Congenital Cleft Palate Research Articles

Иммунологические аспекты ЛОР-инфекции у пациентов с врожденными расщелинами губы и неба

Cleft lip and palate are considered one of the most common and severe among congenital anomalies and occupy the 3rd–4th places in their structure. Due to their complexity, the issues of treatment and rehabilitation of this category of children are relevant and open for discussion. In addition to the surgical correction of anatomical and functional disorders, the restoration of immunological resistance is of great importance. The state of immunity plays one of the key roles in the course of treatment and rehabilitation of children with congenital cleft lip and palate, determines the frequency and severity of ENT infections, and directly affects the wound healing processes. This review analyzes the scientific literature on immunological and microbiological disorders that occur in congenital cleft lip and palate and methods for their correction. Methods for assessing and monitoring pathological changes in cellular and humoral immunity at different stages of treatment are presented. It was revealed that the qualitative and quantitative composition of the microbiota of the oronasopharyngeal zone before and after the surgical stage of treatment is a direct reflection of the state of mucosal immunity and one of the leading factors affecting wound healing.

Primary Palatoplasty: A Comparison of Results by Various Techniques - A Retrospective Study.

Introduction:To identify a better method for primary cleft palate (CP) repairs with respect to velopharyngeal function.Materials and Methods:A retrospective, longitudinal review of medical charts of patients with congenital CP who underwent four different techniques of palatoplasty, performed by three different surgeons in the Department of Maxillofacial Surgery of the National Center for Maternal and Child Health. Nasopharyngoscopy (NPS) was used for velopharyngeal function evaluation. CP was classified according to the Veau system and the “Golding-Kushner” scale for NPS results was used for assessing the patient’s velopharyngeal function and its association with cleft types and the primary palatoplasty techniques. Pearson’s Chi-square analysis and binary logistic regression were used for statistical analysis.Results:A total of 335 patients were included in the study. The mean age at primary palate repair was 22.9 ± 13.6 months. There were 56, 42, 177, and 60 patients with Veau-I, Veau-II, Veau-III, and Veau-IV types, respectively, whereas for primary palatoplasty 65 patients underwent Furlow, 148 patients – Mongolian, 108 patients – two flap, 34 patients – von Langenbeck technique. NPS assessment of adequate velopharyngeal function was followed by Furlow’s technique in 89.4% of cases, Mongolian technique in 62.2% of cases but by “two flap” only in 48.1% and von Langenbeck in 47.1% of cases.Discussion:The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after primary palatoplasty.

Reappraising the Value of Fetal First-Trimester Ultrasonography

Abstract In the last few years, the introduction of cell-free DNA has rapidly altered prenatal screening regimens and is increasingly offered as the second- or, at times, even the first-tier screening test. Should an early anomaly scan also be part of an up-to-date screening policy? This paper reappraises the value of fetal first-trimester ultrasonography. The primary aims of the first-trimester scan are to establish gestational age based on the measurement of fetal crown-rump length, to detect multiple pregnancy and chorionicity, and to measure fetal nuchal translucency thickness as part of a combined screening test for chromosomal abnormalities. With recent advancements in ultrasound technology, there is compelling evidence that a majority of fetuses with major structural abnormalities and almost half of them without chromosomal abnormalities can be detected in the first trimester. We focused on the first-trimester screening of fetal major defects, especially including fetal congenital heart disease and cleft lip and palate by ultrasound markers and views. Moreover, it is critical to highlight that after a detailed anomaly scan in the first trimester without major structural anomalies and positive genetic tests, the residual chance of favorable outcome in fetuses with isolated increased nuchal translucency is relatively high. The discussion on the role of cell-free DNA in prenatal screening is still ongoing. Even in the event of it becoming a first-line screening test for aneuploidies, the importance of a first-trimester fetal scan, including assessment of markers for other anomalies, remains undisputed.

The Prevalence and Risk Factors of Congenital Cleft Lip and Palate in the Northern Region of Saudi Arabia

The Prevalence and Risk Factors of Congenital Cleft Lip and Palate in the Northern Region of Saudi Arabia

Prevention of abandonment of children with congenital cleft lip and palate

Introduction: Congenital facial anomalies are a diverse group of diseases with different genetic basis and clinical manifestation, and the involvement of many facial structures requires the participation of different specialists in their treatment. Aim: The aim of the present study is to assess the attitudes of parents of children with congenital cleft lip and palate toward caring for them in a family environment and to provide guidelines for preventing their abandonment in foster homes. Material s and M ethods: A total of 70 children with congenital cleft lip and palate were examined and assessed in terms of the need for special care. The results were statistically processed by SPSS v. 20.0, using variation, comparison and correlation analyses. Results: The results of the analysis showed that boys predominate (57.1%), as well as children of Bulgarian origin (62.9%), while those of Roma and Turkish origin had the same share (18.6% each). The results of the survey showed that 62.9% of the children were raised in the family, 17.1% of the children were placed with a specialized institution until the operative correction of the anomalies, after which they were raised in the family, and 20.0% were abandoned for upbringing in the specialized institutions. Conclusion: The follow-up of children with congenital cleft lip and palate showed that children who were raised in a family environment socialized significantly better than the children who were abandoned with specialized institutions, because they were not only provided with specialized care, but were surrounded by attention in the family, attended kindergartens and schools and had the opportunity to communicate with normal healthy children.

Analysis of bone-reconstructive surgery aimed at normalization of occlusal relationships of the jaws at the final stages of rehabilitation treatment of children with congenital cleft lips and palate (Literature review)

BACKGROUND: The completion of medical rehabilitation of children aged 1618 years with congenital cleft lips and palate is often impossible without surgical correction of occlusal relationships of the jaws and improvement of facial aesthetics. At the same time, the main efforts of the specialists engaged in the treatment of children with orofacial clefts are aimed at correcting local plastic operations of the upper lip, nose, oral cavity, and orthodontic, using non-removable arc equipment, correction of disturbed occlusion.
 AIM: Our aim is to study and analyze the problems of final bone reconstructive operations in patients with HRGN.
 MATERIALS AND METHODS: The article presents a review of the literature on this topic, based on 61 sources. The literature was searched by keywords in the databases such as PubMed, ScienceDirect, E-library, and Google Scholar from 1938 to 2020. The data on the treatment of children with combined maxillofacial anomalies and deformities with cleft lips and palate, who underwent reconstructive bone operations on the jaws in order to normalize their occlusal relationships, were analyzed.
 RESULTS: In order to achieve good morphofunctional and aesthetic results, as well as early socialization of patients with VRGN at the final stages of rehabilitation, complex hardware and surgical treatment are necessary. The indication for reconstructive operations on the jaws in patients is the face disorder and disharmony of the face, which cannot be corrected by orthodontic treatment. The operations should be based on careful planning, including CT modeling, the use of sparing techniques, including various modifications of Le Faure I osteotomy on the upper jaw, and retromolar sagittal osteotomy of the jaw and, according to indications, genioplasty on the lower jaw.
 CONCLUSIONS: Two-jaw orthognatic bone reconstructive operations on the jaws to restore the correct bite have recently been used in the complex medical rehabilitation of patients, especially in adolescents with VGN. At the same time, there are a number of unresolved issues of orthodontic and surgical treatment that require further study. There is a strong need for a clear understanding of the age of planning and timing of such operations considering the stage of completion of skeletal growth. The criteria for the patients readiness for surgery for multiple occlusive contacts also need to be evaluated. It is of paramount importance to determine the order of performing corrective operations on the soft tissues of the face and oral cavity. Hence there is a necessity to develop new methods of reconstructive operations on the jaws.

Determination of occlusal connections in patients with congenital cleft lip and palate before and after their orthopedic rehabilitation

The aim of this study was to define and analyze the reproducibility of occlusal relationships according to the results of occlusogram in jaw closure using quantitative analysis of occlusion in adult patients with congenital cleft lip and palate before and after their prosthesis with different versions of dentures and types of their constructive features.
 Materials and methods. The study was conducted on 37 patients with congenital cleft lip and palate, 11 (29.73 %) of whom had right-sided clefts, 11 (29.73 %) – left-sided and 15 (40.54 %) – bilateral.
 The number of occlusal contact points was measured for all patients before the treatment and after the orthopaedic rehabilitation.
 Research results. Significant differences were found between the number of occlusal contact points before (unusually small number) and after orthopaedic treatment (significant increase), regardless of the type of cleft (p<0.001). Such conditions in the oral cavity significantly complicate the tactics of orthopaedic rehabilitation, which affects the need to find more complex options for combinations of fixed and removable orthopaedic structures.
 Conclusion. Based on the conditions and objectives of this study, the application of the basic principles of a multidisciplinary approach determine the possibility of rehabilitation of such patients by orthopedic methods by making different versions of orthopedic structures. Adequate and high-quality prosthesis for defects and deformations of the teeth rows and occlusion in patients with CCLP leads to improved occlusal relationships and increase in the number of occlusal contact points.

EFFECT OF SURGICAL MANIPULATION TO MORPHOMETRIC DEVELOPMENT OF FACE AND JAW IN PATIENTS WITH CONGENITAL LIP AND PALATE SPLITS

The article presents the results of maxillofacial morphometry after surgery in patients with congenital cleft lip and palate. Patients were divided into two groups. The results of the two groups were compared. Proportions of morphometric parameters of maxillofacial region in patients with congenital cleft lip and palate and relative changes in compliance with control group of healthy children were studied. The more perfect and age-appropriate surgical procedures in patients with congenital cleft lip and palate, the more likely it is that the morphometric parameters of the maxillofacial region will comply with the “Golden Section” principle and reduce the rehabilitation period.

Feeding Plate of an Eight-day-old Patient Having Veau Type III Cleft Lip and Palate

Congenital Cleft lip and palate is a craniofacial defect which results into difficulty in feeding because of the communication between the oral and nasal cavities. Feeding plate restores the gap between the oral and nasal cavities and helps in feeding and reduces the chances of airway problems, regurgitations. This clinical report describes a design and method of fabricating a feeding plate in an 8-day old neonate with a cleft lip and palate.

Median facial cleft syndrome: A case report

Congenital Cleft Lip and Palate is a common birth defect with an incidence of 1 in 600 to 800 live births. This defect usually affects either the left, right or in some cases both sides of the lip and is called a Tessier Type 3 cleft. Clefting of the face in the midline is exceedingly rare and such a case of a Median Facial Cleft Syndrome is being reported which occurs in nearly 1 in 1,000,000 live births. This was first described by Bechard in 1823 and can be sporadic or part of an inherited syndrome. The child had a median cleft of the upper lip, nose, and palate of a severe, complete variety, with absent philtrum of the upper lip, premaxilla, columella, nasal septum and vomer.

СОМАТИЧЕСКИЕ ЗАБОЛЕВАНИЯ У ДЕТЕЙ С ВРОЖДЕННОЙ РАСЩЕЛИНОЙ ГУБЫ И НЕБА В РЕГИОНЕ С ПРОМЫШЛЕННЫМИ НЕФТЕХИМИЧЕСКИМИ ЭКОТОКСИКАНТАМИ

Monitoring of congenital malformations and concomitant somatic diseases in children is one of the important indicators of the causal influence of environmental factors on the health of the population. From the moment of birth, a child with congenital cleft lip and palate differs significantly from healthy peers not only externally, but also morpho-functional features of the structure of the primary section of the digestive and respiratory systems and often has a greater number of previous diseases in the history. Purpose: To determine the structure and frequency of somatic morbidity in children with congenital cleft lip and palate in regions with petrochemical ecotoxicants. Materials and methods: During the study, 3463 children from birth to 16 years old with congenital cleft lip were treated and monitored at the Department of Maxillofacial Surgery at the Republican Children's Clinical Hospital, Ufa for the period from January 1, 1985 to December 31, 2019 and / or sky. The diagnosis of concomitant systemic pathology was recorded based on the findings of the district pediatricians, ENT doctor, gastroenterologist, immunologist, allergist, rheumatologist from outpatient and inpatient records of the examined patients. Conclusion. In the course of our study, a direct relationship was noted between the level of environmental pollution by ecotoxicants and the frequency of concomitant somatic diseases in children with congenital cleft lip and palate. This must be taken into account in the pre- and postoperative algorithm for the rehabilitation of children with congenital cleft lip and palate with the involvement of pediatricians to improve the general somatic state of children when planning reconstructive surgery.

Fístula oronasal congénita secundaria en un neonato felino de Maine Coon: Terapia clínica y soporte nutricional asistido

Congenital malformations are related to hereditary factors or promoted by environmental agents, to mention: toxic, infectious, nutritional, chemical and physical. In felines, the casuistry of neonates with malformation is between 1% and 2%. Among the most observed pathologies, we highlight the cleft palate (more frequent), hydrocephalus and agenesis of the digestive tract. In secondary cleft palate the closure of the palate is incomplete, the patient has milk flow through the nostrils, coughing, choking and / or sneezing in the food and respiratory tract infections, the diagnosis being confirmed by inspection of the oral cavity. The article deals with clinical management and assisted nutrition, without surgical correction. A newborn, male, Maine Coon cat was admitted to a clinic complaining of a parent's rejection. On physical examination, the presence of a secondary congenital cleft palate was observed. The tutor and veterinary doctor opted for clinical management, considering the scarcity of literature regarding surgical treatment in neonates with this pathology. The patient was fed by an orogastric tube until his complete adaptation to the large format dry food at five months of age. During this process of adaptation to his congenital condition, the feline developed two cases of aspiration pneumonia by Klebsiella pneumoniae and the ingestion of a foreign body (part of the orogastric tube), assessed by radiography and removed by endoscopy in the descending portion of the duodenum. In the follow-up of the patient until the age of one year and nine months, the feline did not present recurrences regarding aspiration pneumonia. The animal was healthy until the date of submission of this work. This report aims to discuss the clinical management of the patient in this condition and the diets offered for vital maintenance, as well as their growth.

FREQUENCY AND RISK FACTORS AFFECTING THE BIRTH RATE OF CHILDREN WITH CONGENITAL CLEFT LIP AND PALATE IN THE SOUTHERN REGION OF KYRGYZSTAN.

The aim of the study is to examine the incidence and factors of congenital cleft lip and palate in the southern region of the Kyrgyz Republic, according to the form of clefts and according to the classification of MMDI, as well as their rehabilitation. We studied in detail the case histories of 2116 patients treated in the maxillofacial surgery department of Osh Interregional United Clinical Hospital according to the age and sex, as well as the form of congenital cleft lip and palate. Moreover, a questionnaire was administered to parents of children with CCLP for risk factors during pregnancy. A retrospective study of medical history revealed, among congenital anomalies, clefts of the soft, hard palate, alveolar process and upper lip prevailed - (combined) 891 (42,3%) Congenital cleft of soft, hard palate - 586 (27,7%), then isolated congenital cleft of the maxilla - 415 (19,6%), congenital cleft of the soft palate only 10,5% - 224 children were followed. The results of the questionnaire revealed that the parents of children born with CCLP were influenced by various unfavorable factors in the period of formation of the facial section of the fetus. The survey revealed that the relatives had CCLP, which accounted for 12.9% of all newborns, indicating a rather high role of hereditary predisposition. In addition to the hereditary genetic factor, an important role is played by infectious diseases suffered during the first trimester. It is noted that 12.8% of the children born with CCLP had infectious diseases. The mothers independently took drugs during pregnancy (antibiotics, salicylates, sulfonamides without a doctor's prescription), 17.6% of women were anemic during pregnancy, and 16.3% had severe toxemia. Along with this, it was found that the smallest number of women suffered mental trauma in the first trimester of pregnancy 0.4% of the mothers of children born with CCLP. Further, we registered patients with CCLP in the special software ONYX CEPH-3 from 01.01.2015 to the present, where we enter detailed information about patients with CCLP pathology. It creates convenience for parents both informationally and economically, as well as directly for the doctor in terms of dynamic observation of the functional and aesthetic condition and development of the child. In order to further develop programs to prevent the prevalence of congenital pathology, improve the quality of comprehensive treatment method, as well as medical and social rehabilitation of such patients and work with families of children with CCLP, we have developed a single program ONYX CEPH3 providing dispensary and rehabilitation of children.

IDENTIFICATION OF THE MORPHOMETRIC PARAMETERS OF THE CRANIO-FASCIAL REGION OF CHILDREN WITH CONGENITAL CLEFT AND PALATE REFLECTIONS USING A DEVELOPED RESEARCH MAP

Relevance. This article proposes the technology of creating an effective morphometric research form (RF) based on an informed study plan. The RF developed is a means of collecting data on morphometric indicators of the craniofascial region of children of the I and II childhood with congenital cleft lips and palate after urano- and cheilorinoplasty and registration of a study on paper media. The aim of the study was to develop a RF to investigate the change in morphometric parameters of the craniofascial region in children with congenital cleft lip and palate after cheilorinoplasty and uranoplasty. Materials and methods. Morphometric indicators of the craniofascial region for each child are collected in a RF, which was conducted at the Department of Surgical Dentistry of the BSMI. The RF was approved by the Ministry of Health of the Republic of Uzbekistan by the Department of Scientific and Medical Information under registration number No. 0456, 08.02.2021. Results. RF facilitates efficient and complete data processing, analysis and reporting on measurement parameters. The measurement data collected during the study were complete and accurately reflected all morphometric measurements, which proved some deviations on the upper jaw in children of the I and II childhood period with congenital cleft lips and palate after urano- and heilorinoplasty. Conclusion. To achieve the effectiveness of comprehensive treatment of children with cleft lip and palate, a detailed study of the dynamics of the movement of upper jaw segments throughout all age periods is necessary. In this regard, RF is of important scientific and practical importance in the collection of morphometric parameters of the craniofascial region of children of the I and II period of childhood with congenital cleft lips and palate.

A de novo 10q11.23q22.1 deletion detected by whole genome mate-pair sequencing: a case report

BackgroundInterstitial deletions of chromosome band 10q11-q22 was a genomic disorder distinguished by developmental delay, congenital cleft palate and muscular hypotonia. The phenotypes involved were heterogeneous, hinge on the variable breakpoints and size.Case presentationHere, we presented a patient with soft palate cleft, growth and development delay. The patient was a 2 years and 5 months girl who was not able to walk unless using a children’s crutches to support herself. Whole-exome sequencing (WES) and whole-genome mate-pair sequencing (WGMS) were both performed by next generation sequencing (NGS). A 20.76 Mb deletion at 10q11.23q22.1 (seq[GRCh37/hg19]del(10)(50,319,387-71,083,899) × 1) was revealed by the WGMS, which was verified as de novo by quantitative polymerase chain reaction (QPCR).ConclusionChildren with 10q11-q22 deletions greater than 20 MB have never been reported before, and we are the first to report and provide a detailed clinical phenotype, which brings further knowledge of 10q11-q22 deletions.

Glomus Tumor: An Unusual Cause of Hypophosphatemic Osteomalacia

Abstract Background: Tumor-induced osteomalacia (TIO) is a rare condition resulting in hypophosphatemic osteomalacia. We present a rare case of TIO secondary to glomus tumor. Clinical Case: A 39-year-old woman with history of chronic sinusitis presented with progressively worsening generalized body pain and muscle weakness of eight months duration. Examination showed decreased muscle strength in bilateral upper and lower extremities and congenital cleft palate. Laboratory work up revealed elevated alkaline phosphatase 603 U/L (44–147 U/L), low serum phosphorus 1.5 mg/dL (3.5–5.0 mg/dL), normal serum calcium 8.9 mg/dL (8.3–10.4 mg/dL), normal 25-hydroxyvitamin D 32 ng/dL (30–100 ng/dL), elevated 1,25-dihydroxyvitamin D 62 g/mL (20–45 pg/mL), elevated intact PTH level 99.01 pg/mL (8–74 pg/mL), high normal 24 hour urinary phosphate levels 1100 mg/dl, and elevated FGF23 level 128 RU/mL (<108 RU/mL). Fractional excretion of filtered phosphate (FEPO4) [FEPO4 = (Urine phosphate / Serum phosphate) / (Urine creatinine / Serum creatinine) * 100] was 107.54 % (normal range <20%). Tubular reabsorption of phosphate (TRP) [Percentage TRP = 100 * {1- (Urine phosphate / Serum phosphate) / (Urine creatinine / Serum creatinine)}] was -7.54 %. Tubular maximum reabsorption of phosphate to glomerular filtration rate (TmP/GFR) calculated using formula [TmP/GFR = TRP x serum phosphate] was -0.1131 mg /dL (2.8–4.2 mg/dL). Bone densitometry revealed normal bone density and parathyroid scintigraphy was negative for adenoma. Clinical symptoms along with biochemical evidence of phosphate wasting confirmed by low TRP and an unsuppressed FGF23 levels suggested oncogenic osteomalacia as underlying etiology. Whole body bone scan demonstrated increased radiotracer uptake in the elbows, spine, sacroiliac joints, knees, ankles and multiple ribs suggestive of inflammatory process. MRI of paranasal sinuses revealed large soft tissue mass occupying right frontal, ethmoid, maxillary and sphenoid sinuses suggestive of sinonasal polyposis. 99mTc-Octreotide scan confirmed increased uptake in the nasopharynx. The sinonasal mass was resected and pathology revealed the mass to be a glomus tumor confirmed on immune histochemical studies with positive staining for vimentin and SMA and Ki67 of 5–10 %. Postoperatively, phosphorus levels normalized to 3 mg/dl on day 7. Conclusion: Glomus tumor as cause of TIO is extremely rare however localization and surgical resection of tumor can result in complete resolution of biochemical and clinical manifestations.

Factors of congenital malformations of dentoalveolar anomalies in the children's population of Kizlyar (environment of trouble) and Khasavyurt (environment of well-being)

Analysis to identify the relationship between the unfavorable living environment and congenital malformations of dental anomalies in the children's population of Kizlyar (the environment of disadvantage) and Khasavyurt (the environment of well-being).Materials and methods. To identify the main causes of the appearance of congenital clefts, we conducted a survey of 125 parents of children with questions included in the questionnaire: Full name, gender, date of birth, address, nationality, what is the pregnancy, whether the mother took medication in the first 3 months of pregnancy, the level of hemoglobin and infectious diseases during pregnancy, whether there were cases (heredity).Results. Dates from 125 medical histories for 2017-2019 with different types of congenital cleft lip and palate showed that in 59 children, the chemical factor was the cause of the disease, since one of the parents worked in agriculture or an industrial enterprise with a chemical bias, for genetic reasons, 15 children; viral colds-22 children, anemia of pregnant women-25 cases. 35 patients with the chemical factor were born in Kizlyar, only 5 patients from Khasavyurt. Conclusions. The high level of morbidity of the child population in Kizlyar indicates the need to develop and implement recommendations for the organization of preventive and medical-dental care for adolescents and children from an early age.

Characteristics of asymmetric cleft lip and palate surgical treatment

Relevance. The correct choice of the surgical technique for the treatment of the congenital asymmetric cleft lip and palate ensures the effectiveness of rehabilitation of patients with this pathology. The purpose is to present the results of the authors’ techniques for the surgical treatment of children with asymmetric cleft lip and/or palate.Materials and methods. Medical records of 687 children treated in 2015-2019 years were retrospectively analyzed at the clinic of maxillofacial surgery “Bonum” MСMC. The prevalence of asymmetric cleft lip and palate in children was determined. The prospective observation group included 84 patients with asymmetric cleft lip and/or palate. Clinical, anthropometric, statistical methods as well as patient photograph analysis and computer technologies were used during the research.Results. Prevalence of congenital asymmetric cleft lip and / or palate was determined (8.59%), classification and novel surgical techniques were offered and the results were evaluated.Conclusions. The prevalence of asymmetric cleft lip and palate is 86 per 1000 newborns with cleft lip and/ or palate. Scientific knowledge about the prevalence of asymmetric cleft lip and palate, as well as the systematization of this type of lesion in classifications, should be present in the practice of a maxillofacial surgeons and rehabilitation physicians who treat patients with this pathology. The proposed surgical techniques for the treatment of asymmetry in bilateral cleftlip and cleft palate provide positive results, excluding the need for further surgery. The reasonable choice of a surgical technique for the treatment of asymmetric cleft lip and palate is individual and may involve the use of additional nanomaterials. The authors’ techniques for the surgical treatment of asymmetric cleft lip and palate can be considered promising and aesthetically justified in view of good cosmetic results and full restoration of functions.

ORTHODONTIC TREATMENT FOR CONGENITAL CLEFT LIP AND PALATE IN CHILDREN

One in 1,000 newborns appears with a congenital maxillofacial anomaly, which accounts for about 0.04% of the world's entire population of the planet. Patients with cleft lip and palate have a significantly lower quality of life. Early orthodontic treatment (EOT) offered to children from the first days of life is a preparatory link in the preoperative period, laying favorable grounds for surgical intervention. EOT is a reasonable option to separate the oral cavity from the nasal cavity, to prevent consequent issues as well as to bring feeding back to the normal. This study involved clinical examinations and early orthodontic treatment of 84 children with congenital bilateral cleft upper lip and palate (CBCULP) from the first days of life and infants based on their referrals coming from all regions of the Republic of Tajikistan embracing the period of 2015 to 2019. Newborns with bilateral CULP within 5 days following birth, and infants who were referred for early orthodontic treatment, had their upper jaw cast model prepared using specially designed and modified spoons for taking impressions in case of cleft lip and palate. Within the study, unrelated marriages prevailed 3.4 times over related ones, which accounted for 22.6% of the cases examined. There were 1.58 times more boys than girls. Close relatives featured congenital maxillofacial abnormalities in 16.1% of the cases. The share of related marriages was 12.9%. Follow-up period — 2016–2017; the patients' age — from the birth period to 1 year. The children were divided into two groups. In the main group, EOT was performed using a dental obturator for orthodontic treatment of children with CBCULP prior to the surgery (n=43). In the comparison group, treatment was carried out in the conventional way (n=41). Before the surgery, all the children were examined through clinical, anthropometric and photometric methods. The statistical processing of the obtained data revealed that before the start of treatment, the studied groups were comparable with no statistically significant differences identified. After the treatment, the age, the weight, as well as the height of the children expectably changed in both groups (p<0.001).

Associated parallels of the initial potential mineralization value of oral fluid and intensity of dental caries in children with cleft lip and palate

BACKGROUND: Cleft upper lip and palate is the most common malformation of the maxillofacial region. Despite the huge successes that have been achieved by dental surgeons in eliminating such defects, the issues of studying the initial indicators of the cariesological status in children with congenital cleft lip and palate are still not fully resolved. The study of the above issues will allow us to correct the plan of therapeutic and preventive action, which will lead to effective rehabilitation of children with cleft lip and palate.
 AIM: This study aimed to conduct a clinical assessment of the initial mineralizing ability of oral fluids in children with congenital cleft lip and palate depending on the cariology status.
 MATERIAL AND METHODS: This study presented the results of the clinical assessment of the initial value of the mineralizing ability of oral fluid depending on the intensity of dental caries in children with congenital cleft lip and palate. To determine the mineralizing ability of mixed saliva, 76 teeth of pediatric volunteers with congenital cleft lip and palate with a high level of mineralization potential of oral fluid, with medium, low, and very low levels of the studied indicator, were examined. The level of the mineralizing ability of mixed saliva was determined by visualization depending on the involvement of functionally oriented groups of teeth with caries.
 RESULTS: The general characteristics of the mineralization potential of oral fluids, depending on the intensity of dental caries, help determine that with mild caries, the average value of the studied indicator was 21.9%, at an average intensity level of 31.0%, at a high intensity level of 47.1%.
 CONCLUSIONS: An inverse-diameter dependence was found in the intensity level of caries on the mineralizing ability of oral fluids.