Palate Group Research Articles

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.

How palatal vault morphology and screw length influence the accuracy of dynamic computer-guided orthodontic miniscrew insertion. A prospective clinical study

ObjectivesThe aim of this study was to evaluate the influence of palatal vault morphology and screw length on the accuracy of miniscrew insertion in dynamic computer-assisted surgery (d-CAS). MethodsTwenty-four subjects were allocated into three groups, according to their palatal vault morphology (Group A: medium; Group B: steep/high; Group C: low/flat) and the length of miniscrew used. For each subject, two miniscrews were inserted using a dynamic navigation system. To assess the accuracy of insertion, a postoperative CBCT was performed, and the pre- and post-operative scans were superimposed. Five variables were evaluated: Entry-3D, Entry-2D, Apex-3D, Apex-vertical and angular deviation. Descriptive statistics, Shapiro-wilk, Kruskal-Wallis and Dunn's tests were used for the statistical analysis. The level of significance was P ≤ 0.05. ResultsThe mean angular deviation values revealed strong discrepancies amongst the groups (Group A:7.11°±5.70°; Group B:13.30°±7.76°; Group C:4.92°±3.15°) and significant differences were found regarding the Apex-3D (P = 0.036) and angular deviations (P = 0.008). A Dunn's test revealed differences in angular deviation between the medium and high/steep palate group (P = 0.004), and between low/flat and high/steep palate group (P = 0.01) but did not confirm any significant difference in the Apex-3D parameter (Group A-B P = 0.10; Group B-C, P = 0.053; Group A-C, P = 1.00). No significant differences were found regarding the length of the miniscrews. ConclusionsPalatal vault morphology is a factor that influences the accuracy of miniscrew insertion in d-CAS. In subjects with steep and high palatal vaults, insertion accuracy is lower when considering the angular deviation value. Miniscrew length does not influence accuracy. Clinical significanceAlthough computer-guided surgery assists the clinician in preventing damage to nearby anatomical structures, individual anatomical variability is a crucial variable. In subjects with a high/steep palate, greater attention should be paid during the planning phase in order to allow for a wide margin from adjacent anatomical structures to achieve better outcomes.

Evaluation of nasolacrimal canal morphology in different facial skeletal relationships

BackgroundAbnormal morphological variations of nasolacrimal canal (NLC) and its lack of understanding contributes to acquired injuries during craniomaxillofacial surgical procedures which leads untoward postoperative complications like nasolacrimal obstruction (NLO) and epiphora. PurposeThe purpose of this study was to determine dimensional and volumetric morphological variations of nasolacrimal canal in various facial skeletal relationships which aid in performing a precise and safe surgery. Materials and methodsThis retrospective cohort study involved dimensional and volumetric analysis of nasolacrimal canal procured from computed tomography scans of 47 individuals grouped as ClassI, Class II and Class III, and unilateral cleft lip and palate (UCLP) groups. The outcome variables included length of NLC, volume of NLC, distance between the inferior orifice of the NLC to nasal floor, distance between inferior orifice of NLC to canine apex and distance between inferior orifice of NLC to central incisor apex. The objectives were to analyse morphological variation of NLC in different facial skeletal relationships and to evaluate the variation with change in facial sides and its relationship with surrounding structures. ResultsVolume of the NLC was found significant in Class I and UCLP population (p < 0.05) with the greatest volume in the UCLP group. The mean linear and volumetric measurements between the right and left sides were found insignificant among all groups. Inferior orifice of NLC from canine apex were farthest in Class III and nearest in the UCLP group (p < 0.05). There was no significant association between outcome variables and skeletal base configuration. ConclusionNLC demonstrates dimensional and anthropometric variations between different skeletal relationships and this study is inevitable in understanding the probability of NLC injury during maxillofacial surgeries.

Analysis Study for Cleft Lip And / Or Palate Patients and Steps of Management in Al-Wasity Hospital

Cleft is defined as defect in the fusion of facial tissues alone or with palatal processes during embryonic life causes an opening in face or roof of mouth in baby which considers as most common anomalies visit our hospital. To analyses most important problems which may consider as one of the cause of cleft lip and palate patients with steps in management of this important anomaly. The sample involves 500 patient distributed between cleft lips only, cleft palate group and cleft lip and palate. The parent of patient takes important field in our study since they are who answer the questions, the study take five years from 2010 to 2015, patients came to our hospital with age extend from few hour to 28 years old .the problem is very important and this first study in our hospital . Of this st udy analyzed by chi-square test, the results were founded cleft li p group was found to be (15.6%), cleft palate group (33.6%) and cleft lip and palate group were (50.8%). We take the order of patient in family found 28% of sample first in order (highest percentage).Most patient fathers above 30 years (65%), 8.6%of them with systemic disease (40%) were smokers. Most age group of mother were younger between 16-30 years old (65.4%), previous history of cleft found in 33% of sample and (45.6 %) of mother had a history of psychological problem. Management of patient include long process therapy as early age of patient when reach hospital to age above 20 years old which include plastic surgery , orthodontic treatment and maxillofacial surgery.

Classification of Skeletal Phenotypes of Preadolescent Patients With Isolated Cleft Palate Using Principal Component Analysis and Cluster Analysis.

This study aimed to classify the skeletal phenotypes of preadolescent patients with isolated cleft palate using principal component analysis and cluster analysis. Sixty-four preadolescent female patients with isolated cleft palate (incomplete hard palate and complete soft palate cleft group, n=51; complete cleft of the hard and soft palate group, n=13; the mean age when lateral cephalograms were taken, 7.08±0.76y) were included. Ten angular and 2 ratio cephalometric variables were measured on a lateral cephalogram. Cluster analysis was performed using 3 representative variables obtained from principal component analysis (SN-GoMe, SNA, and SNB). The differences in the variables among the clusters were characterized using the Kruskal-Wallis test. As a result of the analysis, 6 clusters were obtained from 3 groups: the retrusive maxilla and mandible group: cluster 3 (14.1%, moderately hyperdivergent pattern), cluster 5 (17.2%, severely hyperdivergent pattern); the normal maxilla and mandible group: cluster 1 (23.4%, normodivergent pattern), cluster 4 (12.5%, moderately hyperdivergent pattern), cluster 6 (20.3%, severely hyperdivergent pattern); the normal maxilla and protrusive mandible group: cluster 2 (12.5%, normodivergent pattern). The distribution of isolated cleft palate types did not differ among the 6 clusters ( P >0.05). Two thirds of the patients (68.7%, clusters 1, 2, 4, and 6) had a normal anteroposterior position of the maxilla, while one third of the patients (31.3%, clusters 3 and 5) showed a retrusive mandible. These results indicate that isolated cleft palate patients have diverse maxillo-mandibular growth patterns compared with patients with cleft lip and palate.

Speech Outcomes and Velopharyngeal Function in Children Undergoing Submucous Cleft Palate Repair.

Describe and compare the results of speech and velopharyngeal function in children with classic and occult submucous cleft palate undergoing interdisciplinary treatment at the Gantz Foundation. The clinical history of all patients born between 2012 and 2017 with a diagnosis of classic or occult submucous cleft palate was retrospectively reviewed. Preoperative and postoperative medical, surgical, and speech and language history were collected. Twenty-eight cases diagnosed at the age of 44.8±23.9 months were included. Of these, 71.4% presented classic submucous cleft, and 28.6% occult. Before primary surgery, 7.1% had a diagnosis of the syndrome, and 21.4% were under study. A total of 39.3% had hearing difficulties and 21.4% used tympanic ventilation tubes. A total of 60.7% had language problems, 39.3% had compensatory articulation, 17.9% had absent hypernasality, and 21.4% had absent nasal emission. The team indicated primary palate surgery in 71.4%, of which 85% performed the surgery at the mean age of 61.7±24.7 months. The surgical technique was Furlow in 88.2% of the cases and intravelar veloplasty in the remaining 11.8%. Then, 3 cases underwent velopharyngeal insufficiency surgery; 2 of them eliminated hypernasality and reduced nasal emission. The age of diagnosis ( P =0.021) and the performance of velopharyngeal insufficiency surgery ( P =0029) of the occult submucous cleft palate group was significatively later than the classic cleft palate group. Language, hearing, compensatory articulation, hypernasality, and nasal emission problems were recorded. A high percentage required primary surgery. Of these, a low proportion also required a velopharyngeal insufficiency surgery, which improved the velopharyngeal function of the children but did not completely adapt it. In this regard, early diagnosis is essential, as well as an analysis of each center primary closure protocol.

The burden of psychiatric disorders associated with orofacial cleft pathology among children in Ontario, Canada

Individuals with orofacial cleft (OFC) may be at a higher risk of developing psychiatric disorders (PD) than the general population. We determined the risk of psychiatric diagnoses in children with OFC in Canada. This population-based retrospective cohort study used health administrative data from the province of Ontario, Canada. Children with OFC who were born between April 1, 1994, and March 31, 2017, in Ontario were matched to five non-OFC children based on sex, date of birth, and mother's age. We determined the rate of events and time-to-event for first diagnosis of PD in children aged ≥3 years (y), and for intellectual developmental delay (IDD) from birth. Risk factors for PD and IDD were assessed using 1-way ANOVA for means, Kruskal-Wallis for medians, and the χ2 test for categorical variables. There were 3051 children with OFC (matched to 15,255 controls), of whom 2515 patients with OFC (12,575 controls) had a complete follow-up to the third birthday. Children with OFC were more likely to have PD than controls (54.90 vs. 43.28 per 1000 patient-years, P<.001), with a mean age to first diagnosis of 8.6±4.2y. The cleft palate group had the highest risk (HR 1.33, 95% CI 1.18-1.49). Children with OFC also had a higher risk of IDD than non-OFC children (27.78 vs. 3.46 per 1000 patient-years, p<.001). Children born with OFC in Ontario had a higher risk of psychiatric diagnosis and IDD compared to controls. Further research is also required to better understand the predictors of variation in risk, including geographic location and the presence of congenital abnormalities, and identify potential areas for intervention. Level II.

Intraoral Scanning Evaluation of Maxillary Arch Changes after Modified Sommerlad Palatoplasty for around Three Years.

The purpose of this study was to investigate dental arch changes after modified Sommerlad palatoplasty in patients with cleft palate by intraoral scanning technique in children with early deciduous dentition. This study included 60 patients with nonsyndromic unilateral complete cleft lip with palate or cleft palate only treated by modified Sommerlad palatoplasty without relaxed excision before 18 months of age and 95 healthy controls without cleft. Three-dimensional images of the maxillary dental arches of all participants at age 3 to 4 years were obtained by intraoral scanning technique. Seven parameters (anterior dental arch width, middle dental arch width, posterior dental arch width, anterior palatal arch width, posterior palatal arch width, anterior dental arch length, and entire dental arch length) were measured. Compared with the male group, the posterior palatal arch width distance of controls in the female group decreased significantly ( P = 0.039), and the middle dental arch width, posterior dental arch width, and posterior palatal arch width distance of female patients decreased ( P = 0.013, P = 0.002, P = 0.005, respectively). The anterior dental arch length and entire dental arch length distance of children in the unilateral complete cleft lip with palate group was shorter than those of children with cleft palate only ( P < 0.0001, P < 0.0001, respectively). The patient group showed decreased distance of anterior dental arch width, anterior palatal arch width, anterior dental arch length, and entire dental arch length, and increased distance of posterior dental arch width and posterior palatal arch width compared with the control group ( P = 0.0002, P = 0.002, P < 0.0001, P < 0.0001, P = 0.007, P = 0.027, respectively). The results indicated that the modified palatoplasty group showed no growth inhibition in the middle or posterior dental arch width, or palatal arch width, but slight but significant inhibition in the length of the anterior and entire dental arch. Therapeutic, IV.

Cleft Lip and Palate in Adolescence Identifying Variables Relating to Psychosocial Concerns

Background: It is postulated that individuals with cleft lip and palate may be at risk to experience psychosocial problem based upon their congenital malformation. Since cleft is one of the more common congenital malformations it is of importance to address this postulation. Purpose: To investigate if adolescents with cleft lip and palate have an altered self- concept, and to assess their degree of introversion. Materials and Methods: The cleft lip and/or palate group consisted of 55 adolescents (17 to 20 years) while the control group consisted of 31 adolescents (16 to 19 years). Results: In this study, TSCS indicated the individuals with cleft did not experience low self-concept in comparison with the control group, in actuality the overall score indicated a significant higher self-esteem 356.60 +/-30.22 (t(80) = 2.41; p &lt; .05) as well in sub-scale; identity, behaviour and family self. When comparing the individuals with cleft lip and palate, cleft lip or cleft palate, they did not differ from one another (F(2, 47) = 1,79; p &gt; .05). Conclusion: Adolescents with cleft seem to have a normal to high self-concept without an accentuated degree of introversion and also Academic achievement of adolescents with cleft is significantly reduced, particularly in the group with cleft palate.

Transcriptome heterogeneity of congenital cleft palate model in congener New Zealand rabbits induced by dexamethasone.

This work aimed to investigate the transcriptome heterogeneity of dexamethasone-induced congenital cleft palate in homozygous New Zealand rabbits and determine the molecular mechanism underlying the occurrence of congenital cleft palate. Dexamethasone (1.0 mg per day) was administered intramuscularly to 20 New Zealand pregnant rabbits from day 14 to day 17 of gestation, and the palatal phenotype of all offspring of each pregnant rabbit was observed. Eight embryos with a 4∶4 ratio of cleft palate to non-cleft palate were selected and divided into the cleft palate group (CP) and non-cleft palate group (NCP). Their palatal tissues were collected for RNA sequencing. A total of 225 differentially expressed genes (Q<0.05) were found in the CP group compared with the NCP group, of which 120 genes were upregulated and 105 genes were downregulated. The GO and KEGG enrichment analyses of these differentially expressed genes were carried out. The results showed significant enrichment in GO classification, which included heterotrimeric G protein complex, extracellular matrix, transcription factor complex, and basement membrane. Meanwhile, GABA ergic synapse, morphine addiction, retrograde endocannabinoid signaling, glutamate synapse, serotonergic synapse, regulation of actin cytoskeleton, and the Apelin signaling pathway were significantly enriched in the KEGG pathway. Compared with the NCP group, the gene expression levels of ARHGEF6 (P<0.05) and ABI2 (P<0.001) decreased in the CP group, and APC increased (P<0.001); these results were confirmed by real-time polymerase chain reaction. Abnormal expression levels of the ARHGEF6, APC, and ABI2 genes involved in the regulation of the actin cytoskeleton in the palatal synapse may be associated with the dexamethasone-induced congenital cleft palate in New Zealand rabbits.

Hearing-related problems in children with cleft palate: A single-center cross-sectional study in the sub-Himalayan population

Purpose: Cleft palate is known to cause recurrent otitis media with hearing loss. Various studies have stated the incidence of middle ear disease in patients with cleft palate is around 90%. The anomalous position of the Eustachian tubes in patients with cleft palate leads to otitis media with effusion. If left uncorrected this leads to complications such as cholesteatoma, retraction pockets, and atelectasis leading to permanent hearing loss. In this study, we evaluated the children presenting to our institute with cleft palate for hearing-related issues. Materials and Methods: The study was conducted in our institute from January 2017 to September 2020. It was a cross-sectional study, where 45 children with cleft palate were compared with 36 children with cleft lip who were considered the control group. Hearing of all children was assessed using tympanometry, otoscopy, and brainstem evoked response audiometry (BERA). Results: About 93.3% of children in the cleft palate group had an abnormal tympanic membrane on otoscopy, whereas in the control group only 11.1% of children had an abnormal tympanic membrane on otoscopy. About 97.8% of children in the cleft palate group had a hearing threshold greater than 25 decibels, whereas only 13.9% of children in the control group had a hearing threshold of above 25 decibels. More children in the cleft palate group had an abnormal tympanogram (42.2% had a type B tympanogram and 46.7% had a type C tympanogram) compared to the control group (5.6% had a type B tympanogram and 2.8% had a type C tympanogram). Conclusion: Our study adds to the evidence that there is a high incidence of hearing impairment in children with cleft palate. Hence, we advocate that early identification by screening measures such as otoscopy, tympanometry, auditory brainstem response, and pure tone audiometry during the first visit itself in these children so that early treatment can be initiated.

Cleft Lip and Palate in Adolescence Identifying Variables Relating to Psychosocial Concerns

Background-It is postulated that individuals with cleft lip and palate may be at risk to experiencepsychosocial problem based upon their congenital malformation. Since cleft is one of the more common congenital malformations it is of importance to address this postulation. Purpose: To investigate if adolescents with cleft lip and palate have an altered self-concept, and to assess their degree of introversion. Materials and Methods: The cleft lip and/or palate group consisted of 55 adolescents (17 to 20 years) while the control group consisted of 31 adolescents (16 to 19 years). And Results: In this study, TSCS indicated the individuals with cleft did not experience low self- concept in comparison with the control group, in actuality the overall score indicated a significant higher self-esteem 356.60 +/- 30.22 (t (80) = 2.41; p&lt;.05) as well in sub-scale; identity,behaviour and family self. When comparing the individuals with cleft lip and palate, cleft lip or cleft palate, they did not differ from one another (F (2,47) =1,79; p&gt;.05). Conclusion: Adolescents with cleft seem to have a normal to high self-concept without an accentuated degree of introversion and also Academic achievement of adolescents with cleft is significantly reduced,particularly in the groupwith cleft palate.

Transverse differences between cleft lip and palate and non-cleft palate with skeletal Class III malocclusion using buccolingual inclination: a cone-beam computed tomography retrospective study

BackgroundThe purpose of this study was to evaluate the differences between buccolingual inclination (BI) of maxillary posterior teeth in patients with cleft lip and palate (CLP) and non-cleft palate with skeletal Class III malocclusion. We propose a method of maxillary expansion which is more suitable for patients with CLP.MethodsFor this retrospective study, 40 patients with CLP and 21 patients with skeletal Class III malocclusion were selected. The CLP group was divided into the unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) groups. The BI of the maxillary first premolar (BI4), maxillary second premolar (BI5) and first molar (BI6) were measured using cone-beam computed tomography, and the differences between them were compared and analyzed by Student’s t-test.ResultsThere were significant differences between cleft side BI4 and non-cleft side BI4 in the UCLP group, BI5 in the BCLP group, BI4 and BI5 in all CLP groups and the skeletal Class III malocclusion group. BI6 was similar across all three groups.ConclusionsThe premolars of patients with CLP do not exhibit the same regularity as those with Class III malocclusion; this may be related to surgical scarring of the cleft palate. Greater attention should be paid to the correction of BI in the maxillary expansion of patients with CLP.

Rate of upper incisor retraction in Class II division 1 patients managed with palatal versus buccal miniscrew supported segmental orthodontics: Randomized parallel clinical trial

This study was conducted to compare maxillary incisor retraction rates using buccal orthodontics with segmented arch approach supported by a buccal or palatal mini-screw in non-growing Class II Division 1 patients during a 3-month period. All patients between September 2018 and December 2021 with following criteria were included: non-growing class II division 1 protrusion, indication for premolar extraction, no or little crowding, normal overbite, no previous orthodontic treatment, no systematic disease, good oral hygiene, no periodontal problems or oral habits. Mini-implant was inserted buccally or palatally between upper second premolar and first molar bilaterally. Incisor retraction was manipulated by a 200-gram force through a nickel-titanium closed-coil spring extended from the mini-implant to the segmental design. Study casts were made before retraction and after every 4 weeks (T0: baseline, T1: 4 weeks, T2, 8 weeks, T3: 12 weeks). A repeated measures ANOVA was performed for total comparison of data (mm of retraction) on 3D casts. A pairwise t test with Bonferroni correction was used for comparison between two experimental periods for the same group. An independent samples t-test was also used for comparison between two groups for the same experimental period. Of 30 patients meeting the eligibility criteria, only 28 were included with mean age 16±2.5 years. Repeated measures ANOVA revealed significant differences in incisor retraction between the time intervals for both buccal and palatal groups (P=0.001). In addition, the paired-sample t test indicated a significant difference between each time interval for both the buccal and palatal groups (P=0.001), except between T3 and T2 for the palatal group (P=0.09). The independent sample t-test revealed significant differences between the buccal and palatal groups at T1 (Mean: 0.55 [0.355-0.748],=0.001) and T2 (Mean: 1.4 [0.91-1.88], P=0.001); whereas no significant difference was found at T3 (Mean: 1.15 [0.67-1.63], P=0.945). Anterior retraction using a segmental palatal model with mini-screws was effective regardless of the buccal or palatal situation of the minivis. Retraction of incisors with palatal miniscrews was significantly faster in the first two months.

Alterations in Facial Soft Tissue Thickness Post-Facemask Treatment in Noncleft Skeletal Class III and Bilateral Cleft Lip Palate Class III Patients.

The purpose of this retrospective study was to assess the alteration in the facial soft tissue thickness after rapid maxillary expansion with facemask treatment in bilateral cleft lip and palate (BCLP) Class III patients and noncleft Class III patients. Case records including lateral cephalograms of 30 patients (19 females, 11 males) treated using a rapid maxillary expansion with facemask treatment were analyzed. Group I (age: 11.4 ± 1.02 years) (10 females, 5 males) consisted of noncleft skeletal Class III patients, and group II (age: 10.8 ± 0.84 years) (9 females, 6 males) comprised skeletal Class III patients with bilateral cleft lip and palate. Fifteen hard tissue and 10 soft tissue measurements were made at the beginning and at the end of the treatment to evaluate the change with rapid maxillary expansion combined facemask treatment. The bilateral cleft lip and palate group displayed a statistically significant increase in the thickness of the subnasale, labrale superius, labrale inferius, labiomentale, and pogonion, whereas the thickness of the stomion was found to be significantly decreased. The noncleft group demonstrated a statistically significant decrease in the thickness of the stomion and gnathion. There was a statistically significant difference between the bilateral cleft lip and palate and noncleft groups in the facial soft tissue thickness measurements at labrale superius, gnathion, and subnasale points and in Y axis, U1-SN, U1-NA in the hard tissue measurements. The results of the study indicated that the rapid maxillary expansion with facemask treatment produced diverse alterations in the facial soft tissue thickness of bilateral cleft lip and palate patients and noncleft Class III patients.

Investigation of the relationship between maxillary dimensions and labial and palatal maxillary impacted canines using cone beam computed tomography

ObjectivesTo compare the maxillary dimensions of individuals with labial and palatal bilateral maxillary canine impaction and a control group of individuals with no impaction using CBCT. Methods45 patients were included in the study with age range of 13 to 18 and consisted of 22 females and 23 males. The sample included three groups of 15 patients as the control, labial and palatal group. The measurements made on the axial and coronal planes were made on the levels of the 1st premolar and the 1st molar. Also nasal cavity and anteroposterior depth were measured. ResultsThe maxillary anteroposterior depth, basal first molar width, alveolar first molar and premolar width and first molar palatal vault depth of the control group were significantly higher than labial and palatal groups (p<0.05).The basal first premolar width of the control group was significantly higher than palatal group (p<0.05). The first premolar palatal vault depth and nasal cavity width of the palatal group were significantly lower than other groups (p<0.05). ConclusionsThe basal and alveolar widths associated with the molars and the palatal depths were lower in the impacted group than control group. The anatomical structures in the female patients were affected by the position of impaction to a higher extent in comparison to the anatomical structures in the male patients.

Study intelligence quotient among sample of children suffering from cleft lip and palate &amp; hypospadias attending pediatric surgery clinic in Al-Hussien Hospital

Background: need for more reliable knowledge about speech development &amp; surgical techniques is critical in caring for children born with cleft lip &amp; palate. Aim and objectives: The main goal of this research was to assess the level of intelligence in children born with cleft lip &amp; palate and hypospadias and to find if there is correlation among cleft lip &amp; palate &amp; hypospadias malformations and IQ. Subjects &amp; methods: This cross-sectional research was conducted in pediatric surgery clinics at Al-Azhar University Hospitals. Research was showed on 52 children with cleft lip &amp; palate and hypospadias. All patients were divided into 2 groups: Cleft lip &amp; palate group (n=30) &amp; Hypospadias group (n=22). Results: regarding Full-Scale Intelligence Quotient of Wechsler Intelligence Scale of studied children. Full-Scale Intelligence in Cleft lip and palate group ranged from 72 to 104 with mean ± SD = 86.4 ± 7.56 while in Hypospadias group the Full-Scale Intelligence ranged from 66 to 99 with mean ± SD = 86.18 ± 8.02. Conclusion: The present study assessed the association between intelligence level and incidence of cleft lip &amp; palate &amp; hypospadias.

Dexamethasone Induces Apoptosis of Embryonic Palatal Mesenchymal Cells Through the GATA-6/Bone Morphogenetic Protein-2/p38 MAPK Pathway.

Exposure to dexamethasone (DEX) causes cleft palate at high rates. Our previous studies proved that GATA binding protein 6 (GATA-6)/bone morphogenetic protein-2 (BMP-2) mediated apoptosis is related to DEX-induced cleft palate, but the specific mechanism is still unclear. The goal of this research was to understand the mechanism of apoptosis in cleft palate formation induced by DEX. Palatal mesenchymal cells from mouse embryos on embryonic day 13 were isolated as the experimental group, GATA-6 was silenced by GATA-6 small interfering Ribonucleic Acid (RNA). Cell Counting Kit-8, flow cytometry and Western Blot were applied to detect cell proliferation ability, cell cycle, the proportion of apoptotic cells, and the expression of apoptosis- related proteins of GATA-6 knockdown palatal mesenchymal cells. Further proteins on the BMP-2/Mitogen-activated protein kinase (MAPK) pathways were detected using Western Blot. T results showed that knockdown of GATA-6 by siRNA significantly decreased cell proliferation and increased the expression of apoptosis-related proteins. Bone morphogenetic protein-2/P38 mitogen Activated protein kinase (P38 MARK) pathway proteins decreased significantly among the GATA-6 knockdown group, DEX-cleft palate group and control +DEX groups. The results indicated that the GATA-6/BMP-2/P38 MAPK athway was involved in the apoptosis caused by GATA-6 silencing, which may be the possible mechanism of DEX inducing cleft palate.

Prevalence of dental anomalies in different cleft lip and palate groups

Introduction: Patients with orofacial clefts are usually associated with various dental anomalies. These dental aberrations pose a clinical challenge in treatment planning. Thus, this investigation intends to find the prevalence rate of different types of dental anomalies and their correlation among nonsyndromic cleft patients. Methodology: Orthodontic records of 129 cleft patients classified into different cleft groups were assessed to evaluate the presence of different dental anomalies. Results: The most frequent dental anomaly found in Cleft patients was rotations followed by maxillary lateral incisor agenesis with a prevalence rate of 90.4% and 59.2%, respectively. Maxillary second premolar agenesis, peg-shaped laterals, mandibular second premolar agenesis, and supernumerary teeth showed prevalence rates as 25%, 21%, 7%, and 5%, respectively. There were significant differences in the overall distribution of maxillary lateral incisor agenesis and rotations between patients with Unilateral Cleft Lip and Cleft Palate, Bilateral Cleft Lip and Cleft Palate, Cleft Lip (CL), and Isolated Cleft Palate (ICP). Conclusion: There is a high prevalence of dental anomalies like rotations and maxillary lateral incisor agenesis in different CL and palate patients, which were statistically significant. The presence of such anomalies can deteriorate the already existing functional problem and hence, the study of these anomalies and their treatment is an important step in the rehabilitation of such patients.

Assessment of mandibular symmetry in cleft lip and cleft palate patients

Objective: The objective of this study is to evaluate cleft patients, both unilateral and bilateral clefts and compare them with Skeletal base Class I patients for symmetry using orthopantomogram. Materials and Methods: Three groups of patients within age range of 15–25 years: Group I – Normal participants (mean age = 18.33 ± 2.84); Group II – Unilateral cleft lip and cleft palate participants (mean age = 18.74 ± 3.36); and Group III – Bilateral cleft lip and cleft palate participants (mean age = 17.64 ± 3.10) were assessed and compared to each other. Orthopantomogram was analyzed for vertical symmetry. Habets asymmetry index and the Kjellgren's asymmetry index were applied to assess the relative intensity of asymmetry. Results: Significant difference was seen in condylar height (P = 0.029), ramal height (P = 0.046), mandibular body length (P = 0.014), gonial angle (P = 0.035) and condylion–gonian distance (P = 0.044). Kjellberg's symmetry index/condylar ratio was maximally affected by the groups when compared with the Habets asymmetry index. Conclusion: Mandibular asymmetry has been expressed in unilateral cleft lip and palate (CLP) group. Normal group and bilateral CLP group indicated a symmetrical posterior vertical height of the mandible.