Cleft Palate Research Articles

Surgical Tray Optimization in the Setting of Cleft Lip and Palate Reconstruction: Implications for Operative Cost and Efficiency.

To assess surgical instrument usage in cleft lip (CL) and cleft palate (CP) surgery and create an optimized surgical tray with an associated cost-savings analysis. Prospective, observational study. Single institution, 6-month prospective review. A total of 10 primary CL surgeries and 10 primary CP surgeries were included in this study. Complete lists of surgical instruments utilized in CL and CP surgeries were collected. The average instrument UFs were 26.0% for CL and 22.6% for CP. The estimated costs were $33.15 to $290.29 for the original CL surgical tray and $10.20 to $63.80 for the optimized tray. For CP, the original tray's cost was estimated at $38.25 to $319.00, and the optimized tray at $9.18 to $57.42. This demonstrates a cost reduction of $22.95 to $226.49 for CL and $29.07 to 261.58 for CP. The idealized surgical instrument tray could contribute to reducing healthcare expenditures and promoting operating room efficiency, patient safety, and environmentally friendlier operating theaters.

Prenatal growth patterns of the upper jaw complex with implications for laryngeal echolocation in bats.

Craniofacial morphology is extremely diversified within bat phylogeny, however growth and development of the palate in bats remains unstudied. The formation of both midline and bilateral orofacial clefts in laryngeally echolocating bats, morphologically similar to the syndromic and non-syndromic cleft palate in humans, are not well understood. Developmental series of prenatal samples (n = 128) and adults (n = 10) of eight bat species (two pteropodids, four rhinolophoids, and two yangochiropterans), and two non-bat mammals (Mus musculus and Erinaceus amurensis), were CT-scanned and cranial bones forming the upper jaw complex were three-dimensionally visualised to assess whether differences in palate development can be observed across bat phylogeny. Volumetric data of bones composing the upper jaw complex were measured to quantify palate growth. The premaxilla is relatively reduced in bats compared to other mammals and its shape is heterogeneous depending on the presence and type of orofacial cleft across bat phylogeny. The palatine process of premaxillary bones is lacking in pteropodids and yangochiropterans, whereas the premaxilla is a mobile structure which is only in contact caudally with the maxilla by a fibrous membrane or suture in rhinolophoids. In all bats, maxillary bones progressively extend caudally and palatine bones, in some cases split into three branches, extend caudally so that they are completely fused to another one medially prior to the birth. Ossification of the vomer and fusion of the maxillary and palatine bones occur earlier in rhinolophoids than in pteropodids and yangochiropterans. The vomer ossifies bilaterally from two different ossification centres in yangochiropterans, which is uncommon in other bats and non-bat mammals. Analysis of ontogenetic allometric trajectories of the upper jaw complex revealed faster development of maxillary, vomer, and palatine bones in yangochiropterans compared to other bats, especially rhinolophoids. Ancestral state reconstruction revealed that yangochiropterans have a higher magnitude of change in ossification rate compared to other bats and E. amurensis a lower magnitude compared to M. musculus and bats. This study provides new evidence of heterochronic shifts in craniofacial development and growth across bat phylogeny that can improve understanding of the developmental differences characterising nasal and oral emission strategies.

Monitoring the frequency and risk factors of birth of children with congenital cleft lip and palate in the Volgograd region

The results of a study of the frequency, prevalence, structure, and probable risk factors of congenital cleft lip and palate (CCLP) in the Volgograd region for 2010–2021 are presented. There were no dynamics of increase or decrease in the birth rate of children with congenital cleft lip and palate. Over the past decade, the birth rate of children with CCHD varied from (1.25 ± 0.35) to (1.72 ± 0.41) per 1000 live births. Risk factors for the formation of CCLP in the form of an infectious disease suffered by the mother in the first trimester of pregnancy and taking drugs have been confirmed.

EFFECTIVE APPROACHES TO ENHANCING CONNECTED SPEECH IN PREOPERATIVE CHILDREN WITH OPEN ORGANIC RHINOLALIA

Children with open organic rhinolalia, a condition often resulting from structural anomalies such as cleft palate, face unique challenges in speech development, particularly in the preoperative period. This article examines the methods, techniques, and strategies used to improve connected speech in these children before undergoing surgical intervention. Focusing on evidence-based practices, the article explores various speech therapy approaches, including breathing exercises, articulation drills, and resonance training, all tailored to address the specific needs of children with hypernasal speech. The goal of preoperative speech therapy is not only to prepare children for surgery but also to enhance their overall communication skills by developing more transparent and fluent speech. By reviewing current research and case studies, this article provides insights into effective treatment methods that can be applied in clinical settings to support children with open organic rhinolalia.

Personalized, performance-specific speech intervention in children with a cleft palate: A systematic review protocol.

The provision of speech intervention in children requires personalized, child-tailored approaches. Different speech-intervention approaches exist to eliminate cleft-related speech errors in children with a cleft palate. However, it is unclear what approach works best for the subtypes of cleft-related speech errors. To describe a protocol for a systematic review that provides speech-language pathologists with the current literature concerning more individualized speech intervention in children with a cleft palate. A systematic literature review was performed following the preferred reporting items for systematic reviews and meta-analyses. Two speech-language pathologists with clinical and scientific experience in cleft speech searched different electronic databases for relevant studies. No limit regarding publication date was set. Specific eligibility criteria were defined and used to include or exclude the studies. All included studies were evaluated with a risk-of-bias assessment tool and levels of evidence. Relevant data were extracted from the studies (study design, study population characteristics, intervention characteristics and outcome characteristics) and a narrative synthesis was performed. The findings of this systematic review will significantly contribute to the evidence on personalized speech intervention in children with a cleft palate. The study will inform speech-language pathologists on the possibilities to tailor treatment plans more to the specific subtype of cleft-related speech errors. The planned systematic review also makes recommendations for further cleft speech intervention research. What is already known on this subject At present, there is growing evidence for different speech therapy approaches in children with a cleft palate. Despite the recognized need for personalized, child-tailored therapy, there is no consensus on the best speech therapy approach per different subtype of compensatory cleft speech characteristic. What this study adds to the existing knowledge This paper provides a protocol for a systematic literature review of this topic. Specifically, it searches the literature for the use of personalized speech therapy approaches in children with different subtypes of compensatory cleft speech characteristics. What are the practical and clinical implications of this work? The systematic literature review provides speech-language pathologists with the current literature concerning personalized, performance-specific speech intervention in children with a cleft palate. Besides, the results will support therapy decision-making in children with a cleft palate in different speech-related clinical contexts.

Cleft Lip and Palate Classification Through Vision Transformers and Siamese Neural Networks

This study introduces a novel approach for the diagnosis of Cleft Lip and/or Palate (CL/P) by integrating Vision Transformers (ViTs) and Siamese Neural Networks. Our study is the first to employ this integration specifically for CL/P classification, leveraging the strengths of both models to handle complex, multimodal data and few-shot learning scenarios. Unlike previous studies that rely on single-modality data or traditional machine learning models, we uniquely fuse anatomical data from ultrasound images with functional data from speech spectrograms. This multimodal approach captures both structural and acoustic features critical for accurate CL/P classification. Employing Siamese Neural Networks enables effective learning from a small number of labeled examples, enhancing the model’s generalization capabilities in medical imaging contexts where data scarcity is a significant challenge. The models were tested on the UltraSuite CLEFT dataset, which includes ultrasound video sequences and synchronized speech data, across three cleft types: Bilateral, Unilateral, and Palate-only clefts. The two-stage model demonstrated superior performance in classification accuracy (82.76%), F1-score (80.00–86.00%), precision, and recall, particularly distinguishing Bilateral and Unilateral Cleft Lip and Palate with high efficacy. This research underscores the significant potential of advanced AI techniques in medical diagnostics, offering valuable insights into their application for improving clinical outcomes in patients with CL/P.

Effectiveness of 2 Lip Taping Techniques in Infants With Bilateral Cleft Lip and Palate: A Randomized Clinical Trial.

This trial was designed to test the efficacy of 2 lip taping methods in modifying the maxillary arch dimensions (MADs) of infants with bilateral cleft lip and palate (BCLP) before lip repair surgery. Parallel-group randomized clinical trial. The trial was conducted at 3 centers in Baghdad city. Thirty-six nonsyndromic infants with BCLP. The eligible infants were randomly assigned to either the first experimental group that received a conventional horizontal tape (3 M Steri strip-1/4 inch) or the second experimental group that received a custom-made tape made of Steri strips and orthodontic extra oral elastics. All of the included infants in both groups had rubber base impressions taken for them at the start of treatment (T1) and right before surgical lip repair (T2). A desktop scanner was used to scan each of the generated models, creating digital models that could be used for outcome evaluation. Virtual MAD measurements were performed by a blinded assessor on the generated digital models both before (T1) and after (T2) treatment. At T2, both groups showed statistically significant changes in all measured MADs, with a mean difference ranging from 1.36 to 2.95 mm for the conventional taping group and from 1.46 to 7.96 mm for the custom-made one. The comparison of the 2 groups revealed both statistically and clinically significant differences with a P value <.05. The custom-made taping demonstrated more constriction in maxillary arch in terms of changes, which could provide easier surgical manipulation for the cleft parts. Lip taping appears to be an efficient technique for modifying the MADs in infants with BCLP.

Perception, attitude, and opinion of parents of cleft lip and palate patients treated with nasoalveolar molding (NAM): A cross-sectional questionnaire study.

The main goal of the nasoalveolar molding (NAM) is to mitigate the initial severity of the cleft, facilitating the subsequent surgical procedures. Nevertheless, the use of the appliance entails high stress levels for families. The aim of this study was to assess the perceptions, attitudes, and opinions of parents whose cleft-affected children underwent treatment using the NAM technique. A cross-sectional questionnaire study was conducted on a cohort of relatives of infants born with cleft lip and palate who were treated with the NAM appliance. The parents completed a 59-item questionnaire that had been previously validated. The initial cohort consisted of 104 families. The level of satisfaction was high, and there was a direct correlation with early diagnosis. Satisfaction levels varied depending on the cleft type, with a decrease in cases of bilateral presentation. Satisfaction was influenced by the newborns' adaptation and the absence of complications. Parents who exhibited lower levels of satisfaction contemplated terminating the treatment. Parents expressed high satisfaction with NAM treatment, due to effective management and understanding. Bilateral clefts and delayed diagnosis can significantly impact satisfaction. These results emphasize the importance of personalized approaches to address challenges in NAM treatment, particularly in instances of bilateral clefts and delayed diagnoses.

A Case of Oronasal Fistula Repaired With Inferior Turbinate Rotational Flap

Oronasal fistula is a rare but significant complication that diminishes the quality of life for patients undergoing treatment for cleft palate and head and neck cancer. Various surgical reconstruction methods can be used based on the size and location of the oronasal fistula. The intranasal inferior turbinate rotational flap is a simple and safe method for reconstructing the defect of nasal cavity. In this case report, we experienced a small oronasal fistula of a 50-year-old female caused by osteoradionecrosis after treatment for her malignant melanoma. Successful reconstruction was achieved with inferior turbinate rotational flap alone. For small oronasal fistula in the hard palate, the inferior turbinate flap alone can be a useful option for reconstruction.

Cleft Palate-Lateral Synechiae Syndrome: A Case Report

AbstractLateral synechiae (LS) are fibrous bands extending from the cleft edges to the lateral edges of the tongue. The etiology of LS is still not clear, and although they are rare, they usually coexist with cleft lip palate and other congenital anomalies. In this study, we report a case of cleft palate-lateral synechiae syndrome. In this case, the lateral synechia bands were cauterized and the patient was able to open the jaw fully. Although LS is rare, medical practitioners should have awareness regarding it so that appropriate treatment protocol can be formulated for the patients.

The Spondylocarpotarsal Synostosis Syndrome Case with Ventricular Septal Defect Caused by a Homozygous Frameshift Variation in FLNB

AbstractSpondylocarpotarsal synostosis syndrome (SCT) (OMIM: 272460), an autosomal recessive disorder, is characterized by block vertebrae, carpal–tarsal synostosis, and disproportionate short stature. The clinical features of SCT include dysmorphic facial traits, cleft palate, hypoplastic tooth enamel, brachydactyly, clinodactyly, limited joint movement, and mixed hearing loss. SCT is associated with biallelic nonsense and frameshift pathogenic variants in the FLNB gene. An 8-year-old patient was referred with suspected skeletal dysplasia. The patient presented with short stature, scoliosis, carpal–tarsal synostosis, and ventricular septal defect (VSD). Clinical exome sequence analysis revealed a homozygous frameshift variation in the FLNB gene (c.219_222dup p.Met75Profs*17). No other pathogenic variations in genes related to VSD were found. This study aims to discuss novel clinical findings related to the genotype–phenotype association. To the best of our knowledge, this is the first reported case of SCT with VSD.

Lhx6 deficiency causes human embryonic palatal mesenchymal cell mitophagy dysfunction in cleft palate

BackgroundOverconsumption of retinoic acid (RA) or its analogues/derivatives has been linked to severe craniomaxillofacial malformations, such as cleft palate and midface hypoplasia. It has been noted that RA disturbed the proliferation and migration of embryonic palatal mesenchymal (EPM) cells in these malformations, yet the exact mechanisms underlying these disruptions remained unclear.MethodsA model of retinoic acid (RA)-induced cleft palate in fetal mice was successfully established. Histological alterations in the palate were evaluated using Hematoxylin and Eosin (H&E) staining and RNA in situ hybridization (RNAscope). Cellular proliferation levels were quantified via the Cell Counting Kit-8 (CCK-8) assay and EdU incorporation assay, while cell migration capabilities were investigated using wound healing and Transwell assays. Mitochondrial functions were assessed through Mito-Tracker fluorescence, mitochondrial reactive oxygen species (ROS) measurement, ATP level quantification, and mitochondrial DNA (mtDNA) copy number analysis. Differential gene expression and associated signaling pathways were identified through bioinformatics analysis. Alterations in the transcriptional and translational levels of Lhx6 and genes associated with mitophagy were quantified using quantitative PCR (qPCR) and Western blot analysis, respectively. Mitochondrial morphology and the mitochondrial autophagosomes within cells were examined through transmission electron microscopy (TEM).ResultsAbnormal palatal development in mice, along with impaired proliferation and migration of human embryonic palatal mesenchymal (HEPM) cells, was associated with RA affecting mitochondrial function and concomitant downregulation of Lhx6. Knockdown of Lhx6 in HEPM cells resulted in altered cell proliferation, migration, and mitochondrial function. Conversely, the aberrant mitochondrial function, proliferation, and migration observed in RA-induced HEPM cells were ameliorated by overexpression of Lhx6. Subsequent research demonstrated that Lhx6 ameliorated RA-induced dysfunction in HEPM cells by modulating PINK1/Parkin-mediated mitophagy, thereby activating the MAPK signaling pathways.ConclusionLhx6 is essential for mitochondrial homeostasis via tuning PINK1/Parkin-mediated mitophagy and MAPK signaling pathways. Downregulation of Lhx6 by RA transcriptionally disturbs the mitochondrial homeostasis, which in turn leads to the proliferation and migration defect in HEPM cells, ultimately causing the cleft palate.Graphical abstract

Dental abnormalities observed in the oculo-facio-cardio-dental (OFCD) syndrome present in two Czech families bearing novel de novo BCOR pathogenic variants

BackgroundThe oculo-facio-cardio-dental syndrome (OFCD) is an ultra-rare multiple congenital anomaly. This report describes clinical findings emphasising dental phenotype in five, molecularly confirmed, female cases from two Czech families.Case presentationDental examinations were carried out. An orthopantomogram was taken in three patients, and all patients’ intraoral cavities and teeth were photographed. Exome sequencing was performed in both probands. Results were validated by Sanger DNA sequencing which was also used to follow segregation of the variants in first-degree relatives. Dental abnormalities and congenital cataracts were present in all five cases, whilst other signs were variable and included facial dysmorphism, microphthalmia, and cardiac and skeletal abnormalities. Two individuals had cleft lip and/or cleft palate. Radiculomegaly occurred in three patients with permanent teeth and was diagnosed on orthopantomograms. Two patients had agenesis of permanent teeth. Malocclusion was also present in two patients due to crowding and a Class III malocclusion and mandibular overjet. De novo novel pathogenic variants in the BCOR gene were identified; c.2382del p.(Lys795Argfs*12) and c.3914dup p.(Gln1306Alafs*20) and co-segregated with the disease in each family.ConclusionsThe OFCD syndrome has a unique dental phenotype and dentists should be aware of signs of this ultra-rare genetic disorder. All patients with congenital cataracts and dental abnormalities, including those without a family history, should be referred for genetic testing and indicated to specialised dental care.

Behavioral Correlates of Caregiver-Reported Oral Health of Children with Cleft Lip and/or Cleft Palate Ages 14 to 48 Months: An Observational Study.

To identify behaviors associated with poor caregiver-reported oral health in a population of young children with cleft palate with or without cleft lip (CP ± L). Observational cross-sectional study. U.S. Cleft Outcomes Research NETwork (CORNET) Consortium Eight hundred thirty-four caregivers of US children with CP ± L ages 14 to 48 months who provided demographic and medical information and answered 8 items on oral health behaviors (eg, sugar-sweetened beverage intake frequency, having a regular source of dental care, toothbrushing, and fluoride exposure). Caregiver-reported oral health status of the child (poor/fair vs good/very good). Logistic regression models were used to generate confounder-adjusted odds ratios (OR) and evaluate associations between oral health behaviors and caregiver-reported oral health status of the child. The mean age of children was 25.5 ± 7.5 months, 82.7% were white, and 24.1% were Hispanic/Latino. About 16.7% of caregivers reported their child's oral health as fair/poor. Children consuming 2+ servings of juice and/or sugar-sweetened beverages daily (OR: 2.18; 95% confidence interval [CI]: 1.2, 4.0; P = 0.011), those drinking bottled water (OR: 1.75; 95% CI: 1.0, 3.1; P = 0.049), and those consuming 1+ servings of meal replacement drinks daily (OR: 2.86; 95% CI: 1.2, 6.5; P = 0.015) had increased odds of fair/poor caregiver-reported child oral health. Sugar-sweetened beverages and meal replacement drinks, as well as bottled water intake, were associated with poorer caregiver-reported oral health for children with CP ± L. Future research should focus on ways to improve beverage-related behaviors in children with CP ± L to prevent dental diseases and promote oral health.

Tongue dorsum activity in children with velopharyngeal insufficiency vs. typically developing children.

To investigate whether children with velopharyngeal insufficiency (VPI) exhibit increased elevation and retraction of the tongue dorsum. Two quantitative metrics of tongue dorsum activity: Dorsum excursion Index (DEI) and Tongue Constraint Position Index (TCPI) were captured using mid-sagittal images of the tongue obtained from Ultrasound Tongue Imaging. Participants: Six children with velopharyngeal insufficiency (VPI), six children with palate (w/wo cleft lip) without velopharyngeal insufficiency (wo VPI) and ten typically developing children aged 6-15 repeated six different consonants in aCa and iCi contexts five times. A linear mixed-effect model was used to examine the response variables across three groups. Overall, DEI was not significantly higher in the VPI group than in the other two groups. Also, TCPI was not significantly lower in the cleft palate group (VPI and wo VPI). However, significant differences were detected between certain phonetic contexts in the VPI group. In addition, a significant interaction between group and consonant was found in the context of /i/. These findings suggest that the presence of VPI may not lead to a uniform increase in tongue dorsum elevation or retracted position across all speech sounds. Rather, the articulatory behaviours of children with VPI may be influenced by the specific phonetic context and individual variability.

Content Analysis of Brief Telephonic Conversation with Parents of Children with Cleft Lip and Palate During Sustained Anticipatory Guidance Sessions.

Cleft lip and palate (CLP) represents complex congenital anomalies that necessitate a comprehensive approach to care, involving multiple healthcare disciplines. The primary aim of the study is to explore the content of periodic telephone support calls between parents/caregivers of children with CLP and pediatric dentist during sustained anticipatory guidance. The qualitative analysis was conducted with the available telephonic recordings that was obtained from the STOP database. 40 recordings of 8 children were used for this study. The recorded interviews were translated and transcribed verbatim and analysed using the thematic content analysis method. The four major themes that were addressed by the dentist were the general health of the baby, oral health and development, surgery-related concerns and emotional support. It was also observed that the parents demonstrated a positive shift in oral health related behaviour significantly improving their child's oral hygiene practices. The telephonic support calls offer valuable insights into the concerns and topics the parents of children with CLP are eager to discuss. These calls not only address general concerns, receiving emotional support from the professionals, demonstrate the health related behavior shift that takes place during SAG and reassures parents of their support.

Hearing, speech, and language outcomes in school-aged children after cleft palate repair

Background: Following primary cleft palate repair, individuals face a heightened risk of hearing problems, particularly conductive hearing loss, compensatory articulation disorders (CADs), resonance disorders, delayed speech and language development, and voice disorders. This study aimed to investigate the prevalence and impact of these challenges in children with cleft palate with or without cleft lip (CP± L).Methods: This cross-sectional study included 38 children with CP± L aged 5 to 13 years. A comprehensive evaluation involved audiological assessments (audiograms, tympanograms) by an audiologist and speech-language pathology assessments (Thai Speech Parameters for Patients with Cleft Palate, Articulation Screening Test) by speech-language pathologists.Results: The prevalence of hearing loss affected 27.63% of participants (21 out of 76 ears) and majority of cases involved conductive hearing loss. Velar substitution was the most common CAD, followed by nasalized voiced pressure consonants, phoneme-specific nasal air emission, and pharyngeal substitution. A moderate correlation was found between these CAD patterns and hypernasality at the word, sentence, and screening levels (&lt;i&gt;r&lt;/i&gt;= 0.44, &lt;i&gt;p&lt;/i&gt;&lt; 0.01; &lt;i&gt;r&lt;/i&gt;= 0.43, &lt;i&gt;p&lt;/i&gt;&lt; 0.01; and &lt;i&gt;r&lt;/i&gt;= 0.40, &lt;i&gt;p&lt;/i&gt;= 0.01).Conclusion: For summary, the most common type of hearing loss was conductive hearing loss. The predominant CAD pattern was velar substitution. The protocol could be designed to enhance early improvement in hearing and articulation, thereby supporting academic achievement and long-term quality of life.

A Realistic Ingeniously Designed Cleft Palate Simulator for Training of Residents: Bridging the Gap Between Theory and Practice.

Cleft palate is a congenital deformity that presents significant challenges in surgical correction. Proper training with an educational model for can greatly enhance the learning curve and improve patient outcomes. This article discusses the development and evaluation of an economical cleft palate model designed to enhance surgical skills and confidence among residents. The model was constructed using dental casts, acrylic resin, foam sheets, double-sided adhesives, infant feeding tubes, and red dye. Tertiary care center. Surgical residents. The assembly time and material costs were recorded. To evaluate its effectiveness, participants' feedbacks were collected and analyzed. The cleft palate model was produced at a cost of 250 INR per unit, with assembly taking approximately 15 minutes. Overall, 32 residents completed the simulation exercise of cleft surgery on the model. Participants gave the model an average score of 4 (±0.60) for realistic anatomical appearance, 3.5 (±1.3) for replicating the tactile nature of human tissue. Anatomical accuracy and ability to manipulate tissue and perform suturing received a rating of 3.4 (±1.1) and 3.7 (±0.81), respectively. The model's value as a training tool scored 4.4 (±0.51), with an overall satisfaction rating of 4.6 (±0.22) among residents. Our cleft palate model offers an economical, practical, and accessible solution for surgical training. This model is a viable alternative to more complex and expensive training tools and potentially enhancing the training of healthcare professionals in cleft palate repair.

Quality of Life After Microvascular Alveolar Ridge Reconstruction with Subsequent Dental Rehabilitation

Background/Objectives: Defects in maxillary and mandibular alveolar ridges are common in maxillofacial practice. Reconstruction with microvascular bone grafts and subsequent prosthetic rehabilitation is the gold standard treatment. This study investigated patients’ quality of life (QoL) after microvascular alveolar ridge reconstruction with subsequent dental rehabilitation. The effect of the underlying disease and success rates of the prosthetic treatment on QoL were analysed. Methods: OHIP-49 was used to evaluate oral health-related QoL (OHrQoL). The SF-36 was used to assess disease-nonspecific QoL. Results: Fifty-eight patients were enrolled and divided into four diagnostic (malignancy, osteoradionecrosis, benign disease, and cleft palate) and five prosthetic groups (no prosthetics, removable partial dentures, complete dentures, implant-supported removable dentures, and implant-supported fixed dentures). There was a significant difference between the diagnostic groups in the total score of their OHIP-49 (p = 0.008). Patients with malignant disease and osteoradionecrosis had worse QoL scores than those with benign diseases and cleft palate. Implant-supported prostheses had the best OHrQoL. Removable partial dentures and patients in whom dental rehabilitation was not possible had the worst OHrQoL (p = 0.042). The SF-36 subscale score showed no statistically significant differences between the diagnostic and prosthetic groups (p &gt; 0.05). Conclusions: OHrQoL after microvascular alveolar ridge reconstruction differs significantly based on underlying diagnoses and prosthetic restorations. Benign diseases and implant-supported dentures have the highest scores.

"Evaluation of palatal bone regeneration in cleft palate patients following a two-stage palatoplasty using a modified Furlow procedure".

A palatal cleft can be reconstructed using various palatoplasty techniques. Many techniques use local mucoperiosteal flaps to close the hard palate cleft, without closing the underlying bone defect. The purpose of this study was to explore the possibility of spontaneous bone regeneration in the remaining bone defect following a two-stage palatoplasty. Furthermore, the effect of this bone regeneration on transverse maxillary growth was studied. A retrospective study of unilateral cleft lip and palate patients was performed. Cleft size was measured at the hard-soft palate junction on plaster models obtained during palatoplasty. Residual bony cleft was evaluated at the time of alveolar process reconstruction using CBCT images. The presence of crossbites was evaluated through clinical photographs to evaluate transverse maxillary growth. Forty-six patients were included in this study. Thirteen patients (28%) presented with complete ossification of the hard palate at the age of six years. Six patients (13%) had no ossification, while twenty-seven patients (59%) demonstrated partial closure, averaging 75% of the total hard palate length. All patients with complete closure and 89% of patients with partial closure presented without lateral crossbites. Statistical analysis revealed no significant correlation between lateral crossbites and the extent of hard palate ossification (p = 0.4314). 87% of children presented with at least partial ossification of the hard palate after a two-stage palatoplasty, indicating the potential for spontaneous bone regeneration. Importantly, lateral crossbites demonstrated no correlation with palatal ossification (p = 0.1819), suggesting no detrimental impact of regenerated bone on transverse maxillary growth.