotype in fetuses with crevices identified during imaging examination at any gestational age. As a new diagnostic criterion for cleft palate, detected by B-mode ultrasound, tongue bifurcation can be used. The utilization of the EN method in combination with the developed coloristic criteria for RHN and RN increases their prenatal detection in general population by 9.9 %. At the same time, the detectability of all types of crevices increases by 8.5 %. In order to objectify the explanations about the essence of revealed defects of the face and structures of the oral cavity, it is necessary to demonstrate a three-dimensional sonogram of the fetal face obtained during three-dimensional B-mode reconstruction to its future parents. MRI of the fetal head cannot be recommended as an effective and affordable method for diagnosing facial clefts due to the impossibility to obtain a satisfactory image in most cases.

Secondary Alveolar Bone Grafting (CLEFTSiS) 2000–2004

2010 ◽  
Vol 47 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Grant T. McIntyre ◽  
Mark F. Devlin
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Advisory Group ◽  
Kappa Statistics ◽  
Clinical Services ◽  
Maxillary Expansion ◽  
Bone Harvesting ◽  
Alveolar Bone Grafting

Objective To determine whether alveolar bone graft outcomes improved with reorganization of Scottish cleft services following the Clinical Services Advisory Group United Kingdom finding of 58% success and to determine the accuracy of results from CLEFTSiS (national managed clinical network for Scottish cleft services) annual audits. Design Retrospective random analysis of electronic radiographs by two observers. Setting Surgical-orthodontic care provided through National Health Service. Patients, Participants Sixty-three of 261 patients eligible for alveolar bone grafting by cleft type did not undergo surgery. Nine surgeons operated on 198 patients (2 regrafts). Radiographs were available for 115 subjects (one was excluded). Interventions A standard protocol involved presurgical maxillary expansion (where necessary) and bone harvesting from the iliac crest. Main Outcome Measure(s) The Kindelan Bone-Fill Index evaluated radiographic success with weighted kappa statistics for intraobserver and interobserver reproducibility. Two-sample t-tests were used to determine whether outcomes for bilateral and unilateral cleft lip and palate patients differed and to examine the effects of operator volume, presurgical expansion, and age at the time of grafting. Results Intraobserver (0.93 to 0.97) and interobserver (0.83 to 0.85) reproducibility were almost perfect. Grafts were successful in 76% of patients, while 23% were partial failures and 1% of cases were total failures. Patients who underwent presurgical expansion (n  =  64) had statistically significantly better results ( p  =  .046). However, there was no statistically significant effect for unilateral versus bilateral patients ( p  =  .77), patients treated by the highest volume operator ( p  =  .78), and patients under 11 years of age ( p  =  .29). Conclusions CLEFTSiS alveolar bone graft results between 2000 and 2004 were improved on the Clinical Services Advisory Group study and annual CLEFTSiS audits. Patients who underwent maxillary expansion prior to surgery were more successful.

Comparison of Facial Form in Primary Alveolar Bone-Grafted and Nongrafted Unilateral Cleft Lip and Palate Patients: Intercenter Retrospective Study

1996 ◽  
Vol 33 (2) ◽  
pp. 91-95 ◽  
Author(s):  
Carroll-Ann Trotman ◽  
Ross E. Long ◽  
Sheldon W. Rosenstein ◽  
Carole Murphy ◽  
Lysle E. Johnston
Keyword(s):  
Cleft Palate ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Craniofacial Morphology ◽  
Long Term Effects ◽  
Treatment Protocols ◽  
Alveolar Bone Grafting ◽  
Matching Criteria

The purpose of this study was to describe and compare posttreatment craniofacial morphology in samples of complete unilateral cleft lip and palate (CUCLP) patients treated at two leading clinics: The Children's Memorial Hospital Cleft Palate Clinic, Chicago, Illinois, and the Lancaster Cleft Palate Clinic, Lancaster, Pennsylvania. These centers have well-defined treatment protocols that allow the long-term effects on craniofacial form of the following treatment regimes to be contrasted: (1) Chicago—primary alveolar bone grafting, with definitive lip repair at age 4 to 6 months and hard and soft palate repair at 6 to 12 months; and (2) Lancaster—definitive triangular-flap lip repair at 3 months of age, followed by staged surgeries of the hard and soft palates, both completed by 18 months of age, but without primary alveolar bone grafting. Although the Lancaster center now performs secondary alveolar bone grafting, the majority of the patients studied here were treated before this procedure became part of their protocol. Patients were eligible for inclusion if they had no other congenital anomalies and no previous orthodontic treatment. A sample of 43 (24 male, 19 female) CUCLP patients was obtained from the Chicago Center, each of which was then matched to a non-grafted Lancaster CUCLP patient. The matching criteria were age, sex, and sella-nasion distance (to control, at least in part, for size differences). Lateral cephalometric radiographs of these 86 CUCLP patients were traced, digitized, and analyzed. Additionally, all linear data were adjusted to a standard magnification of 8% because the cephalograms from each center featured different enlargements. The Chicago and Lancaster samples had mean posttreatment ages of 10.32 years (SD = 1.96) and 10.40 years (SD = 2.18), respectively. The grafted Chicago group had faces that were on average less maxillary protrusive compared with the nongrafted Lancaster sample; it appeared, however, that the mandible compensated for the maxillary position by downward and backward rotation. As a result, a similar maxillomandibular relationship was noted in both groups, although, in the Chicago group, the lower anterior facial height increased.

scholarly journals OROFACIAL CLEFTING –AN EXTENSIVE REVIEW

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
T. Ashiq ◽  
Srikrishnan Rajendran Sri Ramkumar ◽  
N. Mugunthan ◽  
R.S. Uma ◽  
Iyyanar Jayaraj ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Clinical Manifestations ◽  
The United States ◽  
World Health ◽  
Upper Respiratory Tract ◽  
Facial Cleft ◽  
Facial Clefts

Groove in the palatal vault makes an abnormal communication between oral and nasal cavity is known as oro-facial cleft. It is an uncommon presentation in day-to-day clinical practice. According to World Health Organization, children with the complaint of oro-facial clefts found to be high in India. Children are commonly suffering from functional and aesthetical problems due to Oro-facial clefting. Globally, an estimated 200,000 babies are born with a cleft lip, palate or both each year in the United States. Etiology may be congenital or acquired. Palatal and Alveolar cleft defects are the most common etiological factors. Cleft lip and cleft palate can sometimes develop in combination with a syndrome due to genetic causes. The acquired causes may be infections, trauma, postsurgical complications, neoplasms, periapical pathology, radio and chemo necrosis. Clinical features like defective speech, and upper respiratory tract and ear infections, fetid odor, bad taste, nasal regurgitation of food are the associated consequences of oro-nasal communication. Therefore, this malformation syndrome is an important public health problem. Many cleft palate and cleft lip develops due to the combination of genetic and environmental factors. There are more than 400 genes linked to formation of cleft lip and palate. Some environmental factors associated with cleft include medications, deficiency of folic acid, and cigarette, drugs or alcohol conception   during pregnancy. In this article we review the anatomy, embryology, epidemiology clinical manifestations and treatment options of the oro-facial cleft Key words: Oro-facial Cleft, Classification, , Anatomy , Embryology, Morphology, Incidence, Congenital Anomaly        

scholarly journals Clinical Evaluation of Surgical Orthodontic Procedure with Bone Grafts for Patients with Cleft Palate during Adolescence

2021 ◽  
pp. 750-755
Author(s):  
Ravindra Manerikar ◽  
Shilpa Pharande ◽  
N. G Toshniwal ◽  
Kishor Chougule ◽  
Abhijit Misal
Keyword(s):  
Cleft Palate ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Multidisciplinary Approach ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Alar Base ◽  
Grafting Technique ◽  
Alveolar Bone Grafting

Background: Cleft lip and palate is a congenital anomaly, presenting in a wide variety of forms and combinations. Successful cleft lip and cleft palate rehabilitation requires a multidisciplinary approach employing the skills of different specialists. Aims & Objectives: The aim of this paper was to present orthodontic preparation of patients prior to alveolar bone grafting & to review our findings in a group of patients treated by secondary and delayed bone-grafting procedures at our institution. Methodology: Thirty eight patients were examined for the type of cleft and the age at the time of examination. 10 patients were treated in our institution with presurgical orthodontics & operated by a delayed bone-grafting technique.  Duration and type of expansion was noted at pre-operative, 2 months and 6 months. Crestal bone heights and the quality of the bone in the grafted areas was examined radiographically, along with presence of any fistulas. Results: All the patients demonstrated improved alar base and upper lip support, also better dental stability was seen in the region of cleft. Conclusion: All the patients included in this study appeared to benefit from the procedure with improved facial balance. In all ten patients the oronasal fistulas remained closed, hence was reported to be a success.

scholarly journals Evaluation of maxillary central incisors on the noncleft and cleft sides in patients with unilateral cleft lip and palate—Part 2: Relationship between root resorption, horizontal tooth movement, and quantity of grafted autogenous bone

2017 ◽  
Vol 87 (6) ◽  
pp. 863-870 ◽  
Author(s):  
Aya Maeda-Iino ◽  
Minami Furukawa ◽  
Sangho Kwon ◽  
Kanako Marutani ◽  
Shoko Nakagawa ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Root Resorption ◽  
Orthodontic Tooth Movement ◽  
Root Apex ◽  
Autogenous Bone ◽  
Alveolar Bone Grafting

ABSTRACT Objective: To evaluate the relationship between external apical root resorption (EARR) of the maxillary central incisors (U1), horizontal orthodontic tooth movement, and quantity of grafted bone in subjects with unilateral cleft lip and palate (UCLP) over an average duration of 8 years. Materials and Methods: Thirty subjects with UCLP were evaluated for EARR of U1 after edgewise treatment (T2). The teeth were classified as having no EARR, moderate EARR (combined into “no/moderate” EARR), or severe EARR. Frontal cephalometric radiographs acquired at eruption of U1 (T0), less than 6 months before secondary alveolar bone grafting (T1), and T2 were evaluated to determine the horizontal inclination (U1-axis angle) and distance of the root apex from the median line (U1-root–VL distance). On the cleft side, the quantities of grafted bone at less than 12 months postsecondary bone grafting and at T2 were evaluated using the alveolar bone graft (ABG) scale. Results: Cleft-adjacent teeth exhibited more severe EARR than did teeth on the noncleft side. The cleft side exhibited greater changes in U1-axis angle and U1-root–VL distance between T0 and T2 than did the noncleft side. On the cleft side, the ABG score at T2 in the severe EARR group was significantly lower than that in the no/moderate EARR group. These measurements were correlated with EARR grade. Conclusions: Cleft-adjacent U1 exhibited more severe EARR than did the U1 on the noncleft side, which might be associated with orthodontic treatment-induced changes in horizontal inclination and root apex movement. On the cleft side, severity of EARR may be correlated with the success of ABG.

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