Cleft Lip Cases Research Articles

Clinical Characteristics Analysis of 1051 Cases of Cleft Lip With/Without Cleft Palate in the Ethnic Tibetan Population

To examine the characteristics of the prevalence of congenital cleft lip with/without cleft palate in the ethnic Tibetan population and to provide support for the precise prevention and treatment of cleft lip with/without cleft palate in the Tibetan population. The clinical data of Tibetan patients with cleft lip with/without cleft palate were collected and the clinical characteristics of the patients were analyzed. The patients' age ranged from 2 months to 51 years old. All the subjects were admitted to West China Stomatology Hospital, Sichuan University for the treatment of cleft lip with/without cleft palate between January 2016 and August 2023. Most of the subjects came from Sichuan Province and the Tibet Autonomous Region. A total of 1051 patients were enrolled and children aged under 12 months (460 cases) accounted for the largest proportion. Among the subjects, 383 had cleft lip only (36.44%), 140 had cleft palate only (13.32%), and 528 had cleft lip with cleft palate (50.24%). The male-to-female ratios of patients with cleft lip only (0.99∶1), cleft palate only (0.54∶1), and cleft lip with cleft palate (1.67∶1) exhibited significant differences (P<0.001). However, there was no significant difference in the male-to-female ratio in patients with cleft lip only or those with cleft lip with cleft palate when the subjects were divided into two groups according to whether they had unilateral or bilateral cleft lip with/without cleft palate. Most of the patients with bilateral cleft lip were female, while most of the patients with unilateral cleft lip and unilateral or bilateral cleft lip with cleft palate were male. The unilateral cleft lip with/without cleft palate was located predominantly on the left side. Syndromic cleft lip with/without cleft palate accounted for 3.43% of all the cases and the most common concomitant deformity was congenital heart disease. 3.81% (40 cases) of the patients had a family history. In the patients with cleft lip only and those with cleft palate only, the proportion of patients having parents with corresponding phenotypes was higher than those of other phenotypes of cleft lip with/without cleft palate. Regarding the birth time distribution of the children with cleft lip with/without cleft palate, Spring saw the highest number of births of these children (311 cases, 29.59%), while Winter saw the lowest number of births (231 cases, 21.98%). The cases of cleft lip with/without cleft palate in the ethnic Tibetan population are predominantly cleft lip and palate. Unilateral cleft lip only or cleft lip with palate is predominantly located on the left side. Lip disease phenotypes may be more heritable.

Missing Puzzle Pieces: Cleft Lip and Palate

Facial differences can arise while a baby is still growing inside the mother. Two common examples include cleft lip and cleft palate. Most of the body’s cells contain DNA, which serves as the instructions for creating all the features of the body, such as the parts of the face. Cells use DNA’s instructions to form the face from five big “puzzle pieces” called prominences. Sometimes the DNA instructions get changed or steps are skipped, which can change how the puzzle pieces, or prominences, connect. This results in facial differences like cleft lip, in which there is a gap in the lip and cleft palate, in which there is a gap in the roof of the mouth. Most cases of cleft lip and cleft palate can be fixed with surgery, and children go on to live long, healthy lives.

Orofacial clefts patients epidemiology in Hermina Hospital during 2008-2017

Background: Malformation of lip and palate closure that occurs during embryology time in the mother's womb will affect the shape of mouth and face. This congenital malformation is often referred to orofacial clefts including cleft lip, cleft palate, cleft lip and palate. Orofacial clefts cases are still commonly found in Indonesia. This study aims to present orofacial clefts patients epidemiology in Hermina Hospital during 2008-2017. Methods: Retrospective studies were conducted on 230 orofacial clefts patients at Hermina Podomoro and Hermina Kemayoran Hospital from 2008 until 2017. The variables include the distribution of age, gender, residency area, diagnosis, and type of operations. Results: From 230 patients, there were 169 patients (73.5%) in age group of 0-4 years with an average 2.1 years old. 125 patients were male (54.34%). 103 patients from Jakarta (44.8%) and 127 patients from outside Jakarta (55.2%). There were 116 cases of cleft lip (50.5%), 99 cases of cleft palate (43%), and 15 cases of cleft lip and palate (6.5%). There were 137 labiaplasty operations (59.57%) and 93 palatoplasty operations (40.43%). Palatoplasty including primary and secondary palatoplasty. Conclusion: Orofacials cleft patients from Hermina Kemayoran and Hermina Podomoro Hospital from 2008-2017 average age 2.1 years old. Most of the patients are male and came from outside Jakarta. The most common diagnosis is cleft lip with labiaplasty operation handling.

Epidemiological Profile of Cleft Lip and Palate Cases in A Libyan Neonatal Unit at Al Wahda Teaching Hospital, Derna: A Comprehensive Analysis

Aim. This study aims to assess the prevalence and associated risk factors of Cleft lip and palate (CLP) among neonates in Derna, Libya, over a six-year period from 2016 to 2021. Methods. This retrospective observational study analysed data from the neonatal unit registry at Al Wahda teaching hospital in Derna, Libya. The study population comprised neonates admitted to the hospital from 2016 to 2021. Inclusion criteria specified Libyan neonates diagnosed with CLP, while exclusion criteria excluded stillbirths and non-Libyan neonates. Data analysis involved calculating incidence rates, descriptive statistics, and subgroup analyses to identify demographic characteristics and associated risk factors. Results. Out of 2,887 neonatal records reviewed, 10 cases of cleft lip ± palate (CL±P) were identified, yielding an overall incidence rate of 0.6 cases per 1000 live births. The majority of cases (50%) presented with both cleft lip and palate, followed by cleft palate only (40%) and cleft lip only (10%). Demographic analysis revealed a higher prevalence among females (60%), full-term neonates (80%), neonates from larger families of more than 6 children (50%), and those with birth weights between 2.5 and 4 kg (70%). Left-sided clefts were more common (90%) than right-sided clefts (10%). Potential risk factors included maternal history of abortion (20%), irregular pregnancy follow-up (90%), and gestational diabetes (10%). Conclusion. This study provides insights into the prevalence and associated risk factors of cleft lip ± palate (CL±P) among neonates in Derna, Libya. The findings underscore the importance of comprehensive prenatal care and public health interventions to address modifiable risk factors and reduce the incidence of cleft lip ± palate in affected populations. Further research is needed to explore additional factors contributing to cleft anomaly occurrence and outcomes.

An Objective Evaluation of Cleft Lip Repair Deformities Based on Standardized Photographic Views.

Several assessment systems of the cleft-related facial deformity have been reported in the medical literature. Assessments have been made from direct clinical evaluations, photographs, on-screen digital images, and 3-dimensional imaging. An evaluation method based on standardized photographic views is developed to evaluate the most common postoperative deformities and to detect the responsible factors for occurrence of these deformities and how to avoid them. One hundred forty-five cleft lip cases (105 unilateral and 40 bilateral) were evaluated by using standard sheet and scoring system designed by Operation Smile Inc (Virginia Beach). The scoring system is based on photographic analysis of items including Cupid's bow, nasal symmetry, vermilion contour, white roll continuity, and scar quality. In the unilateral cleft cases, we found 0.4% excellent, 48.57% good, 38% fair, and 2.85% poor cases. For bilateral clef lip cases, we found 27.5% excellent, 47.5% good, 17.5% fair, and 7.5% poor outcomes. The most common postoperative deformities were nasal asymmetry, scar hypertrophy, deformed Cupid's bow, and vermilion contour asymmetry. This objective evaluation system can determine the common cleft lip nasal deformities with detection of the responsible factors. Principles that guide optimum surgical repair have been advocated to avoid the common postoperative deformities. Scar formation is an independent factor that must be managed early and separately to maintain surgical outcomes.

Rare variant modifier analysis identifies variants in SEC24D associated with orofacial cleft subtypes.

As one of the most common structural birth defects, orofacial clefts (OFCs) have been studied for decades, and recent studies have demonstrated that there are genetic differences between the different phenotypic presentations of OFCs. However, the contribution of rare genetic variation genome-wide to different subtypes of OFCs has been understudied, with most studies focusing on common genetic variation or rare variation within targeted regions of the genome. Therefore, we used whole-genome sequencing data from the Gabriella Miller Kids First Pediatric Research Program to conduct a gene-based burden analysis to test for genetic modifiers of cleft lip (CL) vs cleft lip and palate (CLP). We found that there was a significantly increased burden of rare variants in SEC24D in CL cases compared to CLP cases (p = 6.86 [Formula: see text] 10-7). Of the 15 variants within SEC24D, 53.3% were synonymous, but overlapped a known craniofacial enhancer. We then tested whether these variants could alter predicted transcription factor binding sites (TFBS), and found that the rare alleles destroyed binding sites for 9 transcription factors (TFs), including Pax1 (p = 0.0009), and created binding sites for 23 TFs, including Pax6 (p = 6.12 [Formula: see text] 10-5) and Pax9 (p = 0.0001), which are known to be involved in normal craniofacial development, suggesting a potential mechanism by which these synonymous variants could have a functional impact. Overall, this study indicates that rare genetic variation may contribute to the phenotypic heterogeneity of OFCs and suggests that regulatory variation may also contribute and warrant further investigation in future studies of genetic variants controlling risk to OFC.

Ultrasound Detection of Fetal Palate Development in the Early Stages of the Second Trimester and Its Clinical Application.

To establish normal values of palatal bone growth in fetuses at different gestational weeks in the early stages of the second trimester and to explore the clinical application value of the four-step ultrasound screening method for fetal cleft lip and palate. A prospective study of prenatal ultrasound screening. Secondary maternal and child health institutions. 300 fetuses of 12 to 20 +6 weeks gestation without cleft lip and/or palate; 8538 fetuses at high risk of cleft lip and palate with malformations or karyotypic abnormalities. None. palatomandibular diameter (PMD) and transverse palatal diameter was measured and establish their typical values. (1) There is a typical "superimposed line" sign in the median sagittal section of the typically developing fetal face from 12 to 20+6 weeks of gestation. (2) The PMD and hard palate transverse diameter of fetuses from 12 to 20+6 weeks of gestation increased linearly with time. (3) Among 8538 high-risk fetuses, 21 cases of cleft lip and palate were diagnosed by the four-step ultrasound screening method in the early stages of the second trimester. The median sagittal section of the typically developing fetal face in the early stages of the second trimester presents a typical "superimposed line" sign, and the PMD and transverse palatal diameter increase with time. The four-step ultrasound screening method for fetal cleft lip and palate in the early stages of the second trimester has high clinical application value.

Surgical technique to achieve postoperative alar base symmetry in complete bilateral cleft lip and alveolus repair – A prospective study

ABSTRACT Introduction: Children born with the bilateral cleft lip-cleft palate have a shortened columella and an elevated protruding premaxilla which results in an abnormal appearance of the nose. Materials and Methods: This study was conducted in the Baby MemorialHospital, Calicut, a Smile Train Center in India. After scrutiny, the eligible sample size amounted to30 cases. The patient’s age rangedfrom 4 to 7 months. The basic technique employed is “Veau three straight line repair” technique. This study analyses the importance of a geometrical incision, a back cut extending cephalically above the inferior turbinate at the mucocutaneous junction to elevate the nostril floor, to achieve the symmetry of the alar bases. Result: Preoperative and postoperative anthropometric studies were conducted on the asymmetry and symmetry of the alar bases. The p values for the right side preoperative and postoperative measurement is 0.007 which is highly significant and for the left side, it is &lt;0.001 which also denotes statistical significance of this technique. Conclusion: Further high volume multicentric studies may be suggested since bilateral cases amount for only 10% of the overall incidence of cleft lip cases and even high volume surgeons are privileged to treat only a few. Therefore, it is the obligation of every surgeon who undertakes the care of these children to learn from the past and to analyse results periodically, including comparison with other centres.

Constructing of predictive model for the surgical effect of patients with cleft lip and palate.

To explore effective factors of surgical effect for patients with cleft lip and palate, and to construct the predictive model of surgical effect, which provide reference for improving the effect of cleft lip and palate surgery. This study has been ethically reviewed and approved by the Medical Ethics Committee of Guiyang Stomatological Hospital before the study began.A total of 997 cases of cleft lip and palate surgical treatment in Guiyang Stomatological Hospital from 2015 to 2020 were collected. Logistic regression analysis was used to analyze the factors influencing the surgical outcome, and a score system was established by assigning values to the influencing factors using the nomogram. Data of 110 patients were verified, and decision curve analysis was used to evaluate the predicted results. Logistic regression analysis showed that the number of surgeries, surgical methods, breast milk, prenatal examination, nutrition during pregnancy and labor intensity during pregnancy were independent risk factors for poor surgical results (all P<0.05). The predictive model was built by including the number of surgeries, surgical methods, breast milk, prenatal examination, nutrition and labor intensity during pregnancy into the predictive scoring system. The critical value was 273, the area under ROC curve (AUC) was 0.733(95%CI:0.704~0.76), the sensitivity was 89.57%, and the specificity was 48.14%.When the external validation data of 110 patients were brought into the score, the AUC of poor diagnostic value reached 74.5%, P<0.05, which was close to the modeling accuracy of 73.3%. This study constructed a predictive model of surgical effect for patients with cleft lip and palate, which can be used for the clinical prediction of cleft lip and palate patients in Guizhou Province.

Rare variants found in clinical gene panels illuminate the genetic and allelic architecture of orofacial clefting

PurposeOrofacial clefts (OFCs) are common birth defects including cleft lip, cleft lip and palate, and cleft palate. OFCs have heterogeneous etiologies, complicating clinical diagnostics because it is not always apparent if the cause is Mendelian, environmental, or multifactorial. Sequencing is not currently performed for isolated or sporadic OFCs; therefore, we estimated the diagnostic yield for 418 genes in 841 cases and 294 controls. MethodsWe evaluated 418 genes using genome sequencing and curated variants to assess their pathogenicity using American College of Medical Genetics criteria. Results9.04% of cases and 1.02% of controls had “likely pathogenic” variants (P < .0001), which was almost exclusively driven by heterozygous variants in autosomal genes. Cleft palate (17.6%) and cleft lip and palate (9.09%) cases had the highest yield, whereas cleft lip cases had a 2.80% yield. Out of 39 genes with likely pathogenic variants, 9 genes, including CTNND1 and IRF6, accounted for more than half of the yield (4.64% of cases). Most variants (61.8%) were “variants of uncertain significance”, occurring more frequently in cases (P = .004), but no individual gene showed a significant excess of variants of uncertain significance. ConclusionThese results underscore the etiological heterogeneity of OFCs and suggest sequencing could reduce the diagnostic gap in OFCs.

Relationship Between Cleft Lip and Palate Followed by Osteogenesis Imperfecta Accompanied by Tetralogy of Fallot in Children with a Maternal History of Catatonic Schizophrenia with Valproic Acid Therapy and Diabetes Mellitus

Researchers believe that most cases of cleft lip and cleft palate are caused by genetic and environmental factors. Nevertheless, the exact cause was not found. Nevertheless there are allegations that the condition of the cleft lip and palate has something to do with osteogenesis imperfecta with the heterozygous mutation COL1A2 and the formation of triple helix DNA accompanied by Tetralogy of Fallot in children with a maternal history of catatonic schizophrenia followed by the use of valproic acid and type II diabetes mellitus. Then, it is also found in babies with cleft lip and sky conditions usually accompanied by other congenital anomaly, but not always. This then further gives rise to speculation that there are links between the above variables and the cleft lip and palate. Therefore. Knowing the Relationship Between Cleft Lip and Palate Events with osteogenesis imperfecta with heterozygous mutation COL1A2 and triple helix DNA formation accompanied by Tetralogy of Fallot in children with a maternal history of catatonic schizophrenia followed by the use of valproic acid and type II diabetes mellitus. This research is a Systematic Review using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method or commonly called PRISMA, this method is carried out systematically by following the correct research stages or protocols. The source was taken from the Google Scholar site with journals published in 2017-2023 and then screened the results of 1,870 journals. Journal clustering was carried out and the number of Q1 indexed journals was obtained in 4 journals, Q3 in 1 journal, and Q4 in 1 journal so that there were 6 journals extracted. The entire journal does not directly discuss the relationship between the research variables, but only provides an overview of the increased risk of celestial cleft conditions in babies if the expectant mother has type 2 diabetes mellitus conditions, osteogenesis imperfect, and the relationship of the two health conditions to the possibility of birth of the baby with the Tetralogy of Fallot condition, as well as the relationship of the baby to the condition of the cleft lip and palate and tetralogy of fallot

Initiation to the management of a case of cleft lip and palate in Madagascar: Naso-Alveolar Molding

Introduction: Cleft lip and palate represent the most common facial anomaly in the world, with a prevalence of 4.66‰ in Madagascar in 2016. These malformations constitute aesthetic, functional and social damage. Pre-surgical orthodontic management has not yet been applied in Madagascar. The objective of our study was to report the case of a patient with a cleft lip and palate treated pre-surgically by "Naso-Alveolar Molding". Observation: This is a 3-month-old male child with a bilateral nasolabio-alveolar cleft associated with a total secondary cleft. The initial exo-buccal examination revealed 15mm (left) and 16mm (right) nasal cleft widths, 6mm (left) and 5mm (right) lip cleft widths. The intraoral examination showed 3mm (left) and 4mm (right) of alveolar cleft widths. The treatment consisted of the placement of “Naso-Alveolar Molding”. The evolution having been favorable after a month marked by the reduction of the width of the slits and an aesthetic improvement exo-buccal. Discussion: Pre-surgical orthodontics is performed in infancy to facilitate feeding, reduce cleft width, and reposition deformed nasal cartilages and alveolar processes; to lengthen the deficient columella in the neonatal period. The main objective being to minimize the extent of surgery that would have to be performed. The malleability of the nasal cartilage at the infantile stage indicates the orthodontist to its conception and to ensure a favorable prognosis. Conclusion: The treatment of cleft lip and palate consists of a multidisciplinary approach including Dento-Facial Orthopedics.

A retrospective study on clinical and epidemiological profile of nonsyndromic cleft lip and palate patients admitted in a large Comprehensive Cleft Care Centre in West Bengal, India

Aim: The aim of this study is to observe the clinical and epidemiological profile of nonsyndromic cleft lip (CL) and/or palate patients admitted to a cleft care center in West Bengal from May 2021 to April 2022. Materials and Methods: A retrospective epidemiological study had been done by preparing a master data sheet to record the patient's data from a Comprehensive Cleft Care Centre in West Bengal. The study variables included were patient's age reporting at the hospital, type of cleft, sex distribution of patients, residential address of the parents, socioeconomic status through parents' education, occupation, and monthly income, and consanguineous marriage history of the family. Results: A total of 276 nonsyndromic cleft patients during the time period (May 2021 to April 2022) were considered. Among these, 164 were male and 112 were female patients. The mean age of patients reporting to this hospital on average was 13–18 months. CL with palate patients (62%) predominated than any other type and was mostly seen in male patients (69.59%); isolated CL (22%) cases were more in females (56.25%), whereas isolated cleft palate (16%) cases were seen more in males (62.79%); unilateral (77%) and left-sided cleft (67%) were found predominantly than bilateral cases (23%) and seen mostly in females, whereas bilateral cleft cases were more in males. Most of the patients belonged to North 24 Parganas District which is an adjacent district of Kolkata, and most of the families belonged to a low socioeconomic group, and interestingly, most of them had consanguineous marriage history (61%) with at least one generation. Conclusion: The results of this study provided that CL with palate type is more common among all types of clefts and predominantly found in males than females in West Bengal. The unilateral left-sided cleft is predominant among all other varieties. Most of the parents belonged to low socioeconomic status and are having consanguineous marriage history. We need to spread awareness among the public through ads and banners, social media, and medical free camps about the deformity of CL and/or palate and also possible preventive measures, make arrangements for free treatment among the CL and/or CL and palate population for better life of cleft patients and their parents.

Updated Evidence in Management of Cleft Lip and Palate: Simple Review Article

The most common oro-facial congenital deformity reported in live newborns is a cleft of the lip, palate, or both. The objective of this study was to&nbsp;the&nbsp;updates in management, and outcomes of cases of cleft lip and/or palate. PubMed and EBSCO Information Services&nbsp;will be&nbsp;chosen as the search databases for the publications used within the study. Topics concerning&nbsp;the&nbsp;updates in management, and outcomes of cases of cleft lip and/or palate, published in English around

Cleft lip and palate based on birth order and family history at Mitra Sejati General Hospital, Indonesia

Background: Cleft lip and palate is one of the most common congenital abnormalities in infants and is caused by more than one factors, which can be genetic and environmental. Defects in a family gene can result in cleft lip and palate. The study found a high family history relationship with the incidence of cleft lip and palate. Birth order studied by several researchers also has different results, which were influenced by folic acid consumption, maternal knowledge, lack of antenatal care visits and maternal age. To determine the cases of cleft lip and palate based on the birth order of the children and family history of the patients at Mitra Sejati General Hospital. Purpose: The study aimed to investigate cleft lip and cleft palate patients by birth order and family history. Methods: This research was a retrospective descriptive study using survey method. Researchers gave 13 questions through a questionnaire and data were collected and counted manually. Results: The results showed that based on the birth, the cleft case in the first birth order amounted to 25 people, the second 30 people, the third 19 people, and the fourth or more as many as 20 people. Based on family history, 27 patients had a family history of cleft lip and palate, while 67 patients did not have family history. Conclusion: The cases of clefts at Mitra Sejati General Hospital happened more frequently in the second child and most incidence did not have family history.

Limited Access to Alveolar Bone Graft Surgery Following Primary Cleft Lip and Palate Repair in Indonesia: A Questionnaire-Based Qualitative Study.

Cleft Lip and Palate is the most common craniofacial anomaly, and cleft lip and palate repair is widely performed. Alveolar cleft accompanies 75% of cleft lip cases and requires alveolar bone graft (ABG) surgery at mixed dentition age. However, studies on rates of ABG surgery are scarce. This study aims to investigate the low popularity of ABG and orthodontic care among patients with ABG history at Cleft and Craniofacial Centre, Cipto Mangunkusumo Hospital, Jakarta. A total of 771 patients had orofacial cleft surgeries throughout 2015 to 2021. A descriptive analysis of labioplasty, palatoplasty, and ABG surgeries was presented. Questionnaire-based qualitative analysis of ABG was obtained from the patient's guardians to evaluate the limitation and experience of conducting the surgery at our institution. We distributed questionnaires to 13 patients with a history of ABG. ABG accounted for only 5% of total orofacial cleft surgeries. The average age of ABG surgery and orthodontic care initiation was 11 and 11.8 years old, respectively. About 82% had access to preoperative and postoperative orthodontic care; however, only 11% received PSO before 9 years old. The satisfaction rate was 100% and 75% in ABG patients with and without orthodontic care, respectively, reporting improved feeding, speech, teeth alignment, and esthetic result. Orofacial cleft management requires a multistage, comprehensive, and multidisciplinary approach. The number of ABG surgeries is low in developing countries, attributed to unequal access to ABG and orthodontic care, suggesting that limitations of knowledge, geography, and economy play a big role in Indonesian healthcare.

Embryological approach to philtral hair sparsity in bilateral cleft lip deformities

ObjectiveIn bilateral cleft lip cases, surgeons have long known that the medial nasal prominence or prolabium is devoid of muscle. Despite cheiloplasty restoring orbicular muscle continuity, moustache hair growth is less developed on the philtral skin. We sought to understand this hair disparity. Basic proceduresThe authors conducted a comprehensive literature search using reference materials on the physiological and pathological development of the face in utero and the PubMed database using the keywords 'embryology', 'bilateral cleft lip' and 'hair'. Main resultsIn bilateral cleft lip, the normal fusion between the maxillary and intermaxillary process does not occur, and the migration of cranial neural crest cells (CNCC) is disturbed. CNCCs from different locations and with different myoblastic differentiation potential are arrested on each side of the cleft. Therefore, a reduced concentration of myoblasts and myocytes as well as hormone receptors in the medial process could hinders the normal physiological development of the different layers of the philtral skin and especially the skin appendages. ConclusionPhiltral hair sparsity in patients with bilateral cleft lip can be explain by a defect in the migration of CNCCs to the prolabium, whose cells are not able to develop hair follicles, due to a disruption of the exchange of Wnt/β-catenin, EDA, and or Noggin signals and due to the absence of androgen receptor.

Experience of Unilateral Cleft Lip Repair using the Anatomical Subunit Technique in an Omani Population over a Five-Year Period.

ObjectivesThis study aimed to report the authors’ experience with the anatomical subunit technique for unilateral cleft lip repair, which has gained popularity worldwide.MethodsFrom July 2015 to April 2020, 114 consecutive cases of cleft lip underwent primary cleft lip repair with closed rhinoplasty by a single surgeon. The demographic data, severity and type of the cleft lip, surgical outcomes, including vermillion notching, were assessed by an independent senior surgeon. The rate of revision surgery was collected from the Al-Shifa® - 3Plus healthcare information system (Ministry of Health, Oman). Parents’ satisfaction regarding scar quality and lip and nose appearance was collected and all data were statistically analysed.ResultsA total of 82 cases satisfied the inclusion criteria. The mean age at surgery for cleft lip was 32 weeks. Among these, 35 cases (43%) were complete cleft lips and 47 cases (57%) were incomplete. Additionally, 43 children (52%) were born of consanguineous marriage. Six patients (7%) needed revision surgery. The digital survey was completed by 40 subjects (response rate: 48.8%) which showed 85% satisfaction rate with the postoperative scar and 77.5% satisfaction with the aesthetic appearance of the nose.ConclusionThe anatomical subunit technique resulted in a predictable outcome indicating a high rate of patient satisfaction with scar quality and nasal and lip symmetry in children with varying severity of cleft lip. The high percentage of consanguinity (52%) in this study highlights the need for more targeted national campaigns involving premarital counselling in the Omani population.

Patterns of orofacial clefts and associated risk factors in Pakistan

Background: Orofacial clefts (OFCs) are one of the most common congenital anomalies worldwide. The purpose of the present study is to identify the incidence of different types of OFCs and the presence of known risk factors among cleft cases in the Pakistani population. Patients and Methods: A retrospective study was conducted at a comprehensive cleft care center, and data were collected from patient files from December 2018 to July 2021. Only cases of cleft lip and/or cleft palate (CL/P) that presented to center were included. SPSS was used for data analysis, and risk factors associated with OFCs were identified. Results: The study included 1269 patients with CL/P. Of the total, 677 (53.3%) patients had cleft lip with cleft palate, 211 (16.6%) had cleft lip only, and 365 (28.7%) had cleft palate only. Bilateral complete cleft lip and palate (n = 276) was most common among the participants followed by midline incomplete cleft palate (n = 215). One hundred and six (8.3%) of the cases were syndromic, and among the remaining nonsyndromic cases, 240 (18.9%) had other associated anomalies. Chi-square tests revealed the following risk factors for CL/P: consanguinity among the parents (P &lt; 0.001), a complication during pregnancy (P &lt; 0.001), medication use during pregnancy (P &lt; 0.001), maternal smoking or exposure to smoking (P = 0.002), history of miscarriage (P = 0.02), and positive family history (P &lt; 0.001). Logistic regression analysis for these factors showed maternal smoking (odds ratio [OR]: 1.99), consanguineous marriage (OR: 1.89), complication during pregnancy (OR: 1.98), and positive history of cleft (OR: 1.9) to be increasing the odds of cleft development. Conclusion: While previous studies have shown many environmental factors to be associated with development of OFCs in the child, the present study provides a quantitative estimate of the risk posed by each individual factor in the Pakistani population.

DENTAL HEALTH EDUCATION TO KNOWLEDGE ABOUT MAINTENANCE OF FEEDING PLATE CLEANLINESS IN PARENTS OF PATIENTS

Background: The number of patients with cleft lip cases at RSAB Harapan Kita in 2020 reached 320 patients, in that case as many as 122 patients underwent feeding plates. The success of CLP treatment is highly dependent on the knowledge and role of parents in accompanying children. Efforts to increase knowledge can be done through dental and oral health counseling. The purpose of the study: to determine the effect of dental health education on knowledge about the maintenance of feeding plate hygiene on the parents of patients at RSAB RSAB Harapan Kita. Methods: quasi-experimental research with one group pre and post test design, population of all parents of patients with feeding plate installation cases encountered during November 2021, with accidental sampling technique of 5 people. The measuring instrument is a knowledge questionnaire. Data analysis using Wilcoxon test. The results of the study: the level of knowledge of parents before being given Dental Health Education treatment about maintaining the cleanliness of feeding plates in patients with good criteria was 4 people (80%) and after that increased to 5 people (100%), the average knowledge of parents before being treated was 7, 20 and after being given treatment increased to 7.80. There is no effect of Dental Health Education on knowledge about the maintenance of feeding plate hygiene in the patient's parents with a significant value of 0.180. Conclusion: There is no effect of Dental Health Education on knowledge about the maintenance of feeding plate hygiene in parents of patients at RSAB Harapan Kita.