Palate Children Research Articles

Effect of Congenital Cleft Lip and Palate Treatment on Bacterial Colonization in Children

Purpose : To determine the effect of Inherited Cleft Lip and Palate Management on microbial migration in forked lip and palate (CLP) children. Material and methods: Fifteen forked lip and palate children and fifteen standard children (the control group), aged 3 months to 36 months were selected from the out clinic of Faculty of Dental Medicine, Al-Azhar University for Girls. Dribble samples were collected after the breakfast by inserting sterile cotton gauze in the entry from the jaws before and after construction of obturator. Results: The highest (mean±SD) value of log bacterial count (CFU/μl) was found in the cleft patients pre-operatively (5.64±1.06), while post-operatively there was a significant reduction in value (0.60±0.06) (P<0.001). The (mean±SD) value of the log bacterial count (CFU/μl) in the control group (0.59±0.04) was significantly lower than that of the cleft patients pre-operatively (P<0.001), while post-operatively there was no significant difference (P=0.834). The differences were statistically signifi cant for the bacterial count between pre and postoperative periods in children with cleft lip and palate as tested by analysis of variance. Conclusions: Normal children had lower microbial colonization compared with Fissure lip and palate patients, and using obturators decreased the bacterial colony count following treatment of the fissure lip and palate children. Conclusion, Cleft lip and palate patients had more colonization compared with normal children, and the colony count decreased signifi cantly following treatment of the cleft lip and palate children using obturators.

Congenital Cleft Lip and Palate in Children: Prevalence Rate in Russia and Worldwide, Risk Factors

Congenital cleft lip and palate is one of the most common congenital anomalies in children. It has significant medical and social influence on the self-realization of these patients in society. This review of various researches' results from different countries and territories of the Russian Federation (according to the MEDLINE and eLIBRARY.ru databases) provides information on prevalence rate of this pathology among children of our country and worldwide. The role of medical care organization remains unknown among all the presented results of the studies about the role of risk factors of congenital cleft lip and palate development (such as: inheritance, lifestyle, environment).

International adoption of cleft lip and palate children: Attachment, behavior problems, and parental sensitivity

This study examined parent-child relationship variables (child attachment, parental sensitivity, and prior parenting experience) and child behavior problems in parents and their international adopted children with a cleft lip and palate (CLP+; n = 29) and without a CLP- (n = 55). First, results do not show any group differences on child attachment (secure attachment CLP+ = 69%, CLP- = 59%), or on externalizing problems, but fewer internalizing problems were found for CLP children. Second, mothers of CLP children, although they have more prior parenting experiences, are less sensitive than mothers of children without a CLP. Parents with prior parenting experience or higher sensitivity are more likely to have a child with a secure attachment, but sensitivity, prior parenting experiences and attachment are not significantly associated with behavior problems. Finally, children with both a CLP and an insecure attachment show more externalizing problems and tend to have less sensitive mothers.

Congenital cleft lip and palate in children from Tajikistan in 2009–2019

We analyzed the dynamics of congenital cleft lip and palate in children and studied the archival data of the National Medical Center Shifobakhsh (Dushanbe) of the Republic of Tajikistan on the incidence of outpatient visits due to this abnormality in the Republic of Tajikistan over the period from 2009 to 2019. The number of children born with congenital cleft has been increasing for the last ten years. We found out this pathology to develop in families with in-and-in marriage, it also depends upon the sex of a child. Boys are more prone to maxillofacial anomalies.

Topological properties of the resting-state functional network in nonsyndromic cleft lip and palate children after speech rehabilitation.

Speech therapy has been widely used as an essential therapy for compensatory articulation errors in nonsyndromic cleft lip and palate patients. We sought to identify potential biomarkers of nonsyndromic cleft lip and palate children after speech rehabilitation based on resting-state fMRI and graph theory techniques. We scanned 28 nonsyndromic cleft lip and palate and 28 typically developing children for resting-state fMRI on a 3T MRI scanner. Functional networks were constructed, and their topological properties were obtained for assessing between-group differences (two-sample t-tests). Also, language clear degree scale scores were obtained for correlation analysis with the topological features in nonsyndromic cleft lip and palate patients. Significant between-group differences of local properties were detected in brain regions involved in higher-order language and social cognition. There were no significant correlations between topological feature differences and language clear degree scale scores in nonsyndromic cleft lip and palate patients. Graph theory provided valuable insight into the neurobiological mechanisms of speech rehabilitation in nonsyndromic cleft lip and palate patients. The global network features, small-world index, nodal clustering coefficient, and nodal shortest path length may represent potential imaging biomarkers for the estimation of effective speech rehabilitation.

Effectiveness of cognitive-behavioral therapy compared with basic health education for tobacco cessation among smokers: A randomized controlled trial

Background: Tobacco is a risk factor for oral cancer, adult periodontal diseases, and cleft lip and palate in children. Tobacco cessation counseling has been shown to improve the likelihood of achieving success for quitting the habits. Aim: This study aimed to assess the effectiveness of cognitive-behavioral therapy (CBT) compared with basic health education (BHE) for tobacco cessation among smokers in Bengaluru city. Materials and Methods: A randomized controlled trial was conducted over a period of 6 months among smokers attending a tobacco cessation center in a dental college in Bengaluru city. The participants were assigned to either CBT or BHE groups with 1:1 allocation sequence ratio. Randomization and allocation concealment were done by an investigator who had no clinical involvement in the trial. Nicotine dependence was assessed using the Fagerstrom's Addiction Scale for smokers, while motivational levels were assessed using Transtheoretical model. The groups were followed up for 4 and 12 weeks. Statistical analysis was done using the Statistical Package for Social Sciences (SPSS 22.0, IBM, Armonk, NY, USA). Paired and unpaired “t“-tests, Chi-square test, Fisher's exact test, and analysis of variance test were applied. Statistical significance was considered atP < 0.05. Results: Majority of the study participants started smoking at an early age and had long duration and cigarette smoking years. Among CBT group, the mean Fagerstrom's addiction score at baseline (4.8 ± 7.3) significantly reduced (3.8 ± 3.1) at the 1st follow-up and at the 2nd follow-up (3.5 ± 8.9) (P < 0.001). The proportion of smokers with frequency more than ten cigarettes per day reduced from baseline (P = 0.16) to the 2nd follow-up (P = 0.07) in CBT group compared to BHE group. Conclusion: CBT is effective in reducing tobacco habits and addiction levels when compared to BHE among smokers. Tobacco cessation counseling using CBT has been found to reduce smoking habits, thereby improving the possibility of quitting the habits.

Mothers' sense of coherence and oral health-related quality of life in cleft lip and palate children visiting a private dental college: A Survey.

Background:In addition to an adjusting physical appearance, children with cleft lip and palate also deal with psychological and psychosocial limitation. Mothers' sense of coherence (SOC) could be a psychosocial determinant of oral health quality of life (OH-QoL) of cleft lip and palate patients. Hence, the present study was done to assess the relationship of mothers' SOC on OH-QoL in cleft lip and palate patients.Materials and Methods:The present cross-sectional questionnaire study was conducted on mothers of cleft lip and palate children. The first part consisted of demographic details. The second part of scale was the early childhood and oral health impact scale (ECOHIS) which had a total 13 questions with responses on a 4-point Likert scale. The third part was to assess mothers' SOC using a short version of SOC-13 consists of 13 items on a 7-point Likert scale. Chi-square test was applied to assess the association between mothers' SOC, sociodemographic characteristic, and children's OHRQoL. In the analysis, P < 0.05 was considered significant.Results:Out of 69% of low SOC population, 21.73% were rural, 20.39% were from peri-urban, and 57.97% population was from urban areas. Out of 150 participants, 2.40% in high ECOHIS were illiterate/primary school, “31.32% were high school/intermediate/diploma had high ECOHIS while 66.26% were high school/intermediate/diploma” had low ECOHIS, and 25.37% were graduate/postgraduate. Mothers' education and locality were statistically significant P < 0.001.Conclusion:Action to enhance mothers' SOC might form part of oral health promotion and help to improve the oral health quality of life of cleft lip and palate patients.

Mucoepidermoid carcinoma of the hard palate in a 9-year-old girl (clinical case)

The objective of the work is to demonstrate the signs of mucoepidermoid carcinoma of the minor salivary glands in pediatric patients on a clinical example.Clinical case. In August 2017, a girl of 9 years old appeared in the area of the right half of the hard palate. The dentist at the place of residence diagnosed an abscess in the area of the hard palate, performed the lancing and drainage of the “abscess”, prescribed antibiotic therapy. After 3.5 months (in December 2017), hyperemia and an increase in the volume of the mucous membrane reappeared in the same zone. Reapplied to the dentist. The girl was sent to the Oral and Maxillofacial Surgery Department, where the hard palate formation was removed on 23.01.2018; according to histological examination a highly differentiated tumor of the hard palate was diagnosed. The girl was sent for a consultation to the N. N. Blokhin National Medical Research Center of Oncology, where histological preparations were reviewed: a fragment of the mucous membrane of the hard palate covered with squamous epithelium, with the growth of low-grade mucoepidermoid cancer (from the minor salivary glands of the hard palate). A biopsy of the postoperative scar 3 mm long and of the formation of a hard palate 1 mm in diameter was performed; during histological examination of the biopsy material tumor cells were not detected (the material was represented by fibrous tissue). Despite the biopsy results, taking into account the medical history, the results of a review of histological preparations, the rarity and high aggressiveness of the tumor, poor prognosis for relapse, lack of data for regional and distant metastases, at the concilium it was accepted the decision to conduct repeated surgery. In the Surgical Department No. 1 of the Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology on 13.03.2018 a resection of the hard palate was performed with plastic surgery of the defect with a mixed skin-muscle flap on the vascular pedicle.Conclusion. Mucoepidermoid cancer of the minor salivary glands of the hard palate in children and adolescents can be manifested by the presence of a slowly growing, painless, pale blue tumor. For a correct clinical and morphological diagnosis, a biopsy of the tumor is necessary, further the removal of the tumor is recommended with resection of the hard palate, in view of the high risk of tumor spreading in the thickness of the bone.

КЛИНИКО-АНАТОМИЧЕСКИЕ ФОРМЫ ВРОЖДЕННОЙ РАСЩЕЛИНЫ ГУБЫ И НЕБА В РЕГИОНЕ С ЭКОТОКСИКАНТАМИ

Subject: the study of the features of clinical and anatomical forms of congenital cleft lip and palate in the region with the petrochemical industry.&#x0D; Objectives ― determination of the clinical-anatomical forms of congenital cleft lip and palate, the identification of the frequency of severe forms in the region with the petrochemical industry and in the region without industrial eco-toxicants.&#x0D; Methods. We have studied medical documentation in the Department of Maxillofacial Surgery of the Republican Children's Clinical Hospital for the period from January 1, 1985 to December 31, 2018 to study the structure of the clinical and anatomical forms of congenital clefts of the lips and palate in children living in the Republic of Bashkortostan. During the analyzed period, 3463 children from birth to 16 years with congenital cleft lip and palate underwent treatment and dispensary observation.&#x0D; Results. Our data suggest that in the area with petrochemical ecotoxicants, the percentage of severe forms of congenital cleft lip and palate is higher (77.5%) than in an area without petrochemical ecotoxicants (68.7%).&#x0D; Conclusions. Thus, environmental pollution by petrochemical ecotoxicants leads to an increase in the number of children with congenital cleft lip and palate. There is a relationship between the level of air pollution by gross emissions from petrochemical enterprises and the severity of the clinical-anatomical forms of congenital cleft lip and palate in children living in an industrial area. It is important and important in the prenatal prevention of congenital clefts of the lip and palate.

Rapid Arch Expansion in Cleft Lip and Palate Children: Comparison Between Fan-Shaped Expander and Hyrax-Type Expander by Using Cone Beam Computed Tomography

Purpose: The aim of the current study was to evaluate the skeletal and dentoalveolar effects of rapid palatal expansion (RPE) in children with cleft lip and palate (CLP), ages 8 to 12 years treated with 2 expanders. Methods: Twenty Egyptian children with complete bilateral CLP exhibiting maxillary transverse deficiency were divided randomly into 2 groups according to the appliance used for expansion: (A) fan expander group. (B) hyrax expander group. Cone-beam computed tomography (CBCT) images were taken before and immediately after expansion procedure. Results: There was non-significant vertical movement of the maxilla for the 2 groups. On the transverse plane, there was more anterior expansion and posterior restriction for the fan group. However, the hyrax group showed significant posterior as well as anterior expansion. Both groups showed significant tipping between both sides posteriorly and anteriorly. Mandibular expansion was non-significant. Conclusion: Fan expander showed better results for children with cleft palate requiring anterior expansion only. Hyrax expander is better used for cases seeking for posterior and anterior expansion.

FREQUENCY OF OTITIS MEDIA WITH EFFUSION IN CLEFT PALATE CHILDREN

Background: Children with cleft palate oftenly present with otitis media with effusion. The objective of this study was to determine the frequency of otitis media with effusion among cleft palate children.&#x0D; Material &amp; Methods: This cross-sectional study was carried out in the Department of ENT, Pakistan Institute of Medical Sciences, Islamabad, Pakistan from June 2017 to December 2018. Ninety patients were selected through consecutive sampling technique. All children 3-10 years of age with cleft palate were included. Patients with combined cleft palate and cleft lip were excluded. All patients underwent otoscopy and tympanometry. Type B tympanogram was considered as evidence of fluid in the middle ear. Later on patients with only Type B tympanogram underwent myringotomies. &#x0D; Results: Out of 90 (180 ears) patients 61 (67.78%) were males and 29 (32.22%) females. Mean age of the sample was 6.15±2.226 years (3-10, range 7 years). On otoscopic examination, 107/180 (59.45%) ears were suspected to have fluid in the middle ear. Type B tympanogram was detected in 125/180 (69.45%) ears. Only 38/90 (42.20%) patients (76/180 ears), underwent pure tone audiometry. Based on otoscopic, tympanometric and audiometric findings, myringotomies were performed in 125/180 (69.45%) ears. At myringotomy fluid was present in middle ear space of 98/180 (78.4%) ears. Out of total 180 ears the true frequency of otitis media with effusion was 98/180 (54.45%).&#x0D; Conclusions: The frequency of otitis media with effusion in patients with cleft palate is high. Tympanometry is fairly sensitive in diagnosing this condition in these patients.

FREQUENCY OF OTITIS MEDIA WITH EFFUSION IN CLEFT PALATE CHILDREN

Background: Children with cleft palate oftenly present with otitis media with effusion. The objective of this study was to determine the frequency of otitis media with effusion among cleft palate children. Material &amp; Methods: This cross-sectional study was carried out in the Department of ENT, Pakistan Institute of Medical Sciences, Islamabad, Pakistan from June 2017 to December 2018. Ninety patients were selected through consecutive sampling technique. All children 3-10 years of age with cleft palate were included. Patients with combined cleft palate and cleft lip were excluded. All patients underwent otoscopy and tympanometry. Type B tympanogram was considered as evidence of fluid in the middle ear. Later on patients with only Type B tympanogram underwent myringotomies. Results: Out of 90 (180 ears) patients 61 (67.78%) were males and 29 (32.22%) females. Mean age of the sample was 6.15±2.226 years (3-10, range 7 years). On otoscopic examination, 107/180 (59.45%) ears were suspected to have fluid in the middle ear. Type B tympanogram was detected in 125/180 (69.45%) ears. Only 38/90 (42.20%) patients (76/180 ears), underwent pure tone audiometry. Based on otoscopic, tympanometric and audiometric findings, myringotomies were performed in 125/180 (69.45%) ears. At myringotomy fluid was present in middle ear space of 98/180 (78.4%) ears. Out of total 180 ears the true frequency of otitis media with effusion was 98/180 (54.45%). Conclusions: The frequency of otitis media with effusion in patients with cleft palate is high. Tympanometry is fairly sensitive in diagnosing this condition in these patients.

Non routine use of alveolar incision in Von Langenbeck technique palatoplasty in children; a safe and viable technique in our centre

Background: Repair of the palate is among the challenging reconstructive surgeries in children. No single technique has achieved completely satisfactory results. The von Langenbeck technique (VLT) is one of the techniques in common use. We have sort to find out if the lateral alveolar incision in VLT can be safely avoided in selected cases.Methods: This is a prospective comparative study of cases of isolated unilateral cleft palate in children 18 years and below which were repaired using the VLT with and without lateral alveolar incision in our centre between January 2013 and December 2018. Outcome parameters obtained included duration of surgery, blood loss, complication and fistula rates. Data was analyzed using SPSS 21. Statistical significance was set at p&lt;0.05.Results: Eighty four patients were included in the study; 36 were in the test group and 48 were in the control group. There was no significant difference in the age, weight and gender of the two groups. The duration of surgery was significantly shorter in the test group and fistula and complication rate was less.Conclusions:This study has demonstrated that comparable, if not better results can be achieved in well selected patients with unilateral isolated cleft palate using only dissection along the margin of the cleft. This new technique reduces the duration of surgery and anaesthesia and may reduce blood loss and complications.

Congenital cleft of the lip and palate in children: pathogenetical significance of matrix metalloproteinases

There are presented data about the prevalence offormation of congenital cleft lip and palate (CCLP) - one of the most common birth defects of the maxillofacial region in children. According to WHO the occurrence of children born with CCLP in the world is 0,6-1,6 cases per 1,000 live births, and varies greatly from the region to region and ethnic group residing there. At the same time, in 63,1% of patients there were established chromosomal abnormalities, and in 36,9% - non-chromosomal syndromes. In Russia, every year there are occurred from 3,5 to 5 thousand children with such defects that requires the development of new methods ofprevention of these malformations. There are reported modern views on the pathogenetical and potent diagnostic significance of the evaluation of the content of tissue matrix metalloproteinases (MMPs) and their inhibitors in mechanisms of the formation of CCLP, shown the probable associations of changes in the expression or activity of MMP and TIMP with various forms of malformations of the palate and upper jaw.

Rapid maxillary expansion effects of nasal airway in children with cleft lip and palate using computational fluid dynamics.

Rapid maxillary expansion (RME) improves nasal airway ventilation in non-cleft palate children. Children with unilateral cleft lip and palate (UCLP) may have nasal obstruction and experience an increased risk of obstructive sleep apnoea. The effect of RME in UCLP children is unclear. This retrospective study evaluated RME-induced changes in ventilation parameters in children with UCLP using computational fluid dynamics. Nineteen patients (10 boys, mean age 10.7years) who required RME had cone-beam computed tomography images taken before and after RME. Twenty control participants (11 boys, mean age 11.1years) received regular orthodontic treatment. Nasal airway ventilation parameters (air pressure, air velocity and airflow rate) were analysed via computational fluid dynamics, and nasal cross-sectional area (CSA) was measured. Maximum pressure, velocity and nasal resistance were significantly reduced by RME in the UCLP group. Air flow rate and CSA on the cleft side significantly were increased by RME in the UCLP group. In children with UCLP, increasing the quantity of airflow and CSA on the cleft side by RME substantially improved nasal ventilation.

A study of anaesthetic management of cleft lip and palate surgery in children

Introduction: Anaesthetic management in paediatric patient can present anatomically and physiologically challenges to the anaesthetics. Therefore, surgery of cleft lip and palate in children will require careful consideration and thorough knowledge and clinical application in preparation by the anaesthetics as they are not miniature version of adults. Objective: To evaluate the anaesthetic outcomes including pre-operative selection of cases, intra-operative and post-operative complications in children underwent cleft lip and palate surgery. Materials and Methods: 30 patients of cleft lip and/or cleft palate malformation scheduled for surgical repair under general anaesthesia at plastic surgery unit of tertiary care teaching hospital were selected for the study. All patients with age more than 3 months; weight more than 5 kg; no history of URTI / fever; normal chest x-ray; and leukocyte count less than 10000/cum, were included in the study. The patient’s haemoglobin less than 10 gm% were excluded from the study. Results: A majority of patients (22, 73.33%) belonged to less than 3 years of age. Patients were divided in 2 groups with 15 patients in each group according to induction technique. Group I which was induced by inhalation technique with Oxygen, Nitrous Oxide and Halothane and group II which were induced by intravenous Ketamine and Succinylcholine. Intubation was difficult in one patient of Group II. Increased intratracheal secretion occurred in 2 patients of Group II. Laryngospasm was found in 1 case of group II and there was also vomiting in 1 case of group II. Conclusion: A favourable outcome can be expected in cleft lip and palate surgery in children by adequate understanding of the anatomy, physiology, and psychology of the paediatric patients; and proper selection and through pre-operative assessment and preparation. Keywords: Cleft lip and palate, Laryngospasm, Vomiting, Anaesthetic management.

Analysis of tracheal morphology by spiral CT in 126 cleft palate children

Objective: To discuss the surgical safeness of the cleft palate children with airway stenosis by means of analyzing characteristics of the shape of the upper airway and comparing clinical data of cleft palate children with airway stenosis and non-airway stenosis. Methods: Tracing back from Apirl 2015 to Apirl 2017, 126 cleft palate children treated in Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, were included (46 male and 80 female, age of 7 to 74 months, median age 18 months). According to the spiral CT scan of neck, patients were categorized to airway-stenosis group (65 patients) and non-airway-stenosis group (61 patients). For airway-stenosis group, suspected difficult intubation plan is applied, guiding endotracheal intubation via visible laryngoscope. For non-airway-stenosis group, ordinary plan of endotracheal intubation is applied. Study the statistics of both groups in the measurement of the upper airway, the success rate of tracheal intubation, operation time, hospital day. Results: Based on anatomical location of the airway stenosis, cleft palate children were divided into: nasopharynx, 5 cases; laryngel, 55 cases; initiation part of trachea to arch of aorta, 2 cases; arch of aorta to bronchial bifurcation, 3 cases. Regardless of airway stenosis, the upper airway of cleft palate children in the subglottic area and the cricoid area was elliptical, with the transverse dimension narrow and the anteroposterior dimension wide. Comparing to non-airway-stenosis group, the airway in airway-stenosis group remained narrower in the anteroposterior dimension in the subglottis area [(7.69±1.76) mm]; also remained narrower in the transverse dimension [(5.96±1.27) mm] and the anteroposterior dimension [(8.16±1.31) mm] in the cricoid area (P<0.05). Pre-and post-operative monitor blood oxygen saturation of all patients were normal. Ventilator weaning of all patients was successful. There were no statistical significance in operation time and hospital day between airway-stenosis group and non-airway-stenosis group (P>0.05). Conclusions: The upper airway of the subglottic area and the cricoid area in cleft palate children are elliptical, with the transverse dimension narrow and the anteroposterior dimension wide. Cleft palate children with airway stenosis underwent surgery smoothly by using a portable visible laryngoscope.

The Reliability and Validity of the Measurements in Unilateral Cleft Lip and Palate Laser Scanned 3D Dental Casts

Objective: To evaluate the reliability and validity of the Next Engine 3D Laser scanner. Material and Methods: A total of 30 dental casts of unilateral cleft lip and palate (UCLP) children with 90 linear variables were measured using digital caliper while the laser-scanned 3D dental casts (LS3DM) were measured using Mimics Software. All scanned data coordinates (in x, y, z) were transferred into Mimics software in STL format to be measured. All the variables were measured using a computer mouse accurate to 0.5 mm. The intra-class correlation coefficient (ICC) was used to evaluate the intra- and inter-examiner reliabilities and also for the validity of two methods. Results: Intra-examiner reliabilities of digital caliper and LS3DM were found excellent (ICC 0.916-0.995) and inter-examiner reliabilities of LS3DM were good to excellent (ICC 0.816-0.990). The validity of LS3DM measurements was confirmed based on the ICC values were in the range of 0.913-0.996. The overall time frame for conducting measurements was shorter using a laser-scanned model (10 min.) than using a digital caliper (5 hours). Conclusion: The LS3DM is a valid reliable tool for future high impact research in our institution.

Evaluation of Postsurgical Dentofacial Deformities in Children Operated for Correction of Cleft Lip and Palate-A Cross-sectional Study.

ABSTRACTAimThe aim of this study is to evaluate the various dentofacial deformities in children who were surgically managed for cleft lip and palate (CLP).Materials and methodsThe study was carried out in 100 surgically managed cleft lip palate children between the ages of 4 years and 15 years. After eliciting a detailed history, a thorough intraoral and extraoral examination was done and details were recorded in a printed proforma with photographs.DesignCross-sectional study.Statistical analysis usedAll the data were analyzed using SPSS 11.5 software for evaluation using the Chi-square test.ResultsA wide range of surgical, dental, and functional problems among the surgically managed CLP patients were seen.ConclusionThe timing of direct lip repair showed a significant influence on the severity of dentofacial deformities. Lip repair before the age of 1 increases the severity of the deformity.How to cite this articleJoybell C, Krishnan R, et al. Evaluation of Postsurgical Dentofacial Deformities in Children Operated for Correction of Cleft Lip and Palate—A Cross-sectional Study. Int J Clin Pediatr Dent 2019;12(3):165–177.

Pharyngeal flap construction in cleft palate children with velopharyngeal incompetence

Pharyngeal flap construction in cleft palate children with velopharyngeal incompetence