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Sample records for palatal obturators

  1. Palatal obturators in patients after maxillectomy.

    Science.gov (United States)

    Cardelli, P; Bigelli, E; Vertucci, V; Balestra, F; Montani, M; DE Carli, S; Arcuri, C

    2014-01-01

    Prosthodontic management of palatal defects is fundamental to improve patient's life undergoing to a maxillary surgical treatment. A lot of maxillary defects are a direct consequence of surgical treatment of malformations, neoplasms or trauma. The obturators are prosthesis used to close palatal defects after maxillectomy, to restore masticatory function and to improve speech. The primary goals of the obturator prosthesis are to preserve the remaining teeth and tissue and to provide comfort, function, and aesthetics to the patients. Different materials and retention methods are a characteristic of new types of obturators.

  2. Application of palatal RB obturator in babies with isolated palatal cleft

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    Radojičić Julija

    2009-01-01

    Full Text Available Background. Isolated cleft of secondary palate has a specific clinical picture due to a wide communication between the mouth and nose cavity. As a consequence of that, babies born with this malformation are often subject to infections of the upper bronchial tubes, middle ear, speech disorders, and certainly the most difficult existential problem they face at the very beginning of their lives, the impossibility of suckling (breast feeding. Such babies have to be fed with gastric probe. The difficulties in their nutrition have often been described in literature, yet a singular attitude toward early orthodontic therapy has not been adopted still. The aim of the paper was to describe a design and application of obturator immediately after the birth of a baby with isolated palatal cleft, and the role in feeding. Case report. We presented a female neonate, born on 27th December 2007, with a wide fissure in the shape of the letter U over the entire secondary palate. The baby was referred to the Stomatology Clinic due to nutrition impossibility. To avoid feeding with gastric probe, the formation of RB obturator was performed (artificial palate. Hereby, the procedure of obturator making with an explanation of its function is presented. Conclusion. The application of RB obturator and the necessary education of parents have a major role in shortening the time of breast feeding and increasing the amount of food intake and, thus, for the normal growth and development of newborn infants with isolated palate cleft.

  3. SPEECH EVALUATION WITH AND WITHOUT PALATAL OBTURATOR IN PATIENTS SUBMITTED TO MAXILLECTOMY

    Science.gov (United States)

    de Carvalho-Teles, Viviane; Pegoraro-Krook, Maria Inês; Lauris, José Roberto Pereira

    2006-01-01

    Most patients who have undergone resection of the maxillae due to benign or malignant tumors in the palatomaxillary region present with speech and swallowing disorders. Coupling of the oral and nasal cavities increases nasal resonance, resulting in hypernasality and unintelligible speech. Prosthodontic rehabilitation of maxillary resections with effective separation of the oral and nasal cavities can improve speech and esthetics, and assist the psychosocial adjustment of the patient as well. The objective of this study was to evaluate the efficacy of the palatal obturator prosthesis on speech intelligibility and resonance of 23 patients with age ranging from 18 to 83 years (Mean = 49.5 years), who had undergone inframedial-structural maxillectomy. The patients were requested to count from 1 to 20, to repeat 21 words and to spontaneously speak for 15 seconds, once with and again without the prosthesis, for tape recording purposes. The resonance and speech intelligibility were judged by 5 speech language pathologists from the tape recordings samples. The results have shown that the majority of patients (82.6%) significantly improved their speech intelligibility, and 16 patients (69.9%) exhibited a significant hypernasality reduction with the obturator in place. The results of this study indicated that maxillary obturator prosthesis was efficient to improve the speech intelligibility and resonance in patients who had undergone maxillectomy. PMID:19089242

  4. Maxillary obturator

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    Aruna Jawahirlal Bhandari

    2017-01-01

    Full Text Available Defects in the maxillary jaw can be congenital, developmental, acquired, traumatic or surgical involving the oral cavity and related anatomic structure. Absence or loss of some or all of the soft palate and / or hard palate results in insufficient structure or altered function of the remaining tissues. Defects can cause disruption of articulation and airflow during speech production and also nasal reflux during deglutition. Patients after surgical resection have altered anatomy due to scaring, tissue contracture, lack of bony support and tissue edema. These patients have problem of regurgitation of water and food through nose and difficulty in speech. These changes require the fabrication of prosthesis and also sometimes repeated prosthesis adjustments to confirm to the soft tissue changes. To prevent this and to help the patient in deglutition and speech defects must be restored with prosthesis. In such situation an obturator is designed to close the opening between the residual hard and / or soft palate and the pharynx. The prosthesis provided for these patients are called as obturators. An obturator is a prosthesis which is fabricated for the patients with the palatal defects in the form of cleft lip and palate, oroantral fistula or surgical resection after removable of pathology like tumor or cancer. This review article will highlight on the Prosthetic Rehabilitation of the maxillary defects and the types of obturators.

  5. Prosthetic Rehabilitation by Palatal Hollow Bulb Obturator with Cast Metal Denture Base: A Case Report

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    George Francis

    2015-01-01

    Full Text Available Background: Prosthetic reconstruction of partial maxillectomy defects is a challenging procedure that requires multidisciplinary expertise to achieve an acceptable function, speech and esthetics. This procedure improves the quality of life for the patient as a normal individual. Obturation of the defect depends on its volume and position of remaining hard and soft tissues which determine the retention, stability and support for the prosthesis. The prosthesis should be simple to handle, easy to maintain, biocompatible, light in weight and convenient for future adjustments. This case report describes a clinical case of partial maxillectomy which was successfully rehabilitated with a definitive closed hollow bulb obturator and cast metal denture base.

  6. Obturator with soft liner in the management of hard palate defect: A ...

    African Journals Online (AJOL)

    Maxillary defects are created following surgical treatment of patients with congenital defects, trauma, or neoplasm. Oral cancer is one of the more common malignanciesif detected lately massive tissues will be excised surgically and correction will be challenging. One of the treatment strategies is obturator, the retention of ...

  7. Obturator yang Berfungsi Sebagai Protesa pada Perawatan Pasien Sumbing Langitan (Laporan Kasus

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    Avy Permata Sari

    2015-11-01

    Full Text Available Palatal cleft is opening of palatal including palatum mole and durum. It is caused by growth and development disturbance intra uterine. There are some etiology lke genetic factor, infection, drugs, mutagenic material, malnutrition, and psychological problem during pregnancy. In this case the patient came to our clinic to be made obturator to close the palatal fistule that caused speech and nutrition problems. Because there were some missing teeth, the obturator was combined with prosthetic design. At recall visit the obturator improved speech, swallow, and mastication functions and aesthetics and patient showed the ability to use it by himself.

  8. Candida albicans in patients with oronasal communication and obturator prostheses

    OpenAIRE

    MATTOS, Beatriz Silva Câmara; SOUSA, Andréa Alves de; MAGALHÃES, Marina Helena C. G. de; ANDRÉ, Marcia; BRITO E DIAS, Reinaldo

    2009-01-01

    Patients using obturator prostheses often present denture-induced stomatitis. In order to detect the presence of oral Candida albicans in patients with oronasal communications and to evaluate the effectiveness of a topical antifungal treatment, cytological smears obtained from the buccal and palatal mucosa of 10 adult patients, and from the nasal acrylic surface of their obturator prostheses were examined. A therapeutic protocol comprising the use of oral nystatin (Mycostatin®) and prosthesis...

  9. Speech evaluation with and without palatal obturator in patients submitted to maxillectomy Avaliação de fala com e sem obturador de palato em pacientes submetidos à maxilectomia

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    Viviane de Carvalho-Teles

    2006-12-01

    Full Text Available Most patients who have undergone resection of the maxillae due to benign or malignant tumors in the palatomaxillary region present with speech and swallowing disorders. Coupling of the oral and nasal cavities increases nasal resonance, resulting in hypernasality and unintelligible speech. Prosthodontic rehabilitation of maxillary resections with effective separation of the oral and nasal cavities can improve speech and esthetics, and assist the psychosocial adjustment of the patient as well.The objective of this study was to evaluate the efficacy of the palatal obturator prosthesis on speech intelligibility and resonance of 23 patients with age ranging from 18 to 83 years (Mean = 49.5 years, who had undergone inframedial-structural maxillectomy. The patients were requested to count from 1 to 20, to repeat 21 words and to spontaneously speak for 15 seconds, once with and again without the prosthesis, for tape recording purposes. The resonance and speech intelligibility were judged by 5 speech language pathologists from the tape recordings samples. The results have shown that the majority of patients (82.6% significantly improved their speech intelligibility, and 16 patients (69.9% exhibited a significant hypernasality reduction with the obturator in place. The results of this study indicated that maxillary obturator prosthesis was efficient to improve the speech intelligibility and resonance in patients who had undergone maxillectomy.A maioria dos pacientes submetidos a ressecções de maxila apresenta alterações nas funções de fala e de deglutição. O acoplamento das cavidades oral e nasal resulta em hipernasalidade de graus variados e no comprometimento da inteligibilidade de fala. A reabilitação protética tem como objetivo separar as cavidades oral e nasal podendo reduzir as alterações de ordem estética, funcional e ainda melhorar o ajustamento social deste paciente. Este trabalho teve como objetivo avaliar a eficácia da pr

  10. Radial forearm free flap for soft palate reconstruction.

    Science.gov (United States)

    Lacombe, V; Blackwell, K E

    1999-01-01

    Defects of the soft palate resulting from head and neck oncologic surgery traditionally have been rehabilitated using a prosthetic obturator. In general, the results of soft palate obturation have been satisfactory, with most patients achieving velopharyngeal competence during speech and swallowing. However, soft palate obturators have several disadvantages. Device stability and retention are impaired in patients who are edentulous. In addition, prosthetic obturators cover large areas of sensate mucosa in the hard palate, maxillary alveolus, and oropharynx, contributing significantly to the loss of sensory feedback from the oral cavity and oropharynx. Considerable evidence suggests that sensory impairment within the oral cavity and pharynx results in impaired mastication, deglutition, and articulation. A minority of patients find palatal obturators to be unsatisfactory, secondary to either inconvenience or device discomfort.

  11. Inflatable hollow obturator prostheses for patients undergoing an extensive maxillectomy: a case report

    Science.gov (United States)

    Hou, Yue-Zhong; Huang, Zhi; Ye, Hong-Qiang; Zhou, Yong-Sheng

    2012-01-01

    The presence of a large palatal or maxillary defect after partial or total maxillectomy for tumor, trauma or congenital deformation poses a challenge to prosthodontists, particularly when the use of an implant cannot be considered. This case report described the use of an air valve in a hollow silicone obturator to manufacture an inflatable obturator that could be extended further into undercut area to retain itself. The inflatable obturator exhibited adequate retention, stability and border sealing, thereby improving the masticatory, pronunciation and swallowing functions of patients. It may be a suitable alternative treatment option to an implant-retained obturator. PMID:22653550

  12. Obturator prostheses in post-oncological maxillofacial patients: our experience

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    Edoardo Brauner

    2014-12-01

    Full Text Available Background: Surgical procedures for tumors of the paranasal sinus, palatal epithelium, minor salivary glands or osteosarcoma of the upper jaw require a partial or total maxillectomy of the upper jaw. When the surgical procedure and/or radiation therapy result in a communication, the solution is necessarily prosthetical, through a palatal obturator that recreates a partition between the oral and nasal cavities. Methods: Authors selected 32 post-oncological patients with the upper maxilla completely edentulous prosthetically rehabilitated with a palatal obturator. Results: No serious complications or adverse reactions were reported during the fabrication of surgical or definitive obturators. All patients stated to benefit the palatal obturator in terms of quality of life. Conclusion: Prosthetic rehabilitation of edentulous maxillectomy with oral communication is a demanding challenge for the prosthodontist. The goals of prosthetic rehabilitation include separation of oral and nasal cavities to allow adequate deglutition and articulation of teeth, restore midfacial soft tissue contour and a satisfactory esthetic outcome. When, for any reason, the patient is not a suitable candidate for an implant-retained overdenture, a total removable prosthesis should ensure the most comfort in terms of swallowing, phonation and aesthetics.

  13. Stress analysis in oral obturator prostheses: imaging photoelastic

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    Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; dos Santos, Daniela Micheline; Haddad, Marcela Filié; Andreotti, Agda Marobo; Moreno, Amália

    2013-06-01

    Maxillary defects resulting from cancer, trauma, and congenital malformation affect the chewing efficiency and retention of dentures in these patients. The use of implant-retained palatal obturator dentures has improved the self-esteem and quality of life of several subjects. We evaluate the stress distribution of implant-retained palatal obturator dentures with different attachment systems by using the photoelastic analysis images. Two photoelastic models of the maxilla with oral-sinus-nasal communication were fabricated. One model received three implants on the left side of the alveolar ridge (incisive, canine, and first molar regions) and the other did not receive implants. Afterwards, a conventional palatal obturator denture (control) and two implant-retained palatal obturator dentures with different attachment systems (O-ring; bar-clip) were constructed. Models were placed in a circular polariscope and a 100-N axial load was applied in three different regions (incisive, canine, and first molar regions) by using a universal testing machine. The results were photographed and analyzed qualitatively using a software (Adobe Photoshop). The bar-clip system exhibited the highest stress concentration followed by the O-ring system and conventional denture (control). Images generated by the photoelastic method help in the oral rehabilitator planning.

  14. RTV-silikon sebagai Bahan Protesa Obturator Palatum

    OpenAIRE

    Chandrasegar, Akila

    2011-01-01

    Protesa Obturator palatum adalah protesa yang digunakan untuk menutup jaringan yang terbuka secara kongenital atau yang diperdapat, terutama bagian palatum keras atau lunak serta struktur alveolar yang berdekatan. Obturator palatum dapat diklasifikasikan berdasar pada tahap perawatannya yaitu obturator selama pembedahan (surgical obturator), obturator interim dan obturator definitif. Terdapat beberapa tipe obturator selain dari obturator palatum seperti obturator palato fari...

  15. Function of obturator prosthesis after maxillectomy and prosthetic obturator rehabilitation.

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    Chen, Cheng; Ren, Wenhao; Gao, Ling; Cheng, Zheng; Zhang, Linmei; Li, Shaoming; Zhi, Pro Ke-qian

    2016-01-01

    Maxillary defects are usually rehabilitated by a prosthetic obturator. This study aimed to evaluate the functioning of obturators prosthesis in patients with unilateral defects after maxillectomy. Of 49 patients, 28 underwent to maxillectomy as a result of tumor ablative surgery, and acquired unilateral maxillary defects. Evaluation of the function was performed by applying the Obturator Functional Scale (OFS). From a total of 49 patients, 28 were treated as follows: 9 with a conventional retained obturator prosthesis (COP), 11 (39%) with an enhanced retentive obturator prosthesis with stud attachment (POP) and 8 (28%) with an enhanced retentive obturator prosthesis with magnetic attachment (POM). The mean OFS score was 80. Scores on functions of speech, swallowing and chewing reached statistical significances (p<0.05) among these three subgroups. Comparing COP and MOP groups, the scores of OFS in the domains of "Speech-ability to speak in public" and "Swallowing-leakage with liquids" were significantly higher in AOP group. Comparing COP group, the scores of OFS in "Swallowing-leakage with solid" and "Chewing/eating" domains were increased significantly (p<0.05) both in MOP and AOP groups. Obturator prosthesis improves oral function of patients after maxillary defects; the retention of the obturator prosthesis enhanced by the addition of attachments showed more benefits in oral function. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  16. Function of obturator prosthesis after maxillectomy and prosthetic obturator rehabilitation

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    Cheng Chen

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Maxillary defects are usually rehabilitated by a prosthetic obturator. OBJECTIVE: This study aimed to evaluate the functioning of obturators prosthesis in patients with unilateral defects after maxillectomy. METHODS: Of 49 patients, 28 underwent to maxillectomy as a result of tumor ablative surgery, and acquired unilateral maxillary defects. Evaluation of the function was performed by applying the Obturator Functional Scale (OFS. RESULTS: From a total of 49 patients, 28 were treated as follows: 9 with a conventional retained obturator prosthesis (COP, 11 (39% with an enhanced retentive obturator prosthesis with stud attachment (POP and 8 (28% with an enhanced retentive obturator prosthesis with magnetic attachment (POM. The mean OFS score was 80. Scores on functions of speech, swallowing and chewing reached statistical significances (p < 0.05 among these three subgroups. Comparing COP and MOP groups, the scores of OFS in the domains of "Speech-ability to speak in public" and "Swallowing-leakage with liquids" were significantly higher in AOP group. Comparing COP group, the scores of OFS in "Swallowing-leakage with solid" and "Chewing/eating" domains were increased significantly (p < 0.05 both in MOP and AOP groups. CONCLUSION: Obturator prosthesis improves oral function of patients after maxillary defects; the retention of the obturator prosthesis enhanced by the addition of attachments showed more benefits in oral function.

  17. Case presentation of two maxillectomy patients restored with two-piece hollow bulb obturator retained using two different types of magnets

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    B Devi Parameswari

    2017-01-01

    Full Text Available Palatal defect can be repaired by reconstructive surgery and/or a dental prosthesis. We present prosthodontic rehabilitation of two partially edentulous patients, both with surgically induced palatal defect and explains how to achieve the goal for esthetics and phonetics. This also describes the fabrication of a hollow obturator by two piece method, which is simple and may be used as definitive obturator for maximum comfort of the patient. In both the above cases, since the mouth opening is restricted due to surgery, obturator prosthesis is given as two pieces retained with opposite poles of magnet, which facilitates the removal and insertion of the prosthesis.

  18. Case Presentation of Two Maxillectomy Patients Restored with Two-piece Hollow Bulb Obturator Retained using Two Different Types of Magnets.

    Science.gov (United States)

    Parameswari, B Devi; Rajakumar, M; Jagadesaan, N; Annapoorni, H

    2017-11-01

    Palatal defect can be repaired by reconstructive surgery and/or a dental prosthesis. We present prosthodontic rehabilitation of two partially edentulous patients, both with surgically induced palatal defect and explains how to achieve the goal for esthetics and phonetics. This also describes the fabrication of a hollow obturator by two piece method, which is simple and may be used as definitive obturator for maximum comfort of the patient. In both the above cases, since the mouth opening is restricted due to surgery, obturator prosthesis is given as two pieces retained with opposite poles of magnet, which facilitates the removal and insertion of the prosthesis.

  19. A cast partial obturator with hollow occlusal shim and semi-precision attachment

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    Mukesh Kumar Singhal

    2018-01-01

    Full Text Available A maxillofacial patient's quality of life is distorted and social integration becomes difficult. An obturator is a maxillofacial prosthesis used to close a congenital or acquired tissue defect, primarily of the hard palate and/or contiguous alveolar/soft-tissue structures. Subsequently, it restores the esthetics, speech, and function. The present clinical report aimed for the prosthetic rehabilitation of a maxillectomy defect by the incorporation of a semi-precision attachment as PRECI-SAGIX – male part of 2.2 mm on fixed partial denture (#22 and #23 teeth and matrix – plastic female part of size 2.2 mm and height 4.2 mm of yellow on cast partial in polymer base. It aids in the retention of a hollow lightweight obturator. The technique also described the method to make a bulbless obturator with a hollow self-cured acrylic resin occlusal shim. A patient is quite satisfied with bulb less, lightweight cast partial and hollow shim palatal obturator.

  20. Interim obturator in an infant with Treacher Collins syndrome: Review and chairside modification in impression making

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    Sudhir Bhandari

    2011-01-01

    Full Text Available Treacher Collins syndrome has been described as a syndrome involving 1st and 2nd branchial arches, affecting various organs in the craniofacial region. Affected infants report with nasal regurgitation and minimal dietary intake due to cleft palate, consequently show delayed and retarded growth. The situation is further complicated when the repair of the palatal defect is postponed due to delayed milestones. At this juncture, it is of paramount importance to intervene prosthetically and close the defect with the aid of an interim obturator. Herein we describe a simple, yet successful, chairside approach to make an impression of an infant without the aid of any kind of anesthesia.

  1. Stress analysis in oral obturator prostheses, part II: photoelastic imaging

    Science.gov (United States)

    Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; da Silva, Emily Vivianne Freitas; Haddad, Marcela Filié; Moreno, Amália; Zahoui, Abbas; dos Santos, Daniela Micheline

    2014-06-01

    In part I of the study, two attachment systems [O-ring; bar-clip (BC)] were used, and the system with three individualized O-rings provided the lowest stress on the implants and the support tissues. Therefore, the aim of this study was to assess the stress distribution, through the photoelastic method, on implant-retained palatal obturator prostheses associated with different attachment systems: BOC-splinted implants with a bar connected to two centrally placed O-rings, and BOD-splinted implants with a BC connected to two distally placed O-rings (cantilever). One photoelastic model of the maxilla with oral-sinus-nasal communication with three parallel implants was fabricated. Afterward, two implant-retained palatal obturator prostheses with the two attachment systems described above were constructed. Each assembly was positioned in a circular polariscope and a 100-N axial load was applied in three different regions with implants by using a universal testing machine. The results were obtained through photograph record analysis of stress. The BOD system exhibited the highest stress concentration, followed by the BOC system. The O-ring, centrally placed on the bar, allows higher mobility of the prostheses and homogeneously distributes the stress to the region of the alveolar ridge and implants. It can be concluded that the use of implants with O-rings, isolated or connected with a bar, to rehabilitate maxillectomized patients allows higher prosthesis mobility and homogeneously distributes the stress to the alveolar ridge region, which may result in greater chewing stress distribution to implants and bone tissue. The clinical implication of the augmented bone support loss after maxillectomy is the increase of stress in the attachment systems and, consequently, a higher tendency for displacement of the prosthesis.

  2. Simplified feeding appliance for an infant with cleft palate

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    Shaila Masih

    2014-01-01

    Full Text Available A child born with cleft palate may experience difficulties while feeding. Early surgical treatment may need to be postponed until certain age and weight gain of the infant. The case presented here is of a 1-month-old neonate born with cleft palate, assisted with a new feeding appliance made with ethylene vinyl acetate using pressure molding technique to aid in proper feeding. The patient′s weight and health significantly improved after the insertion of obturator. The advantages of this material included being lightweight, moldability, good palatal fit and decreased soft tissue injury.

  3. Herniography off femoral, obturator and perineal hernias

    International Nuclear Information System (INIS)

    Ekberg, O.; Nordblom, I.; Fork, F.T.; Gullmo, A.

    1985-01-01

    Positive contrast herniography was used in the workup of 550 patients with unclear groin pain. The majority of these patients had rather characteristic hernias of indirect, direct or femoral type. However, now and then diagnostic problems arose. A femoral hernia may look like a direct or even obturator hernia. There is also a variety of multilocular femoral hernias and other types. A femoral hernia may be present together with other hernias in the ipsilateral or contralateral groin. Obturator hernias are usually small but are always confined to the obturator canal laterally in the obturator foramen. Abnormalities in the pouch of Douglas may include a deep rectogenital pouch, diverticula and true herniations. These uncommon herniographic findings are described and discussed. (orig.) [de

  4. Two-piece hollow bulb obturator

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    Subramaniam Elangovan

    2011-01-01

    Full Text Available There are various types of obturator fabrication achievable by prosthodontist. Maxillectomy, which is a term used by head and neck surgeons and prosthodontists to describe the partial or total removal of the maxilla in patients suffering from benign or malignant neoplasms is a defect for which to provide an effective obturator is a difficult task for the maxillofacial prosthodontist. Multidisciplinary treatment planning is essential to achieve adequate retention and function for the prosthesis. Speech is often unintelligible as a result of the marked defects in articulation and nasal resonance. This paper describes how to achieve the goal for esthetics and phonetics and also describes the fabrication of a hollow obturator by two piece method, which is simple and maybe used as definitive obturator for maximum comfort of the patient.

  5. Rehabilitation of an edentulous cleft lip and palate patient with a soft palate defect using a bar-retained, implant-supported speech-aid prosthesis: a clinical report.

    Science.gov (United States)

    Hakan Tuna, S; Pekkan, Gurel; Buyukgural, Bulent

    2009-01-01

    Prosthetic rehabilitation of an edentulous cleft lip and palate patient with a combined hard and soft palate defect is a great challenge, due to the lack of retention of the obturator prosthesis as a result of its weight and the inability to obtain a border seal. Dental implants improve the retention, stability, and occlusal function of prostheses when used in carefully selected cleft lip and palate cases. This clinical report presents an edentulous unilateral cleft lip and palate patient who has hard and soft palate defects and an atrophied maxilla, treated with an implant-supported speech-aid prosthesis.

  6. Management of an infant with cleft lip and palate with phocomelia in dental practice.

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    Muthu, M S

    2000-12-01

    Cleft lip and palate is a severe birth defect occurring approximately one in 800-1000 newborn infants. The incidence varies widely among races. Cleft lip and palate together account for approximately 50% of all cases whereas isolated cleft lip and isolated cleft palate occur in about 25% of cases. Many of these congenital anomalies appear to be genetically determined though the majority are of unknown causes or teratogenic influences. Presented here is a 3 day old infant with bilateral cleft lip and palate and phocomelia for whom a feeding obturator was made and delivered to facilitate feeding.

  7. Preservation of palatal mucoperiosteum for oronasal separation after total maxillectomy.

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    Molumi, Charles Paki; Dubey, Siba Prasad; Apaio, Matupi Lorenzz

    2012-01-01

    Oronasal communication occurs after total maxillectomy for advanced sinonasal cancers. This results in feeding, breathing and cosmetic impairment. Various methods have been described to close off the palatal defect from the oral cavity to improve the function of speech and deglutition. The object of this article is to describe our experience of preservation of palatal mucoperiosteum for oronasal separation. Retrospective review of clinical and operative records of 31 total maxillectomy patients where oronasal separation was achieved by the conventional technique of applying a maxillary obturator. The postoperative complications arising from the use of maxillary obturator for oronasal communication after total maxillectomy in these 31 patients were analysed. To avoid the complications encountered in these 31 patients we preserved and used the ipsilateral palatal mucoperiosteum for oronasal separation. This new technique was applied in 12 patients. The results are presented and compared. A total of 43 patients underwent total maxillectomy for advanced sinonasal tumors. In 31 patients the conventional maxillary obturator was used for oronasal separation. Among these patients, 30 had crustation of the maxillary cavity, nasal regurgitation and cheek skin retraction in 15 each, trismus in eight, infection of skin graft donor site in seven, cheek movement during respiration in five and ill-fitting prosthesis in three. In 12 patients palatal mucoperiosteum was preserved and used for oronasal separation. The complications encountered in oronasal separation by palatal prosthesis were avoided in the modified procedure. We found that oronasal separation by preservation of palatal mucoperiosteum following total maxillectomy allowed excellent palatal function, prompt rehabilitation and minimal complications without compromising the prognosis.

  8. Oral function after maxillectomy and reconstruction with an obturator

    NARCIS (Netherlands)

    Kreeft, A.M.; Krap, M.; Wismeijer, D.; Speksnijder, C.M.; Smeele, L.E.; Bosch, S.D.; Muijen, M.S.A.; Balm, A.J.M.

    2012-01-01

    Maxillectomy defects can be reconstructed by a prosthetic obturator or (free) flap transfer, but there is no consensus about the optimal method. This study evaluated 32 maxillectomy patients with prosthetic obturation regarding function (mastication, subjective oral and swallowing complaints and

  9. MR Imaging Features of Obturator Internus Bursa of the Hip

    International Nuclear Information System (INIS)

    Hwang, Ji Young; Lee, Sun Wha; Kim, Jong Oh

    2008-01-01

    The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the 'boomerang'-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium

  10. MR Imaging Features of Obturator Internus Bursa of the Hip

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Ji Young; Lee, Sun Wha; Kim, Jong Oh [School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2008-08-15

    The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the 'boomerang'-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium

  11. Prosthetic Rehabilitation of Maxillectomy Patient with Post-Surgical Obturator: A Case Report

    Directory of Open Access Journals (Sweden)

    Meena Kumari Mishra

    2015-07-01

    Full Text Available Case description: A 60 year old female patient presented to Department of Prosthodontics, CODS, BPKIHS, Dharan with a chief complain of loose obturator. History revealed that patient had undergone partial maxillectomy for squamous cell carcinoma 7 years back. The patient also has been wearing obturator which was loose when the patient reported to the department. On examination, the site of surgery was the maxillary right buccal sulcus area and a part of the hard palate including teeth number 11, 12, 13, 14, 15, 16, 17. The presented defect situation corresponded to a Class I situation (resection performed along the palatalmidline according to the Aramany classification of defects. The surgical site showed complete healing. A hollow-bulb obturator was fabricated for rehabilitation of the defect. Conclusion: The extensive surgical procedures necessary to eradicate cancer of the head and neck and to prevent local recurrence or regional metastasis often leave extremely large physical defects which present almost insurmountable surgical difficulties in restoring acceptable function or esthetics. The prosthesis rehabilitated the patient in terms of function by providing better masticatory efficiency, phonetics by adding resonance to the voice, hence improving the clarity of speech and also improved the esthetics of the patient. DOI: http://dx.doi.org/10.3126/jcmsn.v10i4.12976 JCMS Nepal 2014; 10(4:32-36

  12. Prosthetic reconstruction with an obturator using swing-lock attachment for a patient underwent maxillectomy: A clinical report

    Science.gov (United States)

    2016-01-01

    Patients who underwent resection of maxilla due to benign or malignant tumor, or accident will have defect in palatal area. They get retention, support and stability from remaining tissues which are hardly optimal. The advantage of swing-lock attachment design is having multiple contacts on labial and lingual side of the abutment teeth by retentive strut and palatal bracing component. Because the force is distributed equally to abutment teeth, abutment teeth of poor prognosis can be benefited from it. It is also more advantageous to cover soft tissue defects which are hard to reach with conventional prosthesis. A 56-year-old female patient who had undergone a maxillectomy due to malignant melanoma complaining of loose and unstable surgical obturator. Surveyed crowns were placed on #12, 26, and 27. Teeth #11, 21, 22, and 23 had lingual rest seat and #24 had mesial rest seat to improve stability and support of the obturator. This clinical report presents the prosthetic management of a patient treated with obturator on the maxilla using swing-lock attachment to the remaining teeth. PMID:27826392

  13. Finite element analysis of maxillary bone stress caused by Aramany Class IV obturator prostheses.

    Science.gov (United States)

    Miyashita, Elcio Ricardo; Mattos, Beatriz Silva Câmara; Noritomi, Pedro Yoshito; Navarro, Hamilton

    2012-05-01

    The retention of an Aramany Class IV removable partial dental prosthesis can be compromised by a lack of support. The biomechanics of this obturator prosthesis result in an unusual stress distribution on the residual maxillary bone. This study evaluated the biomechanics of an Aramany Class IV obturator prosthesis with finite element analysis and a digital 3-dimensional (3-D) model developed from a computed tomography scan; bone stress was evaluated according to the load placed on the prosthesis. A 3-D model of an Aramany Class IV maxillary resection and prosthesis was constructed. This model was used to develop a finite element mesh. A 120 N load was applied to the occlusal and incisal platforms corresponding to the prosthetic teeth. Qualitative analysis was based on the scale of maximum principal stress; values obtained through quantitative analysis were expressed in MPa. Under posterior load, tensile and compressive stresses were observed; the tensile stress was greater than the compressive stress, regardless of the bone region, and the greatest compressive stress was observed on the anterior palate near the midline. Under an anterior load, tensile stress was observed in all of the evaluated bone regions; the tensile stress was greater than the compressive stress, regardless of the bone region. The Aramany Class IV obturator prosthesis tended to rotate toward the surgical resection when subjected to posterior or anterior loads. The amount of tensile and compressive stress caused by the Aramany Class IV obturator prosthesis did not exceed the physiological limits of the maxillary bone tissue. (J Prosthet Dent 2012;107:336-342). Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  14. Predictors of obturator functioning and satisfaction in Turkish patients using an obturator prosthesis after maxillectomy.

    Science.gov (United States)

    Ozdemir-Karatas, Meltem; Balik, Ali; Evlioglu, Gülümser; Uysal, Ömer; Peker, Kadriye

    2018-03-01

    The aim of this study was to determine the sociodemographic, behavioral, and clinical factors affecting obturator function and satisfaction using the obturator functioning scale (OFS) in maxillectomy patients rehabilitated with obturator prostheses. The study sample consisted of 41 maxillectomy patients. The OFS was translated into Turkish and adapted for assessing obturator functioning and patient satisfaction among Turkish patients. Data were collected from patients' medical records and self-completed questionnaires, including the Turkish version of the OFS, sociodemographic and behavioral characteristics. Descriptive statistics, Mann-Whitney U test, Spearman's correlation coefficient, and backward stepwise multiple linear regression were used for data analysis. Internal consistency (Cronbach's alpha = 0.85) and test-retest reliability (intraclass correlation coefficient = 0.86) were acceptable for the OFS. The most frequently reported problem was "difficulty chewing." Bivariate analysis revealed significant differences in total OFS scores in terms of surgery type, defect size, and education level, except for the other clinical and sociodemographic characteristics and behavioral factors. Education level and surgery type were found to be the most important predictors of patient satisfaction and functioning of the obturator. The Turkish version of the OFS might be a useful tool for clinicians to identify patients who are at risk for poor functioning of the obturator, lack of satisfaction, and unmet needs. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Adequacy of velopharyngeal closure and speech competency following prosthetic management of soft palate resection

    International Nuclear Information System (INIS)

    ElDakkak, M

    1999-01-01

    Ten patients who had undergone soft palate resection for the removal of palatal tumors were studied. In each patient, the surgical defect involved the posterior margin of the soft palate and lead to velopharyngeal insufficiency. None of the patients suffered any speech, hearing or nasal problems before surgery. For each patient, a speech aid obturator was constructed and was used at least one month before the evaluation. Prosthetic management of each subject was evaluated as reflected in adequacy of velopharyngeal closure and speech competency. Various aspects of speech including intelligibility, articulation, nasality, hoarseness and overall speech were correlated with the adequacy of velopharyngeal closure. (author)

  16. Obturator Definitive Mandibula Post Hemimandibulectomy Sinistra

    Directory of Open Access Journals (Sweden)

    Paul Sugiyo

    2012-12-01

    Full Text Available Latar Belakang. Operasi bedah pemotongan mandibula pada kasus tumor jinak maupun tumor ganas dapat menyebabkan deviasi mandibula. Tindakan perawatan bedah tergantung pada lokasi dan perluasan tumor mandibula, tindakan perawatan bedah tersebut meliputi bedah marginal, segmental, hemimandibulectomy, dan total mandibulectomy. Tujuan. Makalah ini menjelaskan tentang perawatan rehabilitasi dengan obturator definitive mandibula. Para klinisi harus menunggu masa penyembuhan yang sempurna sebelum disarankan untuk dibuatkan onturator definitive mandibula. Sejak awal penyembuhan diperlukan intervensi prostodontis untuk mencegah deviasi mandibula. Protesa ini membantu pergerakan mandibula secara normal tanpa terjadi penyimpangan pada fungsi bicara dan pengunyahan. Laporan Kasus. Pada bulan Maret 2012, pasien laki-laki, berumur 46 tahun datang ke RSGM Bagian Prostodonsia atas rujukan dari RS. Dr. Sardjito Bagian Bedah Mulut setelah dilakukan operasi tumor ameloblastoma mandibula sinistra (post hemimandibulectomy mandibula sinistra dengan pemasangan plat rekonstruksi tiga bulan sebelumnya untuk dibuatkan obturator definitive mandibula. Pasien mengeluh bibir bawah sebelah kiri sering tergigit, fungsi bicara, fungsi pengunyahan, dan penampilannya terganggu. Hasil. Setelah dilakukan perawatan dengan memakai obturator definitive mandibula dalam kurun waktu 8 bulan, hingga saat ini hasil perawatan ini dapat mengembalikan fungsi bicara, fungsi pengunyahan, dan fungsi estetik sehingga pasien merasa lebih nyaman dan percaya diri. Kesimpulan. Deviasi mandibula setelah operasi hemimandibulectomy diatasi dengan bedah rekonstruksi menggunakan plat rekonstruksi, kemudian segera setelah penyembuhan perlu melibatkan prostodontis untuk pemasangan obturator definitive mandibula.    Background. Surgical restion of the mandible due to presence of benign or malignant tumor is the common cause of the mandibular deviation. Depending upon the location and extent of the tumor in

  17. Manufacturing hollow obturator with resilient denture liner on post hemimaxillectomy

    Directory of Open Access Journals (Sweden)

    Michael Josef Kridanto Kamadjaja

    2006-03-01

    Full Text Available A resilient denture liner is placed in the part of the hollow obturator base that contacts to post hemimaxillectomy mucosa. Replacing the resilient denture liner can makes the hollow obturator has an intimate contact with the mucosa, so it can prevents the mouth liquid enter to the cavum nasi and sinus, also eliminates painful because of using the hollow obturator. Resilient denture liner is a soft and resilient material that applied to the fitting surface of a denture in order to allow a more distribution of load. A case was reported about using the hollow obturator with resilient denture liner on post hemimaxillectomy to overcome these problems.

  18. Endodontic Management of Maxillary Second Molar with Two Palatal Roots: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Surbhi Patel

    2012-01-01

    Full Text Available Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment protocol. Maxillary second molars are recognized as usually having a single palatal root with a single palatal canal. The incidence of second palatal root in the maxillary second molar is very rare. Two cases are presented in this paper describing the endodontic management of a four-rooted maxillary second molar with two distinct palatal roots and canals and two distinct buccal roots and canals. Clinical examination and radiographs showed the presence of two palatal roots during the root canal procedure. The canals were biomechanically prepared with crown-down technique and obturated using lateral condensation technique with AH-Plus sealer.

  19. Obturator hernia: a rare case of acute mechanical intestinal obstruction.

    Science.gov (United States)

    Aydin, Ibrahim; Yucel, Ahmet Fikret; Pergel, Ahmet; Sahin, Dursun Ali

    2013-01-01

    Obturator hernia is a rare type of pelvic hernia which generally occurs in elderly patients with accompanying diseases. Because it is difficult to diagnose before surgery, the morbidity and mortality rates for obturator hernia are high. The most common symptom is strangulation combined with mechanical intestinal obstruction.

  20. Obturator Hernia: A Rare Case of Acute Mechanical Intestinal Obstruction

    Directory of Open Access Journals (Sweden)

    Ibrahim Aydin

    2013-01-01

    Full Text Available Obturator hernia is a rare type of pelvic hernia which generally occurs in elderly patients with accompanying diseases. Because it is difficult to diagnose before surgery, the morbidity and mortality rates for obturator hernia are high. The most common symptom is strangulation combined with mechanical intestinal obstruction.

  1. Obturator foramen dissection for excision of symptomatic transobturator mesh.

    Science.gov (United States)

    Reynolds, W Stuart; Kit, Laura Chang; Kaufman, Melissa R; Karram, Mickey; Bales, Gregory T; Dmochowski, Roger R

    2012-05-01

    Groin pain after transobturator synthetic mesh placement can be recalcitrant to conservative therapy and ultimately requires surgical excision. We describe our experiences with and technique of obturator foramen dissection for mesh excision. The records of 8 patients treated from 2005 to 2010, were reviewed. Obturator dissection was performed via a lateral groin incision over the inferior pubic ramus at the level of the obturator foramen, typically in conjunction with orthopedic surgery. Five patients had transobturator mid urethral sling surgery for stress urinary incontinence, 2 had mid urethral sling and trocar based anterior vaginal wall mesh kits with transobturator passage of mesh arms for stress urinary incontinence and pelvic organ prolapse, and 1 had an anterior vaginal wall mesh kit for pelvic organ prolapse. Patients had 0 to 2 prior transvaginal mesh excisions before obturator surgery. All patients presented with intractable pain in the area of the obturator foramen and/or medial groin for which conservative treatment measures had failed. Six patients underwent concurrent vaginal and obturator dissection and 2 underwent obturator dissection alone. In all cases residual mesh (3 to 11 cm) was identified and excised from the obturator foramen. Mesh was closely associated to or traversing the adductor longus muscle and tendon with significant fibrous reaction in all cases. Postoperatively 5 patients were cured of pain and/or infection, and 3 reported no or some improvement at a mean followup of 6 months (range 1 to 12). Our experience suggests that surgical excision of residual mesh can alleviate many of the symptoms in many patients. In all cases mesh remnants were identified and removed, and typically involved neuromuscular structures adjacent to the obturator foramen. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  2. Cleft Palate Foundation

    Science.gov (United States)

    ... craniofacial journeys. Read the press release here. American Cleft Palate-Craniofacial Association 1504 East Franklin Street, Suite 102 ... order bottles Order ACPA publications © Copyright 2017 American Cleft Palate-Craniofacial Association. Website by Mixer Creative Follow us ...

  3. Modified Nance palatal button

    Directory of Open Access Journals (Sweden)

    Nitin Arora

    2015-01-01

    Full Text Available This paper describes modified Nance palatal button by which problems encountered in the palatal region around the acrylic button during space closure and molar distalization can be minimized.

  4. Evolution of oral cancer treatment in an andalusian population sample: Rehabilitation with prosthetic obturation and removable partial prosthesis.

    Science.gov (United States)

    Flores-Ruiz, Rafael; Castellanos-Cosano, Lizette; Serrera-Figallo, María-Angeles; Gutiérrez-Corrales, Aida; Gonzalez-Martin, Maribel; Gutiérrez-Pérez, Jose-Luis; Torres-Lagares, Daniel

    2017-08-01

    Radical surgical resection as a treatment modality for oral cancer often leads to an extensive deficit in both the maxillary and mandibular levels, where the use of a palatal obturator prosthesis (POP) or removable partial denture (RPP). The aim of this study was to evaluate the treatment with POP and RPP in patients treated for oral cancer in the Unit of Prosthetic Rehabilitation of the University Hospital Virgen del Rocío in a period of 20 years. Retrospective descriptive study during the years 1991 and 2011 analyzing oral cancer type, characteristics, treatment and follow-up. The sample consisted of patients whose tumor had previously been removed and who had been referred to the Oncological Rehabilitation Unit of the Oral and Maxillofacial Surgery Unit of the "Virgen del Rocío" University Hospital for rehabilitation. The inclusion criteria were patients whose underlying pathology was any type of neoplasia, which after its treatment had been referred to the aforementioned Oncological Prosthetic Rehabilitation unit. Of the 45 patients included in our study, 15 patients were rehabilitated with palatal obturator (33.3%) and 5 patients with removable partial denture (11.1%). The mean age of the sample of patients with POP was 57.3 ± 9.23, while the mean age of the sample of patients with RPP was 58 ± 13.5. The most common underlying pathology in patients with POP was squamous cell carcinoma (60%), whereas in patients with RPP it was 100%. The most frequent location found among POP patients was the upper jaw, while in the PRP patients there was no predominant location. The univariate and multivariate logistic regressions did not show any statistically significant association between the independent variables age, sex, smoking habit and alcoholic habit with the dependent variable type of rehabilitating prosthesis. Based on our data, we can conclude that RPP is used in few cases of oncological rehabilitation. The POP has a greater use, as long as the defect in the

  5. Speech rehabilitation of maxillectomy patients with hollow bulb obturator.

    Science.gov (United States)

    Kumar, Pravesh; Jain, Veena; Thakar, Alok

    2012-09-01

    To evaluate the effect of hollow bulb obturator prosthesis on articulation and nasalance in maxillectomy patients. A total of 10 patients, who were to undergo maxillectomy, falling under Aramany classes I and II, with normal speech and hearing pattern were selected for the study. They were provided with definitive maxillary obturators after complete healing of the defect. The patients were asked to wear the obturator for six weeks and speech analysis was done to measure changes in articulation and nasalance at four different stages of treatment, namely, preoperative, postoperative (after complete healing, that is, 3-4 months after surgery), after 24 hours, and after six weeks of providing the obturators. Articulation was measured objectively for distortion, addition, substitution, and omission by a speech pathologist, and nasalance was measured by Dr. Speech software. The statistical comparison of preoperative and six weeks post rehabilitation levels showed insignificance in articulation and nasalance. Comparison of post surgery complete healing with six weeks after rehabilitation showed significant differences in both nasalance and articulation. Providing an obturator improves the speech closer to presurgical levels of articulation and there is improvement in nasality also.

  6. Speech rehabilitation of maxillectomy patients with hollow bulb obturator

    Directory of Open Access Journals (Sweden)

    Pravesh Kumar

    2012-01-01

    Full Text Available Aim: To evaluate the effect of hollow bulb obturator prosthesis on articulation and nasalance in maxillectomy patients. Materials and Methods: A total of 10 patients, who were to undergo maxillectomy, falling under Aramany classes I and II, with normal speech and hearing pattern were selected for the study. They were provided with definitive maxillary obturators after complete healing of the defect. The patients were asked to wear the obturator for six weeks and speech analysis was done to measure changes in articulation and nasalance at four different stages of treatment, namely, preoperative, postoperative (after complete healing, that is, 3-4 months after surgery, after 24 hours, and after six weeks of providing the obturators. Articulation was measured objectively for distortion, addition, substitution, and omission by a speech pathologist, and nasalance was measured by Dr. Speech software. Results: The statistical comparison of preoperative and six weeks post rehabilitation levels showed insignificance in articulation and nasalance. Comparison of post surgery complete healing with six weeks after rehabilitation showed significant differences in both nasalance and articulation. Conclusion: Providing an obturator improves the speech closer to presurgical levels of articulation and there is improvement in nasality also.

  7. Obturator externus was larger, while obturator internus size was similar in ballet dancers compared to nondancing athletes.

    Science.gov (United States)

    Mayes, Susan; Ferris, April-Rose; Smith, Peter; Cook, Jill

    2018-06-02

    To compare the cross-sectional area (CSA) of hip external rotators, obturator externus (OE) and obturator internus (OI), in ballet dancers and nondancing athletes, and evaluate the relationship between obturator muscle size and hip pain. Case-control study. Elite ballet and sport. 33 male and female professional ballet dancers and 33 age and sex-matched athletes. CSA's of OE and OI measured on magnetic resonance imaging (MRI) of one hip. Hip pain was scored with the Copenhagen Hip and Groin Outcome Score (HAGOS): HAGOS pain score of 100 was defined as no pain and a score less than 100 was defined as pain. Participants weight and height. Estimated marginal mean CSA of OE was 14% larger in dancers than athletes (p = 0.01, ηp2 = 0.1); the size of OI was similar (p > 0.05). Men and women in both groups had similar sized OI and OE. There was no interaction between the estimated marginal mean CSA of either obturator and hip pain. It appears that ballet selectively increases muscle size of OE, but not OI. Obturator size was not related to mild hip pain, as OE and OI size was similar in dancers and athletes with and without pain. Copyright © 2018. Published by Elsevier Ltd.

  8. Obturator nerve schwannoma presenting as an adnexal mass: case report

    Energy Technology Data Exchange (ETDEWEB)

    Mehta, M.; Thurston, W.A.; Merchant, N. [The Toronto Hospital, Dept. of Medical Imaging, Toronto, Ontario (Canada); Murphy, K.J. [The Toronto Hospital, Dept. of Obstetrics and Gynecology, Toronto, Ontario (Canada)

    1999-02-01

    Schwannomas are relatively common, benign nerve-sheath tumours. They arise most commonly from either cranial nerves or the dorsal root of spinal nerves. Schwannomas have also been reported to occur in peripheral nerve-root trunks, although this location is much less common. We report a case of a 45-year-old woman with a large pelvic mass originally believed to be an ovarian tumour. Following surgical excision, the tumour was found to be a schwannoma of the obturator nerve. To our knowledge, there are no reported cases of an obturator nerve schwannoma. The imaging features of schwannomas are reviewed. (author)

  9. A conservative method of retaining an interim obturator for a total maxillectomy patient

    Directory of Open Access Journals (Sweden)

    Nirmal Famila Bettie

    2017-01-01

    Full Text Available Interim obturators are indicated during the postsurgical phases. It promotes surgical healing and serves as a temporary prosthesis to rehabilitate a patient with intra-oral surgical defect. Retention is gained by wiring, surgical suturing, and other noninvasive methods to enable functional rehabilitation and easy replacement with a permanent obturator. Interim obturators serve as an easy guide for replacing with definitive obturators by indicating prosthesis extensions and the required method of retention. A more conservative and noninvasive method of retaining an interim obturator for a maxillectomy patient is described in this case report.

  10. A Conservative Method of Retaining an Interim Obturator for a Total Maxillectomy Patient.

    Science.gov (United States)

    Bettie, Nirmal Famila

    2017-11-01

    Interim obturators are indicated during the postsurgical phases. It promotes surgical healing and serves as a temporary prosthesis to rehabilitate a patient with intra-oral surgical defect. Retention is gained by wiring, surgical suturing, and other noninvasive methods to enable functional rehabilitation and easy replacement with a permanent obturator. Interim obturators serve as an easy guide for replacing with definitive obturators by indicating prosthesis extensions and the required method of retention. A more conservative and noninvasive method of retaining an interim obturator for a maxillectomy patient is described in this case report.

  11. Cleft Lip and Palate

    Science.gov (United States)

    Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly. They happen early during ... A baby can have a cleft lip, a cleft palate, or both. A cleft lip happens if the ...

  12. Oral function after maxillectomy and reconstruction with an obturator.

    Science.gov (United States)

    Kreeft, A M; Krap, M; Wismeijer, D; Speksnijder, C M; Smeele, L E; Bosch, S D; Muijen, M S A; Balm, A J M

    2012-11-01

    Maxillectomy defects can be reconstructed by a prosthetic obturator or (free) flap transfer, but there is no consensus about the optimal method. This study evaluated 32 maxillectomy patients with prosthetic obturation regarding function (mastication, subjective oral and swallowing complaints and maximal mouth opening). Outcomes were related to the extent of the resection (Brown maxillectomy classification), dentition and history of adjuvant radiotherapy. Maxillectomy defects ranged from 2-1 to 4B on the Brown classification, and most had a defect graded as 2-A or 2-B. Mean mixing ability test after 10 chewing strokes was 24.2 and after 20 chewing strokes 19.7, which compares to edentulous healthy individuals. None of the outcomes was influenced by Brown classification. Radiotherapy negatively influenced mean maximal mouth opening (29.1mm versus 40.9 mm, p=0.017) and subjective outcomes. Edentate obturated patients had worse outcomes than dentate patients, measured by mixing ability test and questionnaire. In conclusion, mastication after obturator reconstruction of a maxillectomy defect is comparable to mastication with full dentures. Size of the maxillectomy defect did not significantly influence functional outcome, but adjuvant radiotherapy resulted in worse mouth opening and self-reported oral and swallowing problems. Residual dentition had a positive influence on mastication and subjective outcomes. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Bowel obstruction in obturator hernia: A challenging diagnosis

    Directory of Open Access Journals (Sweden)

    L. Conti

    2018-01-01

    Conclusion: Obturator hernia is a rare type of hernia due to his diagnosis, which is often unclear; a prompt suspect based for the non-specific symptoms is crucial for the diagnosis. Surgical management depends on early diagnosis and it is the only possible treatment for this pathology.

  14. Obturator Hernia: diagnosis and management under conditions of ...

    African Journals Online (AJOL)

    85.7%) underwent full resection and anastomosis, and one (14.3%) had partial resection. Hernia defect was closed in four (57.1%). Wound infection was common (71.4%) and three (43%) died. Conclusion: Obturator hernia is mainly a disease ...

  15. Fabrication of Closed Hollow Bulb Obturator Using Thermoplastic Resin Material

    Directory of Open Access Journals (Sweden)

    Bidhan Shrestha

    2015-01-01

    Full Text Available Purpose. Closed hollow bulb obturators are used for the rehabilitation of postmaxillectomy patients. However, the time consuming process, complexity of fabrication, water leakage, and discoloration are notable disadvantages of this technique. This paper describes a clinical report of fabricating closed hollow bulb obturator using a single flask and one time processing method for an acquired maxillary defect. Hard thermoplastic resin sheet has been used for the fabrication of hollow bulb part of the obturator. Method. After fabrication of master cast conventionally, bulb and lid part of the defect were formed separately and joined by autopolymerizing acrylic resin to form one sized smaller hollow body. During packing procedure, the defect area was loaded with heat polymerizing acrylic resin and then previously fabricated smaller hollow body was adapted over it. The whole area was then loaded with heat cure acrylic. Further processes were carried out conventionally. Conclusion. This technique uses single flask which reduces laboratory time and makes the procedure simple. The thickness of hollow bulb can be controlled and light weight closed hollow bulb prosthesis can be fabricated. It also minimizes the disadvantages of closed hollow bulb obturator such as water leakage, bacterial infection, and discoloration.

  16. From birth till palatoplasty: Prosthetic procedural limitations and safeguarding infants with palatal cleft

    Directory of Open Access Journals (Sweden)

    Sudhir Bhandari

    2018-01-01

    Full Text Available The most imminent issue to be addressed in a child born with cleft lip and/or palate is restoration of normal feeding. Early surgical treatment for cleft repair is crucial but may need to be postponed until certain age and weight gain is attained in an infant. When other feeding interventions fail in these children, prosthetic obturation of the defect with feeding instructions in the interim period is indicated to ward off the prevailing concerns. However, the entire prosthetic management presents a significant challenge with respect to the child's age, scope of iatrogenic injury to the delicate oral tissues, and potential for life-threatening situation during the procedures. This article draws attention toward preemptive measures which should be undertaken in the clinical setting during the fabrication of obturator to ascertain a desirable outcome without experiencing a grave complication that may arise due to ignorance and/or lack of facilities.

  17. Quality of life after maxillectomy and prosthetic obturator rehabilitation.

    Science.gov (United States)

    Chigurupati, Radhika; Aloor, Neelam; Salas, Richard; Schmidt, Brian L

    2013-08-01

    Surgical resection of midface neoplasms and subsequent reconstruction have been shown to have significant negative effects on quality of life (QOL). The purpose of this pilot study was to assess individuals' health-related QOL after maxillectomy and reconstruction with a prosthetic obturator. The QOL of 25 of 43 patients who underwent maxillectomy and prosthetic obturator reconstruction at the University of California-San Francisco was assessed using 3 questionnaires: University of Washington Quality of Life version 4 (UWQOL), Obturator Functioning Scale (OFS), and Mental Health Inventory (MHI). The response rate to the QOL questionnaires was 92% (23 of 25 patients). Time elapsed from maxillectomy and prosthetic obturator reconstruction to the QOL survey response ranged from 0.3 to 6.6 years (mean, 2.7 years; standard deviation [SD], 1.9 years). The post-treatment mean QOL scores were 77.3 (SD, 13.6) for UWQOL, 72.0 (SD, 12.6) for OFS, and 4.5 (SD, 0.9) for Mental Health Inventory. Individuals who received adjuvant radiation scored lower for speech and appearance (OFS, P = .05, P = .03, respectively) as well as for saliva and overall QOL (UWQOL, P = .02, P = .08, respectively). There was a strong correlation between QOL scores in OFS and UWQOL questionnaires (r = 0.78, P maxillectomy and prosthetic obturator reconstruction. There is further need for a multicenter trial with a larger sample to identify how factors affecting QOL of patients after maxillectomy might influence the choice of reconstruction. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Cleft Lip and Cleft Palate

    Science.gov (United States)

    ... health conditions > Cleft lip and cleft palate Cleft lip and cleft palate E-mail to a friend Please fill in ... repair cleft lip and palate. What are cleft lip and cleft palate? Cleft lip is a birth defect in which ...

  19. Comparing low volume saphenous-obturator block with placebo and femoral-obturator block for anterior cruciate ligament reconstruction: a randomized controlled trial

    DEFF Research Database (Denmark)

    Lenz, Katja; Jensen, Kenneth; Tanggaard, Katrine

    2018-01-01

    BACKGROUND: Anterior cruciate ligament reconstruction (ACL-RC) is often associated with moderate to severe postoperative pain even with a multimodal analgesic regimen. We aimed to compare the analgesic efficacy of low volume saphenous-obturator block with placebo and femoral- obturator block in p...

  20. Essential Palatal Myoclonus

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    Bhuwan Raj Pandey

    2017-06-01

    Full Text Available Introduction: Palatal myoclonus is a rare condition presenting with clicking sound in ear or muscle tremor in pharynx. There are two varieties: essential and symptomatic. Various treatment options exists ranging from watchful observation to botulinum toxin injection. We have not found any reported case of palatal myoclonus from our country. Here we present a case of essential palatal myoclonus managed with clonazepam. Case report: A young female presented in Ear Nose and Throat clinic with complain of auditory click and spontaneous rhythmic movement of throat muscles for eight months. On examination, there was involuntary, rhythmic contraction of bilateral soft-palate, uvula, and base of tongue. Neurological, eye, and peripheral examination were normal. A diagnosis of essential palatal myoclonus was made. It was managed successfully with clonazepam; patient was still on low dose clonazepam at the time of making this report. Conclusion: Essential palatal myoclonus can be clinically diagnosed and managed even in settings where MRI is not available or affordable.

  1. Rehabilitation of Posterior Maxilla with Obturator Supported by Zygomatic Implants

    Directory of Open Access Journals (Sweden)

    Sankalp Mittal

    2018-01-01

    Full Text Available Prosthetic rehabilitation of atrophic maxilla and large maxillary defects can be done successfully by zygomatic implant-supported prosthesis. Zygomatic implants are an avant-garde to complex and invasive-free vascularised osteocutaneous flaps, distraction osteogenesis, and the solution to flap failures. A treated case of tuberculous osteomyelitis, with a class II (Aramany’s classification maxillary defect, reported to oral maxillofacial department, Government Dental College (RUHS-CODS. The defect in this group was unilateral, retaining the anterior teeth. The patient was previously rehabilitated with a removable maxillary obturator. Inadequate retention affected essential functions like speaking, mastication, swallowing, esthetics, and so on due to lack of sufficient supporting tissues. A fixed prosthetic rehabilitation of posterior maxillary defect was done with obturator supported with two single-piece zygomatic implants. At 1-year follow-up, the patient was comfortable with the prosthesis, and no further complaints were recorded.

  2. Management of maxillectomy defect with a hybrid hollow bulb obturator

    Science.gov (United States)

    Singh, Kamleshwar; Singh, Saumyendra V; Mishra, Niraj; Agrawal, Kaushal Kishor

    2013-01-01

    A woman having already undergone maxillectomy came to the department complaining of difficulty in eating and speech. During the construction of an obturator, the bulb area should be hollowed to reduce weight so that the teeth and supporting tissues are not stressed unnecessarily. The conventional open design drains fluid from the adjacent mucosa, possibly increasing the weight of the prosthesis, and is difficult to clean. The closed bulb design does not drain secretions and may cause obstruction and susceptibility to infection in the paranasal and pharyngeal regions, though it is easier to maintain. An alternative to the two designs, combining their advantages, is presented in this report. As the open hollow part of the obturator was shallow, it was easy to clean. Making the inferior part of the bulb hollow and closed led to a reduction in the overall weight of the prosthesis while increasing its resonance. PMID:23436886

  3. [Clinical-diagnostic estimation of carbohydrates metabolism in obturation jaundice].

    Science.gov (United States)

    Nychytaĭlo, M Iu; Malyk, S V

    2004-07-01

    Complex examination of 175 patients with obturation jaundice was conducted, peculiar attention was spared to the carbohydrates metabolism changes, characterizing hepatic state. It was established, that in obturation jaundice in the liver there are occurring inflammatory changes and disturbances of all kinds of metabolism, including that of carbohydrates, severity of which depends on duration of jaundice, the concurrent diseases presence, they shows lowering of the glucose and glycogen level in the blood, as well as the hepatic glycogen content, that's why they may be applied as a complex of prognostic criterions for the disease course. An early conduction of operative treatment, elimination of the biliary ducts impassability promote the rehabilitation period shortening and the hepatic functional activity normalization.

  4. Uso de obturadores en cirugía oral y maxilofacial: Presentación de cinco casos clínicos Use of obturators in oral and maxillofacial surgery: A report of five cases

    Directory of Open Access Journals (Sweden)

    R.T. Velázquez-Cayón

    2011-03-01

    Full Text Available Los defectos creados en el maxilar, principalmente tras cirugía resectiva de tumores malignos, traumatismo o defectos congénitos, deben ser corregidos con el fin de recuperar los consecuentes déficits en el habla, la deglución, la masticación y la estética. Para ello contamos con dos amplias posibilidades: reconstrucción quirúrgica o colocación de un obturador protésico maxilar. En este artículo llevamos a cabo una revisión de la literatura reciente y clásica sobre obturadores palatinos, ilustrándola mediante 5 casos clínicos con esta opción terapéutica. Hemos encontrado descritas una amplia variedad de modificaciones para los distintos tipos de obturadores, como la fabricación de aletas nasales, colocación de obturadores de forma inmediata tras la cirugía, el hecho de ahuecar el aditamento obturador, etc. En nuestra práctica hemos observado una serie de ventajas en la colocación de este tipo de prótesis de forma posquirúrgica diferida y en estrecha colaboración con su médico responsable.Defects created in the maxillary bone, principally after surgical resection of malignant tumors, trauma or congenital defects, must be corrected to eliminate the resulting speech, swallowing, and chewing defects and restore the cosmetic appearance. Two major options available are surgical reconstruction or the placement of a maxillary obturator prosthesis. The recent and classic literature on palatal obturators is reviewed and five clinical cases treated with a palatal obturator are reported. A large variety of modifications have been reported for different types of obturators, such as nasal wings, immediate postoperative obturator prosthesis placement, etc. In the authors' experience, deferred postoperative obturator placement in close collaboration with the responsible doctor has advantages.

  5. Enhanced retention of a maxillofacial prosthetic obturator using precision attachments: Two case reports

    OpenAIRE

    Murat, Sema; Gurbuz, Ayhan; Isayev, Abulfaz; Dokmez, Bahadir; Cetin, Unsun

    2012-01-01

    The majority of maxillary defects can be rehabilitated with conventional simple obturator prosthesis. However, inadequate retention, stability and support may be associated with the use of an obturator. Precision attachments have been used to retain obturators for some time. The use of precision attachments in a dentate maxillectomy patient can yield significant functional improvement while maintaining the obturator’s aesthetic advantages. This clinical report describes the prosthetic rehabil...

  6. Obturator Neuromodulation with Laparoscopic Placement of an Obturator Lead for the Treatment of Intractable Opioid Dependent Chronic Pelvic Pain due to Obturator Neuralgia.

    Science.gov (United States)

    Marvel, Richard P

    2018-05-12

    Chronic pelvic pain(CPP) is a common condition in women that can have a devastating effect on quality of life. Some of the most severe forms of CPP are related to peripheral nerve injuries causing persistent neuropathic pain. This is a case of a young woman with severe opioid dependent chronic pelvic and right groin pain due to obturator neuralgia. She had failed a multitude of treatments including multiple medications, manual physical therapy, nerve blocks, surgical neurolysis and spinal cord stimulation without significant benefit. She underwent a trial of peripheral neuromodulation of the obturator nerve with laparoscopic placement of a quadripolar lead. During the 6-day trial she had almost complete relief of her pain; therefore, she underwent permanent implantation of an intermittent pulse generator. Over the next 6 months she was completely weaned completely off her chronic opioids. At 23 months post implantation, she had essentially no pain and is no longer on any analgesic, antidepressant or membrane stabilizing medications. Peripheral Neuromodulation has the potential to alleviate pain and significantly improve quality of life in women with longstanding neuropathic chronic pelvic pain who have failed multimodal conservative therapy. Copyright © 2018. Published by Elsevier Inc.

  7. Cleft Lip and Palate Surgery

    Science.gov (United States)

    ... The experts in face, mouth and jaw surgery. Cleft Lip / Palate and Craniofacial Surgery This type of surgery is ... the carefully orchestrated, multiple-stage correctional program for cleft lip and palate patients. The goal is to help restore the ...

  8. Cleft Palate; A Multidiscipline Approach.

    Science.gov (United States)

    Stark, Richard B., Ed.

    Nineteen articles present a multidisciplinary approach to the management of facial clefts. The following subjects are discussed: the history of cleft lip and cleft palate surgery; cogenital defects; classification; the operation of a cleft palate clinic; physical examination of newborns with cleft lip and/or palate; nursing care; anesthesia;…

  9. Root canal obturation of primary teeth: Disposable injection technique

    Directory of Open Access Journals (Sweden)

    S K Bhandari

    2012-01-01

    Full Text Available The aim of the study was to outline a simple, cost-effective technique for obturation of primary tooth root canals. A total of 75 primary teeth were treated in 52 subjects by the technique discussed, i.e. injecting plastic flowable material into the root canals after desired preparation, using disposable needle and syringe. All the patients were followed up for 3 years and 6 months, with no clinical or radiologic evidence of pathology or need for untimely extraction. In conclusion, the technique described is simple, economical, can be used with almost all filling materials used for the purpose, and is easy to master with minimal chances of failure.

  10. Strangulated obturator hernia - an unusual presentation of intestinal obstruction.

    LENUS (Irish Health Repository)

    Zeeshan, Saqib

    2012-01-31

    An 81-year-old Caucasian emaciated female presented with 3 days history of colicky abdominal pain nausea, projectile vomiting and abdominal distension. A pre-operative diagnosis of mechanical bowel obstruction was made. The absence of characteristic clinical signs in this thin elderly woman with a small bowel obstruction failed to provide a pre-operative diagnosis. She underwent a midline laparotomy and resection and anastomosis of small bowel and repair of the strangulated right obturator hernia. The high mortality rate associated with this type of abdominal hernias requires a high index of suspicion to facilitate rapid diagnosis and prompt surgical intervention if the survival rate is to be improved.

  11. Rehabilitation of large maxillary defect with two-piece maxillary obturators

    Directory of Open Access Journals (Sweden)

    Kanchan P Dholam

    2015-01-01

    Full Text Available The insertion and removal of an obturator in large maxillary defects with or without trismus is difficult. Fabrication of a two-piece obturator in such cases overcomes this problem. This article describes rehabilitation of large maxillary defects with two piece maxillary obturator of three types. All these obturators have a maxillary plate and a bulb component, which are approximated together by various techniques namely, silicone cover, embedded magnets, and press studs. Prosthetic rehabilitation of large maxillary defects with two-piece obturators offers the possibility of adequate oral rehabilitation by fabricating light weight prosthesis, which is easy to use. The bulb covers the undercut areas of the defect enhancing the facial contour and retention. It facilitates easy examination of underlying tissues, recreation of the anatomic barrier between the oral and nasal cavities and restoration of the function and esthetics. Thus, it adds to the quality of life.

  12. Obturator hernia should be considered in the differential diagnosis of hip and knee pain.

    Science.gov (United States)

    Belli, Ahmet Korkut; Memiş, Gündüz; Dere, Özcan; Koşan, Ulaş; Nazlı, Okay

    2016-11-01

    Obturator hernia is a rare disease usually occurring in debilitated elderly women. Pain radiating down the medial thigh and knee (Howship-Romberg sign) is a specific sign of the disease. Presently described is a case of obturator hernia in a 73-year-old female patient who presented with severe left hip pain radiating down the medial thigh and knee, nausea, and loss of appetite. Initially, vertebral disc herniation was thought to be cause, but abdomino-pelvic computed tomography scan revealed left strangulated obturator hernia. Diagnosis of obturator hernia can be challenging. Physicians should consider obturator hernia in the differential diagnosis of knee and hip pain, and investigate for Howship-Romberg sign. Early diagnosis of the disease not only decreases morbidity and mortality, but also presents opportunity to treat with minimally invasive methods.

  13. Brief reports: ultrasound-guided obturator nerve block: a proximal interfascial technique.

    Science.gov (United States)

    Taha, Ahmad Muhammad

    2012-01-01

    In this report, I describe and evaluate a proximal ultrasound (US)-guided obturator nerve block technique using an interfascial local anesthetic (LA) injection deep to the pectineus muscle. The pectineus muscle was identified and followed, while the US probe was tilted cranially until the superior pubic ramus was visualized. In this plane, LA was injected interfascially between the pectineus and obturator externus. The median time required to identify the injection site was 4 seconds (95% confidence interval, 3-5 seconds). The median motor block onset was 4 minutes (95% confidence interval, 3-5 minutes). Both obturator nerve branches were blocked successfully in all patients (100%). The US-guided obturator nerve block using interfascial LA injection inferior to the superior pubic ramus, between the pectineus and obturator externus muscles, was shown to be a simple and successful technique.

  14. Cleft Lip and Palate

    Science.gov (United States)

    ... from surgery, coping with speech problems, or improving self-esteem. Some teens join support groups or online forums where they can talk to other people who were born with cleft lip or palate. Reviewed by: Rupal Christine Gupta, MD Date reviewed: ...

  15. Epileptic palatal myoclonus

    International Nuclear Information System (INIS)

    Tatum, W.O.; Sperling, M.R.; Jacobstein, J.G.

    1991-01-01

    Palatal myoclonus (PM) is usually caused by lesions of the brainstem. The authors report a case of PM of focal cortical origin in a patient with epilepsia partialis continua. The PM sometimes occurred in isolation, and at other times was accompanied by unilateral face, neck, and arm twitching. This was documented by both EEG and SPECT

  16. Accommodating Picky Palates

    Science.gov (United States)

    Lum, Lydia

    2007-01-01

    Healthy gourmet offerings are fast becoming the norm at college dining halls around the country. At a time when the children of Baby Boomers are hitting higher education in record numbers, college officials have scrambled to accommodate their picky palates and their insistence for healthier meals than were served to past generations. At the same…

  17. Epileptic palatal myoclonus

    Energy Technology Data Exchange (ETDEWEB)

    Tatum, W.O.; Sperling, M.R.; Jacobstein, J.G. (Graduate Hospital, Philadelphia, PA (USA))

    1991-08-01

    Palatal myoclonus (PM) is usually caused by lesions of the brainstem. The authors report a case of PM of focal cortical origin in a patient with epilepsia partialis continua. The PM sometimes occurred in isolation, and at other times was accompanied by unilateral face, neck, and arm twitching. This was documented by both EEG and SPECT.

  18. Cleft Lip and Palate

    Science.gov (United States)

    ... Cleft Lip or Cleft Palate Print en español Labio leporino y paladar hendido Tilt your head back a bit and look in the mirror. Do you see the way your nose connects to your upper lip? Now open your mouth. Do you see the ...

  19. Measurement of the percentage of root filling in oval-shaped canals obturated with Thermafil Obturators and Beefill 2in1: In vitro study.

    Science.gov (United States)

    Faus-Llácer, Vicente; Collado-Castellanos, Nicolás; Alegre-Domingo, Teresa; Dolz-Solsona, María; Faus-Matoses, Vicente

    2015-04-01

    The aim of the study was to measure the percentage of root canal fillings in long oval canals obturated with thermoplasticized gutta-percha techniques, Beefill 2in1® and Thermafil Obturators®. Fifty four mandibular incisors were selected after bucco-lingual and mesio-distal radiographs showed at 5 mm from apex an internal long:short diameter ≥2. Teeth were instrumented with Protaper Universal and divided in two groups of 27. Group 1 was obturated with Thermafil Obturators® and group 2 with Beefill 2in1®. Two horizontal sections were cut at 5 and 7 mm from the apex and photographed in a stereo-microscope. The total area of the canal and filled canal in cross-sections were measured with AutoCad and the percentages of gutta-percha-sealer and voids in the canal were obtained. Both systems achieved high percentage of filled canal, Thermafil 96.8% and Beefill 2in1 98.9%. The percentages of voids in both groups were very low. No significant differences were found between the two groups . The percentage obtained at 5 and 7 mm from the apex in both groups showed no significant difference. The percentages of filled canal (gutta-percha-sealer) were high and these two thermoplasticized techniques are suitable for long oval canals obturation. Key words:Long oval canal, oval canal, thermoplasticized obturation.

  20. Maxillary molars with morphologic variations of the palatal root canals: a report of four cases.

    Science.gov (United States)

    Holderrieth, Silke; Gernhardt, Christian Ralf

    2009-07-01

    The purpose of this article was to show the importance of the knowledge of the anatomy of root canals. Unusual root and root canal morphologies associated with both buccal roots of upper molars have been recorded in several studies in the literature. However, scientific information focusing on variations of the palatal root is rare. In this report, four cases are presented involving the root canal treatment of maxillary first and second molars with unusual morphologic configurations of the palatal root canals. During root canal treatment, type IV and V configurations as defined by Vertucci of the palatal canals of two first and two second maxillary molars were identified. After mechanical instrumentation, the canals were obturated. Radiologic and clinical re-evaluation showed no signs of inflammation. This report describes and discusses the possibility of different root and canal variations of the maxillary molars from a clinical point of view. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. Therefore, careful examination of radiographs and internal anatomy of teeth is essential.

  1. The influence of obturators on the respiration of patients with maxillary defects: a clinical study.

    Directory of Open Access Journals (Sweden)

    Xian Dong

    Full Text Available The study evaluated the effects of obturators on respiratory function by analyzing the changes in nasal anatomic structures and physiologic function in maxillectomy patients with and without obturators. Twenty-six patients who underwent maxillectomy were chosen and rehabilitated with obturators by a single maxillofacial prosthodontist. The geometric shape of the nasal cavity, the nasal airway resistance, and the ratio of residual volume to total lung capacity (RV/TLC were evaluated using acoustic rhinometry, rhinomanometry, and a pulmonary function test apparatus, respectively. All patients were tested twice, with and without their obturators. The results were statistically analyzed with a paired t-test. The nasal cavities (0-7 cm to the anterior nostril of the patients with obturators had a significantly smaller volume ([-8.92, -0.60], P = 0.027, smaller effective nasal cross-sectional area MCA2 ([-3.80, -1,81], P < 0.0001, increased airflow in the nasal cavity ([17.76, 147.39], P = 0.015, reduced nasal airway resistance ([-0.11, -0.02], P = 0.009, and reduced RV/TLC ([-5.32, -1.30], P = 0.004 compared with the patients without obturators. According to the results of this study, obturators can improve respiratory function by effectively decreasing the volume of enlarged nasal cavities as well as the nasal air resistance and volume of anatomical dead space after maxillectomy.

  2. Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study

    OpenAIRE

    Hiremath, Mallayya C.; Srivastava, Pooja

    2016-01-01

    Purpose: The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. Materials and Methods: A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presenc...

  3. Revis(iting French palatalization

    Directory of Open Access Journals (Sweden)

    Ali Tifrit

    2016-06-01

    Full Text Available This paper explores the diachrony of French and reconsiders the classical analysis of French palatalizations. It is widely admitted that the transition from Latin dorsal stops to French palatal fricatives is triggered by an external palatalizing object which affects the constitution of the targeted consonant. While this analysis can satisfyingly explain the palatalization of dorsals before /i/, it makes the palatalization before /a/, which occurred a few centuries later, completely opaque. Revising the internal structure and the melody used to describe segments (Government Phonology 2.0 – Pöchtrager 2006 allows us to give a unified analysis of both palatalizations: whether /i/ or /a/, the vocalic environment is indeed the trigger, as it interferes with the structure of dorsals and lead to internal changes. However, while /i/ adds palatality to the consonant, /a/, by its lack of melody (Pöchtrager & Živanović 2010, leads to an internal reconfiguration of the dorsal, which already contains . In other words, we face two kinds of palatalization: an external one and an internal one. Furthermore, our analysis takes the intermediate stages from Latin dorsals to French palatals into consideration and attested dialectal variations observed in Northern France.

  4. Correlation of Palatal Rugoscopy with Gender, Palatal Vault Height ...

    African Journals Online (AJOL)

    Background: Palatal rugae (PR) are asymmetrical irregular elevations, recorded during maxillary cast fabrication , that can be used for identification purpose if previous comparative sources are available. Aim: This study investigated uniqueness of PR patterns in relation to gender, palatal vault forms, and ABO blood groups ...

  5. A hollow definitive obturator fabrication technique for management of partial maxillectomy.

    Science.gov (United States)

    Patil, Pravinkumar Gajanan; Patil, Smita Pravinkumar

    2012-11-01

    Maxillary obturator prosthesis is the most frequent treatment option for management of partial or total maxillectomy. Heavy weight of the obturators is often a dislocating factor. Hollowing the prosthesis to reduce its weight is the well established fact. The alternate technique to hollow-out the prosthesis has been described in this article which is a variation of previously described processing techniques. A pre-shaped wax-bolus was incorporated inside the flasks during packing of the heat-polymerized acrylic resin to automatically create the hollow space. The processing technique described is a single step flasking procedure to construct a closed-hollow-obturator prosthesis as a single unit. To best understand the technique, this article describes management of a patient who had undergone partial maxillectomy secondary to squamous cell carcinoma rehabilitated with a hollow-obturator prosthesis.

  6. Congenital Palatal Fistula Associated with Submucous Cleft Palate

    Science.gov (United States)

    Eshete, Mekonen; Camison, Liliana; Abate, Fikre; Hailu, Taye; Demissie, Yohannes; Mohammed, Ibrahim; Butali, Azeez; Losken, H. Wolfgang

    2016-01-01

    Background: Although cleft lip and cleft palate are among the most common congenital malformations, the presence of an isolated congenital palatal fistula along with a submucous cleft is very rare. This appears as an oval-shaped, full-thickness fenestration in the palatal midline that does not fully extend anteriorly or posteriorly, accompanied by the findings of a submucous cleft. Because of the uncommon nature of this entity, there is controversy about its etiology, diagnosis, and management. Methods: Two cases of children with congenital palatal fistulae and a submucous cleft palate are presented who were treated in different settings by different surgeons. Cases are discussed along with a thorough review of the available literature. Results: Patient 1 presented at 4 years of age with “a hole in the palate” since birth and abnormal speech. His palatal fistula and submucous cleft were repaired with a modified von Langenbeck technique in Ethiopia. At a 2-year follow-up, the palate remained closed, but hypernasal speech persisted. Patient 2 was a 1-year-old presenting with failure to thrive and nasal regurgitation, who underwent a Furlow palatoplasty in the United States with good immediate results. She was unfortunately lost to follow-up. Conclusions: A congenital fenestration of the palate is rare. Reports reveal suboptimal speech at follow-up, despite various types of repair, especially when combined with a submucous cleft. Available literature suggests that repair should not focus on fistula closure only but instead on providing adequate palate length to provide good velopharyngeal function, as in any cleft palate repair. PMID:27014542

  7. Endodontic Management of Maxillary First Molar With Two Palatal Canals Aided With Cone Beam Computed Tomography: A Case Report.

    Science.gov (United States)

    Pamboo, Jaya; Hans, Manoj Kumar; Chander, Subhas; Sharma, Kapil

    2017-04-01

    The success of endodontic therapy is based on having sufficient endodontic access, correct cleaning and shaping, and adequate root canal obturation. However, endodontic treatment is also dependent on having a sound knowledge of the internal anatomy of human teeth, especially when anatomic variations are present. Reporting these alterations is important for improving the understanding and expertise of endodontists. The aim of this case report is to describe a unique case of maxillary first molar with 2 palatal canals within a single root, as confirmed by cone-beam computed tomography (CBCT) scans. This article also reviews recent case reports of extra palatal root canals in the maxillary first molars and the role of CBCT analysis in successfully diagnosing them.

  8. Cleft lip and palate repair

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002979.htm Cleft lip and palate repair To use the sharing features on this ... Cheiloplasty; Cleft rhinoplasty; Palatoplasty; Tip rhinoplasty Patient Instructions Cleft lip and palate repair - discharge Images Cleft lip repair - series References ...

  9. REHABILITATION OF A HEMI-MAXILLECTOMY PATIENT WITH A CAST PARTIAL OBTURATOR PROSTHESIS - A CLINICAL REPORT.

    OpenAIRE

    Aprajita; Atul Bhatnagar; Kumari Deepika; Shankar singh.

    2018-01-01

    Prosthodontic rehabilitation of patient who have underwent maxillectomy surgery is a challenging task. Achieving optimum stability, retention and support are the major problems. An obturator with cast partial design is used to rehabilitate maxillectomy defect. The primary goals of the obturator prosthesis are to preserve the remaining teeth and tissues and to provide comfort, function, and aesthetics to the patients. This case report describes several steps of fabrication of a definitive obtu...

  10. [MORPHOLOGICAL CHANGES OF THE LIVER IN OBTURATION JAUNDICE, CAUSED BY CHOLEDOCHOLITHIASIS, DEPENDING ON ITS DURATION].

    Science.gov (United States)

    Sipliviy, V A; Yevtushenko, D V; Naumova, O V; Andreyeshchev, S A; Yevtushenko, A V

    2016-02-01

    Abstract The results of surgical treatment of 184 patients for obturation jaundice, caused by choledocholithiasis, were analyzed. Morphological changes of the liver were studied in 20 patients. There were three groups of patients delineated, depending on the obturation jaundice duration: up to 7 days, from 8 to 14 days, more than 15 days, and also a group of patients after the bile outflow restoration. The obturation jaundice occurrence in choledocholithiasis is accompanied by significant morphological changes in the liver, severity of which is enhancing while the obturation jaundice persistence increasing. While persistence of obturation jaundice through 8 days and more the connective tissue volume is enhancing, a relative volume of hepatocytes is reducing and a stromal-parenchymatous index is increasing. The bile outflow restoration secures significant reduction of intensity of alterative and inflammatory changes in hepatic parenchyma, as well as activation of reparative processes in the tissue. In cholangitis, caused by P. aeruginosa and E. coli, according to morphological investigations data, in the liver a diffuse purulent cholangitis on background of chronic changes in accordance to duration of the obturation jaundice persists.

  11. Successful Treatment of Gluteal Pain from Obturator Internus Tendinitis and Bursitis with Ultrasound-Guided Injection.

    Science.gov (United States)

    Chen, Boqing; Rispoli, Leia; Stitik, Todd; Leong, Michelle

    2017-10-01

    This case report describes what the authors believe is the first case of a patient with obturator internus tendinitis and bursitis successfully treated with a corticosteroid injection using a trans-tendinous lateral to medial approach. The patient presented with right gluteal pain not relieved by physical therapy or right hip and ischial bursa corticosteroid injections. Pelvic and lumbar spine MRIs and EMG/NCS findings were unremarkable. Physical examination demonstrated tenderness to palpation at the right middle lower gluteal region. Ultrasound imaging with sonopalpation identified the maximal local tender point as the right obturator internus muscle and/or its underlying bursa. A 22-gauge 3.5-inch needle was inserted in-plane to the transducer and longitudinal to the obturator internus from a lateral to medial direction, an approach previously described in cadavers. The obturator internus tendon sheath and bursa were injected with 2.5 ml of 0.5% lidocaine combined with 10 mg of triamcinolone. The patient reported immediate complete relief of pain with continued relief at 2 and 6 months post-injection. This case report demonstrates an injection of the obturator internus tendon sheath and bursa using a trans-tendinous approach, which may be successful for treatment of patients presenting with persistent gluteal pain from obturator internus tendinitis and bursitis.

  12. Suction Cup Induced Palatal Fistula: Surgical Closure by Palatal ...

    African Journals Online (AJOL)

    1Department of Pediatrics, Pragna Children's Hospital, Hyderabad, ... Eluru, 4Department of Conservative Dentistry and Endodontics, KIMS Dental College and ... The surgical closure of palatal fistula planned under general anesthesia.

  13. Full Mouth Reconstruction of a Skeletal Class II Division 1 Patient with Adenoid Cystic Carcinoma Using an Interim Immediate Obturator and a Definitive Obturator

    Directory of Open Access Journals (Sweden)

    Mehran Bahrami

    2017-01-01

    Full Text Available A 61-year-old female patient with adenoid cystic carcinoma (ACC of the right maxilla and Angle class II division 1 malocclusion had received a subtotal maxillectomy in right side and used a conventional clasp-retained obturator. After implants placement, a maxillary interim immediate obturator (IIO and then a definitive obturator using six endosseous implants were fabricated. During one-year follow-up, the patient was completely satisfied. Ideally, after implants placement in edentulous patients suffering from hemimaxillectomy, an implant-supported obturator (ISO is designed in order to prevent nasal reflux and to improve speech and swallowing. However, in the following case, because of skeletal class II division 1 malocclusion and implants insertion in the premaxilla, using an ISO was impossible because it would cause excessive upper lip protrusion and lack of anterior teeth contact. Therefore, a five-unit implant-supported fixed partial denture (FPD was fabricated in the maxillary anterior segment so that anterior teeth contacts were possible and the patient’s normal lip support was achieved. A bar and three ball attachments were used in the maxillary posterior segment. A closed-hollow-bulb ISO was preferred. Conventional ISO in these patients results in several problems. Using a maxillary anterior FPD along with ISO caused satisfactory results in the current patient.

  14. Cleft deformities (lip and palate)

    African Journals Online (AJOL)

    dell

    hospital between February 2008 and February 2009, seventeen neonates presented with ..... are low necessitating very large sample sizes often limited by resources. ... Bianco-Davila F: Incidence of cleft lip and palate in northeast of Mexico.

  15. [Surgical correction of cleft palate].

    Science.gov (United States)

    Kimura, F T; Pavia Noble, A; Soriano Padilla, F; Soto Miranda, A; Medellín Rodríguez, A

    1990-04-01

    This study presents a statistical review of corrective surgery for cleft palate, based on cases treated at the maxillo-facial surgery units of the Pediatrics Hospital of the Centro Médico Nacional and at Centro Médico La Raza of the National Institute of Social Security of Mexico, over a five-year period. Interdisciplinary management as performed at the Cleft-Palate Clinic, in an integrated approach involving specialists in maxillo-facial surgery, maxillar orthopedics, genetics, social work and mental hygiene, pursuing to reestablish the stomatological and psychological functions of children afflicted by cleft palate, is amply described. The frequency and classification of the various techniques practiced in that service are described, as well as surgical statistics for 188 patients, which include a total of 256 palate surgeries performed from March 1984 to March 1989, applying three different techniques and proposing a combination of them in a single surgical time, in order to avoid complementary surgery.

  16. A comparative In vivo efficacy of three spiral techniques versus incremental technique in obturating primary teeth

    Directory of Open Access Journals (Sweden)

    Shalini Chandrasekhar

    2018-01-01

    Full Text Available Background: The aim of this study was to evaluate the efficiency of four different obturating techniques in filling the radicular space in primary teeth. Materials and Methods: This clinical trial was carried out on 34 healthy, cooperative children (5–9 years who had 63 carious primary teeth indicated for pulpectomy. They were divided into four groups, such that in each group, a total of 40 canals were allotted for obturation with respective technique. The root canals of selected primary teeth were filled with Endoflas obturating material using either bi-directional spiral (Group 1; incremental technique (Group 2, past inject (Group 3 or lentulo spiral (Group 4 according to the groups assigned. The effectiveness of the obturation techniques was assessed using postoperative radiographs. The assessment was made for a depth of fill in the canal, the presence of any voids using Modified Coll and Sadrian criteria. The obtained data were analyzed by using ANOVA test and unpaired t-test. Results: Bi-directional spiral and lentulo spiral were superior to other techniques in providing optimally filled canals (P< 0.05. The bi-directional spiral was superior to lentulo spiral in preventing overfill (P< 0.05. Conclusion: Based on the present study results, bi-directional spiral can be recommended as an alternate obturating technique in primary teeth.

  17. Aesthethic and masticatory rehabilitation on post mandibular resection with combination of hollow obturator and hybrid prosthesis

    Directory of Open Access Journals (Sweden)

    Arif Rachman

    2009-06-01

    Full Text Available Background: Replacing tooth lost caused by caries, periodontal disease, trauma and neoplasm including ameloblastoma which requires mandibular resection is important. Purpose: The aim of the study to rehabilitation of post mandibular resection with combination of hollow obturator and hybrid prosthesis. Case: A patient 25 years old, male, for having prosthesis to cover defect due to post right mandibular resection. Case Management: In this presented case, mandibular plate was applied due to spreading defect with losing almost a half body of mandible (class II modification 2 according to cantor and curtis classification. The design of therapy was mandibular obturator using hybrid prosthesis (removable partial denture metal frame and fixed splint crown with precision attachment with hollow obturator. The application was based on several advantages: good aesthetic performance, retention, stability, lighter weight and equal share of vertical load for teeth on non surgical site. The result of control I, II, III, showed that aesthetic performance, masticatory function, speech and swallowing were in good condition. Conclusion: The design of mandibular obturator using hybrid denture with hollow obturator could rehabilitate aesthetic performance, masticatory function, speech and swallowing for patient with post mandibular resection.

  18. Trans-obturator Tape in surgical treatment of urinary incontinence

    Directory of Open Access Journals (Sweden)

    Ashrafi M

    2008-06-01

    Full Text Available Background: The aim of this study was to assess the efficacy and safety of a new minimally-invasive surgical procedure using trans-obturator Tape (TOT to treat female stress urinary incontinence.Methods: This clinical trial study was performed from 2003 to 2004 in the Gynecology Department of Imam Hospital, Vali-e-Asr, Tehran, Iran. A total of 35 women with stress urinary incontinence underwent the TOT procedure. All patients underwent pre-operative clinical examination, cough-stress test (full bladder, uroflowmetry and post-voiding residual volume assessment. Results: The mean age of patients was 50 years, ranging from 26 to 74 years, with an average urinary stress incontinence duration of six years. The mean time of follow-up was 14 months (at 1, 6, 12 and 24 months and the average duration of surgery was about 20 minutes. The perioperative complication rate was 9% with no vascular, nerve or bowel injuries. The rate of hemorrhagic side effects (spontaneously-absorbed hematoma and blood loss not requiring blood transfusion was 2.9%. Post-operative urinary retention and vaginal erosion occurred in one case each; the former was treated by intermittent self-catheterization. In total, 91.4% of patients were completely cured and 8.6% were improved without failure of treatment. Conclusions: The present study confirms the results obtained by Delorme and coworkers, and allows us to consider TOT as a safe, minimally invasive and efficient short-term surgical technique for the treatment of female stress urinary incontinence, alone or in combination with prolapse repair. Following this study, a randomized control trial is recommended to compare TOT with the gold standard surgery for women with urinary incontinence.

  19. Examination of Articulation in Patient Using Obturator by Means of Computer Planning

    Directory of Open Access Journals (Sweden)

    Somaieh Allahiary

    2013-02-01

    Full Text Available Background and Aims: Approximately 5% of cancers involve structures of oral cavity. Partial resection of maxilla (maxillectomy may be performed in these cases. Maxillectomy often results in significant functional disabilities such as inability in mastication, deglutition and speech with adverse impact on psychological statusand social life of patients. Obturator prosthesis is a prosthodontic treatment to separate nasal and oral cavities and restore the critical above mentioned functions. The assessment of speech is considered to examine speech function restored by the treatment. The purpose of this study was to evaluate the speech in patients with resected maxilla who have been treated by obturator prosthesis from a pool of related patients in the Prosthodotnics department ofdental faculty, Tehran University of Medical Sciences. The evaluation was performed with computer software using sentence intelligibility (SI test. Materials and Methods: This cross sectional study was conducted on 10 subjects (23-66 years referred to the Prosthodontics department of the faculty and received an obturator. After primary examination of the prosthesis,the patients completed SI test in an acoustic room under guidance of a speech therapist. The performed tests were analyzed by the speech therapist. In addition, the SI with and without the prosthesis was evaluate by lay audience. The statistical analyses were performed using Wilcoxon-signed rank test and Weighted Kappa. Results: Significant differences were found between SI tests with and without the obturators (P<0.001. Two of 10 patients showed problems in speech function using obturator. Conclusion: Within the limitations of the present study, obturators had significant effect on improvement of the speech outcomes of examined patients. Improvement of the quality of life could be predicted.

  20. Quality of Life in Patients After Maxillectomy and Placement of Prosthetic Obturator.

    Science.gov (United States)

    Chen, Cheng; Ren, Wen-Hao; Huang, Rui-Zhe; Gao, Ling; Hu, Zhi-Ping; Zhang, Lin-Mei; Li, Shao-Ming; Dong, Kai; Qi, Hong; Zhi, Ke-Qian

    2016-01-01

    The aim of this study was to assess quality of life (QoL) and obturator functioning in patients having undergone a maxillectomy as a tumor ablative resection and rehabilitation with a prosthetic obturator. The University of Washington Quality of Life scale version 4 (UW-QoLv4) and the Obturator Functioning Scale (OFS) were used to evaluate the self-reported QoL and obturator functioning. The effects of demographic and treatment variables on QoL were assessed using age, defect size, postoperative radiotherapy (RT), neck dissection, and dentition. The study included 16 men and 13 women with a mean age of 48.8 years. Of the 29 patients, 16 had a Brown Class 2a or smaller defect and 13 had a Brown Class 2b or larger defect. The mean OFS score (P = .004) and the physical (P = .001) and social-emotional function scores (P = .001) of the patients who received postoperative RT were significantly lower than those who did not receive postoperative RT. The subscales for swallowing (P = .008), saliva (P = .001), pain (P = .001), and shoulder function (P = .002) correlated strongly with postoperative RT on the UW-QoL. The subscales for pronunciation (P = .007) and saliva (P = .002) correlated significantly with RT on the OFS. The mean OFS scores were significantly lower for the patients with a Brown Class 2a or smaller defect than for Brown Class 2b or larger (P = .005). Postoperative RT was the strongest variable affecting QoL in patients with maxillectomy and prosthetic obturator reconstruction. The size of the defect slightly influenced the obturator function; however, it did not influence the overall QoL.

  1. Modified snap-on attachment with ′O-ring′ for two piece hollow bulb obturator

    Directory of Open Access Journals (Sweden)

    C Gunasekar

    2013-01-01

    Full Text Available Restoration of near normal functions in patients who have been treated with hemimaxillectomy is generally difficult, in view of the restriction in mouth opening following healing of large surgical wound. Further, the extent and nature of the surgical defect differ from patient to patient. Thus, design of an obturator needs to be patient oriented. In this report, we describe a novel snap-on attachment with O-ring in a conventional two piece hollow bulb obturator for a 70-year-old male treated for carcinoma of the left maxilla and sinus.

  2. Closed hollow bulb obturator--one-step fabrication: a clinical report.

    Science.gov (United States)

    Buzayan, Muaiyed M; Ariffin, Yusnidar T; Yunus, Norsiah

    2013-10-01

    A method is described for the fabrication of a closed hollow bulb obturator prosthesis using a hard thermoforming splint material and heat-cured acrylic resin. The technique allowed the thickness of the thermoformed bulb to be optimized for weight reduction, while the autopolymerized seal area was covered in heat-cured acrylic resin, thus eliminating potential leakage and discoloration. This technique permits the obturator prosthesis to be processed to completion from the wax trial denture without additional laboratory investing, flasking, and processing. © 2013 by the American College of Prosthodontists.

  3. [Suture simulator - Cleft palate surgery].

    Science.gov (United States)

    Devinck, F; Riot, S; Qassemyar, A; Belkhou, A; Wolber, A; Martinot Duquennoy, V; Guerreschi, P

    2017-04-01

    Cleft palate requires surgery in the first years of life, furthermore repairing anatomically the soft and hard palate is complex on a surgical level because of the fine tissues and the local intraoral configuration. It is valuable to train first on simulators before going to the operating room. However, there is no material dedicated to learning how to perform intraoral sutures in cleft palate surgery. We made one, in an artisanal manner, in order to practice before the real surgical gesture. The simulator was designed based on precise anatomical data. A steel pipe, fixed on a rigid base represented the oral cavity. An adapted split spoon represented the palate. All pieces could be removed in order to apply a hydrocellular dressing before training for sutures. Our simulator was tested by 3 senior surgeons in our department in close to real-life conditions in order to evaluate its anatomical accuracy. It is valuable to have a simulator to train on cleft palate sutures within teaching university hospitals that manage this pathology. Our simulator has a very low cost, it is easy to make and is anatomically accurate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Obturator or "lateral" bypass in the management of infected vascular prostheses at the groin

    Directory of Open Access Journals (Sweden)

    Davidović Lazar B.

    2002-01-01

    Full Text Available The infection of the previously implanted vascular graft at the groin, is associated with great mortality and morbidity rate [1]. The authors present a retrospective study in which they analyzed management of infected vascular prostheses at the groin, using obturator bypass in 26 cases, and "lateral" bypass in 15 cases. The indications for obturator bypass reconstructions included: 20 infections of aorto-femoral grafts, two infected pse udoaneurysms in the groin after RTA of the superficial femoral artery, and 4 infections of iliac-femoral grafts. The indications for lateral bypass reconstructions were: infections after aorto-femoral reconstructions - 8 cases; infection after femora-popliteal reconstructions - 4 cases; infection after iliac-femoral reconstruction - 2 patients, and one infected pseudoaneurysm in the groin after RTA of the superficial femoral artery. In 3 subjects obturator bypass was performed using extraperitoneal approach while in other 23 patients transperitoneal approach was done by donor's artery. The obturator bypass was performed using a PTFE graft in 3 cases and Dacron graft in 23. The donor's artery used for obturator bypass was a noninfected proximal part of aortofemoral graft in 20 cases, and iliac artery in 6 patients. The superfical femoral artery was recipient artery for obturator bypass in 3 cases, deep femoral artery in one case, and above the knee popliteal artery in 22 cases (Figure 1. In two patients transperitoenal approach to donors artery for "lateral" bypass has been used, and in 13 cases extraperitoneal. The proximal noninfected part of aorto femoral graft was used as a donor's artery for lateral bypass in 8 patients, while common iliac artery in 7 subjects. In 5 cases recon structions were performed using PTFE grafts, in 3 using autologous saphenous vein grafts, and in 7 using Dacron grafts. The recipient artery for "lateral" bypass was deep femoral in 8 cases, superficial femoral in three patients and

  5. Effect of Post Space Preparation on Apical Obturation Quality of Teeth Obturated with Different Techniques: A Micro-computed Tomographic Study.

    Science.gov (United States)

    Küçükkaya Eren, Selen; Askerbeyli Örs, Sevinc; Yılmaz, Zeliha

    2017-07-01

    The purpose of this study was to evaluate the obturation quality of root canals filled with different techniques and to determine whether post space preparation had an effect on the quality of apical obturation using micro-computed tomographic (micro-CT) imaging. The root canals of 30 human mandibular premolar teeth were instrumented, and the specimens were divided into 3 groups according to the obturation technique used: cold lateral compaction (CLC), warm vertical compaction (WVC), or single-cone (SC) techniques. The specimens were stored at 37°C and 100% humidity for 1 week. Then, the coronal root filling material was removed in order to create a post space. Micro-CT scans were performed before and after post space preparation for the volumetric analysis of voids and filling materials. Data were analyzed using repeated-measures analysis of variance and Bonferroni tests. The CLC and SC groups showed a significantly greater percentage volume of voids than the WVC group (P space preparation (P > .05). The post space preparation caused a significant increase in the percentage volume of voids in the CLC and SC groups (P space preparation (P > .05). No root fillings were void free. The WVC group presented the best obturation quality. The post space preparation negatively influenced the apical integrity of the filling materials in the CLC and SC groups, whereas it had no significant effect in the WVC group. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  6. CLEFT PALATE. FOUNDATIONS OF SPEECH PATHOLOGY SERIES.

    Science.gov (United States)

    RUTHERFORD, DAVID; WESTLAKE, HAROLD

    DESIGNED TO PROVIDE AN ESSENTIAL CORE OF INFORMATION, THIS BOOK TREATS NORMAL AND ABNORMAL DEVELOPMENT, STRUCTURE, AND FUNCTION OF THE LIPS AND PALATE AND THEIR RELATIONSHIPS TO CLEFT LIP AND CLEFT PALATE SPEECH. PROBLEMS OF PERSONAL AND SOCIAL ADJUSTMENT, HEARING, AND SPEECH IN CLEFT LIP OR CLEFT PALATE INDIVIDUALS ARE DISCUSSED. NASAL RESONANCE…

  7. Facts about Cleft Lip and Cleft Palate

    Science.gov (United States)

    ... Information For… Media Policy Makers Facts about Cleft Lip and Cleft Palate Language: English (US) Español (Spanish) Recommend on Facebook ... can make referrals to cleft/craniofacial treatment teams. Cleft Lip & Palate Foundation of Smiles Cleft Lip & Palate Foundation of ...

  8. Correlation of Palatal Rugoscopy with Gender, Palatal Vault Height ...

    African Journals Online (AJOL)

    Allen in 1889[3] discussed their role as an identification method. ... a typical orientation pattern, once formed; only changed in its length due to ... along with palatal vault forms as well as ABO blood groups for racial and individualistic soft.

  9. PWR pressurizer with heaters well which can be obturate and sealing process

    International Nuclear Information System (INIS)

    Godin, B.; Guicherd, L.

    1991-01-01

    Each heater well is prolongated at the end located outer the pressurizer containment by a sleeve internally tapped which is prolongated at the other end by a guiding and fixation sleeve for welding the heater. The heater well can be obturated by a threaded plug introduce in the tapped part of the sleeve after cutting the welding sleeve and extraction of the heater [fr

  10. PALATAL ROTATONIAL FLAP: AN ALTERNATIVE FOR PALATAL PRIMARY INTENTION NEALING

    OpenAIRE

    García Linares, Sixto A.

    2014-01-01

    Objectives- The present clinical study tries to show an alternative for closing of superior bicuspids alveolus to maintain alveolar ridge and to avoid alveolitis because of first intention wound healing. Results. It was observed after 15 days; 12 patients had a complete wound healing of the alveolus and the palate showed a mattress of consistent granulation. A patient discontinued the treatment. Two patients had a wound healing lip to 75%. They didn't register adverse effects: hemorrhage, int...

  11. Comparative evaluation of three obturation techniques in primary incisors using digital intra-oral receptor and C.B.C.T-an in vitro study.

    Science.gov (United States)

    Akhil, Jose E J; Prashant, Babaji; Shashibushan, K K

    2018-05-10

    Successful pulpectomy in primary teeth depends on quality of obturation. It can be evaluated using digital intra-oral receptor (D.I.O.R) and cone beam computed tomography (C.B.C.T). The purposes of this study were to compare 3 different obturation techniques such as lentulospiral, insulin syringe, and endodontic plugger in primary incisors and to evaluate its quality of obturation using D.I.O.R and C.B.C.T technique. Thirty-three extracted primary incisors were biomechanically prepared and obturated with zinc oxide eugenol cement by 3 different obturation techniques. The obturation was evaluated for length of obturation and voids using D.I.O.R and C.B.C.T methods. There was a statistically significant difference between all the groups in length of obturation (P = 0.02) in both D.I.O.R and C.B.C.T. Significant differences (P = 0.03) were present in number of voids among 3 obturation techniques in C.B.C.T. Statistically more voids were observed with D.I.O.R in lentulospiral (P = 0.04) group and in insulin syringe (P = 0.02) group. Acceptable result was obtained with lentulospiral in length of obturation compared to insulin syringe and endodontic plugger technique. Insulin syringe technique resulted in increased underfilling with least number of voids. More number of voids were seen in middle one-third and least number of voids were observed at apical one third of the root among all the 3 techniques of obturation. The study concluded that void identification is improved with D.I.O.R compared to C.B.C.T. Lentulospiral reported effective length of obturation, while insulin syringe with least number of voids. D.I.O.R (2-Dimensional) is efficient in detecting voids compared to C.B.C.T (3-Dimensional) in obturated primary teeth.

  12. Effects of sociodemographic, treatment variables, and medical characteristics on quality of life of patients with maxillectomy restored with obturator prostheses.

    Science.gov (United States)

    Artopoulou, Ioli Ioanna; Karademas, Evangelos C; Papadogeorgakis, Nikolaos; Papathanasiou, Ioannis; Polyzois, Gregory

    2017-12-01

    Restoration of maxillary defects resulting from tumor ablative surgery presents a difficult challenge, with both functional and esthetic issues. Whether rehabilitation with an obturator prosthesis could significantly contribute to improved quality of life in patients with maxillary resection has been scarcely studied, with relatively small study samples. The purpose of this survey study was to assess the overall functioning of the obturator prosthesis and the effect of specific sociodemographic, medical, and treatment variables on obturator functioning and quality of life in patients with maxillectomy. Global quality of life (QOL) and satisfaction with the obturator prosthesis of 57 patients who underwent maxillectomy and prosthetic rehabilitation at the National and Kapodistrian University of Athens were assessed using 3 questionnaires: European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30), the EORTC QLQ-HN35, and the obturator functioning scale. The data were analyzed using the Kruskal-Wallis 1-way ANOVA on ranks, hierarchical multiple regression analysis, and the Spearman rank order correlation (α=.05). Satisfactory functioning of the obturator prosthesis was the most significant predictor of improved QOL (Pmaxillectomy defect (Pmaxillectomy defect had a significant effect on QOL but did not influence the functional outcome. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  13. Outcome of zinc oxide eugenol paste as an obturating material in primary teeth pulpectomy: A systematic review

    Directory of Open Access Journals (Sweden)

    Harsha S Nalawade

    2017-01-01

    Full Text Available The aim of this systematic review is to use the principles of evidence-based dentistry to evaluate the outcome of zinc oxide eugenol (ZOE paste as an obturating material in primary teeth pulpectomies. Moderate-to-high success rates are reported with ZOE in preserving chronically infected primary teeth. However, it fails to meet many of the criteria for an ideal obturating material. Databases searched were PubMed, EBSCOhost, and Google Scholar. Articles published between January 1, 1993, and June 30, 2016, with in vivo studies for obturating materials in primary teeth pulpectomy with placement of preformed crown, reporting follow-up period of at least 12 months with clinical and radiographic success rates were selected for this review. In total, 122 articles were retrieved. After the removal of duplicates and screening, full-text articles were analyzed; of which eight articles were selected for the systematic review. No significant difference was seen in the outcome of obturating materials used in comparison with ZOE in the included studies. Outcomes of ZOE paste obtained with clinical and radiographic evaluation were similar when compared to the newer combinations of materials available for obturating primary teeth today. More number of randomized controlled clinical trials for primary teeth pulpectomies with at least 12 months follow-up period and placement of crown as final restoration need to be carried out for testing the newer materials in comparison with ZOE to conclude a suitable alternative obturating material.

  14. [A comparative study on treating femal stress urinary incontinence with TVT-Abbrevo and TVT-Obturator].

    Science.gov (United States)

    Li, W L; Lu, Z W; Li, F P; Yu, H Y

    2016-07-26

    To compare the effectiveness and complications of TVT-Abbrevo (tension-free vaginal tape-Abbrevo) and TVT-Obturator (tension-free vaginal tape-obturator) for the treatment of female stress urinary incontinence (SUI). From Nov.2012 to Nov.2013, 117 patients suffering from SUI were treated with TVT-Abbrebo (n=79) or TVT-Obturator (n=38) procedure, the clinical efficacy and operation-correlated complications were observed. A total of 117 cases, 107 cases of urinary incontinence symptoms disappeared completely, 10 cases were improved. 72 cases (91.1%) were cured and 7 cases (8.9%) were improved in TVT-Abbrevo group; 35 cases (92.1%) were cured and 3 cases (7.9%) were improved in TVT-Obturator group. No significant differences could be found for the curing rates between two groups (P>0.05). Compared with the TVT-Obturator group, the TVT-Abbrevo group had less patients complaining of inner thigh pain at 24 h and 1 w after surgery (PTVT-Abbrevo and TVT-Obturator group (P>0.05). No intraoperative complications such as blood vessel, nerve, bladder damage were recorded and no postoperative retropubic hematoma, tape adjustment and other complications occurred in two goups. No recurrence after 1 year follow-up. The study shows that TVT-Abbrevo procedure is safe and efficacy in treatment of SUI, and associated with low incidence of recent postoperative inner thigh pain.

  15. 3-D shape analysis of palatal surface in patients with unilateral complete cleft lip and palate.

    Science.gov (United States)

    Rusková, Hana; Bejdová, Sárka; Peterka, Miroslav; Krajíček, Václav; Velemínská, Jana

    2014-07-01

    Facial development of patients with unilateral complete cleft lip and palate (UCLP) is associated with many problems including deformity of the palate. The aim of this study was to evaluate palatal morphology and variability in patients with UCLP compared with Czech norms using methods of geometric morphometrics. The study was based on virtual dental cast analysis of 29 UCLP patients and 29 control individuals at the age of 15 years. The variability of palatal shape in UCLP patients was greater than that in nonclefted palates. Only 24% of clefted palates fell within the variability of controls. The palatal form of UCLP patients (range from 11.8 to 17.2 years) was not correlated with age. Compared with control palates, palates of UCLP patients were narrower, more anteriorly than posteriorly. Apart from the praemaxilla region, they were also shallower, and the difference increased posteriorly. The UCLP palate was characterised by the asymmetry of its vault. The maximum height of the palatal vault was anterior on the clefted side, whereas it was posterior on the nonclefted side. The slope of the UCLP palate was more inclined compared with the control group. The praemaxilla was therefore situated more inferiorly. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  16. Hermetizing ability of the new obturating material for root canals «Real Seal» with «Resilon» technology

    Directory of Open Access Journals (Sweden)

    Makedonova Y.A.

    2012-03-01

    Full Text Available Simple, reliable and predictable obturation of root canals side by side with their cleaning and forming is an essential part of the endodontic treatment. The aim of this research is investigation of obturation density of root canals. Canals filled by means of lateral condensation of the new obturative system «Real Seal/Resilon» and by means of traditional method of canals obturation with the help of gutta-percha and sealer АН-plus. The results of the research proved a ligher hermetizing ability of the new experimental material «Real Seal» in comparison with obturation by means of gutta-percha pins. The obtained data reflects an objective picture and can be applied as a unique quality monitoring obturation of root canals.

  17. Improving Informed Consent for Cleft Palate Repair

    Science.gov (United States)

    2017-03-07

    Cleft Palate; Jaw Abnormalities; Maxillofacial Abnormalities; Mouth Abnormalities; Congenital Abnormalities; Jaw Diseases; Musculoskeletal Diseases; Craniofacial Abnormalities; Musculoskeletal Abnormalities; Stomatognathic Diseases; Stomatognathic System Abnormalities

  18. Sabots, Obturator and Gas-In-Launch Tube Techniques for Heat Flux Models in Ballistic Ranges

    Science.gov (United States)

    Bogdanoff, David W.; Wilder, Michael C.

    2013-01-01

    For thermal protection system (heat shield) design for space vehicle entry into earth and other planetary atmospheres, it is essential to know the augmentation of the heat flux due to vehicle surface roughness. At the NASA Ames Hypervelocity Free Flight Aerodynamic Facility (HFFAF) ballistic range, a campaign of heat flux studies on rough models, using infrared camera techniques, has been initiated. Several phenomena can interfere with obtaining good heat flux data when using this measuring technique. These include leakage of the hot drive gas in the gun barrel through joints in the sabot (model carrier) to create spurious thermal imprints on the model forebody, deposition of sabot material on the model forebody, thereby changing the thermal properties of the model surface and unknown in-barrel heating of the model. This report presents developments in launch techniques to greatly reduce or eliminate these problems. The techniques include the use of obturator cups behind the launch package, enclosed versus open front sabot designs and the use of hydrogen gas in the launch tube. Attention also had to be paid to the problem of the obturator drafting behind the model and impacting the model. Of the techniques presented, the obturator cups and hydrogen in the launch tube were successful when properly implemented

  19. [Rehabilitation by hollow obturator prosthesis immediately after total maxillectomy for malignant tumor].

    Science.gov (United States)

    Li, Xiao-ye; Yan, Ai-hui; Hao, Shuai; Li, Wei; Jiang, Xue-jun; Lu, Li; Qin, Xing-jun; Yan, Hai-xin

    2011-05-01

    The feasibility and clinical effects of hollow obturator prosthesis for the repair of maxillofacial defect immediately after maxillectomy for cancer were assessed. Thirteen patients with T3-4aN0M0 maxillary neoplasm were treated by the prostheses immediately after maxillectomy. According to the 3D-CT reconstruction of nasal sinus, the 3D stereoscopic prototype was constructed before the surgery. Simulating surgery with Surgicare 5.0 software and then the prosthesis 3D stereoscopic model was shaped. The prosthesis was made quickly and precisely with methacrylate resins according to the model and the print mold before surgery, with supplementary tooth at the bottom of prosthesis. In the surgery, the prosthesis was installed instantly after maxillectomy. The patients were followed up at 1, 3 and 6 month after the surgery, respectively. The facial features and the pronunciation clarity were examined and the questionnaires were carried out in the patients, with comparation by paired t-test. The hollow obturator prosthesis would be replaced by permanent prosthesis made of methacrylate resins at 6 month after the surgery. The hollow obturator prostheses were installed accurately and maxillofacial defects were repaired immediately after maxillectomy in the 13 patients. Postoperative follow-up showed there were significant differences in eyeball sagging (t = 4.67, P maxillectomy can improve survival quality of patient.

  20. Transfer of obturator nerve for femoral nerve injury: an experiment study in rats.

    Science.gov (United States)

    Meng, Depeng; Zhou, Jun; Lin, Yaofa; Xie, Zheng; Chen, Huihao; Yu, Ronghua; Lin, Haodong; Hou, Chunlin

    2018-07-01

    Quadriceps palsy is mainly caused by proximal lesions in the femoral nerve. The obturator nerve has been previously used to repair the femoral nerve, although only a few reports have described the procedure, and the outcomes have varied. In the present study, we aimed to confirm the feasibility and effectiveness of this treatment in a rodent model using the randomized control method. Sixty Sprague-Dawley rats were randomized into two groups: the experimental group, wherein rats underwent femoral neurectomy and obturator nerve transfer to the femoral nerve motor branch; and the control group, wherein rats underwent femoral neurectomy without nerve transfer. Functional outcomes were measured using the BBB score, muscle mass, and histological assessment. At 12 and 16 weeks postoperatively, the rats in the experimental group exhibited recovery to a stronger stretch force of the knee and higher BBB score, as compared to the control group (p nerve with myelinated and unmyelinated fibers was observed in the experimental group. No significant differences were observed between groups at 8 weeks postoperatively (p > 0.05). Obturator nerve transfer for repairing femoral nerve injury was feasible and effective in a rat model, and can hence be considered as an option for the treatment of femoral nerve injury.

  1. Internal obturator muscle transposition for treatment of perineal hernia in dogs: 34 cases (1998-2012).

    Science.gov (United States)

    Shaughnessy, Magen; Monnet, Eric

    2015-02-01

    To evaluate the outcome of dogs with perineal hernia treated with transposition of the internal obturator muscle. Retrospective case series. 34 dogs. Medical records of dogs with perineal hernia surgically treated from 1998 to 2012 were reviewed. Diagnostic methods and surgical techniques were recorded. Dogs were assigned preoperative and postoperative clinical sign scores. Complication and recurrence rates were evaluated over time. Risk factors were determined. Median follow-up time was 345 days (range, 22 to 1,423 days). Complications were observed in 10 dogs. Tenesmus (n = 9), dyschezia (7), fecal impaction (3), stranguria (4), hematochezia (2), urinary incontinence (2), diarrhea (1), urinary tract infection (1), and megacolon (1) occurred following surgery. Bladder retroflexion at the time of initial evaluation or surgery was not a risk factor for complication (hazard ratio, 1.72). One year after surgery, 51.2% dogs were free of complications. Three dogs developed a perineal hernia on the contralateral side between 35 and 95 days after surgery. The 1-year recurrence rate was 27.4%. Median time for recurrence was 28 days after surgery (range, 2 to 364 days). Postoperative tenesmus was a risk factor for the development of recurrence (hazard ratio, 2.29). Internal obturator muscle transposition was used for primary repair of perineal hernia in dogs. Recurrence was recorded as long as 1 year after surgery. Tenesmus was a risk factor for the development of recurrence after treatment of perineal hernia with internal obturator muscle transposition.

  2. Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study.

    Science.gov (United States)

    Hiremath, Mallayya C; Srivastava, Pooja

    2016-01-01

    The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presence of voids. The obtained data were analyzed using Chi-square test. The results showed significant differences between the four groups for the length of obturation (P tube showed the poor results (37.5% optimal fillings) for the length of obturation. The insulin syringe (79.2% optimal fillings) and local anesthetic syringe (66.7% optimal fillings) showed acceptable results for the length of root canal obturation. However, minor voids were present in all the four techniques used. Endodontic pressure syringe produced the best results in terms of length of obturation and controlling paste extrusion from the apical foramen. However, insulin syringe and local anesthetic syringe can be used as effective alternative methods.

  3. [Cleft palate repair with a combined method of mucosal flap pushback of the hard palate].

    Science.gov (United States)

    Zhao, Z; Li, S; Xu, J

    1996-03-01

    From January of 1992, we applied a combined method to repair cleft palate in 20 patients and received satisfactory results. The method is characterized by pushing back the mucosal flap of the hard palate, a Z-plasty on the nasal mucosa, repositioning the levator muscle to lengthen the palate, circumferential pharyng oplasty using denervated extensor hallucis brevis muscle, without making relaxing incisions and elevating the mucoperiosteal flap, avoiding interference to the greater and lesser palatine vessels and nerves, without relaxing palatal aponeurosis. The advantages of this method are preserving the normal anatomy and function of the palate and nasopharyngeal cavity, improving the function of velopharyngeal closure and minimizing secondary deformities.

  4. Strategies to Improve Regeneration of the Soft Palate Muscles After Cleft Palate Repair

    Science.gov (United States)

    Carvajal Monroy, Paola L.; Grefte, Sander; Kuijpers-Jagtman, Anne Marie; Wagener, Frank A.D.T.G.

    2012-01-01

    Children with a cleft in the soft palate have difficulties with speech, swallowing, and sucking. These patients are unable to separate the nasal from the oral cavity leading to air loss during speech. Although surgical repair ameliorates soft palate function by joining the clefted muscles of the soft palate, optimal function is often not achieved. The regeneration of muscles in the soft palate after surgery is hampered because of (1) their low intrinsic regenerative capacity, (2) the muscle properties related to clefting, and (3) the development of fibrosis. Adjuvant strategies based on tissue engineering may improve the outcome after surgery by approaching these specific issues. Therefore, this review will discuss myogenesis in the noncleft and cleft palate, the characteristics of soft palate muscles, and the process of muscle regeneration. Finally, novel therapeutic strategies based on tissue engineering to improve soft palate function after surgical repair are presented. PMID:22697475

  5. Cleft palate caused by congenital teratoma.

    Science.gov (United States)

    Veyssière, Alexis; Streit, Libor; Traoré, Hamady; Bénateau, Hervé

    2017-02-01

    A cleft palate results from incomplete fusion of the lateral palatine processes, the median nasal septum and the median palatine process. This case report describes a rare case of congenital teratoma originating from the nasal septum that may have interfered with the fusion of the palatal shelves during embryonic development, resulting in a cleft palate. An infant girl was born at 40 weeks of gestation weighing 3020 g with a complete cleft palate associated with a large central nasopharyngeal tumour. Computed tomography (CT) of the head showed a well defined mass of mixed density. The tumour was attached to the nasal septum in direct contact with the cleft palate. A biopsy confirmed the teratoma. Tumour resection was performed at 5 months, soft palate reconstruction at 7 months and hard palate closure at 14 months. There was no sign of local recurrence 1 year later. Most teratomas are benign and the prognosis is usually good. However, recurrence is not rare if germ cell carcinomatous foci are present within the teratoma. For these reasons, we advocate the use of a two-stage procedure in which closure of the cleft palate is postponed until histological examination confirms complete excision of the teratoma.

  6. Evidence-Based Medicine: Cleft Palate.

    Science.gov (United States)

    Woo, Albert S

    2017-01-01

    After studying this article, the participant should be able to: 1. Describe the incidence of cleft palate and risk factors associated with development of an orofacial cleft. 2. Understand differences among several techniques to repair clefts of both the hard and soft palates. 3. Discuss risk factors for development of postoperative fistulas, velopharyngeal insufficiency, and facial growth problems. 4. Establish a treatment plan for individualized care of a cleft palate patient. Orofacial clefts are the most common congenital malformations of the head and neck region, and approximately three-quarters of these patients have some form of cleft palate deformity. Cleft palate repair is generally performed in children between 6 and 12 months of age. The goals of palate repair are to minimize the occurrence of fistulas, establish a normal velopharyngeal mechanism, and optimize facial growth. This Maintenance of Certification review discusses the incidence and epidemiology associated with cleft palate deformity and specifics associated with patient care, including analgesia, surgical repair techniques, and complications associated with repair of the cleft palate.

  7. Nasal Glial Heterotopia with Cleft Palate.

    Science.gov (United States)

    Chandna, Sudhir; Mehta, Milind A; Kulkarni, Abhishek Kishore

    2018-01-01

    Congenital midline nasal masses are rare anomalies of which nasal glial heterotopia represents an even rarer subset. We report a case of a 25-day-old male child with nasal glial heterotopia along with cleft palate suggesting embryonic fusion anomaly which was treated with excision and primary closure for nasal mass followed by palatal repair at later date.

  8. Nasal glial heterotopia with cleft palate

    Directory of Open Access Journals (Sweden)

    Sudhir Chandna

    2018-01-01

    Full Text Available Congenital midline nasal masses are rare anomalies of which nasal glial heterotopia represents an even rarer subset. We report a case of a 25-day-old male child with nasal glial heterotopia along with cleft palate suggesting embryonic fusion anomaly which was treated with excision and primary closure for nasal mass followed by palatal repair at later date.

  9. The role of succinylcholine in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors

    International Nuclear Information System (INIS)

    Cesur, M.; Erdem, Ali F.; Alici, Haci A.; Yuksek, Mustafa S.; Yapanoglu, T.; Aksoy, Y.

    2008-01-01

    Objective was to present our 8 year experience in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors. This study was performed in Ataturk University Hospital between 1999 and 2007. We retrospectively reviewed the records of 89 patients with inferolateral bladder tumors, who underwent transurethral resection under epidural or general anesthesia and requested obturator nerve reflex inhibition. Epidural anesthesia was administered to 57 patients, while the remaining 32 patients underwent general anesthesia via mask; and succinylcholine was administered prior to resection. Of the 57 patients received epidural anesthesia, 18 were diagnosed as inferolateral bladder tumors during endoscopy and had to undergo general anesthesia. Obturator nerve block was attempted preoperatively in 39 patients. However, a nerve identification failure, hematoma and 4 obturator nerve reflex events, despite the block, were observed and these patients were subjected to general anesthesia with succinylcholine. Fifty-six patients (32 patients initially had general anesthesia and 24 converted from epidural to general anesthesia) were all given succinylcholine prior to resection. Due to its mechanisms of action, succinylcholine is completely effective and represents a simple alternative to obturator nerve block. No contraction was observed in any patient given succinylcholine. (author)

  10. Clinical and radiographic evaluation of zinc oxide with aloe vera as an obturating material in pulpectomy: An in vivo study

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    Abhishek Khairwa

    2014-01-01

    Full Text Available Background: Pulp therapy for pulpally involved primary teeth continues to be a challenge to clinicians. One of the major areas of continued research is in the area of finding obturating materials to suit the specific properties of these teeth. Zinc oxide eugenol is used frequently in pulpectomy for the obturation of the primary teeth. Aims: To evaluate clinically and radiographically a mixture of zinc oxide eugenol and aloe vera as an obturating material. Materials and Methods: A total of 50 children, aged between 4 and 9 years, who were screened for unilateral or bilateral carious deciduous molars were studied. Out of these, 15 children were randomly selected for endodontic treatment. Obturation was done with a mixture of zinc oxide powder and aloe vera gel. Clinical and radiographic evaluation was done after 7 days, 1 month, 3 months, 6 months, and 9 months. The data were statistically analyzed. Results and Conclusion: Endodontic treatment using a mixture of zinc oxide powder and aloe vera gel in primary teeth has shown good clinical and radiographic success. A detailed observational study with longer follow-up will highlight the benefits of aloe vera in primary teeth as an obturating medium.

  11. Influence of different palate repair protocols on facial growth in unilateral complete cleft lip and palate.

    Science.gov (United States)

    Xu, Xue; Kwon, Hyuk-Jae; Shi, Bing; Zheng, Qian; Yin, Heng; Li, Chenghao

    2015-01-01

    To address the question of whether one- or two-stage palatal treatment protocol has fewer detrimental effects on craniofacial growth in patients aged 5 years with unilateral complete cleft lip and palate. Forty patients with non-syndromic unilateral complete cleft lip and palate (UCCLPs) who had received primary cleft lip repair at age 6-12 months and cleft palate repair at age 18-30 months were selected in this study. Eighteen UCCLP patients who received two-stage palate repair were selected as group 1, and 22 UCCLP patients who received one-stage palate repair were selected as group 2. The control group consisted of 20 patients with unilateral incomplete cleft lip (UICL patients) whose age and gender matched with UCCLP patients. A one-sample Kolmogorov-Smirnov test was used to analyze the nature of data distribution. Bonferroni test and Kruskal-Wallis H tests were used for multiple comparisons. Both case groups showed reduced maxillary sagittal length (ANS-PMP, A-PM, p palate repair had a reduced posterior maxillary vertical height (R-PMP, p palate repair. Vomer flap repair inhibited maxilla vertical growth. Delayed hard palate repair showed less detrimental effects on maxillary growth compared to early hard palate repair in UCCLP patients aged 5 years. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  12. Bony defect of palate and vomer in submucous cleft palate patients.

    Science.gov (United States)

    Ren, S; Ma, L; Zhou, X; Sun, Z

    2015-01-01

    The aim of this study was to visualize bony defects of the palate and vomer in submucous cleft palate patients (SMCP) by three-dimensional (3D) computed tomography (CT) reconstruction and to classify the range of bony defects. Forty-eight consecutive non-operated SMCP patients were included. Diagnosis was based on the presence of at least one of three classical signs of SMCP: bifid uvula, a translucent zone in the midline of the soft palate, and a palpable 'V' notch on the posterior border of the bony palate. Patients were imaged using spiral CT. 3D reconstruction models were created of the palate and vomer. The sagittal extent of the bony cleft in SMCP was classified into four types: type I, no V-shaped hard palate cleft (8.3%); type II, cleft involving the partial palate (43.8%); type III, cleft involving the complete palate and extending to the incisive foramen (43.8%); type IV, cleft involving the complete palate and the alveolar bone (4.2%). The extent of the vomer defect was classified into three types: type A, vomer completely fused with the palate (8.3%); type B, vomer partially fused with the palate (43.8%); type C, vomer not fused with the palate up to the incisive foramen (47.9%). Significant variability in hard palate defects in SMCP is the rule rather than the exception. The association of velopharyngeal insufficiency with anatomical malformations may be complex. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Oromaxillary Prosthetic Rehabilitation of a Maxillectomy Patient Using a Magnet Retained Two-Piece Hollow Bulb Definitive Obturator; A Clinical Report

    Science.gov (United States)

    Mohamed Usman, Jafar Abdulla; Ayappan, Anuroopa; Ganapathy, Dhanraj; Nasir, Nilofer Nisha

    2013-01-01

    Resection of a malignant lesion involving the maxilla produces severe oromaxillary defect that can seriously jeopardize the normal phonetics of the patient. These defects are effectively managed by well-designed and fabricated obturator. This paper discusses the oromaxillary prosthetic rehabilitation of a maxillectomy patient using a magnet retained two-piece hollow bulb definitive obturator. PMID:23533823

  14. Oromaxillary Prosthetic Rehabilitation of a Maxillectomy Patient Using a Magnet Retained Two-Piece Hollow Bulb Definitive Obturator; A Clinical Report

    Directory of Open Access Journals (Sweden)

    Jafar Abdulla Mohamed Usman

    2013-01-01

    Full Text Available Resection of a malignant lesion involving the maxilla produces severe oromaxillary defect that can seriously jeopardize the normal phonetics of the patient. These defects are effectively managed by well-designed and fabricated obturator. This paper discusses the oromaxillary prosthetic rehabilitation of a maxillectomy patient using a magnet retained two-piece hollow bulb definitive obturator.

  15. Aspiration pneumonia in patients with cleft palate

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Uhm, Ki Il [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-03-01

    To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group.

  16. Aspiration pneumonia in patients with cleft palate

    International Nuclear Information System (INIS)

    Lee, Seung Hun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Uhm, Ki Il

    2003-01-01

    To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group

  17. Health-related quality of life after maxillectomy: obturator rehabilitation compared with flap reconstruction.

    Science.gov (United States)

    Breeze, J; Rennie, A; Morrison, A; Dawson, D; Tipper, J; Rehman, K; Grew, N; Snee, D; Pigadas, N

    2016-10-01

    Health-related quality of life (QoL) reported by patients has the potential to improve care after ablative surgery of the midface, as existing treatment algorithms still generally revolve around outcomes assessed traditionally only by clinicians. Decisions in particular relate to reconstruction with a flap compared with rehabilitation with an obturator, the need for adjuvant treatment, and morbidity related to the size of the defect. We prospectively collected health-related QoL assessments for 39 consecutive patients treated by maxillectomy between 01 January 2010 and 31 December 2014 using the University of Washington Quality of Life Questionnaire, and who had a mean (SD) duration of follow-up of 14 (4). We made sub-group analyses using paired t tests and analysis of variance (ANOVA) to compare reconstruction with a flap with rehabilitation with obturators, size of the vertical defect, and whether adjuvant treatment with radiotherapy or chemoradiotherapy adversely affected it. Overall there was a significant decrease in health-related QoL after treatment compared with before (p<0.001), but there was no significant difference in the effects of any of the paired reconstructive and rehabilitation treatments on it. Obturators remain an important option for rehabilitation in selected patients in addition to reconstruction with a flap. We found that neither increasing the size of the vertical defect (in an attempt to ensure clear margins) nor the use of postoperative radiotherapy seemed to have any adverse effect on QoL. More patients are required before we can conclude that the potential survival benefits of such measures may outweigh any adverse effects. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Evaluation of three instrumentation techniques at the precision of apical stop and apical sealing of obturation

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    Özgür Genç

    2011-08-01

    Full Text Available OBJECTIVE: The aim of this study was to investigate the ability of two NiTi rotary apical preparation techniques used with an electronic apex locator-integrated endodontic motor and a manual technique to create an apical stop at a predetermined level (0.5 mm short of the apical foramen in teeth with disrupted apical constriction, and to evaluate microleakage following obturation in such prepared teeth. MATERIAL AND METHODS: 85 intact human mandibular permanent incisors with single root canal were accessed and the apical constriction was disrupted using a #25 K-file. The teeth were embedded in alginate and instrumented to #40 using rotary Lightspeed or S-Apex techniques or stainless-steel K-files. Distance between the apical foramen and the created apical stop was measured to an accuracy of 0.01 mm. In another set of instrumented teeth, root canals were obturated using gutta-percha and sealer, and leakage was tested at 1 week and 3 months using a fluid filtration device. RESULTS: All techniques performed slightly short of the predetermined level. Closest preparation to the predetermined level was with the manual technique and the farthest was with S-Apex. A significant difference was found between the performances of these two techniques (p<0.05. Lightspeed ranked in between. Leakage was similar for all techniques at either period. However, all groups leaked significantly more at 3 months compared to 1 week (p<0.05. CONCLUSIONS: Despite statistically significant differences found among the techniques, deviations from the predetermined level were small and clinically acceptable for all techniques. Leakage following obturation was comparable in all groups.

  19. Objective clinical assessment of change in swallowing ability of maxillectomy patients when wearing obturator prostheses.

    Science.gov (United States)

    Matsuyama, Miwa; Tsukiyama, Yoshihiro; Koyano, Kiyoshi

    2005-01-01

    Evaluation of treatment outcome is important in maxillofacial rehabilitation. Although eating is one of the oral functions that most strongly influences patients' quality of life, only a few reports exist on the objective assessment of swallowing for maxillectomy patients. The purpose of this study was to identify changes in the swallowing ability of maxillectomy patients when wearing obturator prostheses through the use of an objective clinical assessment. The swallowing ability of 38 postmaxillectomy patients consecutively treated with obturator prostheses was objectively evaluated with the "water-drinking test" that was developed for the assessment of dysphagia patients after cerebrovascular disease. In this test, the subjects were instructed to drink 30 mL of water in one swallow. The profile was evaluated with the combination of the time required for drinking the water and the incidence of cough reflex. Statistical analysis was performed using the Wilcoxon signed-rank test, the paired t test, and the Chi-square test with StatView 5.0 for the Macintosh. Performance improved significantly when the patients wore prostheses (P = .0026, Wilcoxon signed-rank test). The mean drinking times without and with prostheses were 8.2 +/- 6.3 s and 5.0 +/- 3.5 s, respectively. Drinking time was shortened significantly when the prosthesis was worn (P = .0002, paired t test). The assessment of behavior and episodes revealed that the swallowing ability of the maxillectomy patients was significantly improved when a prosthesis was worn (P = .0002, Chi-square test). The swallowing ability of maxillectomy patients was quantitatively and qualitatively improved with obturator prostheses.

  20. A method for obturating microscopic ports in parts submitted to stresses, e.g. heat-exchangers

    International Nuclear Information System (INIS)

    Halstead, W.D.

    1975-01-01

    The invention relates to the obturation of cracks in metal-parts. It refers to a method for obturating the micropores of a member adapted to be submitted to stresses, said method being characterized in that it comprises the steps of exposing one surface of said member to a mixture of nickel-carbonyl and hydrogen sulfide with an inert gaseous carrier, and exposing the member other surface to air or nitrogen with oxygen or steam, the gases being at substantially the same pressure and at a temperature of from 290 to 330 deg K. This can be applied to the obturation of micropores in the heat exchangers of sodium cooled nuclear reactor [fr

  1. Protesa Maksilofasial Thermoplastic Nylon (Valplast dengan Hollow Bulb (Klas III Aramany palate schisis hereditary

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    A. Azhindra

    2012-06-01

    hollow bulb thermoplastic nylon juga dapat mengembalikan estetik yang maksimal sehingga pasien dapat menambah kepercayaan dirinya serta mengembalikan keadaan psikologi pasien yang telah lama menurun.   Background: patients with palato schisis (clelf palate due to hereditary or congenital defect will be seen that cause speech disorders (nasal, swallowing, mastication, esthetic and psychological. Purpose: to inform the way rehabilitation defect in the face with a maxillofacial prosthesis thermoplastic nylon with hollow bulb that is useful to restore the fuction of speech, swallowing, mastication, esthetics, and psychiatric patients. Case and handling:  46-yearold male patient came to RSGM Prof. Soedomo referral from Dr. Sardjito hospital. When patient come to feel annoyed talking, chewing ang swallowing due to the precence cleft palate is open and is a congential abnormality accompanied with loss of many teeth. Obturator is made immediately by considering the closure of cleft palate, using a lighter material (using a hollow bulb with retention, stabilization and occlusion of the right and restore normal nendekati face shape. Hollow bulb is a cavity created in maxillofacial, prosthesis, to close the oral cavity, nasal cavity and the defect.at the time of insetation examined retention, stabilization, occlusion, esthetics and pronunciation. Control was performed 1 week and 1 month after application. The results of the examination and evaluation after 1 week and 1 month after the use of hollow bulb know maxillofacial prostheses retentation, stabilization, occlusion and better pronunciation. Conclusion:  maxillofacial prostheses after using thermoplastic nylon with hollow bulb in patients with palate scisis, patients can speak and chew normaly. Maxillofacial prostheses nylon thermoplastic hollow bulb can also restore the maximum aesthetic, especially in the lose of anterior teeth with retention or grip that can mimic the gingival so the patient increase self confidence and

  2. [Modern tendencies in surgical treatment of patients with obturation jaundice complicated by hepatic insufficiency].

    Science.gov (United States)

    Starosek, V N; Khil'ko, S S; Vlakhov, A K

    2009-04-01

    The article is devoted to the problem of efficacy of the hepatic insufficiency (HI) prophylaxis and treatment methods in obturation jaundice. The role of energy-depending processes and the oxygen deficiency in tissues in the HI occurrence and progressing, the possibilities of medicinal correction of such disorders were studied up. The authors follow the concept of expediency of the oxygen-bearing preparations, which improve the erythrocytes function and oxygen delivery to the tissues in combination with miniinvasive decompression of bilioefferent ways, incorporation into the treatment complex of HI of mechanic genesis.

  3. Threading the Needle: Intrapelvic Displacement of a Femoral Neck Fracture through the Obturator Foramen

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    Gautham Prabhakar

    2018-01-01

    Full Text Available Despite timely and appropriate management, displaced femoral neck fractures are often devastating injuries for the young patient. The risk of negative sequelae is further amplified with increasing displacement and vertical fracture patterns. Open anatomic reduction with rigid internal fixation is essential to maximize the healing potential in displaced fractures of the femoral neck. Successful primary osteosynthesis of significantly displaced femoral neck fractures in the young patient has been reported in the literature. We present a unique case of open reduction and internal fixation of a high-energy femoral neck fracture with extrusion of the head through the obturator foramen into the pelvis without associated acetabular or pelvic injury.

  4. Rehabilitation of patient with acquired maxillary defect, using a closed hollow bulb obturator

    Directory of Open Access Journals (Sweden)

    Abhilasha S Bhasin

    2011-01-01

    Full Text Available Palliative care means providing support and care for patients with life-threatening or debilitating illness so that they can live their life as comfortably as possible. The fact that cure is no longer a reality does not mean that care cannot be made available. Partial maxillectomy defect presents a prosthodontic challenge in terms of re-establishing oronasal separation. Such defect has direct effect on cosmetic, function and psychology of the patient. This article describes step by step clinical and laboratory procedures involved in the rehabilitation of a hemimaxillectomy patient, using a definitive closed hollow bulb obturator, which improved his physical, emotional, functional, social and spiritual needs.

  5. System for sampling liquids in small jugs obturated by screwed taps

    International Nuclear Information System (INIS)

    Besnier, J.

    1995-01-01

    This invention describes a machine which samples automatically liquids in small jugs obturated by screwed taps. This device can be situated in an isolated room in order to work with radioactive liquids. The machine can be divided in three main parts: a module to catch the jug, in order to take and fix it, a module to open and to close it, and a module to sample. The later takes the liquid thanks to a suction device and puts it in a container, in order to analyse the sample. (TEC)

  6. APICAL SEAL BETWEEN ADHESIVE ROOT CANAL OBTURATION SYSTEM AND GUTTA-PERCHA/AH-PLUS SEALER: AN IN VITRO COMPARISON STUDY

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    Girish

    2016-03-01

    Full Text Available BACKGROUND Three dimensional obturation of the root canal is important for success of root canal treatment. Microleakage is one of the reason for root canal failure. Numerous materials have been used for obturation of which Gutta-percha is the most successful with variety of sealers. One of the recent material to further improve root canal treatment success rate is use of Resilon with Epiphany root canal sealer to apply adhesive concepts in to endodontics. An adhesive bond forms between Epiphany sealer, Resilon and dentin, making it monolithic hence less microleakage if any significantly. METHODS 60 single rooted mandibular premolars were dissected at cement enamel junction with diamond disc. Root canals were explored and working length measured using K file. Root canals of all 60 samples were prepared with ProTaper and irrigated with 5% sodium hypochlorite and 17% EDTA solution. Teeth were divided in to group A and B, each having 30 samples. Group A teeth obturated with Resilon Epiphany obturation system and group B with Gutta-percha and AH-plus sealer. All specimens were stored in incubator for 30 days. Clearing process of samples done with Robertson’s technique to make them transparent. All the specimens were immersed in 2% methylene blue dye solution for 7 days. Specimens were then examined under stereomicroscope with 10x magnification to measure dye penetration in mm with image analysis software. The data collected were analysed statistically. RESULTS This study showed that Resilon Epiphany group has a mean leakage of 1.2307, while the Gutta-percha/AH-plus had a mean leakage of 3.6133. There was statistically significant differences between Resilon and Gutta-percha groups. CONCLUSIONS 1. Resilon Epiphany group showed less apical microleakage than Gutta-percha/AH-plus obturation. 2. Based on result obtained it is suggested that Resilon Epiphany can be recommended for root canal obturation.

  7. Magnetic resonance imaging of cleft palate

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    Naito, Yasushi; Tasaka, Yasuyuki; Honjo, Iwao; Nishimura, Kazumasa; Nakano, Yoshihisa

    1987-03-01

    Magnetic resonance imaging (MRI) of the nasopharynx and the eustachian tube was performed in five patients with cleft palate and compared with the results of those without this anomaly. Various degrees of deformity of the eustachian tube cartilage were found in cleft palate patients. The levator veli palatini muscles were situated more laterally in cleft palate patients than in normal subjects. Also, changes in the position of these muscles after palatoplasty were clearly depicted by MRI. Besides several autopsy reports, this is the first demonstration of the characteristic anomaly around the eustachian tube by a non-invasive method.

  8. Prosthetic rehabilitation of the dentate maxillectomy patient from a delayed surgical to an interim obturator: A clinical case report

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    Angleena Y Daniel

    2015-01-01

    Full Text Available The surgical management of maxillary pathosis results in direct communication between the oral and nasal cavity, imposing problems such as nasal regurgitation, unintelligent speech, difficulty in deglutition and compromised esthetics. A restoration of these defects is not always possible surgically, but prosthetic rehabilitation is an established treatment modality. Early rehabilitation can improve the quality of life and reduce the psychological trauma caused by surgical excision. Surgical and interim obturators placed during the initial phase can improve the outcome of the definitive prosthesis. This article presents a case report of a patient with partial maxillectomy who has been rehabilitated with a delayed surgical and an interim obturator.

  9. Monoblock Obturation Technique for Non-Vital Immature Permanent Maxillary Incisors Using Mineral Trioxide Aggregate: Results from Case Series

    International Nuclear Information System (INIS)

    Iqbal, Z.; Qureshi, A. H.

    2014-01-01

    Ten patients presented with non-vital immature teeth for root canal treatment. In all these cases the pre-operative clinical examination revealed apical periodontitis with a buccal sinus tract of endodontic origin. These cases were treated by a mineral trioxide aggregate (MTA) monoblock obturation technique. Follow-up evaluations were performed at 1 - 2 years after treatment. Eight out of 10 cases were associated with periradicular healing at follow-up evaluation. Mineral trioxide aggregate Monoblock obturation technique appears to be a valid material to obtain periradicular healing in teeth with open apices and necrotic pulps. (author)

  10. Extent of palatal lengthening after cleft palate repair as a contributing factor to the speech outcome.

    Science.gov (United States)

    Bae, Yong-Chan; Choi, Soo-Jong; Lee, Jae-Woo; Seo, Hyoung-Joon

    2015-03-01

    Operative techniques in performing cleft palate repair have gradually evolved to achieve better speech ability with its main focus on palatal lengthening and accurate approximation of the velar musculature. The authors doubted whether the extent of palatal lengthening would be directly proportional to the speech outcome. Patients with incomplete cleft palates who went into surgery before 18 months of age were intended for this study. Cases with associated syndromes, mental retardation, hearing loss, or presence of postoperative complications were excluded from the analysis. Palatal length was measured by the authors' devised method before and immediately after the cleft palate repair. Postoperative speech outcome was evaluated around 4 years by a definite pronunciation scoring system. Statistical analysis was carried out between the extent of palatal lengthening and the postoperative pronunciation score by Spearman correlation coefficient method. However, the authors could not find any significant correlation. Although the need for additional research on other variables affecting speech outcome is unequivocal, we carefully conclude that other intraoperative constituents such as accurate reapproximation of the velar musculature should be emphasized more in cleft palate repair rather than palatal lengthening itself.

  11. Histology of palate and soft palate tonsil of collared peccary (Tayassu tajacu).

    Science.gov (United States)

    Teófilo, T S; Morais, M R P T; Dias, G F; Diniz, A N; Chaves, H S A; Fontenele-Neto, J D

    2014-10-01

    Peccaries are characterized by a prominent skin gland, known as scent gland, which is located in the middle of the rump. These animals are able to survive in a great variety of habitats, from humid tropical forests to semi-arid areas. They are omnivorous animals, and their diet includes fibrous material, vegetables, fruits, small vertebrates and insects. Collared peccary hard palate and soft palate tonsils were studied, macroscopic morphometric data were collected and tissue samples were paraffin-embedded. Sections were stained with HE, Gomori's trichrome and von Kossa; the first two were used to study general organization and the latter to detect calcium deposits. The hard palate showed one incisive papilla followed by several rugae united by a distinct raphe. The hard palate is lined by a keratinised squamous epithelium resting on a dense connective, whereas in the soft palate, the epithelium is parakeratinised and showed lymphocyte infiltration. The palate showed several pacinian corpuscles in the propria-submucosa. Two ovoid-shaped tonsils were found in the soft palate, and several crypts were observed on its surface. The epithelium was highly infiltrated by lymphocytes, and within the crypts, tonsilloliths were frequently observed. The study showed that the general organization of collared peccary palate is similar to other species, but in its oropharynx, only the soft palate tonsil was present and the pacinian corpuscles formed small aggregates. © 2013 Blackwell Verlag GmbH.

  12. Evidence-based medicine: cleft palate.

    Science.gov (United States)

    Chepla, Kyle J; Gosain, Arun K

    2013-12-01

    After reading this article, the participant should be able to: 1. Describe recent changes in treatment of cleft palate. 2. Compare the efficacy of different surgical treatments. 3. Assess their own knowledge of cleft palate repair. 4. Determine where further individual in-depth study and development are warranted. The Maintenance of Certification in Plastic Surgery series is designed to ensure professional development and measure continued competency within a specialty or subspecialty. The present article provides an evaluation of the interval studies regarding the management of cleft palate with a specific focus on craniofacial growth, speech outcomes, and obstructive sleep apnea since the last Maintenance of Certification in Plastic Surgery article on the subject published in 2010. This purpose of this article is to update plastic and craniomaxillofacial surgeons on recent changes in treatment of cleft palate, provide a means for accurate self-assessment, and guide further individual in-depth study and development.

  13. Evaluation of the Sealing Ability of Three Obturation Techniques Using a Glucose Leakage Test

    Directory of Open Access Journals (Sweden)

    Katarzyna Olczak

    2017-01-01

    Full Text Available The aim of this study was to evaluate the sealing ability of three different canal filling techniques. Sixty-four roots of extracted human maxillary anterior teeth were prepared using ProTaper® rotary instruments. The specimens were then randomly divided into 3 experimental groups (n=16 and 2 control groups (n=8. The root canals were filled using cold lateral compaction (CLC group, continuous wave condensation technique using the Elements Obturation Unit® (EOU group, and ProTaper obturators (PT group. For the negative control group, 8 roots were filled using lateral compaction as in the CLC group, and the teeth were covered twice with a layer of nail varnish (NCG group. Another 8 roots were filled using lateral compaction, but without sealer, and these were used as the positive control (PCG group. A glucose leakage model was used for quantitative evaluation of microleakage for 24 hours and 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12 weeks. No significant difference in the cumulative amount of leakage was found between the three experimental groups at all observation times. The lateral condensation of cold gutta-percha can guarantee a similar seal of canal fillings as can be achieved by using thermal methods, in the round canals.

  14. Fabrication of a 3D Printing Definitive Obturator Prosthesis: a Clinical Report

    Directory of Open Access Journals (Sweden)

    Georgios Kouveliotis

    2017-01-01

    Full Text Available Introduction: Digital technologies related to imaging and manufacturing provide the clinician with a wide variety of treatment options. Stereolithography (SLA offers a simple and predictable way for an accurate reconstruction of congenital or acquired defects. Clinical case: A 65-years old cancer patient with non- keratinized squamous cell carcinoma of left maxillary sinus came for a prosthetic clinical evaluation. A bilateral maxillectomy was performed and the treatment plan included definite obturator prosthesis for the upper arch. CT data and 3D planning software were used to create a 3D printing plastic model of the defect. A wax pattern of the hollow bulb was fabricated and cured with heatcured silicone soft liner. A final impression was obtained with the hollow bulb placed intraorally. The master cast was duplicated and the new cast was invested and reflasked. The flasks were opened, wax was boiled out and some space was created in the internal part of the obturator. Transparent heat cured acrylic resin was sandwiched with, at the inner part of the bulb, improving the retention between the acrylic denture base and the silicone based soft lining material. The patient was then placed on a 6-month recall. The five-year follow up consists of a chair side relining, when needed, of the definite removable prostheses. Conclusion: Maxillofacial surgery patients may develop postoperative complications such as trismus and pain. In these cases, the combination of digital technology and conventional techniques provide an accurate prosthetic restoration.

  15. Pulsed radiofrequency treatment of articular branches of femoral and obturator nerves for chronic hip pain.

    Science.gov (United States)

    Chye, Cien-Leong; Liang, Cheng-Loong; Lu, Kang; Chen, Ya-Wen; Liliang, Po-Chou

    2015-01-01

    Chronic hip pain is a common symptom experienced by many people. Often, surgery is not an option for patients with multiple comorbidities, and conventional drugs either have many side effects or are ineffective. Pulsed radiofrequency (PRF) is a new method in the treatment of pain. We attempt to compare the efficacy of PRF relative to conservative management for chronic hip pain. Between August 2011 and July 2013, 29 patients with chronic hip pain were divided into two groups (PRF and conservative treatment) according to consent or refusal to undergo PRF procedure. Fifteen patients received PRF of the articular branches of the femoral and obturator nerves, and 14 patients received conservative treatment. Visual analog scale (VAS), Oxford hip scores (OHS), and pain medications were used for outcome measurement before treatment and at 1 week, 4 weeks, and 12 weeks after treatment. At 1 week, 4 weeks, and 12 weeks after treatment initiation, improvements in VAS were significantly greater with PRF. Improvements in OHS were significantly greater in the PRF group at 1 week, 4 weeks, and 12 weeks. Patients in the PRF group also used less pain medications. Eight subjects in the conservative treatment group switched to the PRF group after 12 weeks, and six of them had >50% improvement. When compared with conservative treatment, PRF of the articular branches of the femoral and obturator nerves offers greater pain relief for chronic hip pain and can augment physical functioning.

  16. Application of microcomputed tomography for quantitative analysis of dental root canal obturations

    Directory of Open Access Journals (Sweden)

    Anna Kierklo

    2014-03-01

    Full Text Available Introduction: The aim of the study was to apply microcomputed tomography to quantitative evaluation of voids and to test any specific location of voids in tooth’s root canal obturations. Materials and Methods: Twenty root canals were prepared and obturated with gutta-percha and Tubli-Seal sealer using the thermoplastic compaction method (System B + Obtura II. Roots were scanned and three-dimensional visualization was obtained. The volume and Feret’s diameter of I-voids (at the filling/dentine interface and S-voids (surrounded by filling material were measured.Results: The results revealed that none of the scanned root canal fillings were void-free. For I-voids, the volume fraction was significantly larger, but their number was lower (P = 0.0007, than for S-voids. Both types of voids occurred in characteristic regions (P < 0.001. I-voids occurred mainly in the apical third, while S-voids in the coronal third of the canal filling.Conclusions: Within the limitations of this study, our results indicate that microtomography, with proposed semi-automatic algorithm, is a useful tools for three-dimensional quantitative evaluation of dental root canal fillings. In canals filled with thermoplastic gutta-percha and Tubli-Seal, voids at the interface between the filling and canal dentine deserve special attention due to of their periapical location, which might promote apical microleakage. Further studies might help to elucidate the clinical relevance of these results.

  17. CT and MR imaging findings of palatal tumors

    International Nuclear Information System (INIS)

    Kato, Hiroki; Kanematsu, Masayuki; Makita, Hiroki; Kato, Keizo; Hatakeyama, Daijiro; Shibata, Toshiyuki; Mizuta, Keisuke; Aoki, Mitsuhiro

    2014-01-01

    Palatal tumors commonly arise from the minor salivary glands, and benign tumors account for approximately half of all minor salivary gland tumors. Minor salivary gland tumors have an affinity for the posterior hard palate and soft palate and virtually never arise in the midline, probably because of the distribution of palatal salivary glands. The majority of benign salivary gland tumors of the palate are pleomorphic adenomas, while the most common malignant salivary gland tumor is adenoid cystic carcinoma, followed by mucoepidermoid carcinoma, adenocarcinoma, and polymorphous low-grade adenocarcinoma. Epithelial tumors frequently arise from the soft palate. The majority of benign epithelial tumors of the palate are papillomas, while most malignant epithelial tumors are squamous cell carcinomas. Various types of mesenchymal tumors, including fibromas, lipomas, schwannomas, neurofibromas, hemangiomas, and lymphangiomas, also involve the palate. This article describes the CT and MR findings of benign and malignant palatal tumors

  18. CT and MR imaging findings of palatal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Hiroki, E-mail: hkato@gifu-u.ac.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); Kanematsu, Masayuki, E-mail: masa_gif@yahoo.co.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); High-level Imaging Diagnosis Center, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194 (Japan); Makita, Hiroki, E-mail: makitah@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Kato, Keizo, E-mail: keizo@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Hatakeyama, Daijiro, E-mail: hatakeya@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Shibata, Toshiyuki, E-mail: shibat@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Mizuta, Keisuke, E-mail: kmizuta@gifu-u.ac.jp [Department of Otolaryngology, Gifu University School of Medicine, Gifu (Japan); Aoki, Mitsuhiro, E-mail: aoki@gifu-u.ac.jp [Department of Otolaryngology, Gifu University School of Medicine, Gifu (Japan)

    2014-03-15

    Palatal tumors commonly arise from the minor salivary glands, and benign tumors account for approximately half of all minor salivary gland tumors. Minor salivary gland tumors have an affinity for the posterior hard palate and soft palate and virtually never arise in the midline, probably because of the distribution of palatal salivary glands. The majority of benign salivary gland tumors of the palate are pleomorphic adenomas, while the most common malignant salivary gland tumor is adenoid cystic carcinoma, followed by mucoepidermoid carcinoma, adenocarcinoma, and polymorphous low-grade adenocarcinoma. Epithelial tumors frequently arise from the soft palate. The majority of benign epithelial tumors of the palate are papillomas, while most malignant epithelial tumors are squamous cell carcinomas. Various types of mesenchymal tumors, including fibromas, lipomas, schwannomas, neurofibromas, hemangiomas, and lymphangiomas, also involve the palate. This article describes the CT and MR findings of benign and malignant palatal tumors.

  19. An in vitro Comparison of Bond Strength of Different Sealers/Obturation Systems to Root Dentin Using the Push-Out Test at 2 Weeks and 3 Months after Obturation.

    Science.gov (United States)

    Yap, Wai Ying; Che Ab Aziz, Zeti Adura; Azami, Noor Hayati; Al-Haddad, Afaf Yahya; Khan, Asfand Ali

    2017-01-01

    To evaluate the push-out bond strength and failure modes of different sealers/obturation systems to intraradicular dentin at 2 weeks and 3 months after obturation compared to AH Plus®/gutta-percha. A total of 180 root slices from 60 single-canal anterior teeth were prepared and assigned to 5 experimental groups (n = 36 in each group), designated as G1 (AH Plus®/gutta-percha), G2 (TotalFill BC™ sealer/BC-coated gutta-percha), G3 (TotalFill BC™ sealer/gutta-percha), G4 (EndoREZ® sealer/EndoREZ®-coated gutta-percha), and G5 (EndoREZ® sealer/gutta-percha). Push-out bond strengths of 18 root slices in each group were assessed at 2 weeks and the other 18 at 3 months after obturation using a universal testing machine. Data were analyzed using repeated measures ANOVA. An independent t test was used to compare the mean push-out bond strength for each group at 2 weeks and 3 months after obturation. The mean push-out bond strengths of G4 and G5 were significantly lower than those of G1, G2, and G3 (p strengths of G2 (3.69 ± 1.20 MPa) and G3 (2.84 ± 0.83 MPa) were higher at 3 months compared to 2 weeks after obturation (G2: 1.74 ± 0.43 MPa, G3: 1.33 ± 0.29 MPa). The TotalFill BC™ obturation system (G2) and the TotalFill BC™ sealer/gutta-percha (G3) showed comparable bond strength to AH Plus®. Their bond strength increased over time, whereas the EndoREZ® obturation system (G4) and EndoREZ sealer (G5) had low push-out bond strength which decreased over time. © 2017 The Author(s) Published by S. Karger AG, Basel.

  20. 3-D shape analysis of palatal surface in patients with unilateral complete cleft lip and palate

    Czech Academy of Sciences Publication Activity Database

    Rusková, H.; Bejdová, Š.; Peterka, Miroslav; Krajíček, V.; Velemínská, J.

    2014-01-01

    Roč. 42, č. 5 (2014), e140-e147 ISSN 1010-5182 Grant - others:GA UK(CZ) 309611 Institutional support: RVO:68378041 Keywords : unilateral cleft of lip and palate * palate shape * surface scanning Subject RIV: FF - HEENT, Dentistry Impact factor: 2.933, year: 2014

  1. An ex vivo comparison of pressures within dental pulp space using conventional anesthetic technique versus needle-mounted obturator.

    Science.gov (United States)

    Grubbs, S Lee; Alley, Larry W; Eleazer, Paul D

    2014-07-01

    The intrapulpal (IP) injection technique is 1 of several ways of obtaining profound anesthesia. There is evidence to suggest that pressure is the primary factor in obtaining anesthesia using IP injection. This is an ex vivo comparison of pressures within dental pulp space using the conventional anesthetic technique versus a needle-mounted obturator technique. Twenty extracted anterior and premolar teeth were accessed with a high-speed 169L bur. A saline-filled tube connected to a digital pressure gauge was attached to the apical 10 mm of each tooth in a fixed mount. One operator performed all the injections under moderate pressure. Each tooth was injected twice; first, the tooth was given an IP injection with a normal setup, and then the same tooth was given an IP injection with the modified obturator syringe. The pressure at the apex was recorded for each tooth. A paired sample t test was completed to determine statistical significance. The pressure generated was considerably higher for the obturator group in every tooth when compared with the normal group (P < .001). IP injection with the obturator resulted in increased pressure at the apex of each tooth. This pressure increase may allow for increased anesthesia when IP injections are indicated. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Influence of the spatulation of two zinc oxide-eugenol-based sealers on the obturation of lateral canals

    Directory of Open Access Journals (Sweden)

    Pécora Jesus Djalma

    2002-01-01

    Full Text Available The objective of this research was to evaluate, in vitro, the importance of the correct manipulation of endodontic sealers, correlating it with flow rate and with the consequent obturation of root canals. Twenty-four human canines were prepared, 1 mm from the apex, with K-files up to size 50, by means of the step-back technique. Six lateral canals were then drilled in each tooth, with size 10 file fixed to a low-speed handpiece. The teeth were randomly divided into 4 groups, and root canals were obturated either with the EndométhasoneÒ sealer or Grossman sealer, prepared at ideal or incorrect clinical consistency. After obturation by means of the lateral condensation technique, the teeth were radiographed and evaluated as to the number of sealed lateral canals. Statistical analysis revealed significant differences (p < 0.001 between the tested sealers, and indicated the higher capacity of the well-manipulated Grossman sealer to fill lateral canals. It can be concluded that the flow rate of a sealer and its correct manipulation are very important for the satisfactory obturation of lateral canals.

  3. Bacterial entombment by intratubular mineralization following orthograde mineral trioxide aggregate obturation:a scanning electron microscopy study

    Institute of Scientific and Technical Information of China (English)

    Jun Sang Yoo; Qiang Zhu; Kee-Yeon Kum; Seok-Woo Chang; So Ram Oh; Hiran Perinpanayagam; Sang-Min Lim; Yeon-Jee Yoo; Yeo-Rok Oh; Sang-Bin Woo; Seung-Hyun Han

    2014-01-01

    The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate (MTA) was studied by scanning electron microscopy (SEM). Single-rooted human premolars (n560) were instrumented to an apical size #50/0.06 using ProFile and treated as follows:Group 1 (n510) was filled with phosphate buffered saline (PBS);Group 2 (n510) was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS;Group 3 (n520) was obturated orthograde with a paste of OrthoMTA (BioMTA, Seoul, Korea) and PBS;and Group 4 (n520) was incubated with E. faecalis for 3 weeks and then obturated with OrthoMTA–PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material (IRM), and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoMTA-filled roots (Groups 3 and 4). Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots (Group 4). Therefore, the orthograde obturation of root canals with OrthoMTA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.

  4. Persistent groin pain following a trans-obturator sling procedure for stress urinary incontinence: a diagnostic and therapeutic challenge

    NARCIS (Netherlands)

    Hazewinkel, Menke H.; Hinoul, Piet; Roovers, Jan-Paul

    2009-01-01

    Groin pain after a tension-free vaginal tape-obturator (TVT-O) procedure can occur but mostly disappears within 4 weeks. Persistent groin pain is extremely rare and there is a paucity of literature on how to diagnose and manage this adverse event. We present two cases with severe persistent groin

  5. Comparative assessment of the area of sealer voids in single cone obturation done with mineral trioxide aggregate, epoxy resin, and zinc-oxide eugenol based sealers

    Directory of Open Access Journals (Sweden)

    Anisha Kumar

    2016-01-01

    Full Text Available Introduction: Voids in the sealer mass have the potential to allow leakage through obturation. They are more critical in single cone (SC obturation as the volume of sealer used in this obturation is larger when compared to other obturations. Aim: To compare the area of voids in mineral trioxide aggregate (MTA-based, resin-based, and zinc oxide-eugenol-based sealers when employed with SC obturation technique. Materials and Methods: Fifteen teeth were cleaned and shaped and divided into three groups for SC obturation using MTA Fillapex, AH26, and Pulpdent sealers, respectively. The obturated teeth were sectioned at apical, middle, and coronal third, and area of voids in the sealer was assessed using a stereomicroscope and digital images and image software. The results were statistically analyzed using SPSS software and Kruskal-Wallis and Mann-Whitney tests. Results: The three tested sealers showed voids in all the sections except MTA Fillapex, which was void free in apical and middle sections. There were significant differences between these sealers regarding their section wise area of voids (P < 0.05. Similarly, there were significant differences in their overall area of voids (P < 0.05 with MTA Fillapex showing significantly least area of voids followed by AH26. Conclusions: SC obturation with MTA Fillapex sealer, which showed void free apical and middle third sections, had significantly least area of voids in the sealer followed by the one with AH26 sealer, whereas SC obturation with Pulpdent sealer had significantly most area of voids.

  6. Neurofibroma involving obturator nerve mimicking an adnexal mass: a rare case report and PRISMA-driven systematic review.

    Science.gov (United States)

    Chao, Wei-Ting; Liu, Chia-Hao; Chen, Yi-Jen; Wu, Hua-Hsi; Chuang, Chi-Mu; Wang, Peng-Hui

    2018-02-09

    Pelvic masses are a common gynecologic problem, and majority of them are diagnosed as ovarian tumors finally. Sometimes, it is hard to distinguish the origin of these pelvic masses. The following case is a solitary neurofibroma arising from the right-side obturator nerve, which was impressed as a right-side ovarian tumor initially. We reported this case, and also performed a PRISMA-driven systematic review to summary the similar cases in the literature. This review includes image, molecular and pathological findings and outcome of neurofibroma. A 33-year-old woman with a regular menstrual period denied any symptoms or signs. During her physical check-up, image examination revealed a right-side heterogeneous pelvic mass; it was suggestive of a complex of right-side ovarian tumor. A provisional diagnosis of retroperitoneal pelvic mass, probably a benign ovarian tumor, was made. Excision of the right-side pelvic mass was performed. We sent the specimens for frozen pathology, which indicated neurofibroma and lipomatous tumor and that the possibility of liposarcoma cannot be excluded. A segment of the obturator nerve was attached to the tumor and was severed. A right-side obturator nerve tear during tumor excision was observed, and a neurosurgeon was consulted for obturator nerve grafting and repair. The patient complained of mild weakness and paresthesia affecting the right leg, and we consulted a rehabilitation doctor for neuron injury. The patient's recovery was uneventful, and she was discharged eight days after the drain was removed. Further rehabilitation treatment was arranged. A neurofibroma is an uncommon pelvic retroperitoneal tumor, and it can be misdiagnosed as an adnexal mass. To our knowledge, this is a rare case of a solitary neurofibroma arising from the obturator nerve. It usually does not have any neurological deficit. We present this case to demonstrate that pelvic neurofibroma can be mistaken for an adnexal mass. This fact should be borne in mind

  7. IN VITRO COMPARISON OF GUTTA-PERCHA-FILLED AREA PERCENTAGES IN ROOT CANALS INSTRUMENTED AND OBTURATED WITH DIFFERENT TECHNIQUES*

    Directory of Open Access Journals (Sweden)

    Ayça YILMAZ

    2017-04-01

    Full Text Available Purpose: To evaluate the efficacy of different obturation techniques in root canals instrumented either by hand or rotary instruments with regard to the percentage of gutta- percha-filled area (PGFA. Materials and Methods: One hundred and sixty extracted mandibular premolars with single, straight root canals were studied. Root canals were prepared to an apical size of 30 by hand with a modified crown-down technique or the ProTaper and HEROShaper systems. Teeth were divided into eight groups (n=20 according to the following instrumentation and obturation techniques: G1: Hand files+lateral condensation (LC, G2: Hand files+Thermafil, G3: ProTaper+LC, G4: ProTaper+single-cone, G5: ProTaper+ProTaper-Obturator, G6: HEROShaper+LC, G7: HEROShaper+single-cone, G8: HEROShaper+HEROfill. Horizontal sections were cut at 1, 3, 5, 7, 9, 11 and 13 mm from the apical foramen. A total of 1120 sections obtained were digitally photographed under a stereomicroscope set at 48X magnification. The cross-sectional area of the canal and the gutta-percha was measured by digital image analysis and the PGFA was calculated for each section. Results: The mean of the PGFA in Thermafil (G2, ProTaper-Obturator (G5 and HEROfill (G8 groups was significantly higher than the other groups. In G3 and G4, PGFA showed no significant difference in the apical segments whereas PGFA was significantly higher at the middle and coronal segments in G3. In G6 and G7, PGFA showed no significant difference in the apical and middle segments whereas PGFA was significantly higher at the coronal segments in G6. Conclusion: The carrier-based gutta-percha obturation systems revealed significantly higher PGFA in comparison to single-cone and lateral condensation techniques.

  8. In vitro comparison of gutta-percha-filled area percentages in root canals instrumented and obturated with different techniques.

    Science.gov (United States)

    Yilmaz, Ayca; Karagoz-Kucukay, Isil

    2017-01-01

    To evaluate the efficacy of different obturation techniques in root canals instrumented either by hand or rotary instruments with regard to the percentage of gutta- percha-filled area (PGFA). One hundred and sixty extracted mandibular premolars with single, straight root canals were studied. Root canals were prepared to an apical size of 30 by hand with a modified crown-down technique or the ProTaper and HEROShaper systems. Teeth were divided into eight groups (n=20) according to the following instrumentation and obturation techniques: G1: Hand files+lateral condensation (LC), G2: Hand files+Thermafil, G3: ProTaper+LC, G4: ProTaper+single-cone, G5: ProTaper+ProTaper-Obturator, G6: HEROShaper+LC, G7: HEROShaper+single-cone, G8: HEROShaper+HEROfill. Horizontal sections were cut at 1, 3, 5, 7, 9, 11 and 13 mm from the apical foramen. A total of 1120 sections obtained were digitally photographed under a stereomicroscope set at 48X magnification. The cross-sectional area of the canal and the gutta-percha was measured by digital image analysis and the PGFA was calculated for each section. The mean of the PGFA in Thermafil (G2), ProTaper-Obturator (G5) and HEROfill (G8) groups was significantly higher than the other groups. In G3 and G4, PGFA showed no significant difference in the apical segments whereas PGFA was significantly higher at the middle and coronal segments in G3. In G6 and G7, PGFA showed no significant difference in the apical and middle segments whereas PGFA was significantly higher at the coronal segments in G6. The carrier-based gutta-percha obturation systems revealed significantly higher PGFA in comparison to single-cone and lateral condensation techniques.

  9. Treatment for Adults (with Cleft Lip and Palate)

    Science.gov (United States)

    ... here What treatment is available for adults with cleft lip and palate? Treatments currently available to infants and children with cleft lip and palate are also available to adults with clefts. Although ...

  10. New endodontic obturation systems and their interfacial bond strength with intraradicular dentine - ex vivo studies.

    Science.gov (United States)

    Pawińska, M; Kierklo, A; Tokajuk, G; Sidun, J

    2011-01-01

    To comparatively evaluate adhesive properties of selected root canal fillings through the measurement of the material-dentine interfacial bond strength. Fifty extracted single-rooted human teeth with one canal each were prepared using Hero instruments to size 30.04. Teeth were divided into four subgroups depending on the root canal filling material and the method of obturation: Resilon/Epiphany - a thermoplastic method (IA), Resilon/Epiphany - a matching single-point method (IB), gutta-percha/Roeko Seal Automix - a thermoplastic method (IIA) and gutta-percha/Roeko Seal Automix - a matching single-point method (IIB). The obturated roots were cut perpendicular to the long axis to create 1.7 mm thick slices. The bond strength was measured for each test slice with push -out testing machine. The highest push-out bond strength was registered in subgroup IB (3.98 ± 1.33 MPa). Significantly lower bond strength was observed in subgroups IA (0.50 ± 0.24 MPa), IIA (0.33 ± 0.18 MPa) and IIB (0.08 ± 0.03 MPa) (pmaterial-dentine interfacial bond strength values were observed between IA and IIA, IA and IIB, IIA and IIB subgroups (p > 0.05). The push-out bond strength of the material-dentine interface was dependent on the type of material used and the root canal filling technique. The R/E system exhibited better adhesion ability to intraradicular dentine than G/RSA. The highest bond strength was observed for Resilon/Epiphany introduced with the single-cone technique.

  11. Delayed closure of the palatal defect using buccal inversion and palatal rotation flaps after maxillectomy.

    Science.gov (United States)

    Jung, Seunggon; Kook, Min-Suk; Park, Hong-Ju; Oh, Hee-Kyun

    2013-03-01

    Maxillectomy leaves oronasal and oroantral defects that result in functional impairment of mastication, deglutition, and speech. Many treatment options are suggested and tried including the palatal flap as local flap. Although palatal flaps have been used to repair various oral cavity defects, they have certain limitations due to the dimensions. The amount and location of the palatal tissues available are important for palatal repair. Secondary intentional healing after maxillectomy will allow the epithelialization of the defect margin adjacent to remained palate, and there will be more mucosa that is available for closure of the defect. We delayed the closure of the palatal defect, while the patient underwent prosthetic treatment for functional recovery in 5 maxillectomy patients. Delayed closure of palatal defect with local flap was done at 10.8 ± 7.9 months after the maxillectomy. While delayed closure in hemimaxillectomy patients left postoperative fistula, it provided separation of the oral cavity and nasal/sinus cavity and adequate surface for prosthesis in partial maxillectomy patients.

  12. Acoustic Analysis on the Palatalized Vowels of Modern Mongolian

    Science.gov (United States)

    Bulgantamir, Sangidkhorloo

    2015-01-01

    In Modern Mongolian the palatalized vowels [a?, ??, ?? ] before palatalized consonants are considered as phoneme allophones according to the most scholars. Nevertheless theses palatalized vowels have the distinctive features what could be proved by the minimal pairs and nowadays this question is open and not profoundly studied. The purpose of this…

  13. L2 Perception of Spanish Palatal Variants across Different Tasks

    Science.gov (United States)

    Shea, Christine; Renaud, Jeffrey

    2014-01-01

    While considerable dialectal variation exists, almost all varieties of Spanish exhibit some sort of alternation in terms of the palatal obstruent segments. Typically, the palatal affricate [??] tends to occur in word onset following a pause and in specific linear phonotactic environments. The palatal fricative [?] tends to occur in syllable onset…

  14. Evaluation of Teeth Development in Unilateral Cleft Lip and Palate ...

    African Journals Online (AJOL)

    2018-02-23

    Feb 23, 2018 ... in patients with cleft lip and palate using medical software ... to be used in routine dental treatment and in particular the need to do more study. ... cleft palate/lip surgery were examined. ... segment from the “evaluate” tab of the program. Teeth .... cases of cleft palate or lip. ..... of maxillary canines: A CT study.

  15. A lining vomer flap for palate pushback in unilateral cleft palate repair.

    Science.gov (United States)

    Clavin, H D; Owsley, J Q

    1978-01-01

    A combinaation vomer mucoperiosteal flap and nasal floor mucoperiosteal flap is described which is used to achieve nasal coverage in unilateral cleft palate patients requiring pushbacks. A posteriorly based readily accessible vomer flap is raised on the cleft side and used as nasal lining for the palatal mucoperiosteal flap on the non-cleft side. On the cleft side, a symmetrically sized nasal floor flap is easily elevated under direct vision and used to cover the nasal aspect of the corresponding mucoperiosteal palatal flap.

  16. Postanesthetic ulceration of palate: A rare complication.

    Science.gov (United States)

    Gupta, Ramesh; Garg, Meenu; Pawah, Salil; Gupta, Ajay

    2016-01-01

    The routine dental practice involves various dental procedures which needs the application of local anesthetics. Generally, there are very few complications associated with these procedures. Complications such as tissue necrosis can occur following the rapid injection of local anesthetic solutions. Palate is a favorable site for soft tissue lesions, various factors such as direct effects of the drug, blanching of the tissues during injection, a relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate.

  17. The Fetal Cleft palate: V. Elucidation of the Mechanism of Palatal Clefting in the Congenital Caprine Model

    Science.gov (United States)

    Maternal ingestion of Nicotiana glauca from gestation days 32 through 41 results in a high incidence of cleft palate in Spanish goats. This caprine cleft palate model was used to evaluate the temporal sequence of palatal shelf fusion throughout the period of cleft induction with the poisonous plant...

  18. Maxillary Arch Dimensions and Spectral Characteristics of Children with Cleft Lip and Palate Who Produce Middorsum Palatal Stops

    Science.gov (United States)

    Zajac, David J.; Cevidanes, Lucia; Shah, Sonam; Haley, Katarina L.

    2012-01-01

    Purpose: The purpose of this study was twofold: (a) to determine maxillary arch dimensions of children with repaired cleft lip and palate (CLP) who produced middorsum palatal stops and (b) to describe some spectral characteristics of middorsum palatal stops. Method: Maxillary arch width, length, and height dimensions and first spectral moments of…

  19. Patterning of palatal rugae through sequential addition reveals an anterior/posterior boundary in palatal development

    Czech Academy of Sciences Publication Activity Database

    Pantalacci, S.; Procházka, Jan; Martin, A.; Rothová, Michaela; Lambert, A.; Bernard, L.; Charles, C.; Viriot, L.; Peterková, Renata; Laudet, V.

    2008-01-01

    Roč. 116, č. 8 (2008), s. 116-133 ISSN 1471-213X R&D Projects: GA ČR GA304/07/0223; GA MŠk OC B23.002 Institutional research plan: CEZ:AV0Z50390512 Keywords : secondary palate * cleft - palate * expression analysis Subject RIV: EA - Cell Biology Impact factor: 3.079, year: 2008

  20. Obturator internus pyomyositis manifested as sciatica in a patient with subacute bacterial endocarditis: A rare case report.

    Science.gov (United States)

    Hsu, Wei-Ching; Hsu, Jin-Yi; Chen, Michael Yu-Chih; Liang, Chung-Chao

    2016-07-01

    Pyomyositis is a pyogenic infection of the skeletal muscles causing myalgia and fever in patients. Hematogenous seeding engendered by persistent bacteremia and septic embolism is usually the underlying cause of the disease. Trauma, intravenous drug use, and immunodeficiency are the main predisposing factors.Obturator internus pyomyositis with sciatica has not previously been reported. We report a rare case of a patient with subacute bacterial endocarditis presenting with left buttock pain and sciatica.Computed tomography confirmed the diagnosis of obturator internus pyomyositis. The patient was discharged uneventfully after successful antibiotic treatment.The mortality rate of patients who have pyomyositis comorbid with another condition or disease is extremely high. Early diagnosis and aggressive management are imperative.

  1. Speech intelligibility after gingivectomy of excess palatal tissue

    Directory of Open Access Journals (Sweden)

    Aruna Balasundaram

    2014-01-01

    Full Text Available To appreciate any enhancement in speech following gingivectomy of enlarged anterior palatal gingiva. Periodontal literature has documented various conditions, pathophysiology, and treatment modalities of gingival enlargement. Relationship between gingival maladies and speech alteration has received scant attention. This case report describes on altered speech pattern enhancement secondary to the gingivectomy procedure. A systemically healthy 24-year- female patient reported with bilateral anterior gingival enlargement who was provisionally diagnosed as "gingival abscess with inflammatory enlargement" in relation to palatal aspect of the right maxillary canine to left maxillary canine. Bilateral gingivectomy procedure was performed by external bevel incision in relation to anterior palatal gingiva and a large wedge of epithelium and connective tissue was removed. Patient and her close acquaintances noticed a great improvement in her pronunciation and enunciation of sounds like "t", "d", "n", "l", "th", following removal of excess gingival palatal tissue and was also appreciated with visual analog scale score. Exploration of linguistic research documented the significance of tongue-palate contact during speech. Any excess gingival tissue in palatal region brings about disruption in speech by altering tongue-palate contact. Periodontal surgery like gingivectomy may improve disrupted phonetics. Excess gingival palatal tissue impedes on tongue-palate contact and interferes speech. Pronunciation of consonants like "t", "d", "n", "l", "th", are altered with anterior enlarged palatal gingiva. Excision of the enlarged palatal tissue results in improvement of speech.

  2. Adaptation to an electropalatograph palate: acoustic, impressionistic, and perceptual data.

    Science.gov (United States)

    McLeod, Sharynne; Searl, Jeff

    2006-05-01

    The purpose of this study was to evaluate adaptation to the electropalatograph (EPG) from the perspective of consonant acoustics, listener perceptions, and speaker ratings. Seven adults with typical speech wore an EPG and pseudo-EPG palate over 2 days and produced syllables, read a passage, counted, and rated their adaptation to the palate. Consonant acoustics, listener ratings, and speaker ratings were analyzed. The spectral mean for the burst (/t/) and frication (/s/) was reduced for the first 60-120 min of wearing the pseudo-EPG palate. Temporal features (stop gap, frication, and syllable duration) were unaffected by wearing the pseudo-EPG palate. The EPG palate had a similar effect on consonant acoustics as the pseudo-EPG palate. Expert listener ratings indicated minimal to no change in speech naturalness or distortion from the pseudo-EPG or EPG palate. The sounds [see text] were most likely to be affected. Speaker self-ratings related to oral comfort, speech, tongue movement, appearance, and oral sensation were negatively affected by the presence of the palatal devices. Speakers detected a substantial difference when wearing a palatal device, but the effects on speech were minimal based on listener ratings. Spectral features of consonants were initially affected, although adaptation occurred. Wearing an EPG or pseudo-EPG palate for approximately 2 hr results in relatively normal-sounding speech with acoustic features similar to a no-palate condition.

  3. Parental Reactions to Cleft Palate Children.

    Science.gov (United States)

    Vanpoelvoorde, Leah

    This literature review examines parental reactions following the birth of a cleft lip/palate child, focusing primarily on the mother's reactions. The research studies cited have explored such influences on maternal reactions as her feelings of lack of control over external forces and her feelings of guilt that the deformity was her fault. Delays…

  4. Live Imaging of Mouse Secondary Palate Fusion

    Czech Academy of Sciences Publication Activity Database

    Kim, S.; Procházka, Jan; Bush, J.O.

    jaro, č. 125 (2017), č. článku e56041. ISSN 1940-087X Institutional support: RVO:68378050 Keywords : Developmental Biology * Issue 125 * live imaging * secondary palate * tissue fusion * cleft * craniofacial Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Developmental biology Impact factor: 1.232, year: 2016

  5. Effect of Instrument Design and Access Outlines on the Removal of Root Canal Obturation Materials in Oval-shaped Canals.

    Science.gov (United States)

    Niemi, Tuomas K; Marchesan, Melissa A; Lloyd, Adam; Seltzer, Robert J

    2016-10-01

    The aim of this study was to compare the effectiveness of TRUShape (TS) instruments with ProFile Vortex Blue (VB) instruments for the removal of obturation materials during retreatment of single-canal mandibular premolars performed through 2 access outlines. Initial root canal treatment was completed through a contracted endodontic cavity (CEC) design. Canals were instrumented to an F2 ProTaper instrument, obturated with warm lateral condensation of gutta-percha with AH Plus sealer, and allowed to set for 30 days at 37°C and 100% humidity. For retreatment, specimens were divided into 2 groups (n = 24) on the basis of access outline, CEC or traditional endodontic cavity (TEC). Retreatment was initiated by using ProTaper Retreatment instruments (D1-D3). Specimens were then stratified, further divided (n = 12), and reinstrumented up to TS 40 .06v or 40 .06 VB. Irrigation was performed by using 8.25% NaOCl and QMix 2in1. Retreatment time was recorded. Teeth were sectioned and photographed, and the percentage of remaining obturation materials was measured. Data were analyzed with Kruskal-Wallis analysis of variance for two-factor tests (α canal surface when compared with TEC-VB, CEC-TS, and TEC-TS (P ≤ .05). None of these other combinations were different from each other (P > .05). Significantly more time was required for retreatment with CEC-TS (27.68 ± 1.4 minutes) than the other groups (P root canal surface of mandibular premolars. However, in the presence of a CEC access design, using TS instruments removed more obturating material in single-rooted, oval-shaped canals. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  6. Comparison of radiographic density and compaction index of root canal obturation using nickel titanium or stainless-steel spreaders

    Directory of Open Access Journals (Sweden)

    M. Adel

    2016-08-01

    Full Text Available Background: Both nickel titanium and stainless-steel spreaders are available. The obvious advantage of nickel titanium spreader over stainless steel spreaders is greater penetration in curved canals. Objective: To compare the radiographic density and compaction index of root canal obturation using nickel-titanium or stainless-steel spreaders in curved canals. Methods: In this experimental study the primary weight of 30 acrylic blocks with 45o degrees of apical curvature were measured by a scale (W1. After canals were prepared by step back master apical up to file #30 all blocks were weighed again (W2 and randomly divided in two groups of 15each. All canals were obturated by Cold lateral compaction technique (with nickel-titanium in one group and stainless-steel finger spreaders in another group. After all blocks were reweighed (W3, compaction index (W3-W2/W1-W2 was calculated. One radiograph was taken for each sample. Apical density of the apical third of each canal was measured by digital transmission densitometer. Data were analyzed statistically using T-test. Findings: Mean compaction index for nickel-titanium group was 7.67±2.38 and for stainless-steel group was 9.14±4.06. There was no significant difference between two groups. Mean radiographic density of obturation was 2.05±0.14 in nickel-titanium group and was 2.07±0.21 in stainless-steel group. There was no significant difference between two groups. Conclusion: It is concluded that nickel-titanium spreaders are not superior than stainless-steel spreaders in obturating curved canal.

  7. Penetrating Obturator Artery Injury after Gunshot Wounds: A Successful Multidisciplinary Trauma Team Approach to a Potentially Lethal Injury.

    Science.gov (United States)

    Maraqa, Tareq I; Shin, Ji-Sun J; Diallo, Ismael; Sachwani-Daswani, Gul R; Mercer, Leo C

    2017-11-17

    Obturator artery injury (OAI) from pelvic gunshot wounds (GSW) is a rarely reported condition. Hemorrhages from pelvic trauma (PT) are mostly venous. Arterial hemorrhages represent about 10-20% of PTs. When arterial hemorrhages from PT occur, they are a severe and deadly complication often causing significant hemodynamic instability and eventual shock. A  23-year-old male presented to our emergency service via a private vehicle with multiple gunshot wounds to both thighs and to the lower back, resulted in rectal and obturator artery (OA) injuries. The patient underwent a successful coil-embolization of the right OA. Given the density of structures within the pelvis, patients who sustain gunshot wounds to the pelvic region are at high risk for injury to the small bowel, sigmoid colon, rectum, bladder, and/or vascular structures. While bleeding is the major cause of early mortality in PT, rectal injuries carry the highest mortality due to visceral injuries. A high clinical index of suspicion is needed to diagnose an iliac artery injury or injury to its branches. Prompt computed tomographic angiogram (CTA) and embolization of the OA is the best method to control and stop the bleeding and improve the mortality outcome. Clinicians caring for patients presenting with pelvic gunshot wounds should pay attention to the delayed presentation of internal hemorrhage from the OAs. A multidisciplinary team approach is crucial in the successful management of penetrating injuries to the obturator artery.

  8. Patterns of Cleft Lip and Cleft Palate in Northern Pakistan

    Directory of Open Access Journals (Sweden)

    Mansoor Khan

    2012-04-01

    Results: A total of 159 patients of cleft lip and cleft palate deformities were included in the study, having a mean age of 3.5+6.59 years and containing 59.1% males and 40.9% females with a ratio of 1.4:1. A cleft lip with palate, cleft palate and cleft lip were found in 51.6%, 31.4% and 17% of cases, respectively. Left-sided clefts were most common in the cleft lip with palate and the isolated cleft lip deformity. A cleft lip with palate was a male dominant variety (62.8% of cases, while in the cleft palate variety, the dominant gender was female. In 61.6% of cases, the parent had a consanguineous relationship. In 21.4% of cases, family history was positive for the cleft lip/palate. Other congenital anomalies were associated in 10.7% of cases. Conclusion: Cleft deformities of the lip and palate affect the male population more than females with cleft lips, in association with a cleft palate being the most common anomaly. Females are mainly affected by an isolated cleft palate. The high prevalence of these deformities in consanguineous marriages emphasizes educating people. The lower number of patients from distant distracts of Northern Pakistan calls for the attention of the health department. [Arch Clin Exp Surg 2012; 1(2.000: 63-70

  9. Correction of incomplete cleft palate by u-shaped flap palatoplasty ...

    African Journals Online (AJOL)

    After complete dissection of the nasal and palatal mucosa, palatal muscles were carefully dissected from the posterior edge of the bones of the hard palate, wherein the well-mobilised flap receded backward spontaneously and elongated the soft palate. After suturing the nasal mucosa in the midline, the dissected palatal ...

  10. Hearing outcomes in patients with cleft lip/palate.

    Science.gov (United States)

    Skuladottir, Hildur; Sivertsen, Ase; Assmus, Jorg; Remme, Asa Rommetveit; Dahlen, Marianne; Vindenes, Hallvard

    2015-03-01

    Objective : Children with cleft lip and palate or cleft palate only have a high incidence of conductive hearing loss from otitis media with effusion. Studies demonstrating longitudinal results are lacking. This study was undertaken to investigate long-term longitudinal hearing outcomes of children with cleft lip and/or cleft palate and cleft palate only. Design : Retrospective chart review. Setting : Clinical charts of patients born with cleft lip and palate or cleft palate only in 1985 to 1994 who were referred to the cleft team in Bergen, Norway. Study findings include 15 years of follow-up. Participants : The study population consisted of 317 children of whom 159 had nonsyndromic cleft lip and palate and 158 had nonsyndromic cleft palate. Main Outcome Measures : Pure tone average calculated from pure tone audiometry at ages 4, 6, and 15 years. Results : The median pure tone average significantly improved with increasing age. For the cleft lip and palate group, the median pure tone average at ages 4, 6, and 15 years was 16 dB hearing level (HL), 13 dB HL, and 9 dB HL, respectively (P ≤ .001). In the cleft palate group the median pure tone average at ages 4, 6, and 15 years was 15 dB HL, 12 dB HL, and 9 dB HL, respectively (P ≤ .001). There was no significant difference in the hearing levels between the two groups. Patients who had surgical closure of the palate at age 18 months had a significantly better pure tone average outcome at age 15 compared with patients who had surgery at 12 months. Conclusions : Hearing improves significantly from childhood to adolescence in patients with cleft lip and palate and cleft palate only.

  11. Obturator internus muscle autotransfer: a new concept for the treatment of anismus. Clinical experience.

    Science.gov (United States)

    Farag, A

    1997-01-01

    In this study 20 patients suffering from chronic constipation due to spastic anal sphincters were operated upon using a new surgical technique. The technique aimed at constructing an active anal dilator mechanism using the obturator internus muscles mobilized from both sides and sutured to the side wall of the anal canal in order to overcome the spastic anal sphincters during defaecation. This series included 3 failures (15%), 16 successful cases (80%), and 1 dissatisfied patient despite normal postoperative investigations (5%). Eleven patients (55%) showed immediate postoperative normalization of their defaecation. Five patients (25%) showed normalization of their defaecation after 10 sessions of electric stimulation of the transposed muscles given 1 month postoperatively for 10 successive days. All the successful cases (16 patients) maintained their good results during the period of follow-up which ranged from 16 to 45 months (average = 30.31 months). For the successful cases, follow-up was from 16 to 42 months (average = 26.72 months). Immediate postoperative complications included 3 cases of wound infection and 2 cases of transient incontinence to gases which responded completely to postoperative Faradic stimulation. No cases of persistent incontinence of any degree were detected among the 20 patients studied. The 3 failures were mainly due to avoidable technical problems. The technique was safe, easy, and physiological, using a strictly perineal approach.

  12. Modified prepubic TVT-obturator tape procedure versus the conventional method: a preliminary study.

    Science.gov (United States)

    Long, Cheng-Yu; Wu, Ming-Ping; Wang, Chiu-Lin; Lin, Kun-Ling; Liu, Cheng-Min; Wu, Shu-Hui; Juan, Yung-Shun

    2013-12-01

    To compare the efficacy and safety of the modified prepubic tension-free vaginal tape-obturator (PTVT-O) system procedure with the original TVT-O methods. One hundred and ninety women with urodynamic stress incontinence (USI) were included in this study (93 cases in the TVT-O group and 97 in the PTVT-O group). Clinical assessments before and one year after surgery included urinalyses, 1-h pad tests, urodynamic studies, and a personal interview with the overactive bladder symptom score (OABSS) questionnaire. There were no differences between the two groups in mean age, parity, menopausal status, mean operative time and subjective cure rates (P>0.05), but the efficacy of surgery (cure and improvement) in the PTVT-O group was significantly higher than that in the TVT-O group (P=0.038). Complication rates and visual analog scale (VAS) scores were found to be similar (P>0.05). OABSS decreased significantly after surgery in both groups (P0.05). Our modified procedure is a safe and effective treatment for female USI. It has an advantage over the original TVT-O with better surgical efficacy and comparable postoperative pain, although the follow-up times in this study are different. Copyright © 2013. Published by Elsevier Ireland Ltd.

  13. Pembuatan Obturator Mata pada Pasien dengan Kehilangan Mata Akibat Cacat Bawaan

    Directory of Open Access Journals (Sweden)

    Clara Rosalina

    2010-06-01

    Full Text Available Kasus kehilangan mata pada pasien dapat menimbulkan masalah fungsi dan estetik. Salah satu cara yang dapat dilakukan untuk memperbaiki masalah estetik adalah dengan membuatkan protesa mata kepada pasien tersebut. Tujuan pembuatan obturator mata pada pasien yang kehilangan mata adalah untuk membantu pasien dalam memperbaiki estetik. Pasien wan ita usia 35 tahun datang ke klinik Prostodonsia RSGM FKG UGM dengan kondisi kehilangan mata sebelah kanan yang merupakan cacat bawaan. Pemeriksaan wajah menunjukkan muka asimetris. Pada mata kanan tampak adanya cheloid yang timbul setelah operasi pengangkatan bola mata. Perawatan dilakukan dengan pembuatan protesa mata non fabricated dengan tahap-tahap: pencetakan mata dengan sendok cetak mata perorangan dan pengisian hasil cetakan terdiri dari dua bagian, yang pertama diisi dengan gips keras sampai bagian terlebar dari cetakan dasar soket dan dibuat tiga retensi sebagai kunci, kedua sampai menutupi seluruh hasil cetakan. Pembuatan model malam sklera, mencoba pola malam sklera dan packing model malam sklera. Oef/asking dan polishing untuk membuat sklera akrilik, mencoba sklera akrilik dan penentuan lokasi diameter iris, melukis iris dan pupil, penyelesaian protesa mata, packing sklera dan iris, def/asking dan polishing untuk membuat protesa mata serta insersi protesa mata. Kontrol setelah 2 minggu menunjukkan hasil yang baik, tidak ada keluhan rasa sakit, tidak ada peradangan, volume dan frekuensi air mata menjadi berkurang jumlah dan frekuensinya.

  14. A novel digital workflow to manufacture personalized three-dimensional-printed hollow surgical obturators after maxillectomy.

    Science.gov (United States)

    Kortes, J; Dehnad, H; Kotte, A N T; Fennis, W M M; Rosenberg, A J W P

    2018-04-07

    Partial or complete resection of the maxilla during tumour surgery causes oronasal defects, leading to oral-maxillofacial dysfunction, for which the surgical obturator (SO) is an important treatment option. Traditional manufacturing of SOs is complex, time-consuming, and often results in inadequate fit and function. This technical note describes a novel digital workflow to design and manufacture a three-dimensional (3D)-printed hollow SO. Registered computed tomography and magnetic resonance imaging images are used for gross tumour delineation. The produced RTStruct set is exported as a stereolitography (STL) file and merged with a 3D model of the dental status. Based on these merged files, a personalized and hollow digital SO design is created, and 3D printed. Due to the proper fit of the prefabricated SO, a soft silicone lining material can be used during surgery to adapt the prosthesis to the oronasal defect, instead of putty materials that are not suitable for this purpose. An STL file of this final SO is created during surgery, based on a scan of the relined SO. The digital workflow results in a SO weight reduction, an increased fit, an up-to-date digital SO copy, and overall easier clinical handling. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Use of early hard palate closure using a vomer flap in cleft lip and palate patients.

    Science.gov (United States)

    Smarius, Bram J A; Breugem, Corstiaan C

    2016-08-01

    The aim of the present study was to determine the influence of the vomer flap during cleft palate closure. A retrospective review was performed of all consecutive unilateral/bilateral complete cleft lip and palate (Veau III en IV) children who were treated by a simultaneous lip and hard palate closure using a vomer flap. Data were collected for sex, date of birth, syndrome, adoption, cleft palate type, type of repair, date of cleft repair, cleft width, lateral incisions, fistula and location of fistula. Ninety-one children (M = 62, F 29) were operated. Mean age at time of lip closure and vomer flap was 5.8 months (range 2.9 months to 49.2 months, SD 7.1) and the mean age at palate closure was 13.6 months (range 6.3 months to 79.9 months, SD 10.8). The mean cleft width at first assessment was 13.0 mm (range 7-22 mm) compared to 8.8 mm (range 4-15 mm) at second assessment (mean difference 4.6 mm, 95% CI 3.93-5.35, p cleft width, subsequently leading to a low fistula incidence (1.1%). Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  16. Conventional bone-anchored palatal distractor using an orthodontic palatal expander for the transverse maxillary distraction osteogenesis: technical note.

    Science.gov (United States)

    Iida, Seiji; Haraguchi, Seiji; Aikawa, Tomonao; Yashiro, Kohtaro; Okura, Masaya; Kogo, Mikihiko

    2008-02-01

    Surgical-assisted rapid palatal expansion includes various treatment procedures for solving transverse maxillary deficiencies, especially in cases with a matured palatal suture. Recent introduction of the concept of distraction osteogenesis has contributed to generalize this useful treatment and to develop some bone-borne devices that will not cause the problems found in cases treated by tooth-supported palatal expander. This report shows a conventional bone-borne distractor using commercially available orthodontic palatal expansion screws. The distractor consists of 2 parts: one is a commercially available orthodontic palatal expansion screw (Hyrax type, Fan style) and another is a screw-ring, which is one of the attached parts of the mandibular distraction system. The bone screws are inserted transmucosally to the palatal bone via the screw-rings. The palatal distractor can be applied to varied palatal shapes and can expand the palate without any trouble. This conventional palatal distractor may contribute to generalize the transpalatal maxillary distraction osteogenesis for cases with maxillary teeth problems.

  17. Surgical management of necrotizing sialometaplasia of palate

    Directory of Open Access Journals (Sweden)

    S M Balaji

    2015-01-01

    Full Text Available Necrotizing sialometaplasia (NSM is a rare benign, inflammatory disease of both major and minor salivary glands, although more commonly reported in the minor glands of the palate. The characteristic clinical presentation can perplex the clinician and may be mistaken for a malignant neoplasm, such as mucoepidermoid carcinoma, as well as invasive squamous cell carcinoma. The clinical and histological similarity between this entity and a malignant lesion may result in unnecessary or mis-treatment. Though clinically mimics malignancy, NSM is considered to be a self-limiting disease, and takes about 3-12 weeks to resolve. Majority of the case resolves itself or by supportive and symptomatic treatment. Surgical intervention is rarely required in NSM except the diagnostic biopsy. Herein we report the clinical, histopathological feature and surgical management of a case of NSM of hard palate in a young adult male.

  18. Surgical management of necrotizing sialometaplasia of palate.

    Science.gov (United States)

    Balaji, S M; Balaji, Preetha

    2015-01-01

    Necrotizing sialometaplasia (NSM) is a rare benign, inflammatory disease of both major and minor salivary glands, although more commonly reported in the minor glands of the palate. The characteristic clinical presentation can perplex the clinician and may be mistaken for a malignant neoplasm, such as mucoepidermoid carcinoma, as well as invasive squamous cell carcinoma. The clinical and histological similarity between this entity and a malignant lesion may result in unnecessary or mis-treatment. Though clinically mimics malignancy, NSM is considered to be a self-limiting disease, and takes about 3-12 weeks to resolve. Majority of the case resolves itself or by supportive and symptomatic treatment. Surgical intervention is rarely required in NSM except the diagnostic biopsy. Herein we report the clinical, histopathological feature and surgical management of a case of NSM of hard palate in a young adult male.

  19. Treatment modalities of palatal impacted canines

    OpenAIRE

    Dimova, Cena; Papakoca, Kiro; Ristoska, Sonja; Kovacevska, Ivona

    2012-01-01

    Introduction: The orthodontic treatment of impacted maxillary canine remains a challenge to today’s clinicians. The treatment of this clinical entity usually involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the dental arch. The impacted palatal canine requires a combination of both treatment modalities: orthodontic management and oral surgical treatment. Two types of approach are commonly used: simple exposure, or exposure with brac...

  20. Postanesthetic ulceration of palate: A rare complication

    OpenAIRE

    Gupta, Ramesh; Garg, Meenu; Pawah, Salil; Gupta, Ajay

    2016-01-01

    The routine dental practice involves various dental procedures which needs the application of local anesthetics. Generally, there are very few complications associated with these procedures. Complications such as tissue necrosis can occur following the rapid injection of local anesthetic solutions. Palate is a favorable site for soft tissue lesions, various factors such as direct effects of the drug, blanching of the tissues during injection, a relatively poor blood supply, and reactivation o...

  1. Food palatability, rheology, and meal patterning.

    Science.gov (United States)

    Mattes, Richard D

    2008-01-01

    Overweight and obesity are largely of dietary origin and reflect food choice. Food palatability, eating patterns, and food form are important determinants of choice and energy balance. A review of the literature provides a characterization of the roles of these determinants of feeding. Food palatability is the strongest predictor of intake where availability is not limiting. Whether the rewarding properties of palatable items lead to nonhomeostatic feeding and weight gain warrants further study. Positive energy balance is attributed to greater energy intake within eating events but also to a greater extent, increased eating frequency. Although the size and frequency of eating events may compensate for each other, interventions aimed at limiting the latter may be especially productive. One of the most marked dietary trends is an increase of energy derived from beverages. The weak dietary compensation that energy-yielding beverages elicit leads to positive energy balance. This, too, is a promising target for moderating energy intake. A better understanding of dietary factors promoting positive energy balance should reveal strategies for weight management.

  2. Efficacy of ProTaper Retreatment System in Root Canals Obturated with Gutta-Percha Using Two Different Sealers and GuttaFlow

    Science.gov (United States)

    Siotia, Jaya; Acharya, Shashi Rashmi; Gupta, Sunil Kumar

    2011-01-01

    Objective. To compare the efficacy of ProTaper retreatment files in removing three different obturating materials. Study Design. Forty-five human, single-rooted premolars were divided into three experimental groups. Group 1 was obturated with gutta-percha and AH Plus sealer, Group 2 was obturated with gutta-percha and zinc oxide eugenol sealer, and Group 3 was obturated with GuttaFlow. Retreatment was done using the ProTaper universal rotary retreatment files. Root halves were visualized using magnifying loops at 3X magnification and optical stereomicroscope at 10X magnification. Images were analyzed using AutoCAD 2004 software to calculate area of the remaining debris in the canal. For statistical analysis were used variance test and ANOVA. Results. Total debris/canal area ratio between the three groups showed a statistically significant difference (P < 0.001). Conclusion. ProTaper retreatment system did not produce completely clean canals in any of the groups. However, it had the best efficacy towards removing silicon based obturating material GuttaFlow. PMID:22114598

  3. The Soft Palate Friendly Speech Bulb for Velopharyngeal Insufficiency

    OpenAIRE

    Kahlon, Sukhdeep Singh; Kahlon, Monaliza; Gupta, Shilpa; Dhingra, Parvinder Singh

    2016-01-01

    Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of...

  4. TCDD disrupts posterior palatogenesis and causes cleft palate.

    Science.gov (United States)

    Yamada, Tomohiro; Hirata, Azumi; Sasabe, Eri; Yoshimura, Tomohide; Ohno, Seiji; Kitamura, Naoya; Yamamoto, Tetsuya

    2014-01-01

    Dioxins (e.g. 2,3,7,8-tetrachlorodibenzo-p-dioxin; TCDD) cause cleft palate at a high rate. A post-fusional split may contribute to the pathogenesis, and tissue fragility may be a concern. The objective of this study was to investigate the effects of TCDD on the palatal epithelium, bone and muscle, which contribute to tissue integrity. ICR mice (10-12 weeks old) were used. TCDD was administered on E12.5 at 40 mg/kg. Immunohistochemical staining for AhR, ER-α, laminin, collagen IV, osteopontin, Runx2, MyoD, and desmin were performed. Furthermore, western blot analysis for osteopontin, Runx2, MyoD, and desmin were performed to evaluate protein expression in the palatal tissue. Immunohistologically, there was little difference in the collagen IV and laminin localization in the palatal epithelium between control versus TCDD-treated mice. Runx2 and osteopontin immunoreactivity decreased in the TCDD-treated palatal bone, and MyoD and desmin decreased in the TCDD-treated palatal muscle. AhR and ER-α immunoreactivity were localized to the normal palatal bone, but ER-α was diminished in the TCDD-treated palate. On western blot analysis, Runx2, MyoD, and desmin were all downregulated in the TCDD-treated palate. TCDD may suppress palatal osteogenesis and myogenesis via AhR, and cause cleft palates via a post-fusional split mechanism, in addition to a failure of palatal fusion. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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  11. Parental satisfaction in Ugandan children with cleft lip and palate following synchronous lip and palatal repair.

    Science.gov (United States)

    Luyten, Anke; D'haeseleer, Evelien; Budolfsen, Dorte; Hodges, Andrew; Galiwango, George; Vermeersch, Hubert; Van Lierde, Kristiane

    2013-01-01

    The purpose of the present case control study was to assess parental satisfaction with speech and facial appearance in Ugandan children with complete unilateral or bilateral cleft lip and palate (CLP), who underwent a synchronous lip and palatal closure. The results are compared with an age- and gender-matched control group. The experimental group consisted of the parents or guardians of 44 Ugandan patients (21 males, 23 females) with complete unilateral or bilateral CLP (mean age: 3;1 years). The control group included the foster mothers of 44 orphan children matched by age and gender (mean age: 3;7 years). A survey based on the Cleft Evaluation Profile was used to assess the perceived satisfaction for individual features related to cleft care. Overall high levels of satisfaction were observed in the experimental group for all features (range: 56-100%). No significant differences could be established regarding age, gender, age of lip and palatal closure, cleft type or maternal vs. paternal judgments. In participants who were dissatisfied with the appearance of the lip, the time period between the cleft closure and the survey was significantly larger compared with satisfied participants. Furthermore, significantly lower levels of satisfaction were observed in the cleft group for speech and the appearance of the teeth and the nose compared with the control group. Satisfaction with speech and facial appearance in Ugandan children with cleft lip and/or palate is important since normal esthetics and speech predominantly determine the children's social acceptance in the Ugandan society. As a result of reading this manuscript, the reader will be able to explain the attitudes of parents toward the surgical repair of their children's cleft lip and palate. As a result of reading this manuscript, the reader will be able to identify differences in parental attitudes toward synchronous lip and palate repair. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Variations in Velopharyngeal Structure in Adults With Repaired Cleft Palate.

    Science.gov (United States)

    Perry, Jamie L; Kotlarek, Katelyn J; Sutton, Bradley P; Kuehn, David P; Jaskolka, Michael S; Fang, Xiangming; Point, Stuart W; Rauccio, Frank

    2018-01-01

    The purpose of this study was to examine differences in velopharyngeal structures between adults with repaired cleft palate and normal resonance and adults without cleft palate. Thirty-six English-speaking adults, including 6 adults (2 males and 4 females) with repaired cleft palate (M = 32.5 years of age, SD = 17.4 years) and 30 adults (15 males and 15 females) without cleft palate (M = 23.3 years of age, SD = 4.1 years), participated in the study. Fourteen velopharyngeal measures were obtained on magnetic resonance images and compared between groups (cleft and noncleft). After adjusting for body size and sex effects, there was a statistically significant difference between groups for 10 out of the 14 velopharyngeal measures. Compared to those without cleft palate, participants with repaired cleft palate had a significantly shorter hard palate height and length, shorter levator muscle length, shorter intravelar segment, more acute levator angles of origin, shorter and thinner velum, and greater pharyngeal depth. Although significant differences were evident in the cleft palate group, individuals displayed normal resonance. These findings suggest that a wide variability in velopharyngeal anatomy can occur in the presence of normal resonance, particularly for those with repaired cleft palate. Future research is needed to understand how anatomic variability impacts function, such as during speech.

  13. We can predict postpalatoplasty velopharyngeal insufficiency in cleft palate patients.

    Science.gov (United States)

    Leclerc, Jacques E; Godbout, Audrey; Arteau-Gauthier, Isabelle; Lacour, Sophie; Abel, Kati; McConnell, Elisa-Maude

    2014-02-01

    To find an anatomical measurement of the cleft palate (or a calculated parameter) that predicts the occurrence of velopharyngeal insufficiency (VPI) after palatal cleft repair. Retrospective cohort study. Charts were reviewed from cleft palate patients who underwent palatoplasty by the Von Langenbeck technique for isolated cleft palate or Bardach two-flap palatoplasty for cleft lip-palate. Seven anatomical cleft parameters were prospectively measured during the palatoplasty procedure. Three blinded speech-language pathologists retrospectively scored the clinically assessed VPI at 4 years of age. The recommendation of pharyngoplasty was also used as an indicator of VPI. From 1993 to 2008, 67 patients were enrolled in the study. The best predicting parameter was the ratio a/(30 - b1), in which a is defined as the posterior gap between the soft palate and the posterior pharyngeal wall and b1 is the width of the cleft at the hard palate level. An a/(30 - b1) ratio >0.7 to 0.8 is associated with a higher risk of developing VPI (relative risk = 2.2-5.1, sensitivity = 72%-81%, P cleft at the hard palate level and the posterior gap between the soft palate and the posterior pharyngeal wall were found to be the most significant parameters in predicting VPI. The best correlation was obtained with the ratio a/(30 - b1). 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  14. MSX-1 gene expression and regulation in embryonic palatal tissue.

    Science.gov (United States)

    Nugent, P; Greene, R M

    1998-01-01

    The palatal cleft seen in Msx-1 knock-out mice suggests a role for this gene in normal palate development. The cleft is presumed secondary to tooth and jaw malformations, since in situ hybridization suggests that Msx-1 mRNA is not highly expressed in developing palatal tissue. In this study we demonstrate, by Northern blot analysis, the expression of Msx-1, but not Msx-2, in the developing palate and in primary cultures of murine embryonic palate mesenchymal cells. Furthermore, we propose a role for Msx-1 in retinoic acid-induced cleft palate, since retinoic acid inhibits Msx-1 mRNA expression in palate mesenchymal cells. We also demonstrate that transforming growth factor beta inhibits Msx-1 mRNA expression in palate mesenchymal cells, with retinoic acid and transforming growth factor beta acting synergistically when added simultaneously to these cells. These data suggest a mechanistic interaction between retinoic acid, transforming growth factor beta, and Msx-1 in the etiology of retinoic acid-induced cleft palate.

  15. Long-term effects of palate repair on craniofacial morphology in patients with unilateral cleft lip and palate.

    Science.gov (United States)

    Liao, Yu-Fang; Mars, Michael

    2005-11-01

    To identify the long-term effects of palate repair on craniofacial growth in patients with unilateral cleft lip and palate (UCLP). Retrospective cross-sectional study. Sri Lankan Cleft Lip and Palate Project. Forty-eight adults with nonsyndromic unilateral cleft lip and palate, 29 men and 19 women, had lip repair only (LRO group). Fifty-eight adults with nonsyndromic unilateral cleft lip and palate, 35 men and 23 women, had lip and palate repairs by the age of 9 (LPR group). Clinical notes were used to record surgical treatment histories. Cephalometry was used to determine craniofacial morphology. In the lip and palate repair group, the depth of the bony pharynx (Ba-PMP), the maxillary length at the alveolar level (PMP-A), the effective length of the maxilla (Ar-IZ, Ar-ANS, Ar-A), the maxillary protrusion (S-N-ANS, SNA), the anteroposterior jaw relation (ANS-N-Pog, ANB), and the overjet were smaller than in the lip repair only group. There were no significant differences in the maxillary length at the basal level (PMP-IZ, PMP-ANS) and the anterior and posterior maxillary heights (N-ANS and R-PMP, respectively) in the two groups. Palate repair inhibits the forward displacement of the basal maxilla and anteroposterior development of the maxillary dentoalveolus in patients with unilateral cleft lip and palate. Palate repair has no detrimental effects on the downward displacement of the basal maxilla or on palatal remodeling in patients with unilateral cleft lip and palate.

  16. Diagnosing subtle palatal anomalies: Validation of video-analysis and assessment protocol for diagnosing occult submucous cleft palate.

    Science.gov (United States)

    Rourke, Ryan; Weinberg, Seth M; Marazita, Mary L; Jabbour, Noel

    2017-09-01

    Submucous cleft palate (SMCP) classically involves bifid uvula, zona pellucida, and notched hard palate. However, patients may present with more subtle anatomic abnormalities. The ability to detect these abnormalities is important for surgeons managing velopharyngeal dysfunction (VPD) or considering adenoidectomy. Validate an assessment protocol for diagnosis of occult submucous cleft palate (OSMCP) and identify physical examination features present in patients with OSMCP in the relaxed and activated palate positions. Study participants included patients referred to a pediatric VPD clinic with concern for hypernasality or SMCP. Using an appropriately encrypted iPod touch, transoral video was obtained for each patient with the palate in the relaxed and activated positions. The videos were reviewed by two otolaryngologists in normal speed and slow-motion, as needed, and a questionnaire was completed by each reviewer pertaining to the anatomy and function of the palate. 47 patients, with an average age of 4.6 years, were included in the study over a one-year period. Four videos were unusable due to incomplete view of the palate. The most common palatal abnormality noted was OSMCP, diagnosed by each reviewer in 26/43 and 30/43 patients respectively. Using the assessment protocol, agreement on palatal diagnosis was 83.7% (kappa = 0.68), indicating substantial agreement, with the most prevalent anatomic features being vaulted palate elevation (96%) and visible notching of hard palate (75%). The diagnosis of subtle palatal anomalies is difficult and can be subjective. Using the proposed video-analysis method and assessment protocol may improve reliability of diagnosis of OSMCP. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Prevalence, cause, and location of palatal fistula in operated complete unilateral cleft lip and palate: retrospective study.

    Science.gov (United States)

    de Agostino Biella Passos, Vivian; de Carvalho Carrara, Cleide Felício; da Silva Dalben, Gisele; Costa, Beatriz; Gomide, Marcia Ribeiro

    2014-03-01

    To evaluate the prevalence of fistulas after palate repair and analyze their location and association with possible causal factors. Retrospective analysis of patient records and evaluation of preoperative initial photographs. Tertiary craniofacial center. Five hundred eighty-nine individuals with complete unilateral cleft lip and palate that underwent palate repair at the age of 12 to 36 months by the von Langenbeck technique, in a single stage, by the plastic surgery team of the hospital, from January 2003 to July 2007. The cleft width was visually classified by a single examiner as narrow, regular, or wide. The following regions of the palate were considered for the location: anterior, medium, transition (between hard and soft palate), and soft palate. Descriptive statistics and analysis of association between the occurrence of fistula and the different parameters were evaluated. Palatal fistulas were observed in 27% of the sample, with a greater proportion at the anterior region (37.11%). The chi-square statistical test revealed statistically significant association (P ≤ .05) between the fistulas and initial cleft width (P = .0003), intraoperative problems (P = .0037), and postoperative problems (P = .00002). The prevalence of palatal fistula was similar to mean values reported in the literature. Analysis of causal factors showed a positive association between palatal fistulas with wide and regular initial cleft width and intraoperative and postoperative problems. The anterior region presented the greatest occurrence of fistulas.

  18. Cone Beam Computed Tomography Evaluation of the Periapical Status of Nonvital Tooth with Open Apex Obturated with Mineral Trioxide Aggregate: A Case Report

    Directory of Open Access Journals (Sweden)

    Vijay Shekhar

    2013-01-01

    Full Text Available Management of a tooth with open apex is a challenge to the dental practitioners. Evaluation of the periapical healing is required in such cases by radiographic techniques. The objective of this paper was to assess the healing of a periapical lesion in a non-vital tooth with open apex treated with mineral trioxide aggregate (MTA obturation using cone beam computed tomography (CBCT. The endodontic treatment of a fractured non-vital discolored maxillary left lateral incisor with an open apex was done with MTA obturation. The clinical and radiographic followup done regularly showed that the tooth was clinically asymptomatic and that the size of the periapical lesion observed by intraoral periapical (IOPA radiographs and CBCT was decreased remarkably after two years. CBCT and IOPA radiographs were found to be useful radiographic tools to assess the healing of a large periapical lesion in a non-vital tooth with open apex managed by MTA obturation.

  19. [IMPROVEMENT AND CHOICE OF COLOSTOMY METHOD IN THE TREATMENT OF PATIENTS, SUFFERING AN ACUTE OBTURATIVE IMPASSABILITY OF LARGE BOWEL].

    Science.gov (United States)

    Kustryo, V I; Langazo, O V

    2015-11-01

    Colostomy was done in 49 patients, suffering an acute obturative impassability of large bowel (AOILB). In 28 patients (1st group) colostomy was conducted in accordance to standard method; in 21 (2nd group)--in accordance to the method, proposed by us. Application of the method proposed for surgical treatment of AOILB have guaranteed a reduction of postoperative paracolostomal complications rate in 6.8 times, of postoperative lethality--in 2.2 times, duration of the patient stationary treatment--in 1.4 times, the rate of dressings and the dressing material expanses--in 10 times.

  20. Obturator Neuralgia: A Rare Complication of Tension-free Vaginal Tape Sling-Complete Resolution After Laparoscopic Tension-free Vaginal Tape Removal.

    Science.gov (United States)

    Miklos, John R; Moore, Robert D; Chinthakanan, Orawee

    2015-01-01

    To show a technique of retropubic tension-free vaginal tape (TVT) removal using both a transvaginal and laparoscopic approach in the treatment of a rare condition, obturator neuralgia. A step-by-step explanation of the patient's condition, diagnosis, surgical technique, and postoperative results using video, pictures, and medical illustrations (education video). TVT retropubic slings have become the gold standard for the treatment of stress urine incontinence over the last decade. Despite high cure rates, the TVT is not without potential complications. Typical complications include urine retention, incomplete bladder emptying, frequency, urgency, urethral erosion, vaginal extrusion, vaginal pain, and dyspareunia. The most common complication for sling removal/revision is chronic pain. The TVT obturator neuralgia is a rare and specific type of chronic pain that is normally associated with transobturator tape slings. The purpose of this video is to present an extremely rare complication of TVT retropubic slings, present symptoms and signs of obturator nerve compression, show the normal and the actual position of this patient's TVT sling, describe the laparoscopic removal of the TVT sling, and present the postoperative course and resolution of the patient's pain. The patient signed a release for her video to be used for educational and teaching purposes. A combined transvaginal and laparoscopic approach in a patient with lower abdominal, levator, and obturator-type pain after a TVT retropubic procedure. In patients suffering from obturator neuralgia after a retropubic sling, surgeons should include the sling as a potential causative factor in the differential diagnosis. Surgeons should consider removing the sling based on the patient's symptoms. If the patient suffers from only vaginal pain and dyspareunia, then the surgeon should consider only the removal of the vaginal portion of the sling. In patients with obturator neuralgia, retropubic, and/or lower abdominal

  1. Weight Gain in Children with Cleft Lip and Palate without Use of Palatal Plates

    Science.gov (United States)

    da Silva Freitas, Renato; Lopes-Grego, Andrey Bernardo; Dietrich, Helena Luiza Douat; Cerchiari, Natacha Regina de Moraes; Nakakogue, Tabatha; Tonocchi, Rita; Gabardo, Juarez; da Silva, Éder David Borges; Forte, Antonio Jorge

    2012-01-01

    Goals/Background. To evaluate children's growth in the first year of life, who have cleft palate and lip, without the use of palatal plates. Materials/Method. Chart review was conducted, retrospectively, in the Center for Integral Assistance of Cleft Lip and Palate (CAIF), in Brazil, between 2008 and 2009. Results for both genders were compared to the data published by the World Health Organization (WHO) regarding average weight gain in children during their first year of life. Results. Patients with syndromic diagnosis and with cleft classified as preforamen were excluded, resulting in a final number of 112 patients: 56 male and 56 female. Similar patterns were seen comparing the two genders. Although it was observed weight gain below the average until the 11th month in male patients and until 9 months in female patients, both genders remained at the 50th percentile (p50) and improved after the 4th month of age for boys and the 9th month of age for girls. Conclusion. Children with cleft palate weigh less than regular children during their first months of life. At the end of the first year, weight gain is similar comparing normal and affected children. However, factors that optimized weight gain included choosing the best treatment for each case, proper guidance, and multiprofessional integrated care. PMID:23304489

  2. Unilateral cleft lip and palate: Simultaneous early repair of the nose, anterior palate and lip

    Science.gov (United States)

    Laberge, Louise Caouette

    2007-01-01

    Unilateral cleft lip and palate is a defect involving the lip, nose and maxilla. These structures are inter-related, and simultaneous early correction of all the aspects of the defect is necessary to obtain a satisfactory result that will be maintained with growth. The surgical technique combining various procedures is presented and compared with previously published reports. PMID:19554125

  3. The Soft Palate Friendly Speech Bulb for Velopharyngeal Insufficiency.

    Science.gov (United States)

    Kahlon, Sukhdeep Singh; Kahlon, Monaliza; Gupta, Shilpa; Dhingra, Parvinder Singh

    2016-09-01

    Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of untreated bilateral cleft lip and palate associated with palatal insufficiency treated by means of palate friendly innovative speech bulb. This modified speech bulb is a combination of hard acrylic and soft lining material. The hard self-curing acrylic resin covers only the hard palate area and a permanent soft silicone lining material covering the soft palate area. A claw-shaped wire component was extended backwards from acrylic and was embedded in soft silicone to aid in retention and approximation of two materials. The advantage of adding the soft lining material in posterior area helped in covering the adequate superior extension and margins for maximal pharyngeal activity. This also improved the hypernasality, speech, comfort and overall patient acceptance.

  4. Phonological Patterns Observed in Young Children with Cleft Palate.

    Science.gov (United States)

    Broen, Patricia A.; And Others

    The study examined the speech production strategies used by 4 young children (30- to 32-months-old) with cleft palate and velopharyngeal inadequacy during the early stages of phonological learning. All the children had had primary palatal surgery and were producing primarily single word utterances with a few 2- and 3-word phrases. Analysis of each…

  5. COMPREHENSIVE EVALUATIVE TECHNIQUES FOR THE CHILD WITH A CLEFT PALATE.

    Science.gov (United States)

    BENSEN, JACK F.; WHITE, FRAZER D.

    A MULTIDISCIPLINARY APPROACH TO CHILDREN WITH CLEFT PALATES IS DESCRIBED. THE SOUTH FLORIDA CLEFT PALATE CLINIC, REPRESENTING NINE PROFESSIONAL SPECIALTIES, MEETS WEEKLY TO SEE SIX OR SEVEN CASES. SPEECH PERFORMANCE IS RECORDED ON SIX DIAGNOSTIC, DATA COLLECTING FORMS WHICH PROVIDE A BASIS FOR RECORDING CLINICAL JUDGMENTS. PROGNOSIS AND…

  6. Repair of large palatal fistula using tongue flap

    Directory of Open Access Journals (Sweden)

    Fejjal Nawfal

    2014-01-01

    Full Text Available Large palatal fistulas are a challenging problem in cleft surgery. Many techniques are used to close the defect. The tongue flap is an easy and reproductible procedure for managing this complication. The authors report a case of a large palatal fistula closure with anteriorly based tongue flap.

  7. Perioperative adverse airway events in cleft lip and palate repair ...

    African Journals Online (AJOL)

    Background: Airway-related problems account for the majority of anaesthetic morbidity in paediatric anaesthesia, but more so for cleft lip and palate repair. The aim of this study was to assess the frequency, pattern, management and outcome of adverse airway events during the perioperative period in cleft lip and palate ...

  8. Mucous retention cyst of the soft palate: a case presentation.

    Science.gov (United States)

    Ellis, S G; Lee, N J; Peckitt, N S

    1995-12-01

    This article describes a mucous retention cyst of the soft palate associated with an over-extended complete maxillary denture. The clinical and anatomical relevance of the fovea palatinae are discussed with respect to the posterior palatal seal and post-dam positioning.

  9. Incidence of Cleft Lip and Palate in Uganda

    NARCIS (Netherlands)

    Dreise, Marieke; Galiwango, George; Hodges, Andrew

    Objective: The purpose of the study was to estimate the need for resources for cleft repairs in Uganda by determining the overall incidence of oral-facial clefts and the ratio of isolated cleft lip to isolated cleft palate to cleft lip and palate. Design: A 1-year prospective study was implemented

  10. Palatalization and Intrinsic Prosodic Vowel Features in Russian

    Science.gov (United States)

    Ordin, Mikhail

    2011-01-01

    The presented study is aimed at investigating the interaction of palatalization and intrinsic prosodic features of the vowel in CVC (consonant+vowel+consonant) syllables in Russian. The universal nature of intrinsic prosodic vowel features was confirmed with the data from the Russian language. It was found that palatalization of the consonants…

  11. Repair of large palatal fistula using tongue flap | Nawfal | African ...

    African Journals Online (AJOL)

    Large palatal fi stulas are a challenging problem in cleft surgery. Many techniques are used to close the defect. The tongue fl ap is an easy and reproductible procedure for managing this complication. The authors report a case of a large palatal fi stula closure with anteriorly based tongue fl ap. Key words: Cleft surgery, ...

  12. Fibrotic encapsulation of orthodontic appliance in palate.

    Science.gov (United States)

    Muthu, Jananni; Muthanandam, Sivaramakrishnan; Umapathy, Gubernath; Kannan, Anitha Logaranjani

    2017-01-01

    Iatrogenic trauma though not serious is very common in dental practice. Orthodontic treatment can inflict such injuries as they are prolonged over a long period of time. Ill-fabricated orthodontic appliances, such as wires and brackets, or the patients' habits such as application of constant pressure over the appliance can traumatize the adjacent oral soft tissues. In rare cases, these appliances can get embedded into the mucosa and gingival tissues. This case report describes one such case of iatrogenic trauma to the palatal mucosa due to entrapment of a tongue spike appliance and its surgical management.

  13. Clefting of the Alveolus: Emphasizing the Distinction from Cleft Palate.

    Science.gov (United States)

    Wirtz, Nicholas; Sidman, James; Block, William

    2016-05-01

    Oral clefting is one of the most common significant fetal abnormalities. Cleft lip and cleft palate have drastically different clinical ramifications and management from one another. A cleft of the alveolus (with or without cleft lip) can confuse the diagnostic picture and lead to a false assumption of cleft palate. The cleft alveolus should be viewed on the spectrum of cleft lip rather than be associated with cleft palate. This is made evident by understanding the embryological development of the midface and relevant terminology. Cleft alveolus carries significantly different clinical implications and treatment options than that of cleft palate. Accurately distinguishing cleft alveolus from cleft palate is crucial for appropriate discussions regarding the patient's care. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Pleomorphic adenoma of minor salivary gland: hard palate

    International Nuclear Information System (INIS)

    Garcia Canas, Wilmer; Benitez Narvaez, N.

    2006-01-01

    The pleomorphic adenoma or mixed tumor occurs in 4 to 14% of the accessory glands salivary. Different localizations exist: AEC, nasal block, lips, maxillary sinus, nasopharynx or in any other localization where salivate tissue exists, but the palate constitutes the most frequent localization, because it gathers more than 50% of minor salivary glands. In the palate, it can be developed a wide variety of tumors coming from the connective and epithelial tissue, 44% arise in the minor salivary glands. In 49 to 65% of them are benign tumors, principally pleomorphic adenomas, located preferably in the hard palate, nearby or in the union with the soft palate as in our case. We present a 42 year old patient with at pleomorphic adenoma of hard palate. (The author)

  15. Essential Palatal Tremor Managed by Cognitive Behavioral Therapy

    Directory of Open Access Journals (Sweden)

    Tomohisa Kitamura

    2015-01-01

    Full Text Available Background. Essential palatal tremor is a disorder of unknown etiology involving involuntary movement of the uvula and soft palate. Treatment attempts including drugs or surgery have been conducted to cease the rhythmical movement. Case Report. A 55-year-old female visited our department complaining of a sudden, noticeable, intermittent, and rhythmical clicking noise in her throat for five years. Oral examination revealed rhythmical contractions of the soft palate with clicking at the frequency of 120 per min. Magnetic resonance imaging (MRI examination of the brain performed after consulting with the department of neuropathic internal medicine showed no abnormalities. Thus, essential palatal tremor was diagnosed. The symptoms improved with cognitive behavioral therapy without drugs or surgical treatments. The patient is now able to stop the rhythmical movement voluntarily. Discussion. Cognitive behavioral therapy might be suitable as first-line therapy for essential palatal tremor because the therapy is noninvasive.

  16. Palatal Perforation: A Rare Complication of Postanesthetic Necrosis

    Science.gov (United States)

    Gargi, Vidisha; Mohan, Ravi Prakash Sasankoti; Kamarthi, Nagaraju; Gupta, Swati

    2017-01-01

    The everyday practice of dentistry relies heavily on achieving adequate local anesthesia. Even though the safety record of local anesthetic agents is high, complications do occur. Palate is a favorable site for soft-tissue lesions. Various factors such as direct effects of the drug, blanching of the tissues during injection, relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate. Among various complications, anesthetic necrotic ulcer is a rare and uncommon condition occurring mostly in the hard palate possibly after a local anesthetic infiltration. The ulceration is often deep and shows spontaneous but delayed healing. If proper treatment is not instituted on time, the necrosis can reach deep into the bone causing sequestrum formation and ultimately leading to palatal perforation. Here, we report a case of palatal perforation in a male patient followed by surgical interventions and follow-up. PMID:29042744

  17. Palatal tremor after lithium and carbamazepine use: a case report

    Directory of Open Access Journals (Sweden)

    Kuruvilla Anju

    2010-06-01

    Full Text Available Abstract Introduction Palatal tremor, characterized by rhythmic contractions of the soft palate, can occur secondary to pathology in the dentato-rubro-olivary pathway, or in the absence of such structural lesions. Its pathogenesis is only partially understood. We describe a case of probable drug-induced palatal tremor. Case presentation A 27-year-old Indian man had taken carbamazepine and lithium for 7 years for the treatment of a manic episode. He presented with a one-year history of bilateral rhythmic oscillations of his soft palate and tremors of his tongue. There were no other abnormalities detected from his examination or after detailed investigation. Conclusion Palatal tremors may result from medication used in the treatment of psychiatric disorders.

  18. An in vitro comparative study of the adaptation and sealing ability of two carrier-based root canal obturators.

    Science.gov (United States)

    Alkahtani, Ahmed; Al-Subait, Sara; Anil, Sukumaran

    2013-01-01

    The study was done to assess the sealing ability and adaptation of RealSeal 1, and to compare it with Thermafil. 65 single-rooted extracted teeth were selected and root canal treatment was performed. Root canals were obturated with RealSeal 1 or Thermafil. A double chamber bacterial leakage model using E. faecalis was developed to assess the sealing ability. Samples were monitored daily for 60 days. After the bacterial leakage test, samples were embedded in resin and sectioned horizontally at 2 and 4 mm from the apical foramen. Specimens were examined under scanning electron microscope and digitally photographed. AutoCAD software was used to measure the gap between the canal surface and obturation material. Results were statistically analyzed using nonparametric Kaplan-Meier survival analysis for the bacterial leakage and t-test to compare the means of gap in RealSeal 1 and Thermafil at 2 and 4 mm. There was no significant difference between the RealSeal 1 and Thermafil with respect to leakage over time. At 2 mm and 4 mm, RealSeal 1 had significantly more gaps than Thermafil. From the observations it can be concluded that RealSeal 1 and Thermafil have comparable performance in terms of adaptation and sealing ability.

  19. An In Vitro Comparative Study of the Adaptation and Sealing Ability of Two Carrier-Based Root Canal Obturators

    Directory of Open Access Journals (Sweden)

    Ahmed Alkahtani

    2013-01-01

    Full Text Available The study was done to assess the sealing ability and adaptation of RealSeal 1, and to compare it with Thermafil. 65 single-rooted extracted teeth were selected and root canal treatment was performed. Root canals were obturated with RealSeal 1 or Thermafil. A double chamber bacterial leakage model using E. faecalis was developed to assess the sealing ability. Samples were monitored daily for 60 days. After the bacterial leakage test, samples were embedded in resin and sectioned horizontally at 2 and 4 mm from the apical foramen. Specimens were examined under scanning electron microscope and digitally photographed. AutoCAD software was used to measure the gap between the canal surface and obturation material. Results were statistically analyzed using nonparametric Kaplan-Meier survival analysis for the bacterial leakage and t-test to compare the means of gap in RealSeal 1 and Thermafil at 2 and 4 mm. There was no significant difference between the RealSeal 1 and Thermafil with respect to leakage over time. At 2 mm and 4 mm, RealSeal 1 had significantly more gaps than Thermafil. From the observations it can be concluded that RealSeal 1 and Thermafil have comparable performance in terms of adaptation and sealing ability.

  20. The Effect of Cleft Palate Repair on Contractile Properties of Single Permeabilized Muscle Fibers From Congenitally Cleft Goats Palates

    Science.gov (United States)

    A cleft palate goat model was used to study the contractile properties of the levator veli palatini (LVP) muscle which is responsible for the movement of the soft palate. In 15-25% of patients that undergo palatoplasty, residual velopharyngeal insufficiency (VPI) remains a problem and often require...

  1. Development of the Object Permanence Concept in Cleft Lip and Palate and Noncleft Lip and Palate Infants.

    Science.gov (United States)

    Pecyna, Paula M.; And Others

    1987-01-01

    The development of the concept of object permanence was investigated with eight infants with cleft lip/palate and four nonimpaired infants. Superior performance of the cleft lip/palate group was found, possibly due to increased environmental stimulation provided by parents. (DB)

  2. Soft Palate Reconstruction Using Bilateral Palatal Mucomuscular Flap and Pharyngeal Flap after Resection of Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Jun Sik Kim

    2012-11-01

    Full Text Available Squamous cell carcinoma infrequently occurs at the soft palate. Although various methodscan be used for reconstruction of soft palate defects that occur after resecting squamous cellcarcinoma, it is difficult to obtain satisfactory results from the perspective of the functionalrestoration of the soft palate. A combination of bilateral palatal mucomuscular flap for theoral side and superiorly based posterior pharyngeal flap for the nasal side were performed ontwo patients who were diagnosed with squamous cell carcinoma of the soft palate in orderto reconstruct the soft palate defects after surgical resection. After surgery, the patients werefollowed-up for a mean period of 11 months. The flaps were well maintained in both patients.The donor site defects were epithelialized and completely recovered. Additionally, no recurrenceof the primary sites was shown. Slight hyponasality was observed in the voice assessmentsthat were conducted 6 months after surgery. No food regurgitation or aspiration was observedin the swallowing tests. We used a combination of bilateral palatal mucomuscular flap andsuperiorly based posterior pharyngeal flap to reconstruct the soft palate defects that occurredafter resecting the squamous cell carcinomas. We reduced the donor site complications andachieved functionally satisfactory outcomes.

  3. Three-dimensional morphology of the palate in subjects with isolated cleft palate at the stage of permanent dentition

    Czech Academy of Sciences Publication Activity Database

    Šmahel, Zbyněk; Trefný, P.; Formánek, P.; Müllerová, Ž.; Peterka, Miroslav

    2003-01-01

    Roč. 40, č. 6 (2003), s. 577-584 ISSN 1055-6656 R&D Projects: GA ČR GA304/99/0891 Institutional research plan: CEZ:AV0Z5039906 Keywords : fourier transform profilometry * isolated cleft palate * palatal morphology Subject RIV: FF - HEENT, Dentistry Impact factor: 0.888, year: 2003

  4. TVT-Secur (Hammock) versus TVT-Obturator: a randomized trial of suburethral sling operative procedures.

    Science.gov (United States)

    Hota, Lekha S; Hanaway, Katherine; Hacker, Michele R; Disciullo, Anthony; Elkadry, Eman; Dramitinos, Patricia; Shapiro, Alexander; Ferzandi, Tanaz; Rosenblatt, Peter L

    2012-01-01

    This study aimed to compare TVT-Secur (TVT-S) and TVT-Obturator (TVT-O) suburethral slings for treatment of stress urinary incontinence (SUI). This was a single-center, nonblinded, randomized trial of women with SUI who were randomized to TVT-S or TVT-O from May 2007 to April 2009. The primary outcome, SUI on cough stress test (CST), and quality-of-life and symptom questionnaires (Pelvic Floor Distress Inventory [PFDI-20] and Pelvic Floor Impact Questionnaire [PFIQ-7]) were assessed at 12 weeks and 1 year. Forty-three women were randomized to TVT-S and 44 to TVT-O. There were no differences in median baseline PFDI-20 and PFIQ-7. Twenty-two (52.4%) of 42 participants randomized to TVT-S had a positive CST result at evaluation after 12 weeks or 1 year, whereas 4 (9.1%) of the 44 in the TVT-O group had a positive CST result. The intent-to-treat analysis showed that the risk of a positive CST result was 6 times higher after TVT-S than TVT-O (risk ratio, 6.0; 95% confidence interval [CI], 2.3-16.0). Among women not lost to follow-up, the risk ratio for a positive CST result after TVT-S compared with TVT-O was 17.9 (95% CI, 2.5-128.0) at 12 weeks and 3.5 (95% CI, 1.1-11.0) at 1 year. Both TVT-S and TVT-O resulted in improved quality of life and symptoms at 12 weeks. There was no difference between the groups for PFDI-20 (P = 0.40) or PFIQ-7 (P = 0.43). A similar pattern was seen at 1 year (P = 0.85 and P = 0.36). The TVT-S seems to have a higher risk of positive postoperative CST result; however, the procedures result in similar improvements in quality of life and symptoms.

  5. Expression analyses of human cleft palate tissue suggest a role for osteopontin and immune related factors in palatal development

    DEFF Research Database (Denmark)

    Jakobsen, L.P.; Borup, R.; Vestergaard, J.

    2009-01-01

    . Moreover, selected differentially expressed genes were analyzed by quantitative RT-PCR, and by immunohistochemical staining of craniofacial tissue from human embryos. Osteopontin (SPP1) and other immune related genes were significantly higher expressed in palate tissue from patients with CLP compared to CP...... and palate (CLP). In order to understand the biological basis in these cleft lip and palate subgroups better we studied the expression profiles in human tissue from patients with CL/P. In each of the CL/P subgroups, samples were obtained from three patients and gene expression analysis was performed...... and immunostaining in palatal shelves against SPP1, chemokine receptor 4 (CXCR4) and serglycin (PRG1) in human embryonic craniofacial tissue were positive, supporting a role for these genes in palatal development. However, gene expression profiles are subject to variations during growth and therefore we recommend...

  6. MALT LYMPHOMA OF PALATE AND ORBIT

    Directory of Open Access Journals (Sweden)

    VIVIANA ANDREA CIFUENTES NAVAS

    2018-05-01

    Full Text Available TITLE: Malt palate and orbit lymphoma  Authors: CIFUENTES NAVAS-Viviana Andrea; MARTÍN PASCUAL- María Consolación; FERNÁNDEZ RODRÍGUEZ- Ana; ALONSO MESONERO- Marta; CHAVIANO GRAHJERA-Juan; MORAIS PÉREZ-Darío. INTRODUCTIONMALT-type lymphomas are lymphoid proliferations originated in the glandular epithelium of organs like the stomach, the salivary and lacrimal glands, and even, we can find lymphoid neoformations of non-epithelial localization, like in the orbital soft tissue. The lymphomas of the mucosal-associated lymphatic tissue (MALT represent only 0.2-0.3% and constitute a well-defined group of non-Hodgkin lymphomas of B origin. In the field of oral pathology, the salivary glands, tonsils and palate are mainly affected, it is more rare to find it in jugal mucosa.We present a rare case of MALT lymphoma with involvement of the palate and orbit. MATERIAL AND METHODS84-year-old patient with multiple pathologies. Derived from his primary care physician due to pharyngeal complaints of 4 to 5 days of evolution, associated with a painful palate lesion.He presented in right hemipaladar a tumoration of elastic consistency in submucosa, ulcerated in the center, with normal neck. Also left orbital tumor that limits the visual field. RESULTSCT and MRI of the neck report mass of 4x4 x2.5 cm in right hemipaladar, noninfiltrating concordant with possible lymphoma. The orbital MRI describes an intra and extra nasal left nasal lesion of 2.3x1.2x2 cm with characteristics consistent with lymphoma. CT of the neck: It demostrates a great mass of right hemipaladar, with lobulated contours and homogeneous enhancement of 40x32x25 mm, in intimate contact with medial pterygoid muscle, although there were no signs of infiltration, the rest of the edges being well delimited. Images characteristics look like a lymphoma, without being able to rule out other etiologies. MRI of the neck: It demostrates a diffuse thickening of right side of the soft palate that

  7. Myoepithelioma of the Palate: A Case Report

    Directory of Open Access Journals (Sweden)

    Tetsuro Morikawa

    2017-12-01

    Full Text Available Myoepithelioma, a benign tumor, occurs with a frequency of 1.5% among all salivary gland tumors, and it most commonly affects the parotid gland. Nearly the entire epithelium is composed of neoplastic myoepithelial cells exhibiting spindle, plasmacytic, epithelial-like, and clear cells. Case Report: A 52-year-old woman with myoepithelioma of the palate. The patient was referred to our hospital with a chief complaint of swelling on the right side of the palate. Following clinical and intraoral examinations, the tumor was removed under general anesthesia. Viewed microscopically, the tumor was seen to be surrounded by a fbrous membrane, primarily composed of a solid growth of neoplastic myoepithelial cells, virtually surrounding a hyaline-like eosinophilic substance. Immunohistochemical examination revealed strongly-positive reactions by the tumor cells for widespectrum cytokeratin (CK wide, vimentin, and S-100 proteins. CK 7, smooth muscle actin (SMA, p63, and glial fibrillary acidic protein (GFAP gave weakly-positive reactions. Conclusion: Based on the fndings, a pathological diagnosis of myoepithelioma was reached.

  8. Craniofacial morphology in unoperated infants with isolated cleft palate. A cephalometric analysis in three projections

    DEFF Research Database (Denmark)

    Hermann, N.V.; Kreiborg, S.; Jensen, B.L.

    58th Annual Meeting of the American Cleft Palate-Craniofacial Association, Minneapolis, Craniofacial morphology, unoperated infants, isolated cleft palate, cephalometric analysis, three projections......58th Annual Meeting of the American Cleft Palate-Craniofacial Association, Minneapolis, Craniofacial morphology, unoperated infants, isolated cleft palate, cephalometric analysis, three projections...

  9. Speech and language development in toddlers with and without cleft palate

    NARCIS (Netherlands)

    Priester, G. H.; Goorhuis-Brouwer, S. M.

    Objective: The effect of early palate closure on speech and language development in children with cleft palate. Design: Comparative study. Setting: University Medical Center Groningen, Cleft Palate Team (The Netherlands). Materials and methods: Forty-three toddlers with cleft palate and thirty-two

  10. Aesthetic rehabilitation of a patient with an anterior maxillectomy defect, using an innovative single-step, single unit, plastic-based hollow obturator

    Directory of Open Access Journals (Sweden)

    Vishwas Bhatia

    2015-06-01

    Full Text Available What could be better than improving the comfort and quality of life of a patient with a life-threatening disease? Maxillectomy, the partial or total removal of the maxilla in patients suffering from benign or malignant neoplasms, creates a challenging defect for the maxillofacial prosthodontist when attempting to provide an effective obturator. Although previous methods have been described for rehabilitation of such patients, our goal should be to devise one stage techniques that will allow the patient an improved quality of life as soon as possible. The present report describes the aesthetic rehabilitation of a maxillectomy patient by use of a hollow obturator. The obturator is fabricated through a processing technique which is a variation of other well-known techniques, consisting of the use of a single-step flasking procedure to fabricate a single-unit hollow obturator using the lost salt technique. As our aim is to aesthetically and functionally rehabilitate the patient as soon as possible, the present method of restoring the maxillectomy defect is cost-effective, time-saving and beneficial for the patient.

  11. Obturator externus bursa: prevalence of communication with the hip joint and associated intra-articular findings in 200 consecutive hip MR arthrograms

    International Nuclear Information System (INIS)

    Kassarjian, Ara; Llopis, Eva; Schwartz, Richard B.; Bencardino, Jenny T.

    2009-01-01

    The purpose of the study was to demonstrate the prevalence of communication between the hip joint and the obturator externus bursa on hip MR arthrography. Following institutional review board approval, 200 hip MR arthrograms in 196 subjects were independently reviewed by two musculoskeletal radiologists. Discrepancies were resolved by adjudication. The presence or absence of communication between the hip joint and the obturator externus bursa was recorded. Associated lesions involving the acetabular labrum and articular cartilage were recorded. The obturator externus bursa was shown to communicate with the hip joint in 11 of the 200 (5.5%) hip MR arthrograms. Of these, six were in men and five were in women. The age range was 15-63 years with a mean age of 34 years. All 11 patients had labral tears. Eight of the 11 had cartilage lesions. The obturator externus bursa can be seen to communicate with the hip joint in 5.5% of hip MR arthrograms. Associated labral and cartilage lesions are common. (orig.)

  12. Evaluation of the muscle morphology of the obturator externus and piriformis as the predictors of avascular necrosis of the femoral head in acetabular fractures.

    Science.gov (United States)

    Maini, Lalit; Kumar, Santosh; Batra, Sahil; Gupta, Rajat; Arora, Sumit

    2016-08-01

    Avascular necrosis (AVN) of femoral head is a recognised complication of fracture dislocation of the hip joint but is not studied frequently in relation to acetabulum fractures. The aim was to establish the relationship between obturator externus and piriformis muscle morphology in acetabulum fractures and potenital development of AVN of the femoral head. Twenty-five fractures were included in this prospective study and were subjected to radiological assessment and computed tomography of the pelvis. Magnetic resonance imaging (MRI) of the hip was performed to assess the morphology of obturator externus and piriformis, and findings were compared intraoperatively (in 15 cases). Serial radiographs were taken at monthly intervals to assess the development of avascular necrosis. The patients with no evidence of AVN on radiographs at 6 months had additional MRI scans to look for such changes. Three patients developed AVN of femoral head and two had complete tears of piriformis and/or obturator externus muscles on the pre-operative MRI with the findings confirmed intraoperatively (p = 0.013). None of the patients without changes of AVN at 6-month follow-up had complete tears of either or both muscles. Of these patients, there was one case each of T-type fracture, isolated posterior wall fracture with hip dislocation, and posterior wall with transverse fracture of the acetabulum. Complete tears of obturator externus and/or piriformis muscles are a strong predictor of future development of AVN of the femoral head.

  13. Obturator externus bursa: prevalence of communication with the hip joint and associated intra-articular findings in 200 consecutive hip MR arthrograms

    Energy Technology Data Exchange (ETDEWEB)

    Kassarjian, Ara [Corades, S.L., Majadahonda-Madrid (Spain); Massachusetts General Hospital, Division of Musculoksleletal Radiology, Boston, MA (United States); Llopis, Eva [Hospital de la Ribera, Department of Radiology, Alzira (Valencia) (Spain); Schwartz, Richard B. [Longwood MRI Specialists, Brookline, MA (United States); Bencardino, Jenny T. [NYU Department of Radiology, New York, NY (United States)

    2009-11-15

    The purpose of the study was to demonstrate the prevalence of communication between the hip joint and the obturator externus bursa on hip MR arthrography. Following institutional review board approval, 200 hip MR arthrograms in 196 subjects were independently reviewed by two musculoskeletal radiologists. Discrepancies were resolved by adjudication. The presence or absence of communication between the hip joint and the obturator externus bursa was recorded. Associated lesions involving the acetabular labrum and articular cartilage were recorded. The obturator externus bursa was shown to communicate with the hip joint in 11 of the 200 (5.5%) hip MR arthrograms. Of these, six were in men and five were in women. The age range was 15-63 years with a mean age of 34 years. All 11 patients had labral tears. Eight of the 11 had cartilage lesions. The obturator externus bursa can be seen to communicate with the hip joint in 5.5% of hip MR arthrograms. Associated labral and cartilage lesions are common. (orig.)

  14. Cause analysis, prevention, and treatment of postoperative restlessness after general anesthesia in children with cleft palate

    OpenAIRE

    Xu, Hao; Mei, Xiao-Peng; Xu, Li-Xian

    2017-01-01

    Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery ...

  15. Prevalence of and factors affecting post-obturation pain following single visit root canal treatment in Indian population: A prospective, randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Syed Gufran Ali

    2012-01-01

    Full Text Available Aim: This prospective randomized clinical study (1 investigated the prevalence of post-obturation pain after single visit root canal treatment and (2 evaluated the influence of factors affecting the pain experience. Materials and Methods: One thousand three hundred and twenty eight (1328 patients were included in this study. Conventional single visit root canal treatment was carried out. The chemicomechanical preparation of root canals was done by a rotary protaper system with a combination of hand instruments. Post-operative pain was recorded by each patient by using visual analogue scale in well-defined categories at three time intervals, 12 h, 24 h, and 48 h. The data were analyzed using Fisher′s exact test. Results: The prevalence of post-obturation pain (severe within 48 h after treatment was 4% ( n = 54 but less as compared to the pain experienced after 12 h (9% and 24 h (8.6%. The factors that significantly influenced post-obturation pain experience were: Age (Fishers exact test = 46.387, P = 0.0, gender (Fishers exact test = 23.730, P = 0.0, arch (Fishers exact test = 11.710, P = 0.001, and presence of pre-operative pain (Fishers exact test = 67.456, P = 0.0. Conclusion: The presence of post-operative pain was low (4%. The important prognostic determinants of post-obturation pain were: Old age, female, mandibular teeth, and presence of pre-operative pain. The vital condition of the tooth does not affect the intensity and frequency of post-obturation pain.

  16. Oral delivery of medications to companion animals: palatability considerations.

    Science.gov (United States)

    Thombre, Avinash G

    2004-06-23

    There is an increased need for highly palatable solid oral dosage forms for companion animals, which are voluntarily accepted by the dog or cat, either from a feeding bowl or from the outstretched hand of the pet owner. Such dosage forms represent an emerging trend in companion animal formulations with major impact on medical needs such as convenience and compliance, particularly for chronically administered medications, and on marketing needs such as product differentiation. This review focuses on the science of taste, food and flavor preferences of dogs and cats, and palatability testing, in the context of applying these principles to the development of an oral palatable tablet for companion animals.

  17. Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix.

    Science.gov (United States)

    Emodi, Omri; Ginini, Jiriys George; van Aalst, John A; Shilo, Dekel; Naddaf, Raja; Aizenbud, Dror; Rachmiel, Adi

    2018-03-01

    Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%). We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate.

  18. Pulsed radiofrequency treatment of articular branches of femoral and obturator nerves for chronic hip pain

    Directory of Open Access Journals (Sweden)

    Chye CL

    2015-03-01

    Full Text Available Cien-Leong Chye,1 Cheng-Loong Liang,1 Kang Lu,1 Ya-Wen Chen,2,3 Po-Chou Liliang1 1Department of Neurosurgery, E-Da Hospital, I-Shou University, 2Department of Nursing, I-Shou University, 3School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan Purpose: Chronic hip pain is a common symptom experienced by many people. Often, surgery is not an option for patients with multiple comorbidities, and conventional drugs either have many side effects or are ineffective. Pulsed radiofrequency (PRF is a new method in the treatment of pain. We attempt to compare the efficacy of PRF relative to conservative management for chronic hip pain.Patients and methods: Between August 2011 and July 2013, 29 patients with chronic hip pain were divided into two groups (PRF and conservative treatment according to consent or refusal to undergo PRF procedure. Fifteen patients received PRF of the articular branches of the femoral and obturator nerves, and 14 patients received conservative treatment. Visual analog scale (VAS, Oxford hip scores (OHS, and pain medications were used for outcome measurement before treatment and at 1 week, 4 weeks, and 12 weeks after treatment.Results: At 1 week, 4 weeks, and 12 weeks after treatment initiation, improvements in VAS were significantly greater with PRF. Improvements in OHS were significantly greater in the PRF group at 1 week, 4 weeks, and 12 weeks. Patients in the PRF group also used less pain medications. Eight subjects in the conservative treatment group switched to the PRF group after 12 weeks, and six of them had >50% improvement.Conclusion: When compared with conservative treatment, PRF of the articular branches of the femoral and obturator nerves offers greater pain relief for chronic hip pain and can augment physical functioning. Keywords: pulsed radiofrequency, obturator and femoral nerves, hip joint pain, osteoar­thritis

  19. The effects of palatal lengthening on the functional and speech outcomes after submucous cleft palate repair.

    Science.gov (United States)

    Ezzat, Abdelrahman E M; El-Begermy, Marwa M; Eid, Mustafa I; Akel, Mabrouk M

    2016-02-29

    This study was designed to compare intravelar veloplasty with and without V-Y pushback palatoplasty regarding postoperative functional and speech outcomes. is to find out the importance and influence of palatal lengthening on the functional and speech outcomes after SMCP repair. This is a prospective randomized comparative study of 20 patients divided into 2 equal groups. The study was conducted between February 2008 and January 2015. Radical Intravelar Veloplasty (RIVVP group): included 10 patients with a mean age of 5.539±1.335 years and V-Y Pushback Pharyngoplasty and Radical Intravelar Veloplasty (VYP+RIVVP group): included 10 patients with a mean age of 5.688±1.341 years for non-syndromic SMCP. Academic tertiary care medical centres. In both groups there was a significant change in Eustachian tube function, nasal emission and nasal tone of voice postoperatively than preoperatively, while there was no significant difference between both groups in the postoperative outcomes as regards the same parameters (ET function, nasal emission and resonance) (p=0.558, 0.563 and 0.164 respectively). However, there was a significant difference between both groups as regards palatal lengthening, no statistically significant difference was present between both groups as regards the postoperative mean pharyngeal gap, using videoendoscopic analysis. In conclusion, RIVVP and VYP+RIVVP are both effective methods to repair non-syndromic SMCP. Moreover, the lengthening of the palate in non-syndromic SMCP is an unnecessary process.

  20. Ophthalmic changes in cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Luciano Sólia Násser

    2016-04-01

    Full Text Available ABSTRACT The current study aimed to analyze through a literature review evidence of association between ocular changes and non-syndromic cleft lip and/or palate (NSCL/P. A literature review was carried out in accordance with the Cochrane Collaboration Group protocol. PubMed, Scopus, Academic Google and ISI Web of Science databases were systematically searched. A total of 16 studies were accessed, and three made up the final sample.All three studied ocular abnormalities in patients with NSCL/P.The articles found ocular abnormalities in 6.21%, 17.54% and 1.03% of patients respectively.The presence of ocular abnormalities in patients with NSCL/P was significant in this systematic review, but the articles all agreed that future studies should explore the possibility of a greater occurrence of ocular changes in individuals with NSCL/P.

  1. Necrotizing sialometaplasia of palate: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Krishna, Sowmya [V.S Dental College and Hospital, Karnataka (India); Ramnarayan BK [Dayanada Sagar College of Dental Sciences and Hospital, Karnataka (India)

    2011-03-15

    Necrotizing sialometaplasia (NS) which mimics malignancy both clinically and histopathologically is an uncommon benign, self-limiting inflammatory disease of the mucus-secreting minor salivary glands. The lesion is believed to be the result of vascular ischemia that may be initiated by trauma. Till date, the diagnosis of NS remains a challenge. This report demonstrates a case of NS in a 73-year-old male patient who presented with an ulcerative lesion in his palate. He had a history of local trauma and was long-term user of salbutamol inhaler. An incisional biopsy was carried out and the diagnosis was established through history, clinical examination, histopathology using Hematoxylin and Eosin stain. The patient was given symptomatic treatment and the lesion healed in about 7 weeks.

  2. Necrotizing sialometaplasia of palate: a case report

    International Nuclear Information System (INIS)

    Krishna, Sowmya; Ramnarayan BK

    2011-01-01

    Necrotizing sialometaplasia (NS) which mimics malignancy both clinically and histopathologically is an uncommon benign, self-limiting inflammatory disease of the mucus-secreting minor salivary glands. The lesion is believed to be the result of vascular ischemia that may be initiated by trauma. Till date, the diagnosis of NS remains a challenge. This report demonstrates a case of NS in a 73-year-old male patient who presented with an ulcerative lesion in his palate. He had a history of local trauma and was long-term user of salbutamol inhaler. An incisional biopsy was carried out and the diagnosis was established through history, clinical examination, histopathology using Hematoxylin and Eosin stain. The patient was given symptomatic treatment and the lesion healed in about 7 weeks.

  3. Palatal Fibroma - A Case-report

    Directory of Open Access Journals (Sweden)

    Farooque Khan

    2016-03-01

    Full Text Available Fibroma is a benign tumor of fibrous connective tissue. Fibromas represent inflammatory state rather than neoplastic conditions, which  are mostly sessile or slightly pendunculated with a smooth contour, pale pink and are  firm in consistency, which commonly  occurs on gingiva, tongue, buccal mucosa and palate. Cinical, radiographic and histopathologic data combined with surgical findings are though essential, but it requires further studies to determine the exact nature of such fibromatous lesions. A multidisciplinary approach is needed in the management of ffibrtous lesions, so as to minimize its recurrence and to improve the quality of life, providing better  functioning and esthetics.JCMS Nepal. 2016;12(1:36-9.

  4. Sprouty2 controls proliferation of palate mesenchymal cells via fibroblast growth factor signaling

    Energy Technology Data Exchange (ETDEWEB)

    Matsumura, Kaori [Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Taketomi, Takaharu, E-mail: taketomi@dent.kyushu-u.ac.jp [Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Yoshizaki, Keigo [Section of Orthodontics, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Arai, Shinsaku [Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Sanui, Terukazu [Section of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Yoshiga, Daigo [Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Yoshimura, Akihiko [Department of Microbiology and Immunology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 (Japan); Japan Science and Technology Agency (JST), CREST, Chiyoda-ku, Tokyo 102-0075 (Japan); Nakamura, Seiji [Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)

    2011-01-28

    Research highlights: {yields} Sprouty2-deficient mice exhibit cleft palate as a result of failure of palatal shelf elevation. {yields} We examined palate cell proliferation in Sprouty2-deficient mice. {yields} Palate mesenchymal cell proliferation was increased in Sprouty2 KO mice. {yields} Sprouty2 plays roles in murine palatogenesis by regulating cell proliferation. -- Abstract: Cleft palate is one of the most common craniofacial deformities. The fibroblast growth factor (FGF) plays a central role in reciprocal interactions between adjacent tissues during palatal development, and the FGF signaling pathway has been shown to be inhibited by members of the Sprouty protein family. In this study, we report the incidence of cleft palate, possibly caused by failure of palatal shelf elevation, in Sprouty2-deficient (KO) mice. Sprouty2-deficient palates fused completely in palatal organ culture. However, palate mesenchymal cell proliferation estimated by Ki-67 staining was increased in Sprouty2 KO mice compared with WT mice. Sprouty2-null palates expressed higher levels of FGF target genes, such as Msx1, Etv5, and Ptx1 than WT controls. Furthermore, proliferation and the extracellular signal-regulated kinase (Erk) activation in response to FGF was enhanced in palate mesenchymal cells transfected with Sprouty2 small interfering RNA. These results suggest that Sprouty2 regulates palate mesenchymal cell proliferation via FGF signaling and is involved in palatal shelf elevation.

  5. Sprouty2 controls proliferation of palate mesenchymal cells via fibroblast growth factor signaling

    International Nuclear Information System (INIS)

    Matsumura, Kaori; Taketomi, Takaharu; Yoshizaki, Keigo; Arai, Shinsaku; Sanui, Terukazu; Yoshiga, Daigo; Yoshimura, Akihiko; Nakamura, Seiji

    2011-01-01

    Research highlights: → Sprouty2-deficient mice exhibit cleft palate as a result of failure of palatal shelf elevation. → We examined palate cell proliferation in Sprouty2-deficient mice. → Palate mesenchymal cell proliferation was increased in Sprouty2 KO mice. → Sprouty2 plays roles in murine palatogenesis by regulating cell proliferation. -- Abstract: Cleft palate is one of the most common craniofacial deformities. The fibroblast growth factor (FGF) plays a central role in reciprocal interactions between adjacent tissues during palatal development, and the FGF signaling pathway has been shown to be inhibited by members of the Sprouty protein family. In this study, we report the incidence of cleft palate, possibly caused by failure of palatal shelf elevation, in Sprouty2-deficient (KO) mice. Sprouty2-deficient palates fused completely in palatal organ culture. However, palate mesenchymal cell proliferation estimated by Ki-67 staining was increased in Sprouty2 KO mice compared with WT mice. Sprouty2-null palates expressed higher levels of FGF target genes, such as Msx1, Etv5, and Ptx1 than WT controls. Furthermore, proliferation and the extracellular signal-regulated kinase (Erk) activation in response to FGF was enhanced in palate mesenchymal cells transfected with Sprouty2 small interfering RNA. These results suggest that Sprouty2 regulates palate mesenchymal cell proliferation via FGF signaling and is involved in palatal shelf elevation.

  6. Palatal myoclonus: report of two cases Mioclonia palatal: relato de dois casos

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    GIORGIO FABIANI

    2000-09-01

    Full Text Available We describe two cases of palatal myoclonus (PM, one essential and another secondary to a stroke. Case 1: a 64 years old female who developed clicking sounds in both ears after a stroke and three years later on noticed a progressive involuntary movement of the throat associated with rhythmic contractions of the soft palate, muscles of tongue and throat. MRI showed an ischemic area in brainstem. The patient had a partial response to the use of sumatriptan 6 mg subcutaneously. Case 2: a 66 years old female who began with ear clicking at left ear that worsed slowly associated with tinnitus and arrhythmic movements of soft palate and an audible click at left ear. Brain MRI was normal; audiometry showed bilateral neurosensory loss. She was prescribed clonazepan 1 mg daily with complete recovery. Primary and secondary palatal myoclonus share the same clinical features but probably have different pathophysiological underlying mechanisms.Descrevemos dois casos de mioclonia palatal (MP, um essencial e o outro secundário a acidente vascular cerebral (AVC. Caso1: mulher de 64 anos que desenvolveu cliques audíveis em ambos os ouvidos após um AVC e que três anos depois começou a apresentar movimentos involuntários do pálato, músculos do língua e garganta. A ressonância magnética (RNM mostrou áreas de isquemia no tronco cerebral. A paciente apresentou resposta parcial e não duradoura ao uso subcutâneo de 6 mg de sumatriptano. Caso 2: mulher de 66 anos, com cliques audíveis no ouvido esquerdo que pioraram progressiva e lentamente associados com tinitus e movimentos mais ou menos rítmicos do pálato mole. A RNM encefálica era normal. A audiometria mostrou perda neurossensorial bilateral. Foi medicada com 1,0 mg de clonazepan diariamente com completa recuperação. MP primária e secundária compartilham das mesmas características clínicas, mas evidências sugerem que se devam a diferentes mecanismos fisiopatológicos.

  7. Economic Analysis of Cleft Palate Repair in International Adoptees.

    Science.gov (United States)

    Tomlinson-Hansen, Sandra; Paliga, J Thomas; Tahiri, Youssef; Paine, Kaitlyn M; Bartlett, Scott P; Taylor, Jesse A

    2016-09-01

    Retrospective cohort study. Major international tertiary care referral center for cleft palate repair. One hundred thirty-eight patients at the Children's Hospital of Philadelphia who had palate repair performed between 2010 and 2013, excluding syndromic patients, patients undergoing palate revision, and patients with incomplete payment information. None. Fees and charges for procedures. Surgeon payment was significantly higher for international adoptees (Δ = $2047.51 [$128.35 to $3966.66], P = .038). Medicaid-adjusted surgeon payments averaged $1006 more for adoptees ([-$394.19 to $2406.98], P = .158). Hospital and anesthesiology costs for adoptee palate repair were highly variable but did not differ significantly from those for nonadoptees. Partly due to payer mix, surgeon reimbursement was somewhat higher for international adoptees. No difference in total payment was found.

  8. Computational Embryology and Predictive Toxicology of Cleft Palate

    Science.gov (United States)

    Capacity to model and simulate key events in developmental toxicity using computational systems biology and biological knowledge steps closer to hazard identification across the vast landscape of untested environmental chemicals. In this context, we chose cleft palate as a model ...

  9. Cross-linguistic perspectives on speech assessment in cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Henningsson, Gunilla

    2012-01-01

    . Finally, the influence of different languages on some aspects of language acquisition in young children with cleft palate is presented and discussed. Until recently, not much has been written about cross linguistic perspectives when dealing with cleft palate speech. Most literature about assessment......This chapter deals with cross linguistic perspectives that need to be taken into account when comparing speech assessment and speech outcome obtained from cleft palate speakers of different languages. Firstly, an overview of consonants and vowels vulnerable to the cleft condition is presented. Then......, consequences for assessment of cleft palate speech by native versus non-native speakers of a language are discussed, as well as the use of phonemic versus phonetic transcription in cross linguistic studies. Specific recommendations for the construction of speech samples in cross linguistic studies are given...

  10. Management of Cleft Lip and Palate in Nigeria: A Survey

    African Journals Online (AJOL)

    2017-03-20

    Mar 20, 2017 ... Background: Clefts of the lip and/or palate are the most common congenital craniofacial ... in the number of surgeons, but the training, scope, and standard of care remain ... specialist fellowship qualifications, 6 others (8.6%).

  11. A Rat Model for Muscle Regeneration in the Soft Palate

    Science.gov (United States)

    Carvajal Monroy, Paola L.; Grefte, Sander; Kuijpers-Jagtman, Anne M.; Helmich, Maria P. A. C.; Ulrich, Dietmar J. O.; Von den Hoff, Johannes W.; Wagener, Frank A. D. T. G.

    2013-01-01

    Background Children with a cleft in the soft palate have difficulties with speech, swallowing, and sucking. Despite successful surgical repositioning of the muscles, optimal function is often not achieved. Scar formation and defective regeneration may hamper the functional recovery of the muscles after cleft palate repair. Therefore, the aim of this study is to investigate the anatomy and histology of the soft palate in rats, and to establish an in vivo model for muscle regeneration after surgical injury. Methods Fourteen adult male Sprague Dawley rats were divided into four groups. Groups 1 (n = 4) and 2 (n = 2) were used to investigate the anatomy and histology of the soft palate, respectively. Group 3 (n = 6) was used for surgical wounding of the soft palate, and group 4 (n = 2) was used as unwounded control group. The wounds (1 mm) were evaluated by (immuno)histochemistry (AZAN staining, Pax7, MyoD, MyoG, MyHC, and ASMA) after 7 days. Results The present study shows that the anatomy and histology of the soft palate muscles of the rat is largely comparable with that in humans. All wounds showed clinical evidence of healing after 7 days. AZAN staining demonstrated extensive collagen deposition in the wound area, and initial regeneration of muscle fibers and salivary glands. Proliferating and differentiating satellite cells were identified in the wound area by antibody staining. Conclusions This model is the first, suitable for studying muscle regeneration in the rat soft palate, and allows the development of novel adjuvant strategies to promote muscle regeneration after cleft palate surgery. PMID:23554995

  12. Chemokine Signaling during Midline Epithelial Seam Disintegration Facilitates Palatal Fusion

    Science.gov (United States)

    Suttorp, Christiaan M.; Cremers, Niels A.; van Rheden, René; Regan, Raymond F.; Helmich, Pia; van Kempen, Sven; Kuijpers-Jagtman, Anne M.; Wagener, Frank A.D.T.G.

    2017-01-01

    Disintegration of the midline epithelial seam (MES) is crucial for palatal fusion, and failure results in cleft palate. Palatal fusion and wound repair share many common signaling pathways related to epithelial-mesenchymal cross-talk. We postulate that chemokine CXCL11, its receptor CXCR3, and the cytoprotective enzyme heme oxygenase (HO), which are crucial during wound repair, also play a decisive role in MES disintegration. Fetal growth restriction and craniofacial abnormalities were present in HO-2 knockout (KO) mice without effects on palatal fusion. CXCL11 and CXCR3 were highly expressed in the disintegrating MES in both wild-type and HO-2 KO animals. Multiple apoptotic DNA fragments were present within the disintegrating MES and phagocytized by recruited CXCR3-positive wt and HO-2 KO macrophages. Macrophages located near the MES were HO-1-positive, and more HO-1-positive cells were present in HO-2 KO mice compared to wild-type. This study of embryonic and palatal development provided evidence that supports the hypothesis that the MES itself plays a prominent role in palatal fusion by orchestrating epithelial apoptosis and macrophage recruitment via CXCL11-CXCR3 signaling. PMID:29164113

  13. Teaching Palatoplasty Using a High-Fidelity Cleft Palate Simulator.

    Science.gov (United States)

    Cheng, Homan; Podolsky, Dale J; Fisher, David M; Wong, Karen W; Lorenz, H Peter; Khosla, Rohit K; Drake, James M; Forrest, Christopher R

    2018-01-01

    Cleft palate repair is a challenging procedure for cleft surgeons to teach. A novel high-fidelity cleft palate simulator has been described for surgeon training. This study evaluates the simulator's effect on surgeon procedural confidence and palatoplasty knowledge among learners. Plastic surgery trainees attended a palatoplasty workshop consisting of a didactic session on cleft palate anatomy and repair followed by a simulation session. Participants completed a procedural confidence questionnaire and palatoplasty knowledge test immediately before and after the workshop. All participants reported significantly higher procedural confidence following the workshop (p cleft palate surgery experience had higher procedural confidence before (p cleft palate experience did not have higher mean baseline test scores than those with no experience (30 percent versus 28 percent; p > 0.05), but did have significantly higher scores after the workshop (61 percent versus 35 percent; p cleft palate simulator as a training tool to teach palatoplasty. Improved procedural confidence and knowledge were observed after a single session, with benefits seen among trainees both with and without previous cleft experience.

  14. Reconstruction of a Total Soft Palatal Defect Using

    Directory of Open Access Journals (Sweden)

    Won Jai Lee

    2012-01-01

    Full Text Available Background The soft palate functions as a valve and helps generate the oral pressurerequired for normal speech resonance. Speech problems and nasal regurgitation can resultfrom a soft palatal defect. Reduction of the size of the velopharyngeal orifice is requiredto compensate for the lack of mobility in a reconstructed soft palate. We suggest a largevolume folded free flap for reduction of the caliber and a palmaris longus tendon sling forsuspension of the reconstructed palate.Methods Six patients had total soft palate resection for tonsillar cancer and reconstructionwith a large volume folded radial forearm free flap combined with a palmaris longus sling.A single surgeon and speech therapist examined the patients with three standardizedspeech assessment tools: nasometer test, consonant articulation test, and speech acuity testperformed for speech evaluation.Results Mean nasalance score was 76.20% for sentences with nasal sounds and 43.60% forsentences with oral sounds. Hypernasality was seen for oral sound sentences. The mean scoreof the picture consonant articulation test was 84% (range, 63% to 100%. The mean scoreof the speech acuity test was 5.84 (range, 5 to 6. These mean ratings represent a satisfactorylevel of speech function.Conclusions The large volume folded free flap with a palmaris longus tendon sling for totalsoft palate reconstruction resulted in satisfactory prognosis for speech despite moderatehypernasality.

  15. Chemokine Signaling during Midline Epithelial Seam Disintegration Facilitates Palatal Fusion

    Directory of Open Access Journals (Sweden)

    Christiaan M. Suttorp

    2017-10-01

    Full Text Available Disintegration of the midline epithelial seam (MES is crucial for palatal fusion, and failure results in cleft palate. Palatal fusion and wound repair share many common signaling pathways related to epithelial-mesenchymal cross-talk. We postulate that chemokine CXCL11, its receptor CXCR3, and the cytoprotective enzyme heme oxygenase (HO, which are crucial during wound repair, also play a decisive role in MES disintegration. Fetal growth restriction and craniofacial abnormalities were present in HO-2 knockout (KO mice without effects on palatal fusion. CXCL11 and CXCR3 were highly expressed in the disintegrating MES in both wild-type and HO-2 KO animals. Multiple apoptotic DNA fragments were present within the disintegrating MES and phagocytized by recruited CXCR3-positive wt and HO-2 KO macrophages. Macrophages located near the MES were HO-1-positive, and more HO-1-positive cells were present in HO-2 KO mice compared to wild-type. This study of embryonic and palatal development provided evidence that supports the hypothesis that the MES itself plays a prominent role in palatal fusion by orchestrating epithelial apoptosis and macrophage recruitment via CXCL11-CXCR3 signaling.

  16. Comparison of post-obturation pain experience following one-visit and two-visit root canal treatment on teeth with vital pulps: a randomized controlled trial.

    Science.gov (United States)

    Wang, C; Xu, P; Ren, L; Dong, G; Ye, L

    2010-08-01

    To compare the incidence and intensity of post-obturation pain after one- or two-visit root canal treatment (RCT) on anterior teeth with vital pulps and a single root and canal in a randomized controlled trial. One hundred patients requiring RCT on permanent anterior teeth with vital pulps preoperatively were included. The patients were assigned randomly into two groups of 50 patients each. After local anaesthesia, isolation, access and pulp extirpation, the canals of all teeth were prepared using engine-driven rotary ProTaper nickel-titanium instruments in a crown-down technique and irrigated with 2.5% NaOCl. The teeth in group 1 (n = 50) were filled with AH Plus sealer and gutta-percha using a lateral compaction technique at the first visit, whilst those in group 2 (n = 50) were medicated with a calcium hydroxide paste, a sterile dry cotton pellet and Caviton and scheduled for a second visit 7 days later. A modified verbal descriptor scale was used to measure preoperative pain and post-obturation pain at 6, 24, 48 h and 1 week after operation. Chi-square tests and independent-sample T-tests were used to compare the incidence and intensity of post-obturation pain of two groups at each interval. Eleven patients were excluded from the study as they failed to follow the scheduled revisit or their selected teeth had more than one root canal. Data were obtained from the remaining 89 patients. Forty-three patients were undergoing one-visit treatment (group 1) and 46 undergoing two-visit treatment (group 2). Most patients in both groups reported no pain or only slight pain within each post-obturation interval, only one in group 1 and one in group 2 had flare-ups and slight swelling. There was no statistically significant difference in the incidence and intensity of post-obturation pain experienced by two groups. The incidence and intensity of post-obturation pain experience following one- or two-visit RCT on teeth with vital pulps and a single canal were not

  17. A Comparative Study of Oral Microbiota in Infants with Complete Cleft Lip and Palate or Cleft Soft Palate.

    Science.gov (United States)

    Machorowska-Pieniążek, Agnieszka; Mertas, Anna; Skucha-Nowak, Małgorzata; Tanasiewicz, Marta; Morawiec, Tadeusz

    2017-01-01

    Few reports have been published on the early microbiota in infants with various types of cleft palate. We assessed the formation of the oral microbiota in infants with complete cleft lip and palate (CLP n = 30) or cleft soft palate (CSP n = 25) in the neonatal period (T1 time) and again in the gum pad stage (T2 time). Culture swabs from the tongue, palate, and/or cleft margin at T1 and T2 were taken. We analysed the prevalence of the given bacterial species (the percentage) and the proportions in which the palate and tongue were colonised by each microorganism. At T1, Streptococcus mitis (S. mitis) were the most frequently detected in subjects with CLP or CSP (63% and 60%, resp.). A significantly higher frequency of methicillin-sensitive Staphylococcus aureus ( S. aureus MSSA) was observed in CLP compared to the CSP group. At T2, significantly higher percentages of S. mitis , S. aureus MSSA, Staphylococcus epidermidis , and members of the Enterobacteriaceae family were noted in CLP infants compared to the CSP. S. mitis and Streptococcus sanguinis appeared with the greatest frequency on the tongue, whereas Streptococcus salivarius was predominant on the palate. The development of the microbiota in CLP subjects was characterised by a significant increase in the prevalence of pathogenic bacteria.

  18. Histopathologic and immunohistochemical features of soft palate muscles and nerves in dogs with an elongated soft palate.

    Science.gov (United States)

    Arai, Kiyotaka; Kobayashi, Masanori; Harada, Yasuji; Hara, Yasushi; Michishita, Masaki; Ohkusu-Tsukada, Kozo; Takahashi, Kimimasa

    2016-01-01

    To histologically evaluate and compare features of myofibers within the elongated soft palate (ESP) of brachycephalic and mesocephalic dogs with those in the soft palate of healthy dogs and to assess whether denervation or muscular dystrophy is associated with soft palate elongation. Soft palate specimens from 24 dogs with ESPs (obtained during surgical intervention) and from 14 healthy Beagles (control group). All the soft palate specimens underwent histologic examination to assess myofiber atrophy, hypertrophy, hyalinization, and regeneration. The degrees of atrophy and hypertrophy were quantified on the basis of the coefficient of variation and the number of myofibers with hyalinization and regeneration. The specimens also underwent immunohistochemical analysis with anti-neurofilament or anti-dystrophin antibody to confirm the distribution of peripheral nerve branches innervating the palatine myofibers and myofiber dystrophin expression, respectively. Myofiber atrophy, hypertrophy, hyalinization, and regeneration were identified in almost all the ESP specimens. Degrees of atrophy and hypertrophy were significantly greater in the ESP specimens, compared with the control specimens. There were fewer palatine peripheral nerve branches in the ESP specimens than in the control specimens. Almost all the myofibers in the ESP and control specimens were dystrophin positive. These results suggested that palatine myopathy in dogs may be caused, at least in part, by denervation of the palatine muscles and not by Duchenne- or Becker-type muscular dystrophy. These soft palate changes may contribute to upper airway collapse and the progression of brachycephalic airway obstructive syndrome.

  19. Evaluation of cleft lip and palate by computed tomography with 2 mm thin slice scanning

    International Nuclear Information System (INIS)

    Tanaka, Hiroshi

    1988-01-01

    Computed tomography was carried out in 65 patients of cleft lip and palate with continuous 2 mm slice scanning. The cleft lip and palate was classified by shape of the hard palate as normal, hypoplasia, and aplasia, depending on its developmental degree. The shape of alveolus was also grouped as circular, triangular, and asymmetric forms for the evaluation of maxillar development. The hard palatal development well correlated with the shape of the alveolus. Frequency of sinusitis and mastoiditis increased with the severity of hard palatal malformation. Evaluation of the hard palate by thin slice scanning is usefull standpoint of presumption of future maxillary development. (author)

  20. Evaluation of cleft lip and palate by computed tomography with 2 mm thin slice scanning

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Hiroshi

    1988-07-01

    Computed tomography was carried out in 65 patients of cleft lip and palate with continuous 2 mm slice scanning. The cleft lip and palate was classified by shape of the hard palate as normal, hypoplasia, and aplasia, depending on its developmental degree. The shape of alveolus was also grouped as circular, triangular, and asymmetric forms for the evaluation of maxillar development. The hard palatal development well correlated with the shape of the alveolus. Frequency of sinusitis and mastoiditis increased with the severity of hard palatal malformation. Evaluation of the hard palate by thin slice scanning is usefull standpoint of presumption of future maxillary development.

  1. Effects of dexamethasone on palate mesenchymal cell phospholipase activity

    International Nuclear Information System (INIS)

    Bulleit, R.F.; Zimmerman, E.F.

    1984-01-01

    Corticosteroids will induce cleft palate in mice. One suggested mechanism for this effect is through inhibition of phospholipase activity. This hypothesis was tested by measuring the effects of dexamethasone, a synthetic corticosteroid, on phospholipase activity in cultures of palate mesenchymal cells. Palate mesenchymal cells were prelabeled with [3H]arachidonic acid. The cells were subsequently treated with various concentrations of dexamethasone. Concurrently, cultures of M-MSV-transformed 3T3 cells were prepared identically. After treatment, phospholipase activity was stimulated by the addition of serum or epidermal growth factor (EGF), and radioactivity released into the medium was taken as a measure of phospholipase activity. Dexamethasone (1 X 10(-5) or 1 X 10(-4) M) could inhibit serum-stimulated phospholipase activity in transformed 3T3 cells after 1 to 24 hr of treatment. However, no inhibition of activity was measured in palate mesenchymal cells following this period of treatment. Not until 120 hr of treatment with dexamethasone (1 X 10(-4) M) was any significant inhibition of serum-stimulated phospholipase activity observed in palate mesenchymal cells. When EGF was used to stimulate phospholipase activity, dexamethasone (1 X 10(-5) M) caused an increase in phospholipase activity in palate mesenchymal cells. These observations suggested that phospholipase in transformed 3T3 cells was sensitive to inhibition by dexamethasone. However, palate mesenchymal cell phospholipase is only minimally sensitive to dexamethasone, and in certain instances can be enhanced. These results cannot support the hypothesis that corticosteroids mediate their teratogenic effect via inhibition of phospholipase activity

  2. PREVALENCE OF CLEFT LIP AND PALATE IN GEORGIA.

    Science.gov (United States)

    Chincharadze, S; Vadachkoria, Z; Mchedlishvili, I

    2017-01-01

    Cleft lip and palate take significant place in congenital malformations. We aimed to study epidemiological peculiarities of these pathologies in Georgia for 2006-2015. We compared magnitude of its distribution with the data from 1981-1990. Prevalence of cleft lip and palate in Georgia in 2006-2015 was 0.95±0.04 per 1000 live births, while in 1981-1990- it was 1.05, i.e. in contrast to 1980's frequency of these pathological conditions decreased to some extent. Distribution of cleft lip and palate varies across the country regions. The most intensive spread has been observed in Mtskheta-Mtianeti region, where prevalence composed 2.28/1000. In the rest of the regions frequency of these pathologies is significantly lower. For instance, in Kakheti the rate is equal to 1,87/1000, in Kvemo Kartli - 1.56/1000, in Shida Kartli - 1.55/1000. In the rest of the regions prevalence rate is lower than the country average. It should be noted that in Tbilisi the rate is as low as 0.80/1000. The lowest level has been reported in Guria - 0.56/1000. Currently cleft lip with palate is the most frequently occurring anomaly in Georgia accounting for 39.8% of all congenital malformations. Cleft lip alone ranks the second - 36.1%, followed by cleft palate (24.1%). These pathologies are more frequent in boys than in girls. 60.3% of the cases are reported in males, in contrast to girls - 39.7% (pcleft palate is the most common among girls, but in our case, it had higher prevalence among boys, 53.6% vs. 46,4%. Thus cleft lip and palate distribution in Georgia is characterized by epidemiological peculiarities, which should be considered in implementation of preventive measures.

  3. Palatal bone thickness measured by palatal index method using cone-beam computed tomography in nonorthodontic patients for placement of mini-implants

    Directory of Open Access Journals (Sweden)

    W S Manjula

    2015-01-01

    Full Text Available Introduction: The purpose of this study was to compare the bone thickness of the palatal areas in different palatal index (PI groups. Materials and Methods: Cone-beam computed tomography scans of 10 subjects were selected with a mean age group of 18 years. The measurements of palatal bone thickness were made at 36 sites using CareStream 3D Imaging software. The PI was measured using Korkhaus ratio (palatal height/palatal width. One-way analysis of variance was used to analyze intergroup differences, as well as the PI difference. Results: Bone thickness was higher in the anterior region than in the middle and posterior regions P<0.001. Furthermore, significant differences were found among the midline, medial, and lateral areas of the palate. Conclusions: These findings might be helpful for clinicians to enhance the successful use of temporary anchorage devices in the palate.

  4. Palatability of two artificial feeds for reindeer

    Directory of Open Access Journals (Sweden)

    Arne Rognmo

    1990-09-01

    Full Text Available Two groups of 15 reindeer were used to test the palatability of two artificial diets. None of the animals had experienced the diets before. Trials were carried out from April to mid May. Each group of animals was kept in a separate corral (600 sq. meters. Both groups were fed lichens for three days befort trials began. Then they were offered a concentrate feed (RF-80 or «Mill Waste Product» (MWP ad libitum. Both groups ate little or nothing for the first three days of the trial and so lichens were mixed with the two experimental feeds. The mean voluntary food intake of the RF-80-group increased from 0.8 Kg/day/animal to 1.8 Kg/day/animal after three weeks. A mixed feed, RF-80/lichen, was only used the first day for animals in the RF-80 group. Reindeer refused to eat MWP for twelve days despite mixing it with lichens. They were then offered RF-80 ad lib. without a mixture of lichens. The mean voluntary intake of these animals increased from 1.3 Kg RF-80/day/animal on day 13 to 2.3 Kg/day/animal by day 26. Two calves in the MWP-group got diarrhoea after refeeding with RF-80.

  5. Modulating Wnt Signaling Rescues Palate Morphogenesis in Pax9 Mutant Mice.

    Science.gov (United States)

    Li, C; Lan, Y; Krumlauf, R; Jiang, R

    2017-10-01

    Cleft palate is a common birth defect caused by disruption of palatogenesis during embryonic development. Although mutations disrupting components of the Wnt signaling pathway have been associated with cleft lip and palate in humans and mice, the mechanisms involving canonical Wnt signaling and its regulation in secondary palate development are not well understood. Here, we report that canonical Wnt signaling plays an important role in Pax9-mediated regulation of secondary palate development. We found that cleft palate pathogenesis in Pax9-deficient embryos is accompanied by significantly reduced expression of Axin2, an endogenous target of canonical Wnt signaling, in the developing palatal mesenchyme, particularly in the posterior regions of the palatal shelves. We found that expression of Dkk2, encoding a secreted Wnt antagonist, is significantly increased whereas the levels of active β-catenin protein, the essential transcriptional coactivator of canonical Wnt signaling, is significantly decreased in the posterior regions of the palatal shelves in embryonic day 13.5 Pax9-deficent embryos in comparison with control littermates. We show that small molecule-mediated inhibition of Dickkopf (DKK) activity in utero during palatal shelf morphogenesis partly rescued secondary palate development in Pax9-deficient embryos. Moreover, we found that genetic inactivation of Wise, which is expressed in the developing palatal shelves and encodes another secreted antagonist of canonical Wnt signaling, also rescued palate morphogenesis in Pax9-deficient mice. Furthermore, whereas Pax9 del/del embryos exhibit defects in palatal shelf elevation/reorientation and significant reduction in accumulation of hyaluronic acid-a high molecular extracellular matrix glycosaminoglycan implicated in playing an important role in palatal shelf elevation-80% of Pax9 del/del ;Wise -/- double-mutant mouse embryos exhibit rescued palatal shelf elevation/reorientation, accompanied by restored

  6. Clinical Evaluation of Quality of Obturation and Instrumentation Time using Two Modified Rotary File Systems with Manual Instrumentation in Primary Teeth.

    Science.gov (United States)

    Govindaraju, Lavanya; Jeevanandan, Ganesh; Subramanian, Emg

    2017-09-01

    Pulp therapy in primary teeth has been performed using various instrumentation techniques. However, the conventional instrumentation technique used for root canal preparation in primary teeth is hand instrumentation. Various Nickel-Titanium (Ni-Ti) instruments are available to perform efficient root canal preparation in primary teeth. These Ni-Ti instruments has been designed to aid in better root canal preparation in permanent teeth but are rarely used in primary teeth. It is necessary to assess the feasibility of using these adult rotary files with a modified sequence in primary teeth. To compare the quality of obturation and instrumentation time during root canal preparation using hand files and modified rotary file systems in primary molars. Forty-five primary mandibular molars were randomly assigned to three experimental groups (n=15). Group I was instrumented using k-hand files, Group II with S2 ProTaper universal file and Group III with 0.25 tip 4% taper K3 rotary file. Standardized digital radiographs were taken before and after root canal instrumentation. Root canal preparation time was also recorded. Statistical analysis of the obtained data was done using SPSS Software version 17.0. An intergroup comparison of the instrumentation time and the quality of obturation was done using ANOVA and Chi-square test with the level of significance set at 0.05. No significant differences were noted with regard to the quality of obturation (p=0.791). However, a statistically significant difference was noted in the instrumentation time between the three groups (pProTaper rotary system had significantly lesser instrumentation time when compared to that of K3 rotary system and hand file system. The hand files, S2 ProTaper Universal and K3 0.25 tip 4% taper files systems performed similarly with respect to the quality of obturation. There was a significant difference in instrumentation time with manual instrumentation compared to the modified rotary file systems in primary

  7. Evaluation of microleakage in single-rooted teeth obturated with thermoplasticized gutta-percha using various endodontic sealers: an in-vitrostudy

    International Nuclear Information System (INIS)

    Lone, M.M.; Khan, F.; Lone, M.A.

    2018-01-01

    Objective:To compare apical microleakage of extracted, single-rooted teeth obturated with thermoplasticized injectable gutta-percha using two different endodontic sealers (calcium-hydroxide and resin based). Study Design:An experimental study. Place and Duration of Study:The Aga Khan University Hospital (AKUH), Dental Clinics and Laboratory from June to September 2015. Methodology:The study was conducted using extracted teeth. After access cavities were made, cleaning and shaping of root canals was done in 70 teeth. Teeth were randomly allocated into two groups and obturated with thermoplasticized injectable gutta-percha (Obtura II) using two sealers (Sealapex vs.AH plus). After immersing the teeth in 2.0% methylene blue, they were split longitudinally, viewed under light microscope (magnification X4) and images were taken by a camera connected to microscope. The extent of dye penetration was assessed from apex to its coronal part and recorded in millimeters. Independent sample t-test was used to compare microleakage in the two groups. Pearson correlation coefficient was used for inter-examiner reliability of dye penetration measurements. A p-value of <0.05 was taken as statistically significant. Results:Teeth obturated with Obtura II gutta-percha with AH plus sealer had a mean dye penetration of 1.20 +- 0.79 mm. This was significantly better than Obtura II with Sealapex sealer (p=0.003). Conclusion:Obtura II-AH plus sealer was a better combination for obturation as it showed a lesser degree of microleakage. Obtura II with Sealapex group showed higher microleakage, so this combination should be avoided in single-rooted teeth. (author)

  8. The use of cone beam computed tomography and three dimensional printing technology in the restoration of a maxillectomy patient using a dental implant retained obturator.

    Science.gov (United States)

    Michelinakis, George

    2017-01-01

    This case report presents an alternative method for fabricating an obturator for patients that develop xerostomia and mild trismus following radiation to the Head and Neck region. Multiple initial impression stages are avoided leading to less irritation to soft tissues and less discomfort to the patient. A 69-year-old male patient was referred to our dental practice by the Maxillofacial Surgery Department of the local General Hospital. The patient had undergone a right maxillectomy for removal of a Squamous Cell Carcinoma 2 weeks prior. Four endosseous dental implants were placed in the remaining upper jaw and 2 implants were inserted into the canine region of his edentulous mandible 3 weeks after ablative surgery. Five months following completion of radiotherapy and chemotherapy, a cone beam computed tomography of the maxilla was obtained, and a three dimensional model was constructed using an appropriate resin. Using the model as the detailed primary cast, a custom acrylic special tray was fabricated for the final impression of the remaining maxilla and the maxillary defect. An implant retained maxillary obturator and an implant retained mandibular overdenture were constructed to restore patient's speech, mastication and deglutition. The method presented here can limit the impression stages needed for construction of a maxillary obturator prosthesis to a single impression procedure advocating a partial digital workflow process. This can be very beneficial to the patient suffering from postradiation side-effects such as trismus, mucositis, and xerostomia.

  9. The use of cone beam computed tomography and three dimensional printing technology in the restoration of a maxillectomy patient using a dental implant retained obturator

    Directory of Open Access Journals (Sweden)

    George Michelinakis

    2017-01-01

    Full Text Available This case report presents an alternative method for fabricating an obturator for patients that develop xerostomia and mild trismus following radiation to the Head and Neck region. Multiple initial impression stages are avoided leading to less irritation to soft tissues and less discomfort to the patient. A 69-year-old male patient was referred to our dental practice by the Maxillofacial Surgery Department of the local General Hospital. The patient had undergone a right maxillectomy for removal of a Squamous Cell Carcinoma 2 weeks prior. Four endosseous dental implants were placed in the remaining upper jaw and 2 implants were inserted into the canine region of his edentulous mandible 3 weeks after ablative surgery. Five months following completion of radiotherapy and chemotherapy, a cone beam computed tomography of the maxilla was obtained, and a three dimensional model was constructed using an appropriate resin. Using the model as the detailed primary cast, a custom acrylic special tray was fabricated for the final impression of the remaining maxilla and the maxillary defect. An implant retained maxillary obturator and an implant retained mandibular overdenture were constructed to restore patient's speech, mastication and deglutition. The method presented here can limit the impression stages needed for construction of a maxillary obturator prosthesis to a single impression procedure advocating a partial digital workflow process. This can be very beneficial to the patient suffering from postradiation side-effects such as trismus, mucositis, and xerostomia.

  10. Comparison of quality of obturation and instrumentation time using hand files and two rotary file systems in primary molars: A single-blinded randomized controlled trial.

    Science.gov (United States)

    Govindaraju, Lavanya; Jeevanandan, Ganesh; Subramanian, E M G

    2017-01-01

    In permanent dentition, different rotary systems are used for canal cleaning and shaping. Rotary instrumentation in pediatric dentistry is an emerging concept. A very few studies have compared the efficiency of rotary instrumentation for canal preparation in primary teeth. Hence, this study was performed to compare the obturation quality and instrumentation time of two rotary files systems - Protaper, Mtwo with hand files in primary molars. Forty-five primary mandibular molars were randomly allotted to one of the three groups. Instrumentation was done using K-files in Group 1; Protaper in Group 2; and Mtwo in Group 3. Instrumentation time was recorded. The canal filling quality was assessed as underfill, optimal fill, and overfill. Statistical analysis was done using Chi-square, ANOVA, and post hoc Tukey test. No significant difference was observed in the quality of obturation among three groups. Intergroup comparison of the instrumentation time showed a statistically significant difference between the three groups. The use of rotary instrumentation in primary teeth results in marked reduction in the instrumentation time and improves the quality of obturation.

  11. Assessing Technical Performance and Determining the Learning Curve in Cleft Palate Surgery Using a High-Fidelity Cleft Palate Simulator.

    Science.gov (United States)

    Podolsky, Dale J; Fisher, David M; Wong Riff, Karen W; Szasz, Peter; Looi, Thomas; Drake, James M; Forrest, Christopher R

    2018-06-01

    This study assessed technical performance in cleft palate repair using a newly developed assessment tool and high-fidelity cleft palate simulator through a longitudinal simulation training exercise. Three residents performed five and one resident performed nine consecutive endoscopically recorded cleft palate repairs using a cleft palate simulator. Two fellows in pediatric plastic surgery and two expert cleft surgeons also performed recorded simulated repairs. The Cleft Palate Objective Structured Assessment of Technical Skill (CLOSATS) and end-product scales were developed to assess performance. Two blinded cleft surgeons assessed the recordings and the final repairs using the CLOSATS, end-product scale, and a previously developed global rating scale. The average procedure-specific (CLOSATS), global rating, and end-product scores increased logarithmically after each successive simulation session for the residents. Reliability of the CLOSATS (average item intraclass correlation coefficient (ICC), 0.85 ± 0.093) and global ratings (average item ICC, 0.91 ± 0.02) among the raters was high. Reliability of the end-product assessments was lower (average item ICC, 0.66 ± 0.15). Standard setting linear regression using an overall cutoff score of 7 of 10 corresponded to a pass score for the CLOSATS and the global score of 44 (maximum, 60) and 23 (maximum, 30), respectively. Using logarithmic best-fit curves, 6.3 simulation sessions are required to reach the minimum standard. A high-fidelity cleft palate simulator has been developed that improves technical performance in cleft palate repair. The simulator and technical assessment scores can be used to determine performance before operating on patients.

  12. Cleft lip and palate: series of unusual clinical cases.

    Science.gov (United States)

    Paranaíba, Lívia Máris Ribeiro; Miranda, Roseli Teixeira de; Martelli, Daniella Reis Barbosa; Bonan, Paulo Rogério Ferreti; Almeida, Hudson de; Orsi Júnior, Julian Miranda; Martelli Júnior, Hercílio

    2010-01-01

    Cleft lip and/or palate (CL/P) represent the most common congenital anomalies of the face, corresponding to approximately 65% of all malformations of the craniofacial region. to describe unusual clinical cases of non-syndromic CL/P (CL/PNS), diagnosed in a reference service in Minas Gerais, Brazil, and correlate these alterations with possible risk factors. we carried out a retrospective study, between the years of 1992 and the 1st half of 2009, from medical records. Among the 778 cases of CL/PNS diagnosed in the period of 17 years, 5 (0.64%) were unusual CL/PNS, and all patients were male. It was found that among the 5 patients, 2 had incomplete right cleft lip with incomplete cleft palate, 2 were affected by left incomplete cleft lip and incomplete cleft palate, and 1 had a cleft lip and palate associated with complete right cleft palate. Risk factors such as consanguinity, maternal smoking and alcohol consumption, medication usage during pregnancy, history of abortion and/or stillbirths and maternal diseases were not associated with unusual CL/PNS. This study described 5 unusual cases of CL/PNS in a Brazilian population; no associations with the risk factors analyzed were seen. It also confirmed the unusualness of the prevalence of such alterations.

  13. Early lexical characteristics of toddlers with cleft lip and palate.

    Science.gov (United States)

    Hardin-Jones, Mary; Chapman, Kathy L

    2014-11-01

    Objective : To examine development of early expressive lexicons in toddlers with cleft palate to determine whether they differ from those of noncleft toddlers in terms of size and lexical selectivity. Design : Retrospective. Patients : A total of 37 toddlers with cleft palate and 22 noncleft toddlers. Main Outcome Measures : The groups were compared for size of expressive lexicon reported on the MacArthur Communicative Development Inventory and the percentage of words beginning with obstruents and sonorants produced in a language sample. Differences between groups in the percentage of word initial consonants correct on the language sample were also examined. Results : Although expressive vocabulary was comparable at 13 months of age for both groups, size of the lexicon for the cleft group was significantly smaller than that for the noncleft group at 21 and 27 months of age. Toddlers with cleft palate produced significantly more words beginning with sonorants and fewer words beginning with obstruents in their spontaneous speech samples. They were also less accurate when producing word initial obstruents compared with the noncleft group. Conclusions : Toddlers with cleft palate demonstrate a slower rate of lexical development compared with their noncleft peers. The preference that toddlers with cleft palate demonstrate for words beginning with sonorants could suggest they are selecting words that begin with consonants that are easier for them to produce. An alternative explanation might be that because these children are less accurate in the production of obstruent consonants, listeners may not always identify obstruents when they occur.

  14. Treatment of Palatal Myoclonus with Botulinum Toxin Injection

    Directory of Open Access Journals (Sweden)

    Mursalin M. Anis

    2013-01-01

    Full Text Available Palatal myoclonus is a rare cause of pulsatile tinnitus in patients presenting to the otolaryngology office. Rhythmic involuntary contractions of the palatal muscles produce the pulsatile tinnitus in these patients. Treatment of this benign but distressing condition with anxiolytics, anticonvulsants, and surgery has been largely unsuccessful. A few investigators have obtained promising results with botulinum toxin injection into the palatal muscles. We present a patient with palatal myoclonus who failed conservative treatment with anxiolytics. Unilateral injection of botulinum toxin into her tensor veli palatini muscle under electromyographic guidance resolved pulsatile tinnitus in her ipsilateral ear and unmasked pulsatile tinnitus in the contralateral ear. A novel method of following transient postinjection symptoms using a diary is presented in this study. Botulinum toxin dose must be titrated to achieve optimal results in each individual patient, analogous to titrations done for spasmodic dysphonia. Knowledge of the temporal onset of postinjection side effects and symptomatic relief may aid physicians in dose titration and surveillance. We present suggestions on titrating the botulinum toxin dose to optimal levels. A review of the literature on the use of botulinum toxin for palatal myoclonus and some common complications are discussed.

  15. Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients

    DEFF Research Database (Denmark)

    Andersen, Kristian

    2012-01-01

    Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients......Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients...

  16. Endodontic Management of Maxillary Second Molar with Two Palatal Roots: A Report of Two Cases

    OpenAIRE

    Patel, Surbhi; Patel, Pawan

    2012-01-01

    Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment protocol. Maxillary second molars are recognized as usually having a single palatal root with a single palatal canal. The incidence of second palatal root in the maxillary second molar is very rare. Two cases are presented in this paper describing the endodontic management of a four-rooted maxillary second molar with two distinct palatal roots and canals and two distinct buccal r...

  17. Palatal growth in complete unilateral cleft lip and palate patients following neonatal cheiloplasty: Classic and geometric morphometric assessment.

    Science.gov (United States)

    Hoffmannova, Eva; Bejdová, Šárka; Borský, Jiri; Dupej, Ján; Cagáňová, Veronika; Velemínská, Jana

    2016-11-01

    A new method of early neonatal cheiloplasty has recently been employed on patients having complete unilateral cleft lip and palate (cUCLP). We aimed to investigate (1) their detailed palatal morphology before surgery and growth during the 10 months after neonatal cheiloplasty, (2) the growth of eight dimensions of the maxilla in these patients, (3) the development of these dimensions compared with published data on noncleft controls and on cUCLP patients operated using later operation protocol (LOP; 6 months of age). Sixty-six virtual dental models of 33 longitudinally evaluated cUCLP patients were analysed using metric analysis, a dense correspondence model, and multivariate statistics. We compared the palatal surfaces before neonatal cheiloplasty (mean age, 4 days) and before palatoplasty (mean age, 10 months). The palatal form variability of 10-month-old children was considerably reduced during the observed period thanks to their undisturbed growth, that is, the palate underwent the same growth changes following neonatal cheiloplasty. A detailed colour-coded map identified the most marked growth at the anterior and posterior ends of both segments. The maxilla of cUCLP patients after neonatal cheiloplasty had a growth tendency similar to noncleft controls (unlike LOP). Both methodological approaches showed that early neonatal cheiloplasty in cUCLP patients did not prevent forward growth of the upper jaw segments and did not reduce either the length or width of the maxilla during the first 10 months of life. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. The Efficacy of the WaveOne Reciprocating File System versus the ProTaper Retreatment System in Endodontic Retreatment of Two Different Obturating Techniques.

    Science.gov (United States)

    Jorgensen, Ben; Williamson, Anne; Chu, Rene; Qian, Fang

    2017-06-01

    This ex vivo study aimed to evaluate the efficacy of retreating GuttaCore (Dentsply Tulsa Dental Specialties, Tulsa, OK) and warm vertically condensed gutta-percha in moderately curved canals with 2 different systems: ProTaper Universal Retreatment (Dentsply Tulsa Dental) and WaveOne (Dentsply Tulsa Dental). Eighty mesial roots of mandibular molars were used in this study. The mesiobuccal canals in each sample were prepared to length with the WaveOne Primary file (Dentsply Tulsa Dental). The canals were obturated with either a warm vertical approach or with GuttaCore and divided into 4 retreatment groups with the same mean root curvature: warm vertical retreated with ProTaper, warm vertical retreated with WaveOne, GuttaCore retreated with ProTaper, and GuttaCore retreated with WaveOne. The warm vertical groups were obturated using a continuous-wave technique of gutta-percha compaction, and the GuttaCore groups were obturated according to the manufacturer's instructions. After allowing sealer to set, each specimen was retreated with either the ProTaper Universal Retreatment files D1, D2, or D3 or with the WaveOne Primary file to the predetermined working length. The time taken to reach the working length was recorded. Instrument fatigue and failure were also evaluated. The post hoc 2-sample t tests showed that the overall mean total time taken to reach the working length for the warm vertical groups was significantly greater than that observed for the GuttaCore groups (mean = 87.11 vs 60.16 seconds, respectively), and the overall mean total time taken to reach the working length for WaveOne was significantly greater than that observed for ProTaper (99.09 vs 48.18 seconds, respectively). Two-way analysis of variance showed a significant main effect for both the type of experiment groups (F 1,76  = 15.32, P = .0002) and the type of retreatments (F 1,76  = 54.67, P file underwent more separations than the ProTaper files. The WaveOne Primary file underwent

  19. Lexical selectivity in Danish toddlers with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth

    2013-01-01

    . Methods: All participants were video recorded at 18 months of age during play interaction with a parent. The video recordings were transcribed according to the IPA and an individual consonant inventory was established for each participant. The video recordings were also analysed with respect to word...... productions establishing an observed productive vocabulary size for each participant. Results: At 18 months of age Danish toddlers with cleft palate showed marked lexical selectivity in their early words. The distribution of consonant classes observed at 11 months of age in a previous study of the children...... as it has been described for English speaking toddlers with and without cleft palate, even though some qualitative differences were found. Keywords: consonant inventory, lexical selectivity, early words, cleft palate....

  20. Fixed prosthetic treatment in patients with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Bajevska Jagoda

    2017-01-01

    Full Text Available Introduction. The prosthetic treatment of patients with cleft palate includes various treatment options such as fixed partial dentures, removable partial prosthesis, etc. The type of prosthetic appliance is determined by the oral health of each individual and the circumstances. We presented three adult patients with the cleft lip and palate subjected to prosthetic treatment. Case report. From the possible prosthetic solutions according to the conditions in the oral cavity and the circumstances, fixed partial dentures veneered with composite or ceramic were chosen. A proper relationship between the teeth was reached with the fixed partial dentures, and function established, the phonetics improved and satisfying aesthetics effect accomplished improving the profile appearance of the patient’s face. Plastic surgery of the nose was performed after that. Conclusion. Multidisclipinary treatment is necessary for favourable long-term outcome in cleft lip and palate patients.

  1. Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix

    Directory of Open Access Journals (Sweden)

    Omri Emodi, DMD

    2018-03-01

    Full Text Available Summary:. Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%. We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate.

  2. Prosthodontic management of mandibular deviation using palatal ramp appliance

    Directory of Open Access Journals (Sweden)

    Prince Kumar

    2012-08-01

    Full Text Available Segmental resection of the mandible generally results in deviation of the mandible to the defective side. This loss of continuity of the mandible destroys the balance of the lower face and leads to decreased mandibular function by deviation of the residual segment toward the surgical site. Prosthetic methods advocated to reduce or eliminate mandibular deviation include intermaxillary fixation, removable mandibular guide flange, palatal ramp, implant-supported prosthesis and palatal guidance restorations which may be useful in reducing mandibular deviation and improving masticatory performance and efficiency. These methods and restorations would be combined with a well organized mandibular exercise regimen. This clinical report describes the rehabilitation following segmental mandibulectomy using palatal ramp prosthesis.

  3. Common dental anomalies in cleft lip and palate patients.

    Science.gov (United States)

    Haque, Sanjida; Alam, Mohammad Khursheed

    2015-01-01

    Cleft lip and palate (CLP) is the most common orofacial congenital malformation in live births. CLP can occur individually or in combination with other congenital deformities. Affected patients experience a number of dental, aesthetic, speech, hearing, and psychological complications and have a higher incidence of severe dental conditions. The purpose of this study is to characterise the different types of dental anomalies that are frequently associated with CLP patients based on a literature survey. By literature survey, this study characterises the different types of dental anomalies that are frequently associated with cleft lip and palate patients. Common dental anomalies associated with CLP are supernumerary tooth, congenitally missing tooth, delayed tooth development, morphological anomalies in both deciduous and permanent dentition, delayed eruption of permanent maxillary incisors, microdontia, and abnormal tooth number. The incidence of certain dental anomalies is strongly correlated with Cleft lip and palate, a finding that is consistent with previous studies.

  4. Palatoglossal fusion with cleft palate and hypoplasia of cerebellar vermis

    Directory of Open Access Journals (Sweden)

    Shailesh Solanki

    2016-01-01

    Full Text Available A new-born male presented within 12 h of birth with respiratory distress. On examination and workup, he had palatoglossal fusion, cleft palate and hypoplasia of the cerebellar vermis. A 2.5 Fr endotracheal tube was inserted into the pharynx through nostril as a nasopharyngeal stent, following which his respiratory distress improved. Once child was optimised, then feeding was started by nasogastric tube and feeds were tolerated well. Elective tracheostomy and gastrostomy were done, followed by release of adhesions between the tongue and palate at a later stage. Review of literature suggests that palatoglossal fusion is uncommon and presents as an emergency. Mostly, these oral synechiae are associated with digital and/or cardiac anomaly. Other disorders associated with intra-oral synechiae include congenital alveolar synechiae, van der Woude syndrome, popliteal pterygium syndrome and oromandibular limb hypogenesis syndrome. The authors report a hitherto undescribed association of palatoglossal fusion with cleft palate and hypoplasia of the cerebellar vermis.

  5. Communicative abilities in toddlers and in early school age children with cleft palate

    NARCIS (Netherlands)

    Ruiter, Jolien S.; Korsten-Meijer, Astrid G. W.; Goorhuis-Brouwer, Siena M.

    Objectives: Evaluation of improvement in communicative abilities in children with nonsyndromic cleft palate. Methods: Longitudinal retrospective case history Study. Out of 117 children with cleft lip and/or cleft palate born in 1998, 1999 and 2000 and enrolled in the cleft palate team of the

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  16. Three Cases of Palatal Tics and Gilles De La Tourette Syndrome

    NARCIS (Netherlands)

    Rizzo, Renata; Cath, Danielle; Pavone, Piero; Tijssen, Marina; Robertson, Mary M.

    Five patients with palatal tics and Gilles de la Tourette syndrome have been previously reported. Little is known about the characteristics of palatal tics given that there are so few reports. On one hand, palatal tics may be rare. Alternatively, they may be less well recognized than repetitive eye

  17. Otolaryngology Service Usage in Children With Cleft Palate.

    Science.gov (United States)

    Whittemore, Kenneth R; Dargie, Jenna M; Dornan, Briana K; Boudreau, Brian

    2018-05-01

    To determine the usage of otolaryngology services by children with cleft palate at a pediatric tertiary care facility. Retrospective case series. Specialty clinic at a pediatric tertiary care hospital. Children born between January 1, 1999, and December 31, 2002, with the diagnosis of cleft palate or cleft lip and palate. A total of 41 female and 48 male patients were included. Total number of otolaryngology clinic visits and total number of otolaryngologic surgeries (tympanostomy tube placements and other otologic or upper airway procedures). In the first 5 years of life, these children utilized an average of 8.2 otolaryngology clinic visits (SD = 5.0; range: 1-22) and underwent 3.3 tympanostomy tube surgeries (SD = 2.0; range: 0-10). Seventy-three had their first tube placed at the time of palate repair, and 4 at the time of lip repair. Fifty-one (57.3%) required other otologic or upper airway procedures, including tonsillectomy and/or adenoidectomy (27 children), removal of tympanostomy tubes (24 children), tympanomastoidectomy (3 children), and tympanoplasty (14 children). Of the children who underwent other procedures, they underwent a mean of 1.67 (SD = 0.84; range: 1-4) surgeries. Children with cleft palate are at increased risk for eustachian tube dysfunction, frequently utilize otolaryngology care, and typically receive multiple sets of tympanostomy tubes. This study found that children with cleft palate receive on average of approximately 3 sets of tympanostomy tubes, and the majority required another otologic or upper airway surgery.

  18. Presurgical nasoalveolar moulding in unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Mohammed Zuhaib

    2016-01-01

    Full Text Available Context: Presurgical nasoalveolar moulding (PNAM is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the effi cacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1 To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM. (2 To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM. (3 To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, signifi cant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle

  19. Low-Energy Traumatic Obturator Hip Dislocation with Ipsilateral Femoral Shaft Fracture in a Patient with Omolateral Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    G. Gazzotti

    2016-01-01

    Full Text Available Ipsilateral obturator hip dislocation and femoral shaft fracture are rare. We report such a case in an older woman after a low-energy injury. She had a knee prostheses in the same limb. The patient was treated by open manipulative reduction of the luxation without opening joint and open reduction and internal fixation of the femur with angular stability plate and screws. We could not find a similar case in the literature. An early diagnosis of the dislocation is crucial in order to obtain good results. Great awareness and radiologic examination are fundamental to achieve precocious diagnosis of both these rare combined injuries, as treatment in these cases is considered an emergency. The first step was an attempt to reduce the dislocation by closed means but it failed. Then we performed a short approach at the trochanteric region and used Lambotte forceps to manoeuvre the proximal femur without opening the joint achieving reduction. Thereafter the femoral shaft fracture underwent open reduction and internal fixation with an angular stable plate. After a 2-year follow-up the outcome was very good.

  20. Postoperative groin pain and success rates following transobturator midurethral sling placement: TVT ABBREVO® system versus TVT™ obturator system.

    Science.gov (United States)

    Canel, Virginie; Thubert, Thibault; Wigniolle, Ingrid; Fernandez, Hervé; Deffieux, Xavier

    2015-10-01

    Placement of a transobturator midurethral sling (MUS) is the standard surgical treatment for stress urinary incontinence. Most recent MUS procedures have been poorly evaluated. We compared the results using a "new" device expected to reduce postoperative pain, the TVT ABBREVO® system (TVT-Abb), with those using the TVT™ obturator system (TVT-O). This was a retrospective study comparing the use of the TVT-Abb (in 50 patients) and the TVT-O (in 50 patients). The main outcomes were the amount of postoperative pain, the success rate (no reported urinary leakage and negative cough test) with both MUS procedures, and the prevalence of complications. The mean follow-up time was 12 months. The preoperative characteristics of the two groups were comparable. There was less postoperative pain (VAS, 0 to 100) in the TVT-Abb group than in the TVT-O group (12.2 vs. 24.4, p TVT-Abb group and the TVT-O group (8 % vs. 12 %, p = 0.74). The prevalences of perioperative and postoperative complications (bladder/urethral injury, haemorrhage) in the two groups were equal. The success rates were similar at 12 months after surgery (88 % vs. 78 %, p = 0.29). The success rates with TVT-Abb and TVT-O were equal at 12 months after surgery, but there was less immediate postoperative pain with TVT-Abb.

  1. Randomized clinical trial comparing TVT Secur system and trans vaginal obturator tape for the surgical management of stress urinary incontinence.

    Science.gov (United States)

    Maslow, Ken; Gupta, Chander; Klippenstein, Peter; Girouard, Lise

    2014-07-01

    This prospective randomized study aimed to compare the safety and efficacy of the TVT-Secur (TVT-S) with the trans vaginal obturator tape (TVT-O) for the treatment of stress urinary incontinence. We set out to enroll 136 patients in our study. 106 patients with stress urinary incontinence were randomized to either the TVT-S (n = 56) or TVT-O (n = 50) procedure. Patients were evaluated postoperatively at 2 months and 1 year. Our primary outcome was objective cure measured by the cough test. Secondary outcomes of subjective symptoms, questionnaires, pain scores, complications, and urodynamic studies were also included. Statistical analysis was by Chi-squared, Kruskal-Wallis, Wilcoxon, and Fisher's exact tests as appropriate. P values of TVT-O compared with TVT-S at 1 year (86 % and 63 % respectively, p = 0.01). Subjective cure rates were 88 % for TVT-O and 63 % for TVT-S. Quality of life scores through questionnaires improved in both groups and were not statistically different. Initial post-operative groin pain was more prevalent in the TVT-O group; however, this resolved quickly with time. TVT-O was superior to TVT-S in the objective cure of stress urinary incontinence at 1-year follow-up.

  2. Psychological issues in cleft lip and cleft palate

    Directory of Open Access Journals (Sweden)

    Sousa Avinash

    2009-01-01

    Full Text Available Vocational and social issues affect rehabilitation and development of patients with cleft lip and cleft palate. However, psychological problems like lowered self esteem and difficulties in social interaction have also been noted in them. Not many pediatric reconstructive surgery teams have a psychiatrist on their panel. It is likely that psychological problems are higher in incidence than literature actually suggests. Hence it is very essential that such cases are identified by the surgical team to maximize positive outcome of surgery and rehabilitation. This study discusses psychological issues revolving around cleft lip and cleft palate along with lacunae in many psychological research studies.

  3. Conditioned taste aversion, drugs of abuse and palatability.

    Science.gov (United States)

    Lin, Jian-You; Arthurs, Joe; Reilly, Steve

    2014-09-01

    We consider conditioned taste aversion to involve a learned reduction in the palatability of a taste (and hence in amount consumed) based on the association that develops when a taste experience is followed by gastrointestinal malaise. The present article evaluates the well-established finding that drugs of abuse, at doses that are otherwise considered rewarding and self-administered, cause intake suppression. Our recent work using lick pattern analysis shows that drugs of abuse also cause a palatability downshift and, therefore, support conditioned taste aversion learning. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. The development of speech production in children with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Chapman, Kathy

    2012-01-01

    The purpose of this chapter is to provide an overview of speech development of children with cleft palate +/- cleft lip. The chapter will begin with a discussion of the impact of clefting on speech. Next, we will provide a brief description of those factors impacting speech development...... for this population of children. Finally, research examining various aspects of speech development of infants and young children with cleft palate (birth to age five) will be reviewed. This final section will be organized by typical stages of speech sound development (e.g., prespeech, the early word stage...

  5. A novel cognitive palatability assessment protocol for dogs.

    Science.gov (United States)

    Araujo, J A; Milgram, N W

    2004-07-01

    Assessment of canine palatability is important for both the pet food and pharmaceutical industries; however, the current palatability assessment protocols are limited in their utility. The most common technique, the two-pan test, does not control for the satiating effects of food and may not be useful for long-term palatability analysis because nutritional or caloric characteristics of the diets may interfere with the results. Furthermore, the large quantities of foods consumed may be detrimental to the health of animals that do not self-limit their food intake. The purpose of this study was to determine whether a cognitive protocol could be used to determine food palatability in dogs. Five beagle dogs were trained on a three-choice object-discrimination learning task. After establishing object preferences, the preferred object was associated with no reward, a second object was associated with the dog's normal laboratory diet (Purina Agribrands Canine Lab Chow No. 5006; Agribrands Purina Canada, Inc., Woodstock, ON, Canada), and the third object was associated with a commercial (Hill's P/D; Hill's Pet Nutrition Inc., Topeka, KS) diet. In the discrimination-training phase, dogs were trained until they learned to avoid the no-reward object. They were subsequently given an additional 20 test sessions, which were used to determine food preference. In the reversal phase, which involved reversal learning, the object-food associations were modified, such that the object that was previously associated with Hill's P/D diet was now associated with the normal laboratory diet and vice versa. Once the dogs learned to avoid the no-reward object, they were tested for an additional 20 sessions. All subjects learned to avoid the no-reward object during the initial learning, and the number of choices to the object associated with the Hill's P/D diet was greater than the number of choices to the objects associated with the dry laboratory diet (P food-choice associations were reversed

  6. Influence of timing of two-stage palate closure on early phonological and lexical development in children with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth

      BACKGROUND AND PURPOSE Numerous studies have indicated that early closure of the palatal cleft has a positive influence on the phonological development in children with cleft palate. So far, however, substantial evidence for this assumption has been lacking due to a variety of weaknesses...... of the studies conducted, including the lack of randomized clinical trials (RCT) (Peterson-Falzone 1996). A  prospective RCT was conducted to add to the knowledge of the influence of timing of hard palate closure on early phonological and lexical development from 1 to 3 years. METHODS Fourty-one children...... were video-recorded during a play interaction with a parent, and the video-recordings were transcribed in IPA. At 36 months, a naming test was administered. RESULTS At 18 months, the phonological development in the early group was more similar to that of the control group, than that of the late group...

  7. Speech outcomes of early palatal repair with or without intravelar veloplasty in children with complete unilateral cleft lip and palate.

    Science.gov (United States)

    Doucet, Jean-Charles; Herlin, Christian; Captier, Guillaume; Baylon, Hélène; Verdeil, Mélanie; Bigorre, Michèle

    2013-12-01

    We compared the early speech outcomes of 40 consecutive children with complete unilateral cleft lip and palate (UCLP) who had been treated according to different 2-stage protocols: the Malek protocol (soft palate closure without intravelar veloplasty at 3 months; lip and hard palate repair at 6 months) (n=20), and the Talmant protocol (cheilorhinoplasty and soft palate repair with intravelar veloplasty at 6 months; hard palate closure at 18 months) (n=20). We compared the speech assessments obtained at a mean (SD) age of 3.3 (0.35) years after treatment by the same surgeon. The main outcome measures evaluated were acquisition and intelligibility of speech, velopharyngeal insufficiency, and incidence of complications. A delay in speech articulation of one year or more was seen more often in patients treated by the Malek protocol (11/20) than in those treated according to the Talmant protocol (3/20, p=0.019). Good intelligibility was noted in 15/20 in the Talmant group compared with 6/20 in the Malek group (p=0.010). Assessment with an aerophonoscope showed that nasal air emission was most pronounced in patients in the Malek group (p=0.007). Velopharyngeal insufficiency was present in 11/20 in the Malek group, and in 3/20 in the Talmant group (p=0.019). No patients in the Talmant group had an oronasal fistula (ppalate, early speech outcomes were better in the Talmant group because intravelar veloplasty was successful and there were no fistulas after closure of the hard palate in 2 layers. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

  8. Influence of timing of hard palate repair in a two-stage procedure on early language development in Danish children with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth

    2012-01-01

    Objective: to investigate the influence of timing of hard palate closure on early language development from 18 months to 3 years of age. Design: a prospective, randomized clinical trial. Participants: thirty-four children with UCLP with velum closure at 4 months of age, and hard palate closure...... language development in cleft palate children. Key words: cleft palate, phonological development, lexical development, surgical timing....... at 12 months (EarlyHPR (Early hard palate repair)) or 36 months (LateHPU (Late hard palate Unrepaired)) by random assignment. Thirty-five control children matched for gender and age. Methods: all children were video recorded during a play interaction with a parent at 18 months of age. These recordings...

  9. FOXE1 Association with both Isolated Cleft Lip with or without Cleft Palate; and Isolated Cleft Palate

    DEFF Research Database (Denmark)

    Moreno, Lina M; Mansilla, Maria Adela; Bullard, Steve A

    2009-01-01

    Nonsyndromic orofacial clefts are a common complex birth defect caused by genetic and environmental factors and/or their interactions. A previous genome-wide linkage scan discovered a novel locus for cleft lip with or without cleft palate (CL/P) at 9q22-q33. To identify the etiologic gene, we......) and rs4460498 (p=6.51E-12) were located inside a 70Kb high LD block containing FOXE1. Association signals for Caucasians and Asians clustered 5' and 3' of FOXE1, respectively. Isolated cleft palate (CP) was also associated indicating that FOXE1 plays a role in two phenotypes thought to be genetically...

  10. Gene expression of Hsp70, Hsp90 and Hsp110 families in normal palate and cleft palate during mouse embryogenesis.

    Science.gov (United States)

    Zhu, Yongfei; Ren, Chuanlu; Wan, Xuying; Zhu, Yuping; Zhu, Jiangbo; Zhou, Hongyuan; Zhang, Tianbao

    2013-11-01

    Most previous studies focused on a small number of heat shock proteins (Hsps) and their relationships with embryogenesis, and the actual roles of these Hsps in normal and abnormal embryonic development remain unclear. It was found in the present systemic study that except for Grp170, whose expression was not detectable at GD18, all 19 Hsps of Hsp70, Hsp90 and Hsp110 families were expressed in the normal development of embryonic palate tissue in mice, but their expression patterns varied with different Hsps, presenting as a correlation with the developmental phases. In the treatment group by all-trans retinoic acid (atRA), the messenger RNA (mRNA) abundance of HspA1A, HspA1L, HspA8, HspA9, HspA12A, HspA12B, HspA13, HspA14, Hsp90AA1, Hsp90AB1, Grp94, Trap1, Hsp105, Hsp110 and Grp170 was higher in the palates at GD11 (the beginning of palate development), the mRNA abundance of HspA1A, HspA12A and HspA12B was higher at GD18 (before birth) and an mRNA expression peak of HspA1L, HspA8, HspA9, Hsp90AA1, Grp94, Hsp110 and Grp170 was observed at GD17. The mRNA abundance of most genes in atRA-induced cleft palates of the treatment group was different from that of the control group. Grp78, HspA14 and Hsp105 were closely associated with the normal palate development and cleft palate in mouse embryo, possibly as palate development-related genes. Except Grp170, the other genes may be closely associated with the development of mouse palates through participating in the stress response process and/or the antiapoptosis process.

  11. Palate dimensions in six-year-old children with unilateral cleft lip and palate: a six-center study on dental casts.

    Science.gov (United States)

    Koželj, Vesna; Vegnuti, Miljana; Drevenšek, Martina; Hortis-Dzierzbicka, Maria; Gonzalez-Landa, Gonzalo; Hanstein, Siiri; Klimova, Irena; Kobus, Kazimierz; Kobus-Zaleśna, Katarzyna; Semb, Gunvor; Shaw, Bill

    2012-11-01

    To compare palatal dimensions in 6-year-old children with unilateral cleft lip and palate (UCLP) treated by different protocols with those of noncleft children. Retrospective intercenter outcome study. Patients : Upper dental casts from 129 children with repaired UCLP and 30 controls were analyzed by the trigonometric method. Six European cleft centers. Main outcome measures : Sagittal, transverse, and vertical dimensions of the palate were observed. Palate variables were analyzed with descriptive methods and nonparametric tests. Regarding several various characteristics measured on a relatively small number of subjects, hierarchical, k-means clustering, and principal component analyses were used. Mean values of the observed dimensions for five cleft groups differed significantly from the control (p cleft differed significantly from all other cleft groups in most variables (p palate. A similar number of treated children were classified into each cluster, while all children without clefts were classified in the same cluster. The percentage of treated children from a particular group that fit this cluster ranged from 0% to 70% and increased with age at palatal closure and number of primary surgical procedures. At 6 years of age, children with stepwise repair and hard palate closure after the age of two more frequently result in palatal dimensions of noncleft control than children with earlier palatal closure and one-stage cleft repair.

  12. Experimental study on the effect of radiation in the secondary palate formation

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo [Department of Dental Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1977-11-15

    The author observed the effect of X-ray irradiation on the secondary palate formation of the rat fetuses. The mothers were exposed to X-radiation on the 10 1/2th, 11 1/2th, and 12 1/2th day of gestation with respectively 150, 200, 250, 300, and 350 rads. The fetuses were removed from mothers on 15 1/2th, 16 1/2th, and 18 1/2th day of gestation. Morphological changes in palate formation were examined and histochemical preparations were made. 1. In control fetuses, the secondary palates were fully developed on the 15 1/2th, to 18 1/2th day of gestation. But in experimental fetuses, many cleft palates were observed in accordance with increase of X-radiation dose. 2. Frequency of incidence of horizontal position of both palatal shelves in cleft palate was highest. 3. According to the dislocation of palatal processes, the stain ability of palatal crest was varied. 4. The thickened area of palatal epithelium of palatal crest showed intense methyl green-pyronin and PAS reaction 5. Mesenchymal cell condensation was appeared under the thickened epithelium of palatal process and this mesenchymal tissue showed strong colloidal iron reaction. 6. The stain ability of alizarin red S and alkaline phosphatase reaction of tectal ridge were decreased in accordance with increase of irradiation doses.

  13. Experimental study on the effect of radiation in the secondary palate formation

    International Nuclear Information System (INIS)

    You, Dong Soo

    1977-01-01

    The author observed the effect of X-ray irradiation on the secondary palate formation of the rat fetuses. The mothers were exposed to X-radiation on the 10 1/2th, 11 1/2th, and 12 1/2th day of gestation with respectively 150, 200, 250, 300, and 350 rads. The fetuses were removed from mothers on 15 1/2th, 16 1/2th, and 18 1/2th day of gestation. Morphological changes in palate formation were examined and histochemical preparations were made. 1. In control fetuses, the secondary palates were fully developed on the 15 1/2th, to 18 1/2th day of gestation. But in experimental fetuses, many cleft palates were observed in accordance with increase of X-radiation dose. 2. Frequency of incidence of horizontal position of both palatal shelves in cleft palate was highest. 3. According to the dislocation of palatal processes, the stain ability of palatal crest was varied. 4. The thickened area of palatal epithelium of palatal crest showed intense methyl green-pyronin and PAS reaction 5. Mesenchymal cell condensation was appeared under the thickened epithelium of palatal process and this mesenchymal tissue showed strong colloidal iron reaction. 6. The stain ability of alizarin red S and alkaline phosphatase reaction of tectal ridge were decreased in accordance with increase of irradiation doses.

  14. Maxillary growth in a congenital cleft palate canine model for surgical research.

    Science.gov (United States)

    Paradas-Lara, Irene; Casado-Gómez, Inmaculada; Martín, Conchita; Martínez-Sanz, Elena; López-Gordillo, Yamila; González, Pablo; Rodríguez-Bobada, Cruz; Chamorro, Manuel; Arias, Pablo; Maldonado, Estela; Ortega, Ricardo; Berenguer, Beatriz; Martínez-Álvarez, Concepción

    2014-01-01

    We have recently presented the Old Spanish Pointer dog, with a 15-20% spontaneous congenital cleft palate rate, as a unique experimental model of this disease. This study aimed to describe the cleft palate of these dogs for surgical research purposes and to determine whether congenital cleft palate influences maxillofacial growth. Seven newborn Old Spanish Pointer dogs of both sexes, comprising a cleft palate group (n = 4) and a normal palate group (n = 3), were fed using the same technique. Macroscopic photographs and plaster casts from the palate, lateral radiographs and computer tomograms of the skull were taken sequentially over 41 weeks, starting at week 5. The cleft morphology, the size and the tissue characteristics in these dogs resembled the human cleft better than current available animal models. During growth, the cleft width varies. Most of the transverse and longitudinal measures of the palate were statistically lower in the cleft palate group. The cleft palate group showed hypoplasia of the naso-maxillary complex. This model of congenital cleft palate seems suitable for surgical research purposes. A reduced maxillofacial pre- and post-natal development is associated to the congenital cleft palate in the Old Spanish Pointer dog. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  15. Palatization in Japanese Mimetics: Response to Mester and Ito.

    Science.gov (United States)

    Schourup, Lawrence; Tamori, Ikuhiro

    1992-01-01

    Mester and Ito's evidence for the phonological theory of Restricted Underspecification (RU) is refuted. Attention is focused on reduplicated forms; and it is concluded that, if there is only a rough and sporadic sound-syllable meaning association with palatization, the argument for RU is untenable. (12 references) (LB)

  16. Helping the Child with a Cleft Palate in Your Classroom.

    Science.gov (United States)

    Moran, Michael J.; Pentz, Arthur L.

    1995-01-01

    Guidelines for teachers of a student with a cleft palate include understand the physical problem; know what kind of speech problem to expect; be alert to the possibility of language-based learning difficulties; watch for signs of hearing loss; be alert to socialization problems; help the student make up work; and avoid self-fulfilling prophecies.…

  17. Frequency of oronasal fistulae in complete cleft palate repair

    International Nuclear Information System (INIS)

    Aslam, M.

    2015-01-01

    To determine the frequency of oro-nasal fistula in patients undergoing complete cleft palate repair by two flappalatoplasty. Study Design: Case series. Place and Duration of Study: Department of Plastic Surgery, Services Hospital, Lahore, from January to December 2013. Methodology: Patients admitted to the study place for repair of cleft palate after informed consent obtained were included. Cleft palate was repaired by two-flap palatoplasty, using Bardach technique. Patients were discharged on the second postoperative day and followed-up at third week postoperatively. During follow-up visits, fistulae formation and their sites were recorded on pre-designed proforma. Results: Among the total 90 patients, 40 patients (44.4%) were male and 50 patients (55.6%) were female. The mean age was 6.4 +- 5.7 years ranging from 9 months to 20 years. At third week follow-up, 5 patients (5.6%) had fistulae formation. Four patients (80%) had anterior fistulae and one patient (20%) had posterior fistula. Conclusion: With two-flap palatoplasty Bardach procedure for repair of cleft palate, the complication of fistula formation was uncommon at 5.6%, provided the repair was tension free and multi-layered. (author)

  18. Cleft Palate Repair Using a Double Opposing Z-Plasty.

    Science.gov (United States)

    Moores, Craig; Shah, Ajul; Steinbacher, Derek M

    2016-07-01

    Cleft palate is a common congenital defect with several described surgical repairs. The most successful treatment modality remains a controversy. The goals of repair focus on achievement of normal speech and optimizing velopharyngeal function while minimizing both fistula formation and facial growth restriction. In this video, the authors demonstrate use of the double opposing Z-plasty technique in the repair of a Veau II type cleft palate. The video demonstrates the marking, incisions, dissection, and repair of the cleft. It also examines the use of von Langenbeck-type relaxing incisions and demonstrates a specific approach to the repair of this particular cleft. The authors believe that the Furlow double opposing Z-plasty with the von Langenbeck relaxing incision can provide the best postoperative outcome by combining the benefits of each individual operation. The Z-plasty technique works to correct the aberrant muscle of the soft palate while increasing the length of the palate. The authors believe that this results in better velopharyngeal function.

  19. Overexpression of mouse TTF-2 gene causes cleft palate

    Science.gov (United States)

    Meng, Tian; Shi, Jia-Yu; Wu, Min; Wang, Yan; Li, Ling; Liu, Yan; Zheng, Qian; Huang, Lei; Shi, Bing

    2012-01-01

    In humans, mutations of the gene encoding for thyroid transcription factor-2 (TTF-2 or FOXE1) result in Bamforth syndrome. Bamforth syndrome is characterized by agenesis, cleft palate, spiky hair and choanal atresia. TTF-2 null mice (TTF-2−/−) also exhibit cleft palate, suggesting its involvement in the palatogenesis. However, the molecular pathology and genetic regulation by TTF2 remain largely unknown. In the present study, the recombinant expression vector pBROAD3-TTF-2 containing the promoter of the mouse ROSA26 gene was created to form the structural gene of mouse TTF-2 and was microinjected into the male pronuclei of fertilized ova. Sequence analysis confirmed that the TTF-2 transgenic mouse model was established successfully. The transgenic mice displayed a phenotype of cleft palate. In addition, we found that TTF-2 was highly expressed in the medial edge epithelium (MEE) from the embryonic day 12.5 (E12.5) to E14.5 in TTF-2 transgenic mice. These observations suggest that overexpression of TTF-2 during palatogenesis may contribute to formation of cleft palate. PMID:22304410

  20. Cleft lip and palate surgery in children: Anaesthetic considerations ...

    African Journals Online (AJOL)

    Background: The Care of cleft patients is very challenging. Team cleft care is usually lacking in many developing countries due to shortage of qualified manpower. This study is aimed at highlighting anaesthetic challenges in the management of cleft in children. Patients and Methods: This was a study of cleft lip and palate ...

  1. Cleft lip and palate malformations: essential knowledge for the ...

    African Journals Online (AJOL)

    Cleft lip and palate malformations are a common group of congenital abnormalities, and are therefore frequently encountered by the general practitioner, who is often the primary coordinator in the management of these patients. This is especially true in a South African setting, where specialist treatment is not always readily ...

  2. Management of cleft lip and palate in Nigeria: A survey ...

    African Journals Online (AJOL)

    Background: Clefts of the lip and/or palate are the most common congenital craniofacial defects and second only to club foot among all congenital anomalies. The management of this condition is resource intensive due to the multidimensional needs. This survey was carried out to ascertain the current state of cleft ...

  3. Awareness, knowledge and attitude on cleft lip and palate among ...

    African Journals Online (AJOL)

    Background: Adequate knowledge and awareness of cleft lip and palate (CLP) deformity may help to counter the negative beliefs and attitudes toward the condition. The objective of this study was to assess the level of awareness, knowledge and attitude of women attending antenatal clinics about CLP. Materials and ...

  4. Teratogenic effect of isotretinoin on the morphology and palate ...

    African Journals Online (AJOL)

    SERVER

    2007-12-03

    Dec 3, 2007 ... 4Department of Anatomy and Cell Biology, Faculty of Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife,. Osun State. ... that certain stages of embryonic development are more ... period of human development of the eyes, ears and heart. ..... germ and palate development in mouse embryos. Braz.

  5. The nose in children with unilateral cleft lip and palate

    NARCIS (Netherlands)

    Verwoerd, C. D.; Mladina, R.; Nolst Trenité, G. J.; Pigott, R. W.

    1995-01-01

    Surgeons and orthodontists are still challenged to achieve 'better' noses for children with a unilateral cleft or lip, alveoulus and palate (UCLP). Various aspects are discussed: infant anatomy and later changes, developmental mechanics, cleft syndrome in animals with surgically produced facial

  6. Feeding Techniques for Children Who Have Cleft Lip and Palate.

    Science.gov (United States)

    Klein, Marsha Dunn

    This pamphlet on feeding techniques for children who have cleft lip and palate emphasizes the role of the parent as part of a team involving many specialists. The pamphlet begins with explanations of complete and incomplete separations of the lip, unilateral and bilateral cleft lips, corrective surgical procedures, etc. The importance of weight…

  7. Pleomorphic adenoma of the palate in a child.

    Science.gov (United States)

    Bovino, Brian F; Sohn, Andy; Winston, Daniel

    2013-01-01

    Presented is a pleomorphic adenoma of the palate in a 12-year-old boy. Pleomorphic adenoma is usually found in adults and is rarely found in patients under 20 years of age. We present initial exam, diagnosis, treatment and a review of literature.

  8. Awareness, knowledge and attitude on cleft lip and palate among ...

    African Journals Online (AJOL)

    2012-11-09

    Nov 9, 2012 ... negative beliefs and attitudes toward the condition. The objective of this ... Conclusion: There is need for increased public enlightenment/health education to increase awareness and subsequently ... The parent's feelings about their child's cleft defect ..... Gene/environment causes of cleft lip and/or palate.

  9. Chronic Pharyngitis And Multiple Soft Palate Peforation In An HIV ...

    African Journals Online (AJOL)

    This report is at advocating the need for repeated investigation and screening for HIV particularly when there is persistent clinical feature strongly suggestive of AIDS. Should we even start to contemplate therapeutic of antiretroviral dugs in some cases? KEY WORDS: Chronic pharyngitis, Soft palate perforation, AIDS, HIV ...

  10. Plexiform (multinodular) schwannoma of soft palate. Report of a case.

    Science.gov (United States)

    Kapetanakis, Stylianos; Vasileiadis, Ioannis; Petousis, Aristotelis; Fiska, Aliki; Stavrianaki, Anna

    2012-01-01

    Plexiform schwannoma is a rare benign neoplasm of the neural sheath characterized by a multinodular plexiform growth pattern. Only 5% of schwannomas have a plexiform or multinodular growth pattern. Schwannoma apparently derives from the Schwann cells. Extracranially, 25% of all schwannomas are located in the head and neck region, but only 1% show an intraoral origin. The intraoral lesions show a predilection for the tongue, followed by the palate, buccal mucosa, lip and gingival. Microscopic examination is necessary to confirm the diagnosis. Characteristic histological signs are the palisading of the spindle-shaped Schwann cells around the central acellular area, so called Verocay bodies. We report a case of a 21-year-old woman with a smooth mass of the soft palate that was gradually increasing. Surgical excision of the mass was done and the histopathology and immunohistochemistry study of the excised lesion revealed a multinodular plexiform schwannoma of the soft palate. The patient is under regular clinical control, with no signs of recurrence after 17 months. Plexiform schwannomas of the soft palate are mentioned very rarely in the English literature. This rare benign tumor is worthy of recognition because it can be misdiagnosed as plexiform neurofibroma.

  11. Christ-Siemens-Touraine syndrome with cleft palate, absent nipples ...

    African Journals Online (AJOL)

    We report a 6 year old child, second in order of birth of non consanguineous Egyptian parents with typical characteristics of Christ-Siemens-Touraine syndrome. The patient had sparse light hair over the scalp, scanty eyebrows and eyelashes, a high arched cleft palate, decayed oligodontic teeth, hyperpigmentation all over ...

  12. Speech pattern improvement following gingivectomy of excess palatal tissue.

    Science.gov (United States)

    Holtzclaw, Dan; Toscano, Nicholas

    2008-10-01

    Speech disruption secondary to excessive gingival tissue has received scant attention in periodontal literature. Although a few articles have addressed the causes of this condition, documentation and scientific explanation of treatment outcomes are virtually non-existent. This case report describes speech pattern improvements secondary to periodontal surgery and provides a concise review of linguistic and phonetic literature pertinent to the case. A 21-year-old white female with a history of gingival abscesses secondary to excessive palatal tissue presented for treatment. Bilateral gingivectomies of palatal tissues were performed with inverse bevel incisions extending distally from teeth #5 and #12 to the maxillary tuberosities, and large wedges of epithelium/connective tissue were excised. Within the first month of the surgery, the patient noted "changes in the manner in which her tongue contacted the roof of her mouth" and "changes in her speech." Further anecdotal investigation revealed the patient's enunciation of sounds such as "s," "sh," and "k" was greatly improved following the gingivectomy procedure. Palatometric research clearly demonstrates that the tongue has intimate contact with the lateral aspects of the posterior palate during speech. Gingival excess in this and other palatal locations has the potential to alter linguopalatal contact patterns and disrupt normal speech patterns. Surgical correction of this condition via excisional procedures may improve linguopalatal contact patterns which, in turn, may lead to improved patient speech.

  13. Anterior palatal island advancement flap for bone graft coverage ...

    African Journals Online (AJOL)

    ... Palatal Island Advancement Flap was effective in bone graft coverage in premaxillary edentulous area. Conclusion: It can be used as an aid for bone graft coverage of premaxillary edentulous ridge, where the need for mucosa is small in width but long in length. Keywords: Anterior maxilla, bone graft, dental implant, ...

  14. Polymorphous low grade adenocarcinoma of the palate a case report

    African Journals Online (AJOL)

    The piezoelectric unit was used to excise the mass with no further metastasis or Involvement of the palatal vault. The site of excision healed uneventfully and the hlstopathologlcal report of the excised mass showed no signs of nerve Involvement. This tumor is not only a rare lesion but also depicts a similar clinical picture of ...

  15. The nose in children with unilateral cleft lip and palate

    NARCIS (Netherlands)

    C.D.A. Verwoerd (Carel); R. Mladina (R.); G.J. Nolst-Trenité (Gilbert J.); R.W. Pigott (R.)

    1995-01-01

    textabstractSurgeons and orthodontists are still challenged to achieve ‘better’ noses for children with a unilateral cleft or lip, alveolus and palate (UCLP). Various aspects are discussed: infant anatomy and later changes, developmental mechanics, cleft syndrome in animals with surgically produced

  16. A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Semb, Gunvor; Enemark, Hans; Friede, Hans

    2017-01-01

    with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project. METHOD: Ten established national or regional...... cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12...... months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes. RESULTS: Recruitment of 448 infants took place over a 9-year...

  17. Scandcleft Randomised Trials of Primary Surgery for Unilateral Cleft Lip and Palate. Planning and Management

    DEFF Research Database (Denmark)

    Semb, Gunvor; Enemark, Hans; Paulin, Gunnar

    2017-01-01

    with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project. Method: Ten established national or regional...... cleft centres participated. Lip and soft palate closure at 3–4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3–4 months and hard and soft palate closure at 12...... months. Trial 3 compared it with lip and hard palate closure at 3–4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes. Results: Recruitment of 448 infants took place over a 9-year...

  18. Rat embryonic palatal shelves respond to TCDD in organ culture

    International Nuclear Information System (INIS)

    Abbott, B.D.; Birnbaum, L.S.

    1990-01-01

    TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin), a highly toxic environmental contaminant, is teratogenic in mice, inducing cleft palate (CP) and hydronephrosis at doses which are not overtly maternally or embryo toxic. Palatal shelves of embryonic mice respond to TCDD, both in vivo and in organ culture, with altered differentiation of medial epithelial cells. By contrast, in the rat TCDD produces substantial maternal, embryonic, and fetal toxicity, including fetal lethality, with few malformations. In this study the possible effects of maternal toxicity on induction of cleft palate were eliminated by exposure of embryonic rat palatal shelves in organ culture. The shelves were examined for specific TCDD-induced alterations in differentiation of the medial cells. On Gestation Day (GD) 14 or 15 palatal shelves from embryonic F344 rats were placed in organ culture for 2 to 3 days (IMEM:F12 medium, 5% FBS, 0.1% DMSO) containing 0, 1 x 10(-8), 1 x 10(-9), 1 x 10(-10), or 5 x 10(-11) M TCDD. The medial epithelial peridermal cells degenerated on shelves exposed to control media or 5 x 10(-11) M TCDD. Exposure to 10(-10), 10(-9), and 10(-8) M TCDD inhibited this degeneration in 20, 36, and 60% of the shelves, respectively, and was statistically significant at the two highest doses. A normally occurring decrease in [3H]TdR incorporation was inhibited in some GD 15 shelves cultured with 10(-10) and 10(-9) M TCDD. The medial cells of TCDD-exposed shelves continued to express high levels of immunohistochemically detected EGF receptors. The altered differentiation of rat medial epithelium is similar to that reported for TCDD-exposed mouse medial cells in vivo and in vitro. However, in order to obtain these responses, the cultured rat shelves require much higher concentrations of TCDD than the mouse shelves

  19. Cleft lip and palate in the arts: a critical reflection.

    Science.gov (United States)

    Saman, Masoud; Gross, Justin; Ovchinsky, Alexander; Wood-Smith, Donald

    2012-03-01

    The aesthetics of facial structure are used by humans to measure one's beauty, character, and overall "goodness." Individuals born with cleft lip and/or palate are often stigmatized and face much psychosocial adversity. Social attitudes and beliefs have a direct impact upon the psychological development of these individuals. Such social norms are in large part shaped by the physical representations of "good" and "attractive" in various art media including films, advertisements, and paintings. Individuals born with a cleft have been portrayed in the artworks of different eras. The light in which they are portrayed stems from the prevalent beliefs of each period and sheds light on the social attitudes of each epoch toward clefts. Here we discuss the social and psychological ramifications of these works. We then review several artworks representing cleft lip and/or palate and propose an active role for the artist in shaping social attitudes regarding facial deformities. Numerous articles and works of arts were examined and inspected for signs of facial deformity, with particular attention to cleft lip and/or palate. Social media have an important role in defining the norms of society. Much of the art of the past has depicted negatively individuals born with cleft lip and/or palate deformity, thus excluding them from the norm. In order to decrease the negative social stigmas of cleft lip and/or palate, it is now the responsibility of society to widen its range of norms to include individuals born with these deformities through "normal" representations in the various media.

  20. Cleft Lip and Cleft Palate Surgery: Malpractice Litigation Outcomes.

    Science.gov (United States)

    Justin, Grant A; Brietzke, Scott E

    2017-01-01

      This study examined malpractice claims related to cleft lip and cleft palate surgery to identify common allegations and injuries and reviewed financial outcomes.   The WestlawNext legal database was analyzed for all malpractice lawsuits and settlements related to the surgical repair of cleft lip and palate.   Inclusion criteria included patients undergoing surgical repair of a primary cleft lip or palate or revision for complications of previous surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes.   A total of 36 cases were identified, with 12 unique cases from 1981 to 2006 meeting the inclusion criteria. Six cases (50%) were decided by a jury and six by settlement. Five cases involved complications related to the specific surgery, and the other seven were associated with any surgery and perioperative care of children and adults. Cleft palate repair (50%) was the most frequently litigated surgery. Postoperative negligent supervision was the most common allegation (42%) and resulted in a payout in each case (mean = $3,126,032). Death (42%) and brain injury (25%) were the most frequent injuries reported. Financial awards were made in nine cases (after adjusting for inflation, mean = $2,470,552, range = $0 to $7,704,585). The awards were significantly larger for brain injury than other outcomes ($4,675,395 versus $1,368,131 after adjusting for inflation, P = .0101).   Malpractice litigation regarding cleft lip and palate surgery is uncommon. However, significant financial awards involving perioperative brain injury have been reported.

  1. Management of cleft lip and palate in adults

    Directory of Open Access Journals (Sweden)

    Murthy Jyotsna

    2009-10-01

    Full Text Available Introduction: With advancement of medical services in developed countries and awareness among the patients, it is rare to find an adult with an unoperated cleft lip and palate. However, the scenario is totally different in developing countries. Working as a part of a team in developing country, where co-coordinated team work is primitive, resources to provide treatment are very thin, public awareness of availability of treatment for this anomaly is minimal, the age of patients reaching for primary treatment varies from few days to late forties. Though the aim and aspiration is to provide holistic multidisciplinary care, the priority is getting treatment for all cleft patients. In such situation, the management of cleft lip and palate demands changes of approach, techniques and philosophy. Aims and Objectives: The deformed anatomy especially the facial bones and dentition is described. Due to well established deformities, the approach for management is individualized. The procedures and modification of procedures has been described. Results and Outcome: The outcome of the primary repair is adults certainly have less than satisfactory outcome for obvious reasons. The expected outcome and expectation of patients and families following primary surgeries in cleft lip and palate has been discussed. Though all adult patients got some improvement in speech after palate repair, achieving normal speech was difficult. The naso-labial appearance was not perfect, but well accepted by the patients and families. There are many psychosocial problems in these patients, the objective evaluation could not be done due to too many variables. However, primary repair of cleft lip and palate is justified and beneficial for the patients.

  2. Uroflowmetric changes, success rate and complications following Tension-free Vaginal Tape Obturator (TVT-O) operation in obese females.

    Science.gov (United States)

    Fouad, Reham; El-Faissal, Yahia M; Hashem, Ahmed T; Gad Allah, Sherine H

    2017-07-01

    The goal of this study was to evaluate the outcome of Tension-free Vaginal Tape Obturator (TVT-O) operation in the treatment of urodynamic stress incontinence (USI) in obese females, with respect to uroflowmetric changes, success rate and postoperative complications. This prospective observational study included 26 patients with USI at the Obstetrics & Gynecology department-Cairo University hospital during the year 2015. The participants had body mass index (BMI)≥30. Patients underwent TVT-O operation. Follow up of the patients was performed by cough test and uroflowmetry after one week, one month, three months and six months. Postoperative complications such as groin pain, sense of incomplete emptying, need to strain to complete micturition and urinary tract infection were recorded. Comparisons between groups were done using Chi square, Phi-Cramer test for categorical variables. The mean age for the subjects was 43.58±9.01years. The mean BMI was 33.4±2.1. The success rate of TVT-O operation was 21 out of 26 patients (≈81%). Normal maximum flow rate was in 88% of patients at week one and was normal in 100% of patients at months three and six (p=0.101 & 0.101). Postoperative groin pain was the main complaint during the first week after operation and decreased significantly from week one to the 1st month postoperative (84.62% & 65.38%, P=0.041). TVT-O operation showed a high success rate in treatment of USI in obese patients without affecting the voiding function of the bladder as proven by the uroflowmetry. The main postoperative complaint was the groin pain which significantly improved after one month. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Food choice effects on herbivory: Intra-specific seagrass palatability and inter-specific macrophyte palatability in seagrass communities

    Science.gov (United States)

    Jiménez-Ramos, Rocío; Brun, Fernando G.; Egea, Luis G.; Vergara, Juan J.

    2018-05-01

    Interactions between the palatability and abundance of different food sources may influence herbivory patterns in seagrass-dominated communities. In addition, intra-specific differences in nutrient and structural quality of leaves may also alter seagrass palatability and generate different rates of consumption within these communities. We offered two temperate seagrasses species, (Cymodocea nodosa and Zostera noltei) from two different locations to look at intraspecific differences, and two other macrophytes, both of which occur at the same location as seagrasses but represent the extremes of palatability, to a generalist herbivore Paracentrotus lividus (purple sea urchin). Using feeding assays, we compared the consumption rates in individual (single plant species) and combined diets at different food availabilities. Intra-specific differences between seagrass species growing at different locations (inner and outer bay) were indeed found to significantly modify the consumption rate for one species. Structural traits such as carbon content were linked to the low consumption found in Cymodocea nodosa from the inner bay location. In addition, we found that the co-occurrence of different macrophyte species can result in preferential consumption of the more palatable macrophyte with high nutritional content and low structural defence over seagrasses, especially when P. lividus has an abundant food supply. Overall, our findings suggest that intra- and inter-specific differences in seagrass traits and the relative abundance of other macrophytes may explain the variability in patterns of herbivory found within seagrass communities.

  4. The value of multislice spiral CT in the pre-operative diagnosis of cleft palate

    International Nuclear Information System (INIS)

    Tang Guangxi; Sun Lianfen; Zhang Xiaolin; Yu Chengxin; Lu Ji; Wang Xiaopeng; Li Liya; Yang Cheng; Wang Jun; Tian Yiqing

    2004-01-01

    Objective: To evaluate the practical value of multislice spiral CT (MSCT) in the preoperative diagnosis of cleft palate. Methods: Twenty patients with cleft palate were examined by using thin-slice (1.25 mm/4i) axial MSCT scanning and CT virtual endoscope (CTVE) imaging before and after operations. The cleft of each lesion was measured in the primary axial images. Results: Of the 20 cases, soft-and-hard cleft palate (grade II) was detected in 10 cases, with the clefts of soft palate between 1.5 cm and 2.2 cm, and the clefts of soft-and-hard palate between 1.2 cm and 2.0 cm. The right utter cleft palates were found in 3 cases with the clefts of soft palate between 2.0 cm and 2.5 cm, the clefts of soft-and-hard palate between 2.0 cm and 2.4 cm, and the clefts of hard palate between 1.8 cm and 2.2 cm. The left utter cleft palates (grade III) were found in 5 cases with the clefts of soft palate between 1.2 cm and 1.8 cm, the clefts of soft-and-hard palate between 0.9 cm and 2.0 cm, and the clefts of hard palate between 0.9 cm and 1.8 cm. The bilateral utter cleft palates (grade III) were detected in 2 cases with the clefts of soft palate between 2.1 cm and 2.3 cm, the clefts of soft-and-hard palate between 1.8 cm and 2.0 cm, and the clefts of hard palate between 1.9 cm and 2.3 cm. Conclusion: MSCT could excellently display the shape of all lesions before operation, especially the splitting degree of hard cleft palates in the axial images. Accurate measurements could be done for the cleft of different lesions in MSCT images. CTVE could clearly and directly show the shape of the lesion's interior surface. The pre-operative and post-operative images of each case could be perfectly compared by the combination of MSCT and CTVE

  5. A Shh-Foxf-Fgf18-Shh Molecular Circuit Regulating Palate Development.

    Directory of Open Access Journals (Sweden)

    Jingyue Xu

    2016-01-01

    Full Text Available Cleft palate is among the most common birth defects in humans. Previous studies have shown that Shh signaling plays critical roles in palate development and regulates expression of several members of the forkhead-box (Fox family transcription factors, including Foxf1 and Foxf2, in the facial primordia. Although cleft palate has been reported in mice deficient in Foxf2, whether Foxf2 plays an intrinsic role in and how Foxf2 regulates palate development remain to be elucidated. Using Cre/loxP-mediated tissue-specific gene inactivation in mice, we show that Foxf2 is required in the neural crest-derived palatal mesenchyme for normal palatogenesis. We found that Foxf2 mutant embryos exhibit altered patterns of expression of Shh, Ptch1, and Shox2 in the developing palatal shelves. Through RNA-seq analysis, we identified over 150 genes whose expression was significantly up- or down-regulated in the palatal mesenchyme in Foxf2-/- mutant embryos in comparison with control littermates. Whole mount in situ hybridization analysis revealed that the Foxf2 mutant embryos exhibit strikingly corresponding patterns of ectopic Fgf18 expression in the palatal mesenchyme and concomitant loss of Shh expression in the palatal epithelium in specific subdomains of the palatal shelves that correlate with where Foxf2, but not Foxf1, is expressed during normal palatogenesis. Furthermore, tissue specific inactivation of both Foxf1 and Foxf2 in the early neural crest cells resulted in ectopic activation of Fgf18 expression throughout the palatal mesenchyme and dramatic loss of Shh expression throughout the palatal epithelium. Addition of exogenous Fgf18 protein to cultured palatal explants inhibited Shh expression in the palatal epithelium. Together, these data reveal a novel Shh-Foxf-Fgf18-Shh circuit in the palate development molecular network, in which Foxf1 and Foxf2 regulate palatal shelf growth downstream of Shh signaling, at least in part, by repressing Fgf18

  6. Self-reports of psychosocial functioning among children and young adults with cleft lip and palate.

    Science.gov (United States)

    Hunt, Orlagh; Burden, Donald; Hepper, Peter; Stevenson, Mike; Johnston, Chris

    2006-09-01

    A cross-sectional study was employed to determine the psychosocial effects of cleft lip and/or palate among children and young adults, compared with a control group of children and young adults without cleft lip and palate. The study comprised 160 children and young adults with cleft lip and/or palate and 113 children and young adults without cleft lip and/or palate. All participants were between 8 and 21 years of age. Psychological functioning (anxiety, self-esteem, depression, and behavioral problems) was assessed using validated psychological questionnaires. Happiness with facial appearance was rated using a visual analog scale. Social functioning, including experience of teasing/bullying and satisfaction with speech, was assessed using a semistructured interview. Participants with cleft lip and/or palate reported greater behavioral problems (p palate and subjects without cleft lip and/or palate in terms of anxiety (p > .05) or self-esteem (p > .05). Having been teased was a significant predictor of poor psychological functioning, more so than having a cleft lip and/or palate per se (p palate and it was a significant predictor of poorer psychosocial functioning. Children and young adults with cleft lip and/or palate require psychological assessment, specifically focusing on their experience of teasing, as part of their routine cleft care.

  7. [Inconformity between soft tissue defect and bony defect in incomplete cleft palate].

    Science.gov (United States)

    Zhou, Xia; Ma, Lian

    2014-12-01

    To evaluate the inconformity between soft tissue defect and bony defect by observing the cleft extent of palate with complete secondary palate bony cleft in incomplete cleft palate patient. The patients with incomplete cleft palate treated in Hospital of Stomatology Peking University from July 2012 to June 2013 were reviewed, of which 75 cases with complete secondary palate bony cleft were selected in this study. The CT scan and intraoral photograph were taken before operation. The patients were classified as four types according to the extent of soft tissue defect. Type 1: soft tissue defect reached incisive foremen region, Type 2 was hard and soft cleft palate, Type 3 soft cleft palate and Type 4 submucous cleft palate. Type 1 was defined as conformity group (CG). The other three types were defined as inconformity group (ICG) and divided into three subgroups (ICG-I), (ICG-II) and (ICG-III). Fifty-seven patients were in ICG group, and the rate of inconformity was 76% (57/75). The percentage of ICG-I, ICG-II and ICG-III was 47% (27/57), 23% (13/57) and 30% (17/57), respevtively. There are different types of soft tissue deformity with complete secondary palate bony cleft. The inconformity between soft tissue and hard tissue defect exits in 3/4 of isolated cleft palate patients.

  8. Influence of Timing of Delayed Hard Palate Closure on Articulation Skills in 3-Year-Old Danish Children with Unilateral Cleft Lip and Palate

    Science.gov (United States)

    Willadsen, Elisabeth; Boers, Maria; Schöps, Antje; Kisling-Møller, Mia; Nielsen, Joan Bogh; Jørgensen, Line Dahl; Andersen, Mikael; Bolund, Stig; Andersen, Helene Søgaard

    2018-01-01

    Background: Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. Aims: To assess the influence of different timing of hard palate closure in a two-stage procedure on articulation skills in 3-year-olds born with unilateral…

  9. Influence of timing of delayed hard palate closure on articulation skills in 3-year-old Danish children with unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Boers, Maria; Schöps, Antje

    2017-01-01

    Background Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. Aims To assess the influence of different timing of hard palate closure in a two-stage procedure on articu......Background Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. Aims To assess the influence of different timing of hard palate closure in a two-stage procedure...... on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery...

  10. Six2 Plays an Intrinsic Role in Regulating Proliferation of Mesenchymal Cells in the Developing Palate

    Directory of Open Access Journals (Sweden)

    Dennis O. Okello

    2017-11-01

    Full Text Available Cleft palate is a common congenital abnormality that results from defective secondary palate (SP formation. The Sine oculis-related homeobox 2 (Six2 gene has been linked to abnormalities of craniofacial and kidney development. Our current study examined, for the first time, the specific role of Six2 in embryonic mouse SP development. Six2 mRNA and protein expression were identified in the palatal shelves from embryonic days (E12.5 to E15.5, with peak levels during early stages of palatal shelf outgrowth. Immunohistochemical staining (IHC showed that Six2 protein is abundant throughout the mesenchyme in the oral half of each palatal shelf, whereas there is a pronounced decline in Six2 expression by mesenchyme cells in the nasal half of the palatal shelf by stages E14.5–15.5. An opposite pattern was observed in the surface epithelium of the palatal shelf. Six2 expression was prominent at all stages in the epithelial cell layer located on the nasal side of each palatal shelf but absent from the epithelium located on the oral side of the palatal shelf. Six2 is a putative downstream target of transcription factor Hoxa2 and we previously demonstrated that Hoxa2 plays an intrinsic role in embryonic palate formation. We therefore investigated whether Six2 expression was altered in the developing SP of Hoxa2 null mice. Reverse transcriptase PCR and Western blot analyses revealed that Six2 mRNA and protein levels were upregulated in Hoxa2−/− palatal shelves at stages E12.5–14.5. Moreover, the domain of Six2 protein expression in the palatal mesenchyme of Hoxa2−/− embryos was expanded to include the entire nasal half of the palatal shelf in addition to the oral half. The palatal shelves of Hoxa2−/− embryos displayed a higher density of proliferating, Ki-67 positive palatal mesenchyme cells, as well as a higher density of Six2/Ki-67 double-positive cells. Furthermore, Hoxa2−/− palatal mesenchyme cells in culture displayed both increased

  11. Facial tissue depths in children with cleft lip and palate.

    Science.gov (United States)

    Starbuck, John M; Ghoneima, Ahmed; Kula, Katherine

    2015-03-01

    Cleft lip and palate (CLP) is a craniofacial malformation affecting more than seven million people worldwide that results in defects of the hard palate, teeth, maxilla, nasal spine and floor, and maxillodental asymmetry. CLP facial soft-tissue depth (FSTD) values have never been published. The purpose of this research is to report CLP FSTD values and compare them to previously published FSTD values for normal children. Thirty-eight FSTDs were measured on cone beam computed tomography images of CLP children (n = 86; 7-17 years). MANOVA and ANOVA tests determined whether cleft type, age, sex, and bone graft surgical status affect tissue depths. Both cleft type (unilateral/bilateral) and age influence FSTDs. CLP FSTDs exhibit patterns of variation that differ from normal children, particularly around the oronasal regions of the face. These differences should be taken into account when facial reconstructions of children with CLP are created. © 2014 American Academy of Forensic Sciences.

  12. [Rhabdomyosarcoma of soft palate. A case on purpose].

    Science.gov (United States)

    Arias Marzán, F; De Bonis Redondo, M; Redondo Ventura, F; Betancor Martínez, L; Sanginés Yzzo, M; Arias Marzán, J; De Bonis Braun, C; Zurita Expósito, V; Reig Ripoll, F; De Lucas Carmona, G

    2006-01-01

    The rabdomiosarcoma (RMS) are infrequent tumors. They are principally described in infancy and located in 35% of the cases in head and neck. The nasopharynx localisation is relatively rare, being in these cases the tongue, palate and oral mucosa the preferent places of establishment. Classically the patient presented very low standard healing with surgery and radiotherapy. The introduction in the middle 70 of systematic chimiotherapy as complementary treatment, improved the survival rate in large scale. In this article the case of an adolescent patient, who presented a RMS at the level of the soft palate, the diagnostic procedure and the therapeutic decision adopted, after revision of the last studies at this respect, are described.

  13. CIRPLAST: Cleft Lip and Palate Missions in Peru.

    Science.gov (United States)

    Navarro, Carlos E

    2015-06-01

    The author presents a 20-year experience leading cleft lip and palate surgical volunteer missions in Peru for CIRPLAST, a nonprofit volunteer plastic surgery goodwill program that has provided free surgery for patients with cleft lip and palate deformities in remote areas of Peru. Surgical procedures were performed by the author, together with a group of experienced plastic surgeons, under the auspices of the Peruvian Plastic Surgery Society, and local health authorities. CIRPLAST missions are scheduled annually in different locations around Peru. Selected patients for surgery after adequate screening are photographed, and their cleft deformity is recorded. Scheduled patients or their parents, when they are minors, sign an informed consent form. Patients operated on in any given day are examined and photographed 1 day after surgery, before discharge. Between 30 and 35 patients are operated on at each mission site. About 2 weeks after the mission, patients are checked and photographed, and the outcome of surgery is recorded. Complications that may occur are recorded and treated by the CIRPLAST team as soon as possible. Almost all operations are performed under general endotracheal anesthesia coupled by local anesthesia containing a vasoconstrictor, to reduce bleeding and facilitate tissue dissection. All wounds of the lip and palate are closed with absorbable sutures, to avoid the need for suture removal. After cleft lip surgery, patients go to the recovery room for monitoring by nurses until they recover completely. A total of 6108 cleft lip and palate repairs, primary and secondary, were performed by CIRPLAST in 141 missions, between May 12, 1994, and October 15, 2014. The medical records of the 5162 patients (84.5%) who returned for follow-up (ranging from 12 days to 9 years) were reviewed retrospectively. Between 45% and 70% of the patients operated on a mission have returned for early follow-up and some the following year. There were 3176 males (51.9%) and 2932

  14. Superior perioperative analgesia with combined femoral-obturator-sciatic nerve block in comparison with posterior lumbar plexus and sciatic nerve block for ACL reconstructive surgery.

    Science.gov (United States)

    Bareka, Metaxia; Hantes, Michael; Arnaoutoglou, Eleni; Vretzakis, George

    2018-02-01

    The purpose of this randomized controlled study is to compare and evaluate the intraoperative and post-operative outcome of PLPS nerve block and that of femoral, obturator and sciatic (FOS) nerve block as a method of anaesthesia, in performing ACL reconstruction. Patients referred for elective arthroscopic ACL reconstruction using hamstring autograft were divided in two groups. The first group received combined femoral-obturator-sciatic nerve block (FOS Group) under dual guidance, whereas the second group received posterior lumbar plexus block under neurostimulation and sciatic nerve block (PLPS Group) under dual guidance. The two groups were comparable in terms of age, sex, BMI and athletic activity. The time needed to perform the nerve blocks was significantly shorter for the FOS group (p block under dual guidance for arthroscopic ACL reconstructive surgery is a safe and tempting anaesthetic choice. The success rate of this technique is higher in comparison with PLPS and results in less peri- and post-operative pain with less opioid consumption. This study provides support for the use of peripheral nerve blocks as an exclusive method for ACL reconstructive surgery in an ambulatory setting with almost no complications. I.

  15. Reconstruction of palatal defect using mucoperiosteal hinge flap and pushback palatoplasty.

    Science.gov (United States)

    Lee, S I; Lee, H S; Hwang, K

    2001-11-01

    This article describes a simple, new surgical technique to provide a complete two-layer closure of palatal defect resulting from a surgical complication of trans palatal resection of skull base chordoma. The nasal layer was reconstructed with triangular shape oral mucoperiosteal turn over hinge flap based on anterior margin of palatal defect and rectangular shaped lateral nasal mucosal hinge flaps. The oral layer was reconstructed with conventional pushback V-Y advancement 2-flaps palatoplasty. Each layer of the flaps were secured with two key mattress suture for flap coaptation. This technique has some advantages: simple, short operation time, one-stage procedure, no need of osteotomy. It can close small- to medium-sized palatal defect of palate or wide cleft palate and can prevent common complication of oronasal fistula, which could be caused by tension.

  16. Psychological issues in cleft lip and cleft palate

    OpenAIRE

    Sousa Avinash; Devare Shibani; Ghanshani Jyoti

    2009-01-01

    Vocational and social issues affect rehabilitation and development of patients with cleft lip and cleft palate. However, psychological problems like lowered self esteem and difficulties in social interaction have also been noted in them. Not many pediatric reconstructive surgery teams have a psychiatrist on their panel. It is likely that psychological problems are higher in incidence than literature actually suggests. Hence it is very essential that such cases are identified by the surgical t...

  17. Factors prognostic for phonetic development after cleft palate repair.

    Science.gov (United States)

    Lee, Joon Seok; Kim, Jae Bong; Lee, Jeong Woo; Yang, Jung Dug; Chung, Ho Yun; Cho, Byung Chae; Choi, Kang Young

    2015-10-01

    Palatoplasty is aimed to achieve normal speech, improve food intake, and ensure successful maxillary growth. However, the velopharyngeal function is harder to control than other functions. Therefore, many studies on the prognostic factor of velopharyngeal insufficiency have been conducted. This study aimed to evaluate the relationships between speech outcomes and multimodality based on intraoral and preoperative three-dimensional computerized tomographic (CT) findings. Among 73 children with cleft palate who underwent palatoplasty between April 2011 and August 2014 at Kyungpook National University Hospital (KNUH), 27 were retrospectively evaluated. The 27 cases were non-syndromic, for which successful speech evaluation was conducted by a single speech-language pathologist (Table 1). Successful speech evaluation was defined as performing the test three times in 6-month intervals. Three intraoral parameters were measured before and immediately after operation (Fig. 1). On axial- and coronal-view preoperative facial CT, 5 and 2 different parameters were analyzed, respectively (Figs. 2 and 3). Regression analysis (SPSS IBM 22.0) was used in the statistical analysis. Two-flap palatoplasty and Furlow's double opposing Z-plasty were performed in 15 and 12 patients, respectively. The operation was performed 11 months after birth on average. Children with a higher palatal arch and wider maxillary tuberosity distance showed hypernasality (p palate width and height, rather than initial diagnosis, treatment method, or palate length. Therefore, a more active intervention is needed, such as orthopedic appliance, posterior pharyngeal wall augmentation, or early speech training. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Ectrodactyly, ectodermal dysplasia, cleft lip, and palate (EEC syndrome

    Directory of Open Access Journals (Sweden)

    Mohita Marwaha

    2012-01-01

    Full Text Available The ectodermal dysplasias (EDs are a large and complex group of diseases. More than 170 different clinical conditions have been recognized and defined as ectodermal dysplasias. Commonly involved ectodermal-derived structures are hair, teeth, nails, and sweat glands. In some conditions, it may be associated with mental retardation. We report a case of 10-year-old male child with ectrodactyly, syndactyly, ED, cleft lip/palate, hearing loss, and mental retardation.

  19. Unique expression of cytoskeletal proteins in human soft palate muscles.

    Science.gov (United States)

    Shah, Farhan; Berggren, Diana; Holmlund, Thorbjörn; Levring Jäghagen, Eva; Stål, Per

    2016-03-01

    The human oropharyngeal muscles have a unique anatomy with diverse and intricate functions. To investigate if this specialization is also reflected in the cytoarchitecture of muscle fibers, intermediate filament proteins and the dystrophin-associated protein complex have been analyzed in two human palate muscles, musculus uvula (UV) and musculus palatopharyngeus (PP), with immunohistochenmical and morphological techniques. Human limb muscles were used as reference. The findings show that the soft palate muscle fibers have a cytoskeletal architecture that differs from the limb muscles. While all limb muscles showed immunoreaction for a panel of antibodies directed against different domains of cytoskeletal proteins desmin and dystrophin, a subpopulation of palate muscle fibers lacked or had a faint immunoreaction for desmin (UV 11.7% and PP 9.8%) and the C-terminal of the dystrophin molecule (UV 4.2% and PP 6.4%). The vast majority of these fibers expressed slow contractile protein myosin heavy chain I. Furthermore, an unusual staining pattern was also observed in these fibers for β-dystroglycan, caveolin-3 and neuronal nitric oxide synthase nNOS, which are all membrane-linking proteins associated with the dystrophin C-terminus. While the immunoreaction for nNOS was generally weak or absent, β-dystroglycan and caveolin-3 showed a stronger immunostaining. The absence or a low expression of cytoskeletal proteins otherwise considered ubiquitous and important for integration and contraction of muscle cells indicate a unique cytoarchitecture designed to meet the intricate demands of the upper airway muscles. It can be concluded that a subgroup of muscle fibers in the human soft palate appears to have special biomechanical properties, and their unique cytoarchitecture must be taken into account while assessing function and pathology in oropharyngeal muscles. © 2015 Anatomical Society.

  20. Trans-obturator vaginal tape (TOT) for female stress incontinence: one year follow-up in 120 patients.

    Science.gov (United States)

    Roumeguère, Thierry; Quackels, Th; Bollens, R; de Groote, A; Zlotta, A; Bossche, M Vanden; Schulman, C

    2005-11-01

    The aim of this study was to evaluate the effectiveness of a new minimally invasive surgical procedure, the Trans-obturator Vaginal Tape (TOT) in the treatment of female urodynamic stress incontinence (USI) and to analyse functional results and quality of life after one year of follow up. 120 consecutive women with stress urinary incontinence underwent the procedure since February 2002 under general or loco-regional anesthesia. Minimum follow up was one year (range 12-30 months). Mean age was 58 years (range 31-86). 70% of the patients had pure USI. 5 patients were previously operated for USI. In 10 cases, concomitant repair of pelvic floor defects was mandatory. Collection of the data included operative time, pre- and post-operative complications. Patients were post-operatively assessed at one week, one month and one year. A validated urinary incontinence-specific measure of Quality of Life (QoL) questionnaire (Contilife) was sent and completed 12 months after surgery. The mean operative time was 12 min (range 6-30) with a catheterisation time of 0,9 day (range 0-2). No severe bleeding was observed. There were 13 minor lateral tears of the vagina without any sequelae. Three perforations of the urethra and one of the bladder occurred during the learning phase. In two cases a re-intervention was necessary for tape removal when the injury was not recognised during the procedure. Two transient urinary retention needed a supra pubic catheter and tape release. Eleven women presented transient voiding outflow obstruction. After one month, 93% patients were cured with no pad and a negative cough test with a full bladder. Uroflowmetry did not show any significant changes between pre- and post-operative time in all the population. De novo urgency occurred only in 2.5% and persistent dysuria (Qmax 120 cc) in 4%. 80% of patients were completely dry after one year and 12% were greatly improved. According to the pre-operative maximal urethral closure pressure, continence rate

  1. Linking suckling biomechanics to the development of the palate

    Science.gov (United States)

    Li, Jingtao; Johnson, Chelsey A.; Smith, Andrew A.; Hunter, Daniel J.; Singh, Gurpreet; Brunski, John B.; Helms, Jill A.

    2016-02-01

    Skulls are amongst the most informative documents of evolutionary history but a complex geometry, coupled with composite material properties and complicated biomechanics, have made it particularly challenging to identify mechanical principles guiding the skull’s morphogenesis. Despite this challenge, multiple lines of evidence, for example the relationship between masticatory function and the evolution of jaw shape, nonetheless suggest that mechanobiology plays a major role in skull morphogenesis. To begin to tackle this persistent challenge, cellular, molecular and tissue-level analyses of the developing mouse palate were coupled with finite element modeling to demonstrate that patterns of strain created by mammalian-specific oral behaviors produce complementary patterns of chondrogenic gene expression in an initially homogeneous population of cranial neural crest cells. Neural crest cells change from an osteogenic to a chondrogenic fate, leading to the materialization of cartilaginous growth plate-like structures in the palatal midline. These growth plates contribute to lateral expansion of the head but are transient structures; when the strain patterns associated with suckling dissipate at weaning, the growth plates disappear and the palate ossifies. Thus, mechanical cues such as strain appear to co-regulate cell fate specification and ultimately, help drive large-scale morphogenetic changes in head shape.

  2. Reliable critical sized defect rodent model for cleft palate research.

    Science.gov (United States)

    Mostafa, Nesrine Z; Doschak, Michael R; Major, Paul W; Talwar, Reena

    2014-12-01

    Suitable animal models are necessary to test the efficacy of new bone grafting therapies in cleft palate surgery. Rodent models of cleft palate are available but have limitations. This study compared and modified mid-palate cleft (MPC) and alveolar cleft (AC) models to determine the most reliable and reproducible model for bone grafting studies. Published MPC model (9 × 5 × 3 mm(3)) lacked sufficient information for tested rats. Our initial studies utilizing AC model (7 × 4 × 3 mm(3)) in 8 and 16 weeks old Sprague Dawley (SD) rats revealed injury to adjacent structures. After comparing anteroposterior and transverse maxillary dimensions in 16 weeks old SD and Wistar rats, virtual planning was performed to modify MPC and AC defects dimensions, taking the adjacent structures into consideration. Modified MPC (7 × 2.5 × 1 mm(3)) and AC (5 × 2.5 × 1 mm(3)) defects were employed in 16 weeks old Wistar rats and healing was monitored by micro-computed tomography and histology. Maxillary dimensions in SD and Wistar rats were not significantly different. Preoperative virtual planning enhanced postoperative surgical outcomes. Bone healing occurred at defect margin leaving central bone void confirming the critical size nature of the modified MPC and AC defects. Presented modifications for MPC and AC models created clinically relevant and reproducible defects. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  3. Tomographic mapping of the hard palate and overlying mucosa

    Energy Technology Data Exchange (ETDEWEB)

    Marquezan, Mariana; Nojima, Lincoln Issamu; Freitas, Amanda Osorio Ayres de; Baratieri, Carolina; Alves Junior, Matheus; Nojima, Matilde da Cunha Goncalves; Araujo, Monica Tirre de Souza, E-mail: marianamarquezan@gmail.com [Department of Pedodontics and Orthodontics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2012-01-15

    The aim of this study was to measure the thickness of the hard palate and its overlying mucosa using cone-beam computed tomography (CBCT), for purposes of miniscrew placement. The sample comprised 36 CBCT scans of patients aged 12 to 52 years from a database of the Orthodontics Department of the Federal University of Rio de Janeiro. Paracoronal views of the palatal region were reconstructed at 4, 8, 16 and 24 mm posterior to the incisive foramen. In each reconstruction measurements were taken at the suture, 3 mm and 6 mm bilaterally to it. Wilcoxon's test verified the differences between the selected regions. Total bone height decreased from the anterior to the posterior region. In cross sections 4, 16 and 24, bone height decreased from the suture laterally to the 3 mm region and then increased in the 6 mm region. The cortical thickness does not seem to be a concern because it presented a mean thickness of at least 1 mm at all sites evaluated. The measurements of the mucosa thickness decreased from lateral to median and from anterior to posterior regions. The most suitable areas for miniscrew placement in the palate are located 4 mm posterior to the incisive foramen, in the median or paramedian regions 3 mm adjacent to the suture. (author)

  4. Legal considerations in the management of cleft lip and palate.

    Science.gov (United States)

    Berbert-Campos, Cláudia

    2007-03-01

    To inform professionals providing care to individuals with cleft lip and palate on the legal aspects and organizations available to protect individuals with this alteration, and to advocate that cleft lip and palate should be considered a handicap, even though it is provisional and may be rehabilitated, to assure afflicted individuals basic rights and complete personal, social, and economic welfare. Literature review on the issue, including assessment of national and international laws, doctrines, and jurisprudences; conceptual analysis of the word "handicapped" in dictionaries. Analysis included the federal constitutions of Brazil, France, Argentina, Spain, Cuba, Italy, China, Portugal, Japan, Great Britain, and Colombia, regarding the protection of handicapped people. Constitutional protection of handicapped people is a recent issue that has been addressed only in the last few decades in some countries such as Brazil, Italy, Spain, China, and Portugal. The Brazilian Federal Constitution of 1988 addresses the protection of handicapped people to assure them access to social and individual rights, freedom, security, welfare, development, equality, and justice as supreme values of a fraternal, pluralist, and prejudice-free society. Individuals with cleft lip and palate should be included in national policies for integration of handicapped people, in agreement with programs of human rights, establishing a collaborative action between state and society. This would assure their inclusion in the socioeconomic and cultural context and equal opportunities in society, without privileges or paternalism.

  5. Sensory influences on food intake control: moving beyond palatability.

    Science.gov (United States)

    McCrickerd, K; Forde, C G

    2016-01-01

    The sensory experience of eating is an important determinant of food intake control, often attributed to the positive hedonic response associated with certain sensory cues. However, palatability is just one aspect of the sensory experience. Sensory cues based on a food's sight, smell, taste and texture are operational before, during and after an eating event. The focus of this review is to look beyond palatability and highlight recent advances in our understanding of how certain sensory characteristics can be used to promote better energy intake control. We consider the role of visual and odour cues in identifying food in the near environment, guiding food choice and memory for eating, and highlight the ways in which tastes and textures influence meal size and the development of satiety after consumption. Considering sensory characteristics as a functional feature of the foods and beverages we consume provides the opportunity for research to identify how sensory enhancements might be combined with energy reduction in otherwise palatable foods to optimize short-term energy intake regulation in the current food environment. Moving forward, the challenge for sensory nutritional science will be to assess the longer-term impact of these principles on weight management. © 2015 World Obesity.

  6. Modelling human hard palate shape with Bézier curves.

    Directory of Open Access Journals (Sweden)

    Rick Janssen

    Full Text Available People vary at most levels, from the molecular to the cognitive, and the shape of the hard palate (the bony roof of the mouth is no exception. The patterns of variation in the hard palate are important for the forensic sciences and (palaeoanthropology, and might also play a role in speech production, both in pathological cases and normal variation. Here we describe a method based on Bézier curves, whose main aim is to generate possible shapes of the hard palate in humans for use in computer simulations of speech production and language evolution. Moreover, our method can also capture existing patterns of variation using few and easy-to-interpret parameters, and fits actual data obtained from MRI traces very well with as little as two or three free parameters. When compared to the widely-used Principal Component Analysis (PCA, our method fits actual data slightly worse for the same number of degrees of freedom. However, it is much better at generating new shapes without requiring a calibration sample, its parameters have clearer interpretations, and their ranges are grounded in geometrical considerations.

  7. Neurosensory changes of palatal mucousa following Le Fort I osteotomy

    Directory of Open Access Journals (Sweden)

    Bijan Movahedian Attar

    2009-09-01

    Full Text Available

    • BACKGROUND: This study evaluated the sensation of palatal ucosa before and after Le Fort I osteotomy and compared it based on whether greater palatine nerve has been dissected or not.
    • METHODS: Sixteen patients were studied within one week before  urgery and then one week, 6 weeks, 3 months and 6 months after surgery. Four tests including sharp-blunt discrimination, cold perception, pin prick sensation and electrical stimulation were performed.
    • RESULTS: Mean values of electrical stimulation were significantly higher 6 months after surgery (p < 0.05, on the other hand mean values of pin-prick sensation were significantly lower (p < 0.05. All patients regardless of the condition of greater palatine nerve were responsive to cold perception and sharp-blunt discrimination 6 months after surgery.
    • CONCLUSIONS: Following Le Fort I osteotomy, palatal  esponsiveness to electrical stimulation decreases and mechanical hyper sensitization occurs. Dissection of greater palatine nerve was shown to have no effect on the results.
    • KEYWORDS: Lefort I Osteotomy, Palatal Mocousa, Nerve Recovery.

  8. Presurgical cleft lip and palate orthopedics: an overview

    Directory of Open Access Journals (Sweden)

    Alzain I

    2017-05-01

    Full Text Available Ibtesam Alzain,1 Waeil Batwa,2 Alex Cash,3 Zuhair A Murshid2 1Pediatric Dentistry, 2Orthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 3Cleft Lip and Palate Orthodontics, Queen Victoria NHS Foundation Trust, South Thames Cleft Service, London, UK Abstract: Patients with cleft lip and/or palate go through a lifelong journey of multidisciplinary care, starting from before birth and extending until adulthood. Presurgical orthopedic (PSO treatment is one of the earliest stages of this care plan. In this paper we provide a review of the PSO treatment. This review should help general and specialist dentists to better understand the cleft patient care path and to be able to answer patient queries more efficiently. The objectives of this paper were to review the basic principles of PSO treatment, the various types of techniques used in this therapy, and the protocol followed, and to critically evaluate the advantages and disadvantages of some of these techniques. In conclusion, we believe that PSO treatment, specifically nasoalveolar molding, does help to approximate the segments of the cleft maxilla and does reduce the intersegment space in readiness for the surgical closure of cleft sites. However, what we remain unable to prove equivocally at this point is whether the reduction in the dimensions of the cleft presurgically and the manipulation of the nasal complex benefit our patients in the long term. Keywords: presurgical orthopedic, nasoalveolar molding, cleft lip and palate

  9. Perception of English palatal codas by Korean speakers of English

    Science.gov (United States)

    Yeon, Sang-Hee

    2003-04-01

    This study aimed at looking at perception of English palatal codas by Korean speakers of English to determine if perception problems are the source of production problems. In particular, first, this study looked at the possible first language effect on the perception of English palatal codas. Second, a possible perceptual source of vowel epenthesis after English palatal codas was investigated. In addition, individual factors, such as length of residence, TOEFL score, gender and academic status, were compared to determine if those affected the varying degree of the perception accuracy. Eleven adult Korean speakers of English as well as three native speakers of English participated in the study. Three sets of a perception test including identification of minimally different English pseudo- or real words were carried out. The results showed that, first, the Korean speakers perceived the English codas significantly worse than the Americans. Second, the study supported the idea that Koreans perceived an extra /i/ after the final affricates due to final release. Finally, none of the individual factors explained the varying degree of the perceptional accuracy. In particular, TOEFL scores and the perception test scores did not have any statistically significant association.

  10. Tomographic mapping of the hard palate and overlying mucosa

    International Nuclear Information System (INIS)

    Marquezan, Mariana; Nojima, Lincoln Issamu; Freitas, Amanda Osorio Ayres de; Baratieri, Carolina; Alves Junior, Matheus; Nojima, Matilde da Cunha Goncalves; Araujo, Monica Tirre de Souza

    2012-01-01

    The aim of this study was to measure the thickness of the hard palate and its overlying mucosa using cone-beam computed tomography (CBCT), for purposes of miniscrew placement. The sample comprised 36 CBCT scans of patients aged 12 to 52 years from a database of the Orthodontics Department of the Federal University of Rio de Janeiro. Paracoronal views of the palatal region were reconstructed at 4, 8, 16 and 24 mm posterior to the incisive foramen. In each reconstruction measurements were taken at the suture, 3 mm and 6 mm bilaterally to it. Wilcoxon's test verified the differences between the selected regions. Total bone height decreased from the anterior to the posterior region. In cross sections 4, 16 and 24, bone height decreased from the suture laterally to the 3 mm region and then increased in the 6 mm region. The cortical thickness does not seem to be a concern because it presented a mean thickness of at least 1 mm at all sites evaluated. The measurements of the mucosa thickness decreased from lateral to median and from anterior to posterior regions. The most suitable areas for miniscrew placement in the palate are located 4 mm posterior to the incisive foramen, in the median or paramedian regions 3 mm adjacent to the suture. (author)

  11. The Epidemiology of Cleft Lip and Palate in Canada, 1998 to 2007.

    Science.gov (United States)

    Matthews, Jennifer L K; Oddone-Paolucci, Elizabeth; Harrop, Robertston A

    2015-07-01

    To examine the birth prevalence, gender distribution, and pattern of surgical intervention for clefts in Canada (1998 to 2007). Also to highlight the difficulties associated with studying the epidemiology of clefts using the current data collection mechanisms. Epidemiologic data acquired from the Canadian Institute for Health Information. Population-based study in Canada 1998 to 2007. All live births with an International Classification of Diseases (9th or 10th revision) diagnostic code for cleft palate or for cleft lip with or without cleft palate or with a surgical intervention code for repair of cleft lip or cleft palate. Birth prevalence, gender distribution, and pattern of surgical intervention. There were 3,015,325 live births in Canada (1998 to 2007). The mean birth prevalence was 0.82 per 1000 live births for cleft lip with or without cleft palate and 0.58 per 1000 live births for cleft palate. The birth prevalence of cleft lip with or without cleft palate was significantly higher in boys, with a stable boy to girl ratio of 1.75:1. Cleft palate was significantly greater in girls; however, the boy to girl ratio decreased from 0.97:1 in 1998 to 0.59:1 in 2007. The median age of repair in Canada from 1998 to 2007 was 4.7 months for cleft lip and 11.6 months for cleft palate. Thirty percent of patients underwent cleft palate repair after age 1. The birth prevalence of cleft palate and cleft lip with or without cleft palate is stable in Canada. An increasing birth prevalence of cleft palate in girls is suggested. The timing of surgical intervention is consistent with current standards. The challenges associated with collecting these data in Canada are discussed.

  12. Isolated cleft palate requires different surgical protocols depending on cleft type.

    Science.gov (United States)

    Elander, Anna; Persson, Christina; Lilja, Jan; Mark, Hans

    2017-08-01

    A staged protocol for isolated cleft palate (CPO), comprising the early repair of the soft palate at 6 months and delayed repair of the eventual cleft in the hard palate until 4 years, designed to improve maxillary growth, was introduced. CPO is frequently associated with additional congenital conditions. The study evaluates this surgical protocol for clefts in the soft palate (CPS) and for clefts in the hard and soft palate (CPH), with or without additional malformation, regarding primary and secondary surgical interventions needed for cleft closure and for correction of velopharyngeal insufficiency until 10 years of age. Of 94 consecutive children with CPO, divided into four groups with (+) or without (-) additional malformations (CPS + or CPS - and CPH + or CPH-), hard palate repair was required in 53%, performed with small local flaps in 21% and with bilateral mucoperiosteal flaps in 32%. The total incidence of soft palate re-repair was 2% and the fistula repair of the hard palate was 5%. The total incidence of secondary velopharyngeal surgery was 17% until 10 years, varying from 0% for CPS - and 15% for CPH-, to 28% for CPS + and 30% for CPH+. The described staged protocol for repair of CPO is found to be safe in terms of perioperative surgical results, with comparatively low need for secondary interventions. Furthermore, the study indicates that the presence of a cleft in the hard palate and/or additional conditions have a negative impact on the development of the velopharyngeal function.

  13. Phonetic description of babbling in Danish toddlers born with and without unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Albrechstn, Helle

    2006-01-01

    Objective: To investigate prelinguistic vocalization sequences of 1-year-old children with and without cleft lip and palate. Design: Prospective study. Participants: Thirty-eight children born with unilateral cleft lip and palate and 36 control children born without clefts. The cleft children had...... of occurrence of nasal contoids and a smaller frequency of occurrence of alveolar contoids in the cleft group. Canonical babbling was achieved by most children in both groups, and no significant difference was found between the groups. Conclusions: Early closure of the soft palate seems to have a positive...... influence on the prelinguistic development of children with cleft palate....

  14. The comparative study of resonance disorders for Vietnamese and Korean cleft palate speakers using nasometer.

    Science.gov (United States)

    Shin, Yu-Jeong; Kim, Yongsoo; Kim, Hyun-Gi

    2017-12-01

    Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this experimentation. Instead of Korean control, the standard value of Korean version of the simplified nasometric assessment procedures (kSNAP) was used. The results are as follows: (1) the highest nasalance score among the Vietnamese normal vowels is the low vowel /a/; however, that of Korean normal vowels is the high vowel /i/. (2) The average nasalance score of Korean cleft palate vowels is 18% higher than that of Vietnamese cleft palate vowels. There was a nasalance score of over 45% among the vowels /e/ and /i/ in Vietnamese cleft palate patients and /i/, /o/, and /u/ in Korean cleft palate patients. These different nasalance scores of the same vowels seem to cause an ethnic difference between Vietnamese and Korean cleft palate children.

  15. Evaluation of cleft lip and palate by computed tomography with 2 mm thin slice scanning, 2

    International Nuclear Information System (INIS)

    Uchiyama, Mayuki; Tanaka, Hiroshi; Harada, Junta

    1992-01-01

    Computed tomography was performed on 104 patients with cleft lip and palate by continuous 2 mm slice scanning. The type of hard palate was classified as normal, hypoplasia and aplasia, depending on its developmental degree. The shape of alveolus was also classified as circular, triangular and asymmetric forms for the evaluation of the maxillary development. The hard palate development correlated with the shape of the alveolus, the diameter of maxillary and mandibular bone, and frequency of sinusitis and otitis media. Evaluation of the hard palate by thin slice scanning is useful in presumption of future fecial development. (author)

  16. Evaluation of cleft lip and palate by computed tomography with 2 mm thin slice scanning, 2

    Energy Technology Data Exchange (ETDEWEB)

    Uchiyama, Mayuki; Tanaka, Hiroshi; Harada, Junta (Jikei Univ., Tokyo (Japan). School of Medicine)

    1992-06-01

    Computed tomography was performed on 104 patients with cleft lip and palate by continuous 2 mm slice scanning. The type of hard palate was classified as normal, hypoplasia and aplasia, depending on its developmental degree. The shape of alveolus was also classified as circular, triangular and asymmetric forms for the evaluation of the maxillary development. The hard palate development correlated with the shape of the alveolus, the diameter of maxillary and mandibular bone, and frequency of sinusitis and otitis media. Evaluation of the hard palate by thin slice scanning is useful in presumption of future fecial development. (author).

  17. Prevalence of dental anomalies of number in different subphenotypes of isolated cleft palate

    Directory of Open Access Journals (Sweden)

    João Paulo Schwartz

    2014-01-01

    Full Text Available OBJECTIVE: This study aimed at carrying out a radiographic analysis on the prevalence of dental anomalies of number (agenesis and supernumerary teeth in permanent dentition, in different subphenotypes of isolated cleft palate pre-adolescent patients. METHODS: Panoramic radiographs of 300 patients aged between 9 and 12 years, with cleft palate and enrolled in a single treatment center, were retrospectively analyzed. The sample was divided into two groups according to the extension/severity of the cleft palate: complete and incomplete . The chi-square test was used for intergroup comparison regarding the prevalence of the investigated dental anomalies (P < 0.05. RESULTS: Agenesis was found in 34.14% of patients with complete cleft palate and in 30.27% of patients with incomplete cleft palate. Supernumerary teeth were found in 2.43% of patients with complete cleft palate and in 0.91% of patients with incomplete cleft palate. No statistically significant difference was found between groups with regard to the prevalence of agenesis and supernumerary teeth. There was no difference in cleft prevalence between genders within each study group. CONCLUSION: The prevalence of dental anomalies of number in pre-adolescents with cleft palate was higher than that reported for the general population. The severity of cleft palate did not seem to be associated with the prevalence of dental anomalies of number.

  18. Diagnostic value of dynamic contrast-enhanced MRI for submucosal palatal tumors

    International Nuclear Information System (INIS)

    Matsuzaki, Hidenobu; Yanagi, Yoshinobu; Hara, Marina; Katase, Naoki; Hisatomi, Miki; Unetsubo, Teruhisa; Konouchi, Hironobu; Takenobu, Toshihiko

    2012-01-01

    Objectives: To evaluate the diagnostic value of dynamic contrast-enhanced MRI (DCE-MRI) for differentiating between benign and malignant tumors in the palate. Materials and methods: 26 patients with submucosal palatal tumors were preoperatively examined using DCE-MRI. Their maximum contrast index (CImax), time of CImax (Tmax), and washout ratios (WR300 and WR600) were determined from contrast index curves. The submucosal palatal tumors were divided into two groups according to their Tmax values: the early enhancement group (Tmax 2 = 0.92, P < 0.001). Conclusions: Tmax is a useful parameter for distinguishing between benign and malignant submucosal palatal tumors.

  19. A randomised controlled trial of ultrasound-guided blockade of the saphenous nerve and the posterior branch of the obturator nerve for postoperative analgesia after day-case knee arthroscopy

    DEFF Research Database (Denmark)

    Westergaard, B; Jensen, K; Lenz, K

    2014-01-01

    The purpose of this study was to investigate the effects of blockade of the saphenous nerve and the posterior branch of the obturator nerve in addition to a standard analgesic regimen for patients discharged the same day after knee arthroscopy. The primary outcome was knee pain on flexion during...

  20. Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study

    Science.gov (United States)

    Sitzman, Thomas J; Hossain, Monir; Carle, Adam C; Heaton, Pamela C; Britto, Maria T

    2017-01-01

    Objectives To test whether cleft centres vary in their use of secondary cleft palate surgery, also known as revision palate surgery, and if so to identify modifiable hospital factors and surgeon factors that are associated with use of secondary surgery. Design Retrospective cohort study. Setting Forty-three paediatric hospitals across the USA. Patients Children with cleft lip and palate who underwent primary cleft palate repair from 1999 to 2013. Main outcome measures Time from primary cleft palate repair to secondary palate surgery. Results We identified 4939 children who underwent primary cleft palate repair. At 10 years after primary palate repair, 44% of children had undergone secondary palate surgery. Significant variation existed among hospitals (ppalate repair before 9 months of age was associated with an increased hazard of secondary palate surgery (initial HR 6.74, 95% CI 5.30 to 8.73). Postoperative antibiotics, surgeon procedure volume and hospital procedure volume were not associated with time to secondary surgery (p>0.05). Of the outcome variation attributable to hospitals and surgeons, between-hospital differences accounted for 59% (ppalate surgery exists depending on a child’s age at primary palate repair and the hospital and surgeon performing their repair. Performing primary palate repair before 9 months of age substantially increases the hazard of secondary surgery. Further research is needed to identify other factors contributing to variation in palate surgery outcomes among hospitals and surgeons. PMID:29479567

  1. Influence of timing of delayed hard palate closure on articulation skills in 3-year-old Danish children with unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Boers, Maria; Schöps, Antje

    2018-01-01

    BACKGROUND: Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. AIMS: To assess the influence of different timing of hard palate closure in a two-stage procedure...... on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery...

  2. Ontogeny and innervation of taste buds in mouse palatal gustatory epithelium.

    Science.gov (United States)

    Rashwan, Ahmed; Konishi, Hiroyuki; El-Sharaby, Ashraf; Kiyama, Hiroshi

    2016-01-01

    We investigated the relationship between mouse taste bud development and innervation of the soft palate. We employed scanning electron microscopy and immunohistochemistry using antibodies against protein gene product 9.5 and peripherin to detect sensory nerves, and cytokeratin 8 and α-gustducin to stain palatal taste buds. At E14, nerve fibers were observed along the medial border of the palatal shelves that tracked toward the epithelium. At E15.5, primordial stages of taste buds in the basal lamina of the soft palate first appeared. At E16, the taste buds became large spherical masses of columnar cells scattered in the soft palate basal lamina. At E17, the morphology and also the location of taste buds changed. At E18-19, some taste buds acquired a more elongated shape with a short neck, extending a variable distance from the soft palate basal lamina toward the surface epithelium. At E18, mature taste buds with taste pores and perigemmal nerve fibers were observed on the surface epithelium of the soft palate. The expression of α-gustducin was demonstrated at postnatal day 1 and the number of pored taste buds increased with age and they became pear-shaped at 8 weeks. The percent of pored fungiform-like papillae at birth was 58.3% of the whole palate; this increased to 83.8% at postnatal day 8 and reached a maximum of 95.7% at 12 weeks. The innervation of the soft palate was classified into three types of plexuses in relation to taste buds: basal nerve plexus, intragemmal and perigemmal nerve fibers. This study reveals that the nerve fibers preceded the development of taste buds in the palate of mice, and therefore the nerve fibers have roles in the initial induction of taste buds in the soft palate. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla

    DEFF Research Database (Denmark)

    Andersen, Kristian; Nørholt, Sven Erik; Küseler, Annelise

    2012-01-01

    A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla......A Retrospective Study of Cleft lip and palate Patients' Satisfaction after Maxillary Distraction or Traditional Advancement of the Maxilla...

  4. Development of the first permanent mandibular molar in young children with unilateral complete cleft lip and palate (UCCLP)

    DEFF Research Database (Denmark)

    Hermann, Nuno Vibe; Darvann, Tron A; Kreiborg, Sven

    Development of the first permanent mandibular molar in young children with unilateral complete cleft lip and palate (UCCLP)......Development of the first permanent mandibular molar in young children with unilateral complete cleft lip and palate (UCCLP)...

  5. Cone-Beam Computed Tomography Analysis of the Nasopharyngeal Airway in Nonsyndromic Cleft Lip and Palate Subjects.

    Science.gov (United States)

    Al-Fahdawi, Mahmood Abd; Farid, Mary Medhat; El-Fotouh, Mona Abou; El-Kassaby, Marwa Abdelwahab

    2017-03-01

      To assess the nasopharyngeal airway volume, cross-sectional area, and depth in previously repaired nonsyndromic unilateral cleft lip and palate versus bilateral cleft lip and palate patients compared with noncleft controls using cone-beam computed tomography with the ultimate goal of finding whether cleft lip and palate patients are more liable to nasopharyngeal airway obstruction.   A retrospective analysis comparing bilateral cleft lip and palate, unilateral cleft lip and palate, and control subjects. Significance at P ≤ .05.   Cleft Care Center and the outpatient clinic that are both affiliated with our faculty.   Cone-beam computed tomography data were selected of 58 individuals aged 9 to 12 years: 14 with bilateral cleft lip and palate and 20 with unilateral cleft lip and palate as well as 24 age- and gender-matched noncleft controls.   Volume, depth, and cross-sectional area of nasopharyngeal airway were measured.   Patients with bilateral cleft lip and palate showed significantly larger nasopharyngeal airway volume than controls and patients with unilateral cleft lip and palate (P cleft lip and palate showed significantly larger cross-sectional area than those with unilateral cleft lip and palate (P .05). Patients with bilateral cleft lip and palate showed significantly larger depth than controls and those with unilateral cleft lip and palate (P cleft lip and palate showed insignificant nasopharyngeal airway volume, cross-sectional area, and depth compared with controls (P > .05).   Unilateral and bilateral cleft lip and palate patients did not show significantly less volume, cross-sectional area, or depth of nasopharyngeal airway than controls. From the results of this study we conclude that unilateral and bilateral cleft lip and palate patients at the studied age and stage of repaired clefts are not more prone to nasopharyngeal airway obstruction than controls.

  6. The palatability of oral nutritional supplements : before, during, and after chemotherapy

    NARCIS (Netherlands)

    IJpma, Irene; Renken, Remco J.; ter Horst, Gert J.; Reyners, Anna K. L.

    2016-01-01

    Oral nutritional supplements (ONS) are commonly prescribed to malnourished patients to improve their nutritional status. Taste and smell changes in patients with cancer can affect the palatability of ONS. The present study investigated: (1) the palatability of six ONS in testicular cancer patients

  7. Unilateral cleft lip and palate : treatment outcome and long-term craniofacial growth

    NARCIS (Netherlands)

    Nollet, Petrus Josephus Paulinus Maria

    2006-01-01

    Treatment results of children with a complete Unilateral Cleft Lip and Palate (UCLP) from the Cleft Palate Craniofacial Unit of the Radboud University Nijmegen Medical Centre were evaluated and compared with prominent European cleft centers. Treatment outcome of the Nijmegen patients with UCLP and

  8. Nasalance Scores of Children with Repaired Cleft Palate Who Exhibit Normal Velopharyngeal Closure during Aerodynamic Testing

    Science.gov (United States)

    Zajac, David J.

    2013-01-01

    Purpose: To determine if children with repaired cleft palate and normal velopharyngeal (VP) closure as determined by aerodynamic testing exhibit greater acoustic nasalance than control children without cleft palate. Method: Pressure-flow procedures were used to identify 2 groups of children based on VP closure during the production of /p/ in the…

  9. EVIDENCE FOR EGFR PATHWAY MEDIATION OF CLEFT PALATE INDUCTION BY TCDD

    Science.gov (United States)

    EVIDENCE FOR EGFR PATHWAY MEDIATION OF CLEFT PALATE INDUCTION BY TCDD. B D Abbott, A R Buckalew, and K E Leffler. RTD, NHEERL, ORD,US EPA, RTP, NC, USA.2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is teratogenic in C57BL/6J mice, producing cleft palate (CP) after exposure...

  10. A Demonstration Project of Speech Training for the Preschool Cleft Palate Child. Final Report.

    Science.gov (United States)

    Harrison, Robert J.

    To ascertain the efficacy of a program of language and speech stimulation for the preschool cleft palate child, a research and demonstration project was conducted using 137 subjects (ages 18 to 72 months) with defects involving the soft palate. Their language and speech skills were matched with those of a noncleft peer group revealing that the…

  11. Changes in the palatal dimensions of mouth breathing children caused by nasal obstruction

    Science.gov (United States)

    Indiarti, I. S.; Setyanto, D. B.; Kusumaningrum, A.; Budiardjo, S. B.

    2017-08-01

    During children’s growth and development, the breathing process plays an important role in craniofacial growth, especially of the palate. Nose breathing can stimulate the lateral growth of the maxilla, thus making the palate flat. Disturbances in nose breathing caused by nasal obstruction such as allergic rhinitis, adenoid hypertrophy, rhinosinusitis, nasal polyps, and obstructive sleep apnea can lead to a mouth breathing habit in children. This habit can cause palatal dimension changes such as a narrow V-shaped maxillary arch and a high palatal vault. This study analyzed the relationship between the mouth breathing habit in children who have nasal obstruction and palatal dimension changes. A cross-sectional descriptive study was conducted with a consecutive sampling method on children 7-18 years old with a history of allergic rhinitis, adenoid hypertrophy, rhinosinusitis, nasal polyps, and obstructive sleep apnea in the Pediatric Respirology and Pediatric Immunology Allergy Outpatient Clinic Kiara Maternal and Child Health Center at Cipto Mangunkusumo Hospital in Jakarta. The palatal dimensions were measured by the height and transversal width of the hard palate of castings of each child’s upper dental arch using vernier calipers. Palatal dimension changes were found in children with a mouth breathing habit due to nasal obstruction.

  12. Validation of 3D documentation of palatal soft tissue shape, color, and irregularity with intraoral scanning

    NARCIS (Netherlands)

    Deferm, Julie T.; Schreurs, Ruud; Baan, Frank; Bruggink, Robin; Merkx, Matthijs A. W.; Xi, Tong; Bergé, Stefaan J.; Maal, Thomas J. J.

    2017-01-01

    The purpose of this study was to assess the feasibility of 3D intraoral scanning for documentation of palatal soft tissue by evaluating the accuracy of shape, color, and curvature. Intraoral scans of ten participants' upper dentition and palate were acquired with the TRIOS® 3D intraoral scanner by

  13. Palatal Rugae Pattern as an Aid for Personal Identification: A Forensic Study

    Directory of Open Access Journals (Sweden)

    R Kamala

    2011-01-01

    Conclusion: No two palates are alike in their configuration and once formed, they do not undergo any changes except in length due to normal growth, remaining in the same position throughout a person′s entire life. Thus, palatal rugae appear to possess the features of an ideal forensic identification parameter, i.e. uniqueness, postmortem resistance and stability, provided antemortem record exists.

  14. Quantitative assessment of palatal bone thickness in an ethnic Indian population: A computed tomography study

    Directory of Open Access Journals (Sweden)

    Ganesan Jayakumar

    2012-01-01

    Conclusions: Despite the palatal bone being thickest in the mid-palatal suture (MPS region, this is not the ideal site for anchorage purposes due to inadequate calcification and interposition of connective tissue, especially in young growing children. So, the alternate optimum position is the paramedian region, 3 mm lateral to the MPS and 4 mm from the incisive foramen (IF.

  15. Cleft lip and palate: the Jos exprience | Orkar | East African Medical ...

    African Journals Online (AJOL)

    Objective: To determine the pattern of occurrence of cleft lip/palate and the factors that may have influenced treatment outcome. Design: Descriptive Study. Setting: Jos University Teaching Hospital, Jos, Nigeria. Subject: This study included 107 consecutive patients with cleft lip/palate managed between January 1991 and ...

  16. Receptive and expressive language performance in children with and without Cleft Lip and Palate.

    Science.gov (United States)

    Lamônica, Dionísia Aparecida Cusin; Silva-Mori, Mariana Jales Felix da; Ribeiro, Camila da Costa; Maximino, Luciana Paula

    2016-01-01

    To compare the performance in the abilities of receptive and expressive language of children with cleft lip and palate with that of children without cleft lip and palate with typical 12 to 36-month chronological development. The sample consisted of 60 children aged 12 and 36 months: 30 with cleft lip and palate diagnosis and 30 without cleft lip and palate diagnosis with typical development. The groups were paired according to gender, age (in months), and socioeconomic level. The procedures consisted of analysis of medical records, anamnesis with family members, and valuation of the Early Language Milestone Scale (ELMS). The chart analysis showed 63.34% of the children with unilateral cleft lip and palate, 16.66% with bilateral incisive transforamen cleft, and 20% with post-foramen cleft. Children with cleft lip and palate underwent surgeries (lip repair and/or palatoplasty) at the recommended ages and participated in early intervention programs; 40% presented recurrent otitis history, and 50% attended schools. Statistical analysis included the use of the Mann Whitney test with significance level of p cleft lip and palate showed statistically significant low performance in receptive and expressive language compared with children without cleft lip and palate.

  17. Early Predictors of Attachment in Infants with Cleft Lip and/or Palate.

    Science.gov (United States)

    Speltz, Matthew L.; And Others

    1997-01-01

    Examined attachment classification of children with cleft lip and palate (CLP) and isolated cleft palate (ICP) and comparison group at 12 months of age; found no significant differences. Findings suggest that infants with clefts, despite special needs and caregiving requirements, seem not to have elevated risk for insecure attachments at the end…

  18. Current Controversies in Diagnosis and Management of Cleft Palate and Velopharyngeal Insufficiency

    Science.gov (United States)

    Ysunza, Pablo Antonio; Repetto, Gabriela M.; Pamplona, Maria Carmen; Calderon, Juan F.; Shaheen, Kenneth; Chaiyasate, Konkgrit; Rontal, Matthew

    2015-01-01

    Background. One of the most controversial topics concerning cleft palate is the diagnosis and treatment of velopharyngeal insufficiency (VPI). Objective. This paper reviews current genetic aspects of cleft palate, imaging diagnosis of VPI, the planning of operations for restoring velopharyngeal function during speech, and strategies for speech pathology treatment of articulation disorders in patients with cleft palate. Materials and Methods. An updated review of the scientific literature concerning genetic aspects of cleft palate was carried out. Current strategies for assessing and treating articulation disorders associated with cleft palate were analyzed. Imaging procedures for assessing velopharyngeal closure during speech were reviewed, including a recent method for performing intraoperative videonasopharyngoscopy. Results. Conclusions from the analysis of genetic aspects of syndromic and nonsyndromic cleft palate and their use in its diagnosis and management are presented. Strategies for classifying and treating articulation disorders in patients with cleft palate are presented. Preliminary results of the use of multiplanar videofluoroscopy as an outpatient procedure and intraoperative endoscopy for the planning of operations which aimed to correct VPI are presented. Conclusion. This paper presents current aspects of the diagnosis and management of patients with cleft palate and VPI including 3 main aspects: genetics and genomics, speech pathology and imaging diagnosis, and surgical management. PMID:26273595

  19. Current Controversies in Diagnosis and Management of Cleft Palate and Velopharyngeal Insufficiency

    Directory of Open Access Journals (Sweden)

    Pablo Antonio Ysunza

    2015-01-01

    Full Text Available Background. One of the most controversial topics concerning cleft palate is the diagnosis and treatment of velopharyngeal insufficiency (VPI. Objective. This paper reviews current genetic aspects of cleft palate, imaging diagnosis of VPI, the planning of operations for restoring velopharyngeal function during speech, and strategies for speech pathology treatment of articulation disorders in patients with cleft palate. Materials and Methods. An updated review of the scientific literature concerning genetic aspects of cleft palate was carried out. Current strategies for assessing and treating articulation disorders associated with cleft palate were analyzed. Imaging procedures for assessing velopharyngeal closure during speech were reviewed, including a recent method for performing intraoperative videonasopharyngoscopy. Results. Conclusions from the analysis of genetic aspects of syndromic and nonsyndromic cleft palate and their use in its diagnosis and management are presented. Strategies for classifying and treating articulation disorders in patients with cleft palate are presented. Preliminary results of the use of multiplanar videofluoroscopy as an outpatient procedure and intraoperative endoscopy for the planning of operations which aimed to correct VPI are presented. Conclusion. This paper presents current aspects of the diagnosis and management of patients with cleft palate and VPI including 3 main aspects: genetics and genomics, speech pathology and imaging diagnosis, and surgical management.

  20. Survival of palatal miniscrews used for orthodontic appliance anchorage: a retrospective cohort study

    NARCIS (Netherlands)

    Karagkiolidou, A.; Ludwig, B.; Pazera, P.; Gkantidis, N.; Pandis, N.; Katsaros, C.

    2013-01-01

    INTRODUCTION: The purpose of this study was to examine the overall success of miniscrews inserted in the paramedian palatal region for support of various appliances during orthodontic treatment. METHODS: The patients received 1 or 2 miniscrews in the paramedian anterior palate of 8.0-mm length and

  1. Assessment of Speech in Primary Cleft Palate by Two‑layer Closure ...

    African Journals Online (AJOL)

    the term “obturateur” to describe the plates of gold and silver used to occlude palatal ... complete cleft lip/palate), age at palatoplasty, preoperative and post operative ... in all these patients to free the tensor veli palatine tendon to facilitate the ...

  2. Speech Production in 3-Year-Old Internationally Adopted Children with Unilateral Cleft Lip and Palate

    Science.gov (United States)

    Larsson, AnnaKarin; Schölin, Johnna; Mark, Hans; Jönsson, Radi; Persson, Christina

    2017-01-01

    Background: In the last decade, a large number of children with cleft lip and palate have been adopted to Sweden. A majority of the children were born in China and they usually arrive in Sweden with an unoperated palate. There is currently a lack of knowledge regarding speech and articulation development in this group of children, who also have to…

  3. Dental fear in children with a cleft lip and/or cleft Palate

    NARCIS (Netherlands)

    Vogels, W.E.J.C.; Aartman, I.H.A.; Veerkamp, J.S.J.

    2011-01-01

    Objective: To assess the level of dental fear in children with a cleft lip and/or palate, to compare this level with that of a normative group testing the hypothesis that children with a cleft lip and/or palate have a higher level of dental anxiety than children from the general population, and to

  4. Bright Promise for Your Child with Cleft Lip and Cleft Palate. Revised Edition.

    Science.gov (United States)

    McDonald, Eugene T.; Berlin, Asa J.

    Intended for parents of children with cleft lip and cleft palate, the booklet provides an overview of the condition. Addressed are the following topics (sample subtopics in parentheses): prenatal development and birth defects (facial development); possible causes of cleft lip/cleft palate (common misconceptions, genetic factors, environmental…

  5. Psychosocial Aspects of Cleft Lip and Palate: Implications for Parental Education. Research Report 138.

    Science.gov (United States)

    Kalland, Mirjam

    This study focused on the psychosocial aspects of cleft lip and/or palate on maternal emotional reactions and the family, with emphasis on the effect on the maternal-infant bond. Interviews were conducted with 40 mothers of 1-year-old infants with non-syndromic cleft lip and/or palate. The interviews were analyzed using the phenomenological…

  6. Cleft Lip and Cleft Palate--What to Know and Who Can Help

    Science.gov (United States)

    Apel, Laura

    2008-01-01

    Craniofacial defects such as cleft lip and cleft palate are among the most common of all birth defects in the United States, with one in every 600 newborns affected. Cleft lip and/or palate can occur as an isolated condition or may be one component of an inherited disease or syndrome. Dealing with the condition is an extremely difficult and…

  7. Orthodontic treatment of a stubborn palatally ectopic canine: a case report.

    Science.gov (United States)

    Al-Musfir, Tumadher M; Morris, David O

    2014-03-01

    This is a case report that highlights a different treatment approach in dealing with palatally ectopic canines. The modified transpalatal arch with an 'active' arm was used to align a palatally ectopic canine with 'push' mechanics after the initial use of more conventional 'pull' mechanics (piggy-back archwire technique) had failed.

  8. In vitro migration and adhesion of fibroblasts from different phases of palatal wound healing.

    NARCIS (Netherlands)

    Beurden, H.E. van; Snoek, P.A.; Hoff, J.W. Von den; Torensma, R.; Maltha, J.C.; Kuijpers-Jagtman, A.M.

    2006-01-01

    Cleft palate patients often show mid-facial growth impairment after surgical closure of the defect. This is a consequence of palatal wound healing, and more specifically of wound contraction and scar tissue formation. Cells of the fibroblast lineage are responsible for these processes and they

  9. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Lohmander, Anette; Persson, Christina

    2017-01-01

    Background and aim: Normal articulation before school start is a main objective in cleft palate treatment. The aim was to investigate if differences exist in consonant proficiency at age 5 years between children with unilateral cleft lip and palate (UCLP) randomised to different surgical protocol...

  10. Disruption of epithelial cell migration as a potential mechanism of cleft palate induction

    Science.gov (United States)

    Cleft palate occurs in about one in seven hundred births per year, making it the most prevalent craniofacial birth defect in the world. During embryonic development, tissue fusion is a critical step in the formation of the palate, cornea, urethra, and neural tube. Epithelial cell...

  11. Techniques and outcome of repair of cleft of the secondary palate at ...

    African Journals Online (AJOL)

    Background: The technique adopted in the repair of cleft of the secondary palate must not just be based on the choice of the surgeon but on several factors which include the width of the cleft, length of palate and age of the patient. The aim of the article was to document our 4-year experience of the techniques and outcome ...

  12. One-flap Palatoplasty: A Cohort Study to Evaluate a Technique for Unilateral Cleft Palate Repair

    Directory of Open Access Journals (Sweden)

    Percy Rossell-Perry, PhD, FACS

    2015-04-01

    Conclusions: Use of a 1-flap technique for unilateral cleft palate repair allowed us to achieve results comparable to those of a 2-flap technique in terms of postoperative fistula development and hypernasal speech. Additional studies are required to evaluate the effect of this technique on palatal growth.

  13. Epidemiology, Etiology, and Treatment of Isolated Cleft Palate

    Science.gov (United States)

    Burg, Madeleine L.; Chai, Yang; Yao, Caroline A.; Magee, William; Figueiredo, Jane C.

    2016-01-01

    Isolated cleft palate (CPO) is the rarest form of oral clefting. The incidence of CPO varies substantially by geography from 1.3 to 25.3 per 10,000 live births, with the highest rates in British Columbia, Canada and the lowest rates in Nigeria, Africa. Stratified by ethnicity/race, the highest rates of CPO are observed in non-Hispanic Whites and the lowest in Africans; nevertheless, rates of CPO are consistently higher in females compared to males. Approximately fifty percent of cases born with cleft palate occur as part of a known genetic syndrome or with another malformation (e.g., congenital heart defects) and the other half occur as solitary defects, referred to often as non-syndromic clefts. The etiology of CPO is multifactorial involving genetic and environmental risk factors. Several animal models have yielded insight into the molecular pathways responsible for proper closure of the palate, including the BMP, TGF-β, and SHH signaling pathways. In terms of environmental exposures, only maternal tobacco smoke has been found to be strongly associated with CPO. Some studies have suggested that maternal glucocorticoid exposure may also be important. Clearly, there is a need for larger epidemiologic studies to further investigate both genetic and environmental risk factors and gene-environment interactions. In terms of treatment, there is a need for long-term comprehensive care including surgical, dental and speech pathology. Overall, five main themes emerge as critical in advancing research: (1) monitoring of the occurrence of CPO (capacity building); (2) detailed phenotyping of the severity (biology); (3) understanding of the genetic and environmental risk factors (primary prevention); (4) access to early detection and multidisciplinary treatment (clinical services); and (5) understanding predictors of recurrence and possible interventions among families with a child with CPO (secondary prevention). PMID:26973535

  14. Bite force evaluation in subjects with cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Carla Renata Sipert

    2009-04-01

    Full Text Available The purpose of this study was to evaluate the masticatory function of subjects with cleft lip and palate by analyzing the bite force developed by these individuals. Bite force was evaluated in a group of 27 individuals with repaired unilateral cleft lip and palate (14 males and 13 females - aged 18-26 years and compared to the data achieved from a group of 20 noncleft subjects (10 males and 10 females - aged 18-26 years. Measurement was achieved on three positions within the dental arch (incisors, right molars and left molars, three times at each position considering the highest value for each one. Statistical analysis was performed by ANOVA and Mann-Whitney test ( α = 5%. There was a significant deficit in bite force in male individuals with cleft lip and palate compared to the male control group (p=0.02, p=0.004, p=0.003 for incisors, right and left molars, respectively. For the female group, the difference was not statistically significant (p=0.79, p=0.06, p=0.47. In the group of individuals with clefts, 92.6% were under orthodontic treatment, which could be a reason for the present findings, since it can decrease the bite force more remarkably in males than in females. In conclusion, the bite force is significantly reduced in men when comparing the cleft group to the noncleft group. In females, this reduction was not significant in the same way. However, the main reason for this reduction and for the different behavior between genders should be further investigated.

  15. Protein Hydrolysates as Hypoallergenic, Flavors and Palatants for Companion Animals

    Science.gov (United States)

    Nagodawithana, Tilak W.; Nelles, Lynn; Trivedi, Nayan B.

    Early civilizations have relied upon their good sense and experience to develop and improve their food quality. The discovery of soy sauce centuries ago can now be considered one of the earliest protein hydrolysates made by man to improve palatability of foods. Now, it is well known that such savory systems are not just sources for enjoyment but complex semiotic systems that direct the humans to satisfy the body's protein need for their sustenance. Recent developments have resulted in a wide range of cost effective savory flavorings, the best known of which are autolyzed yeast extracts and hydrolyzed vegetable proteins. New technologies have helped researchers to improve the savory characteristics of yeast extracts through the application of Maillard reaction and by generating specific flavor enhancers through the use of enzymes. An interesting parallel exists in the pet food industry, where a similar approach is taken in using animal protein hydrolysates to create palatability enhancers via Maillard reaction scheme. Protein hydrolysates are also utilized extensively as a source of nutrition to the elderly, young children and immuno-compromised patient population. These hydrolysates have an added advantage in having peptides small enough to avoid any chance of an allergenic reaction which sometimes occur with the consumption of larger sized peptides or proteins. Accordingly, protein hydrolysates are required to have an average molecular weight distribution in the range 800-1,500 Da to make them non-allergenic. The technical challenge for scientists involved in food and feed manufacture is to use an appropriate combination of enzymes within the existing economic constraints and other physical factors/limitations, such as heat, pH, and time, to create highly palatable, yet still nutritious and hypoallergenic food formulations.

  16. Effect of tension-free vaginal tape and TVT-obturator on lower urinary tract symptoms other than stress urinary incontinence.

    Science.gov (United States)

    Ballert, Katie N; Kanofsky, Jamie A; Nitti, Victor W

    2008-03-01

    Variable effects on lower urinary tract symptoms (LUTS) other than stress urinary incontinence (SUI) have been reported after tension-free vaginal tape (TVT). We measured the effect of TVT on LUTS using the American Urological Association Symptom Index (AUASI). Patients undergoing TVT completed the AUASI pre- and post-operatively. Total scores (TS), storage scores (SS), and voiding scores (VS) were compared overall and among patients with SUI vs mixed urinary incontinence (MUI) and those who underwent TVT vs TVT-obturator (TVT-O). The mean change in TS and SS was -3.6 and -3.0. Mean reductions in TS and SS were significant in all patient subsets with no change in VS. There was no significant difference in the mean changes in TS between patients with SUI vs MUI or those undergoing TVT vs TVT-O. LUTS are improved after TVT in most patients. In general, voiding symptoms were not adversely affected.

  17. Necrotizing sialometaplasia of the palate: A case report

    Directory of Open Access Journals (Sweden)

    Ashwarya Trivedi

    2014-01-01

    Full Text Available Necrotizing sialometaplasia is a benign, self-limiting, reactive inflammatory disorder of the salivary tissue, which mimics malignancy both clinically and histopathologically. The etiology is unknown, although it most likely represents a local ischemic event, infectious process or perhaps an immune response to an unknown allergen. A case of necrotizing sialometaplasia of the palate in a 40-year-old male patient is presented. Histopathological examination is necessary for the diagnosis of necrotizing sialometaplasia because the clinical features of this condition can mimic other diseases, particularly malignant neoplasms.

  18. Anophthalmia with cleft palate and micrognathia: a new syndrome?

    Science.gov (United States)

    Phadke, S R; Sharma, A K; Agarwal, S S

    1994-01-01

    A 5 day old male with bilateral anophthalmos, hypospadias, bifid scrotum, micrognathia, and cleft palate with normal chromosomes is described. There have been two case reports with similar clinical manifestations but associated with interstitial deletion of 14q (q22q23). We propose that either our patient represents a new syndrome or has a microdeletion which could not be detected on routine cytogenetics. High quality cytogenetics and FISH may show microdeletions in patients presenting with this clinical picture and normal chromosomes. Images PMID:7891380

  19. Ectrodactyly-ectodermal dysplasia-cleft lip and palate syndrome

    Directory of Open Access Journals (Sweden)

    Reema Sharma Dhar

    2014-01-01

    Full Text Available Ectrodactyly-ectodermal dysplasia-cleft (EEC syndrome is an autosomal dominant disorder characterized by the triad of ectrodactyly-ectodermal dysplasia, and facial clefting along with some associated features. Presence of all the three major features in a single individual is extremely rare. We report a case of 4 year 11 months old child with EEC syndrome having ectodermal dysplasia-cleft lip and cleft palate and ectrodactyly with some associated features. Clinical features, diagnosis and role of a dentist in the multidisciplinary treatment approach have been elaborated in this case report.

  20. Ectrodactyly-ectodermal dysplasia-cleft lip and palate syndrome.

    Science.gov (United States)

    Dhar, Reema Sharma; Bora, Amitava

    2014-01-01

    Ectrodactyly-ectodermal dysplasia-cleft (EEC) syndrome is an autosomal dominant disorder characterized by the triad of ectrodactyly-ectodermal dysplasia, and facial clefting along with some associated features. Presence of all the three major features in a single individual is extremely rare. We report a case of 4 year 11 months old child with EEC syndrome having ectodermal dysplasia-cleft lip and cleft palate and ectrodactyly with some associated features. Clinical features, diagnosis and role of a dentist in the multidisciplinary treatment approach have been elaborated in this case report.

  1. Orbicularis oris musculomucosal flap for anterior palatal fistula

    Directory of Open Access Journals (Sweden)

    Tiwari V

    2006-01-01

    Full Text Available Anterior palatal fistulae or residual anterior clefts are a frequent problem following palatoplasty. Various techniques have been used to repair such fistulae, each having its own advantages and disadvantages. We have successfully used orbicularis oris musculomucosal flap to close anterior fistula and residual clefts in 25 patients. This study shows the superiority of this flap over other techniques because of its reliable blood supply, easy elevation and transfer to fistula site and finally because it is a single-stage procedure.

  2. A novel route for placing free flap pedicle from a palatal defect

    Directory of Open Access Journals (Sweden)

    Rajeev B Ahuja

    2014-01-01

    Full Text Available One of the better options available to repair a large palatal defect is by employing a free flap. Almost all the times such free flaps are plumbed to facial vessels. The greatest challenge in such cases is the placement of the pedicle from palatal shelf to recipient vessels because there is no direct route available. As majority of large palatal fistulae are encountered in operated cleft palates there is a possibility of routing the pedicle through a cleft in the maxillary arch or via pyriform aperture. When such a possibility doesn′t exist the pedicle is routed behind the maxillary arch. We describe a novel technique of pedicle placement through a maxillary antrostomy, in this case report, where a large palatal fistula in a 16 year old boy was repaired employing a free radial artery forearm flap. The direct route provided by maxillary antrostomy is considered the most expeditious of all possibilities mentioned above.

  3. Analysis of the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair.

    Science.gov (United States)

    Chen, Qi; Li, Yang; Shi, Bing; Yin, Heng; Zheng, Guang-Ning; Zheng, Qian

    2013-12-01

    The objective of this study was to analyze the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair. Ninety-five nonsyndromic patients with cleft palate were enrolled. Two surgical techniques were applied in the patients: simple palatoplasty and combined palatoplasty with pharyngoplasty. All patients were assessed 6 months after the operation. The postoperative velopharyngeal closure (VPC) rate was compared by χ(2) test and the correlative factors were analyzed with logistic regression model. The postoperative VPC rate of young patients was higher than that of old patients, the group with incomplete cleft palate was higher than the group with complete cleft palate, and combined palatoplasty with pharyngoplasty was higher than simple palatoplasty. Operative age, cleft type, and surgical technique were the contributing factors for postoperative VPC rate. Operative age, cleft type, and surgical technique were significant factors influencing postoperative VPC rate of patients with cleft palate. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Long term follow up study of survival associated with cleft lip and palate at birth

    DEFF Research Database (Denmark)

    Christensen, Kaare; Juel, K.; Herskind, Anne Maria

    2004-01-01

    OBJECTIVE: To assess the overall and cause specific mortality of people from birth to 55 years with cleft lip and palate. DESIGN: Long term follow up study. SETTING: Danish register of deaths. PARTICIPANTS: People born with cleft lip and palate between 1943 and 1987, followed to 1998. MAIN OUTCOME...... MEASURES: Observed and expected numbers of deaths, summarised as overall and cause specific standardised mortality ratios. RESULTS: 5331 people with cleft lip and palate were followed for 170 421 person years. The expected number of deaths was 259, but 402 occurred, corresponding to a standardised...... of death. CONCLUSIONS: People with cleft lip and palate have increased mortality up to age 55. Children born with cleft lip and palate and possibly other congenital malformations may benefit from specific preventive health measures into and throughout adulthood....

  5. Study of relationship between clinical factors and velopharyngeal closure in cleft palate patients

    Science.gov (United States)

    Chen, Qi; Zheng, Qian; Shi, Bing; Yin, Heng; Meng, Tian; Zheng, Guang-ning

    2011-01-01

    BACKGROUND: This study was carried out to analyze the relationship between clinical factors and velopharyngeal closure (VPC) in cleft palate patients. METHODS: Chi-square test was used to compare the postoperative velopharyngeal closure rate. Logistic regression model was used to analyze independent variables associated with velopharyngeal closure. RESULTS: Difference of postoperative VPC rate in different cleft types, operative ages and surgical techniques was significant (P=0.000). Results of logistic regression analysis suggested that when operative age was beyond deciduous dentition stage, or cleft palate type was complete, or just had undergone a simple palatoplasty without levator veli palatini retropositioning, patients would suffer a higher velopharyngeal insufficiency rate after primary palatal repair. CONCLUSIONS: Cleft type, operative age and surgical technique were the contributing factors influencing VPC rate after primary palatal repair of cleft palate patients. PMID:22279464

  6. Short mandible - a possible risk factor for cleft palate with/without a cleft lip

    DEFF Research Database (Denmark)

    Hermann, Nuno Vibe; Darvann, Tron Andre; Ersbøll, Bjarne Kjær

    2014-01-01

    Structured Abstract Objectives To estimate the influence of a short mandible on the risk of developing a cleft palate with/without a cleft lip (CP). Setting and sample population The retrospective sample consisted of 115 2-month-old Danish infants with CP, and 70 control infants with unilateral...... the risk of having a cleft palate. Results The mean mandibular length in the group with CP was about 4mm shorter than in the control group. Odds ratio (OR) was calculated to be 0.58 (95% confidence interval 0.48-0.68), implying that an individual's risk of cleft palate with/without a cleft lip increases...... about 50% per mm decrease in mandibular length. Conclusions A special facial type including a short mandible is a possible risk factor for cleft palate, and it was found that the risk of cleft palate increases 58% per mm decreases in mandibular length....

  7. Induction of cleft palate in newborn pigs by maternal ingestion of poison hemlock (Conium maculatum).

    Science.gov (United States)

    Panter, K E; Keeler, R F; Buck, W B

    1985-06-01

    Cleft palates were induced in newborn pigs of gilts fed Conium maculatum seed or plant during gestation days 30 through 45. Twelve of 23 newborn pigs born to 3 gilts given Utah-grown C maculatum seed and 9 of 12 newborn pigs born to a single gilt given the fresh Utah spring-growth C maculatum plant had cleft palates. The cleft palates ranged from a unilateral cleft, involving only 1 side of the palate, to a full bilateral cleft. Brachygnathia was also observed in some of these newborn pigs with cleft palate. Other malformations were not observed. Chemical analysis of seed and plant samples indicated that gamma-coniceine was the responsible teratogenic alkaloid. A daily dose of plant or seed that provided greater than or equal to 1.07 mg of gamma-coniceine/kg of body weight fed to gilts during the 30th through the 45th day of pregnancy resulted in teratogenic effects.

  8. Prevalence of dental anomalies of number in different subphenotypes of isolated cleft palate.

    Science.gov (United States)

    Schwartz, João Paulo; Somensi, Daniele Salazar; Yoshizaki, Priscila; Reis, Luciana Laís Savero; de Cássia Moura Carvalho Lauris, Rita; da Silva Filho, Omar Gabriel; Dalbén, Gisele; Garib, Daniela Gamba

    2014-01-01

    This study aimed at carrying out a radiographic analysis on the prevalence of dental anomalies of number (agenesis and supernumerary teeth) in permanent dentition, in different subphenotypes of isolated cleft palate preadolescent patients. Panoramic radiographs of 300 patients aged between 9 and 12 years, with cleft palate and enrolled in a single treatment center, were retrospectively analyzed. The sample was divided into two groups according to the extension/severity of the cleft palate: complete and incomplete. The chi-square test was used for intergroup comparison regarding the prevalence of the investigated dental anomalies (Pdental anomalies of number in preadolescents with cleft palate was higher than that reported for the general population. The severity of cleft palate did not seem to be associated with the prevalence of dental anomalies of number.

  9. Dentofacial morphology in adolescent or early adult patients with cleft lip and palate after a treatment regimen that included vomer flap surgery and pushback palatal repair.

    Science.gov (United States)

    Friede, H; Lilja, J

    1994-06-01

    Dentofacial morphology was evaluated in 94 adolescent or early adult patients born with unilateral or bilateral cleft lip and palate. As well as lip closure, the primary treatment included vomer flap surgery and pushback palatal repair. Roentgencephalometric measurements as well as classification of the patients into different classes of dentofacial deformity indicated development of bimaxillary retrognathia with severe midfacial deficiency in about a quarter of the cases. Our results were similar to those reported by other teams who used similar surgical regimen.

  10. Speech in Adults Treated for Unilateral Cleft Lip and Palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair.

    Science.gov (United States)

    Morén, Staffan; Mani, Maria; Lilian, Stålhammar; Lindestad, Per Åke; Holmström, Mats

    2017-11-01

      To evaluate speech in adults treated for unilateral cleft lip and palate with one-stage or two-stage palate closure and compare the speech of the patients with that of a noncleft control group.   Cross-sectional study with long-term follow-up.   All unilateral cleft lip and palate patients born from 1960 to 1987 and treated at Uppsala University Hospital, Sweden, were invited (n = 109). Participation rate was 67% (n = 73) at a mean of 35 years after primary surgery. Forty-seven had been treated according to one-stage palate closure and 26 according to two-stage palate closure. Pharyngeal flap surgery had been performed in 11 of the 73 patients (15%). The noncleft control group consisted of 63 age-matched volunteers.   Speech-language pathologists rated perceptual speech characteristics from blinded audio recordings.   Among patients, seven (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one (2%) had reduced intelligibility. Controls had no audible signs of velopharyngeal insufficiency and no quantifiable problems with the other speech production variables. No significant differences were identified between patients treated with one-stage and two-stage palate closure for any of the variables.   The prevalence of speech outcome indicative of velopharyngeal insufficiency among adult patients treated for unilateral cleft lip and palate was low but higher compared with individuals without cleft. Whether palatal closure is performed in one or two stages does not seem to affect the speech outcome at a mean age of 35 years.

  11. Feeding interventions for growth and development in infants with cleft lip, cleft palate or cleft lip and palate.

    Science.gov (United States)

    Bessell, Alyson; Hooper, Lee; Shaw, William C; Reilly, Sheena; Reid, Julie; Glenny, Anne-Marie

    2011-02-16

    Cleft lip and cleft palate are common birth defects, affecting about one baby of every 700 born. Feeding these babies is an immediate concern and there is evidence of delay in growth of children with a cleft as compared to those without clefting. In an effort to combat reduced weight for height, a variety of advice and devices are recommended to aid feeding of babies with clefts. This review aims to assess the effects of these feeding interventions in babies with cleft lip and/or palate on growth, development and parental satisfaction. The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 27 October 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4), MEDLINE via OVID (1950 to 27 October 2010), EMBASE via OVID (1980 to 27 October 2010), PsycINFO via OVID (1950 to 27 October 2010) and CINAHL via EBSCO (1980 to 27 October 2010). Attempts were made to identify both unpublished and ongoing studies. There was no restriction with regard to language of publication. Studies were included if they were randomised controlled trials (RCTs) of feeding interventions for babies born with cleft lip, cleft palate or cleft lip and palate up to the age of 6 months (from term). Studies were assessed for relevance independently and in duplicate. All studies meeting the inclusion criteria were data extracted and assessed for validity independently by each member of the review team. Authors were contacted for clarification or missing information whenever possible. Five RCTs with a total of 292 babies, were included in the review. Comparisons made within the RCTs were squeezable versus rigid feeding bottles (two studies), breastfeeding versus spoon-feeding (one study) and maxillary plate versus no plate (two studies). No statistically significant differences were shown for any of the primary outcomes when comparing bottle types, although squeezable bottles were less likely to require

  12. Stress and displacement pattern evaluation using two different palatal expanders in unilateral cleft lip and palate: a three-dimensional finite element analysis.

    Science.gov (United States)

    Mathew, Anoop; Nagachandran, K S; Vijayalakshmi, Devaki

    2016-12-01

    In this finite element (FE) study, the stress distribution and displacement pattern was evaluated in the mid-palatal area and around circum-maxillary sutures exerted by bone-borne palatal expander (BBPE) in comparison with conventional HYRAX rapid palatal expander in unilateral cleft lip and palate. Computed tomography scan images of a patient with unilateral cleft palate was used to create a FE model of the maxillary bone along with circum-maxillary sutures. A three-dimensional model of the conventional HYRAX (Hygienic Rapid Expander) expander and custom-made BBPE was created by laser scanning and programmed into the FE model. With the BBPE, the maximum stress was observed at the implant insertion site, whereas with the conventional HYRAX expander, it was at the dentition level. Among the circum-maxillary sutures, the zygomaticomaxillary suture experienced maximum stress followed by the zygomaticotemporal and nasomaxillary sutures. Displacement in the X-axis (transverse) was highest on the cleft side, and in the Y-axis (antero-posterior), it was highest in the posterior region in the BBPE. The total displacement was observed maximum in the mid-palatal cleft area in the BBPE, and it produced true skeletal expansion at the alveolar level without any dental tipping when compared with the conventional HYRAX expander.

  13. Stress and displacement pattern evaluation using two different palatal expanders in unilateral cleft lip and palate: a three-dimensional finite element analysis

    Directory of Open Access Journals (Sweden)

    Anoop Mathew

    2016-11-01

    Full Text Available Abstract Background In this finite element (FE study, the stress distribution and displacement pattern was evaluated in the mid-palatal area and around circum-maxillary sutures exerted by bone-borne palatal expander (BBPE in comparison with conventional HYRAX rapid palatal expander in unilateral cleft lip and palate. Methods Computed tomography scan images of a patient with unilateral cleft palate was used to create a FE model of the maxillary bone along with circum-maxillary sutures. A three-dimensional model of the conventional HYRAX (Hygienic Rapid Expander expander and custom-made BBPE was created by laser scanning and programmed into the FE model. Results With the BBPE, the maximum stress was observed at the implant insertion site, whereas with the conventional HYRAX expander, it was at the dentition level. Among the circum-maxillary sutures, the zygomaticomaxillary suture experienced maximum stress followed by the zygomaticotemporal and nasomaxillary sutures. Displacement in the X-axis (transverse was highest on the cleft side, and in the Y-axis (antero-posterior, it was highest in the posterior region in the BBPE. Conclusions The total displacement was observed maximum in the mid-palatal cleft area in the BBPE, and it produced true skeletal expansion at the alveolar level without any dental tipping when compared with the conventional HYRAX expander.

  14. Relevance of the palatal protein kinase A pathway to the pathogenesis of cleft palate by secalonic acid D in mice

    International Nuclear Information System (INIS)

    Dhulipala, Vamsidhara C.; Hanumegowda, Umesh M.; Balasubramanian, Ganesh; Reddy, Chada S.

    2004-01-01

    Secalonic acid-D (SAD) is a teratogenic mycotoxin inducing cleft palate (CP) in the offspring of the exposed mice by reducing palatal shelf size secondary to reduced proliferation of the palatal mesenchymal (PM) cells. Co-administration of dimethylsulfoxide (DMSO) reversed the CP-inducing effect of SAD. Although SAD has been shown to affect both protein kinases A (PKA) and C (PKC) pathways, the relevance of each of these pathways to its CP induction is unknown. The present studies were designed to test the hypothesis that the protective effect of DMSO is mediated by its specific reversal of the effect(s) of SAD on one of these two pathways using ELISA-based activity assays, Western blot analysis, electrophoretic mobility shift assays (EMSA), and murine embryonic PM (MEPM) cell growth in culture. Within the PKA pathway, SAD inhibited the activity of the catalytic subunit of PKA and its migration into the nucleus, elevated phosphorylated cyclic AMP (cAMP) response element (CRE)-binding protein (pCREB) level, and reduced the binding of CREB to CRE. In the PKC pathway, SAD reduced the activity of PKC and the binding of transcription factors (TF) to 12-O-tetradecanoate-13 phorbol acetate-response element (TRE). SAD also inhibited MEPM cell growth and the expression of the CRE- and TRE-containing gene, proliferating cell nuclear antigen (PCNA). Reversal, by DMSO, of the effects of SAD on MEPM cell growth, on PCNA expression and on all components of the PKA, but not of PKC, pathway suggests that the perturbation of the PKA pathway by SAD is relevant to its induction of CP in mice

  15. Morphology of bone defects in patient with unilateral cleft lip and palate. Cone beam x-ray CT evaluation

    International Nuclear Information System (INIS)

    Kyo, Iyu; Kubota, Masato; Sato, Yuki; Nakano, Haruhisa; Maki, Koutaro

    2006-01-01

    Orthodontic treatment planning of the cleft lip and palate vary according to the morphology of the alveolar bone and palatal bone. The purpose of this study is to evaluate the three-dimensional anatomy of the alveolar and palatal bone in children with complete unilateral cleft lip and palate. Thirty-three nonsyndromic consecutive patients with complete unilateral cleft lip and palate were treated by the cleft palate team at Showa University. Each patient had lip and palate surgeries at Showa University. Cone beam CT radiographs (CB MercuRay, Hitachi) were taken prior to secondary bone grafting, and were classified according to the method of Kita et al. 1997. Cone beam CT radiographs showed multiple types of alveolar and palatal bone morphology, and focused on special types described in the method of Kita et al. It was most frequently found that bone defects in the alveolar crest showed similar patterns in both buccal and palatal aspect, and the buccal bone defect in the nasal floor was larger than the palatal bone defect in the nasal floor. In 80% of the patients, the palatal bone defect showed similar patterns in both anterior and posterior aspects, and the anterior palatal bone defect was smaller than the posterior palatal bone defect. In addition, inadequate bone bridges were frequently found at the cleft site. It is suggested that patients with unilateral cleft lip and palate have various types of alveolar and palatal bone morphology, and are required to take three-dimensional radiographic X-rays prior to any orthodontic treatment. (author)

  16. Considerations Regarding Age at Surgery and Fistula Incidence Using One- and Two-stage Closure for Cleft Palate

    Directory of Open Access Journals (Sweden)

    Simona Stoicescu

    2013-12-01

    Full Text Available Introduction: Although cleft lip and palate (CLP is one of the most common congenital malformations, occurring in 1 in 700 live births, there is still no generally accepted treatment protocol. Numerous surgical techniques have been described for cleft palate repair; these techniques can be divided into one-stage (one operation cleft palate repair and two-stage cleft palate closure. The aim of this study is to present our cleft palate team experience in using the two-stage cleft palate closure and the clinical outcomes in terms of oronasal fistula rate. Material and methods: A retrospective analysis was performed on medical records of 80 patients who underwent palate repair over a five-year period, from 2008 to 2012. All cleft palate patients were incorporated. Information on patient’s gender, cleft type, age at repair, one- or two-stage cleft palate repair were collected and analyzed. Results: Fifty-three (66% and twenty-seven (34% patients underwent two-stage and one-stage repair, respectively. According to Veau classification, more than 60% of them were Veau III and IV, associating cleft lip to cleft palate. Fistula occurred in 34% of the two-stage repairs versus 7% of one-stage repairs, with an overall incidence of 24%. Conclusions: Our study has shown that a two-stage cleft palate closure has a higher rate of fistula formation when compared with the one-stage repair. Two-stage repair is the protocol of choice in wide complete cleft lip and palate cases, while one-stage procedure is a good option for cleft palate alone, or some specific cleft lip and palate cases (narrow cleft palate, older age at surgery

  17. Prevalence of Dental Anomalies in Patients With Nonsyndromic Cleft Lip and/or Palate in a Brazilian Population.

    Science.gov (United States)

    Paranaiba, Lívia Máris Ribeiro; Coletta, Ricardo D; Swerts, Mário Sérgio Oliveira; Quintino, Rafaela Pacífico; de Barros, Letízia Monteiro; Martelli-Júnior, Hercílio

    2013-07-01

    Objective : Many studies have demonstrated a high frequency of dental anomalies in patients with cleft lip and/or palate. Because dental anomalies may complicate dental treatment, we investigated the prevalence of dental anomalies in a group of Brazilian patients with nonsyndromic cleft lip and/or palate. Design, Participants, Setting : Retrospective analysis was performed using clinical records of 296 patients aged between 12 and 30 years with repaired nonsyndromic cleft lip and/or palate without history of tooth extraction and orthodontic treatment. Associations between oral clefts and presence of dental anomalies outside the cleft area were investigated. Results : Dental anomalies were identified in 39.9% of the nonsyndromic cleft lip and/or palate patients, and tooth agenesis (47.5%), impacted tooth (13.1%), and microdontia (12.7%) were the most common anomalies. Cleft lip patients were less affected by dental anomalies compared with cleft palate or cleft lip and palate patients (p  =  .057). Specifically, patients with unilateral cleft lip and palate were significantly more affected by dental anomalies than those with bilateral cleft lip and palate (p  =  .00002), and individuals with unilateral complete cleft lip and palate (p  =  .002) and complete cleft palate (p  =  .01) were significantly more affected by tooth agenesis than other cleft types. Agenesis of the premolars (p  =  .043) and maxillary lateral incisors (p  =  .03) were significantly more frequent in patients with unilateral complete cleft lip and palate. Conclusions : The present study revealed a high frequency of dental anomalies in nonsyndromic cleft lip and/or palate patients and further demonstrated that patients with unilateral cleft lip and palate were frequently more affected by dental anomalies than those with bilateral cleft lip and palate. Moreover, our results demonstrate that dental anomalies should be considered during dental treatment planning for

  18. Study of palatal rugae pattern in gender identification

    Directory of Open Access Journals (Sweden)

    Pooja Balgi

    2014-01-01

    Full Text Available Aim: The aim was to determine the gender differences in rugae pattern with regards to the length, number, and shape. Materials and Methods: Fifty patients (25 males, 25 females aged 30-50 years were randomly selected from the routine outpatient department at Sinhgad Dental College and Hospital. Maxillary impressions were made using alginate hydrocolloid and cast in dental stone. Palatal rugae pattern were then evaluated under the parameters such as length, number, and shape. Results: The association of rugae pattern (length, number, shape and the gender was analyzed using Chi-square test for qualitative variable and t-test for quantitative variable. The average length of the rugae was greater in males than in females. The average numbers of rugae were same in both males and females. Straight pattern was commonly seen in females than in males. Analysis showed significant difference with parameters like length and shape (straight pattern in both the males and females. Conclusion: As the analysis showed significant difference with the length and shape of rugae patterns in both males and females, rugoscopy, thereby could be an important tool for gender identification. The study will be continued with larger sample size to expand knowledge about gender differences in palatal rugae patterns.

  19. Palatal Rugoscopy: A new era for forensic identification

    Directory of Open Access Journals (Sweden)

    Namrata Harchandani

    2015-01-01

    Full Text Available Aims and Objectives: To observe and compare the distribution of various palatal rugae patterns in western and northern Indian populations and to study the variations in male and female subjects respectively. Materials and Methods: The study consisted of 100 subjects, 50 each from the two groups of geographically different regions of western and northern India. After obtaining informed consent, an alginate impression of maxillary arch was made for interpretation. The number, type, and unification were followed according to Thomas and Kotze′s classification and the shape was recorded according to Kapali et al.′s classification. Results: The shape of rugae was compared between the two study groups and was found to be highly significant between western Indian and northern Indian subjects. The number and shape of rugae differed significantly between the genders, with males having a highly significant difference as compared to the females. The western Indian group showed wavy shape predominantly in males and females had straight rugae. Similarly, the northern Indian male participants also had wavy shape; however, females in this group had more curved shaped rugae. Conclusion: The uniqueness of palatal rugae pattern can be utilized similar to fingerprints and when combined with other methods, it can help in the identification of a person.

  20. Enhancement technology improves palatability of normal and callipyge lambs.

    Science.gov (United States)

    Everts, A K R; Wulf, D M; Wheeler, T L; Everts, A J; Weaver, A D; Daniel, J A

    2010-12-01

    The objective of this research was to determine if BPI Processing Technology (BPT) improved palatability of normal (NN) and callipyge (CN) lamb meat and to determine the mechanism by which palatability was improved. Ten ewe and 10 wether lambs of each phenotype were slaughtered, and carcass traits were assessed by a trained evaluator. The LM was removed at 2 d postmortem. Alternating sides served as controls (CON) or were treated with BPT. Muscles designated BPT were injected to a target 120% by weight with a patented solution containing water, ammonium hydroxide, carbon monoxide, and salt. Muscle pH, cooking loss, Warner-Bratzler shear force (WBS), sarcomere length, cooked moisture retention, and desmin degradation were measured. A trained sensory panel and a take-home consumer panel evaluated LM chops. Callipyge had a heavier BW and HCW, less adjusted fat thickness, reduced yield grades, and greater conformation scores than NN (P cooked moisture retention, smaller WBS values, greater juiciness ratings, less off-flavors, and greater consumer ratings for raw characteristics (like of portion size, like of color, overall like of appearance) and eating characteristics (like of juiciness, like of flavor) than CON (P lamb by increasing cooked moisture retention, improving consumer acceptability of CN to near-normal levels.

  1. MRI findings of fetal cleft lip and palate

    International Nuclear Information System (INIS)

    Wang Guangbin; Chen Liguang; Zhu Xiangyu; Wang Cuiyan; Zhang Yinghua; Wang Liajuan; Li Huihua; Qiu Xiuling; Qu Lei; Wei Yulong; Ding Rui; Sun Xueqin

    2010-01-01

    Objective: To investigate the MR findings of fetal cleft lip (CL) and evaluate the advantages and limitations of MRI in the diagnosis. Methods: Twelve pregnant women suspicious of fetal CL/cleft palate (CP) on ultrasonography were enrolled in the study. The findings of ultrasonography, MRI and following-up were compared. Results: MRI and ultrasonography detected 12 fetuses with CL/CP. The following-up results showed 1 case with incomplete cleft lip and the other 11 cases with complete cleft lips and cleft palates. MRI and unltrasonography were consistent with the follow-up in CL detection, showing completed or uncompleted soft tissue interruption of the fetal lips with amniotic fluid filling which is high signal on T 2 WI. On MRI, CP showed discontinuous of the soft tissue which were interrupted by long T 2 signal and communicating with oral cavity ad nasal cavity. MRI missed 1 case and excluded 1 case of CP. Ultrasonography predicted 5 case of CL, excluded 1 CP but missed 6 cases. The accuracy, sensitivity and specificity in detection CL/CP was 91.7% (11/12), 90.9% (10/11), 100% (1/1) for MRI and 50.0% (6/12), 45.5% (5/11), 100% (1/1) for ultrasonography, respectively. Conclusion: MR imaging had advantage over ultrasonography in detecting CP, MRI is an essential when CP is suspicious on ultrasonography. (authors)

  2. Cleft Lip and Palate Repair Using a Surgical Microscope.

    Science.gov (United States)

    Kato, Motoi; Watanabe, Azusa; Watanabe, Shoji; Utsunomiya, Hiroki; Yokoyama, Takayuki; Ogishima, Shinya

    2017-11-01

    Cleft lip and palate repair requires a deep and small surgical field and is usually performed by surgeons wearing surgical loupes. Surgeons with loupes can obtain a wider surgical view, although headlights are required for the deepest procedures. Surgical microscopes offer comfort and a clear and magnification-adjustable surgical site that can be shared with the whole team, including observers, and easily recorded to further the education of junior surgeons. Magnification adjustments are convenient for precise procedures such as muscle dissection of the soft palate. We performed a comparative investigation of 18 cleft operations that utilized either surgical loupes or microscopy. Paper-based questionnaires were completed by staff nurses to evaluate what went well and what could be improved in each procedure. The operating time, complication rate, and scores of the questionnaire responses were statistically analyzed. The operating time when microscopy was used was not significantly longer than when surgical loupes were utilized. The surgical field was clearly shared with surgical assistants, nurses, anesthesiologists, and students via microscope-linked monitors. Passing surgical equipment was easier when sharing the surgical view, and preoperative microscope preparation did not interfere with the duties of the staff nurses. Surgical microscopy was demonstrated to be useful during cleft operations.

  3. Causal attributions of cleft lip and palate across cultures.

    Science.gov (United States)

    Mednick, Lauren; Snyder, Julie; Schook, Carolyn; Blood, Emily A; Brown, Shan-Estelle; Weatherley-White, R C A

    2013-11-01

    Objective : To describe and compare the causal beliefs associated with cleft lips and/or palates across several different countries. Design : Cross-sectional survey. Setting : Operation Smile surgery screenings in six developing countries. Participants : Two hundred seventy-nine adult patients and parents of children with cleft lips and/or palates in Kenya, Russia, Cambodia, India, Egypt, and Peru. Interventions : In person interviews were conducted with interpreters. Main Outcome Measure : As part of a larger study, a semistructured questionnaire was created to explore cleft perceptions, belief systems that affect these perceptions, and social reactions to individuals with clefts. Results : Causal attributions were grouped by category (environment, self-blame, supernatural, chance, unknown, or other) and type of locus of control (external, internal, or unknown). Results indicate significant difference by country for both causal attribution category (P < .001) and type (P < .001). This difference was maintained in multivariate analyses, which controlled for differences by demographic variables between countries. Conclusions : This study provides evidence that causal attributions for clefts are influenced by culture. As harmful beliefs about cause may continue to impact affected individuals and their families even after a repair, it is insufficient to provide surgical care alone. Care of the entire person must include attempts to change misinformed cultural beliefs through educating the broader community.

  4. A Review of Hearing Loss in Cleft Palate Patients

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    Bilal Gani

    2012-01-01

    Full Text Available Background. Cleft palate is associated with recurrent otitis media with effusion and hearing loss. This study analysed the way these patients’ hearing is managed in Alder Hey Children’s Hospital. Method. A retrospective audit was carried out on cleft palate patients in Alder Hey Children’s Hospital. Audiology assessment and treatment options were reviewed. Comparisons were made between the use of ventilation tubes (VTs and hearing aids (HAs. The types of cleft, types of hearing loss, and the management output of the audiology regions were also reviewed. Results. The audiology assessments of 254 patients were examined. The incidence of VT insertion in this group of patients was 18.9%. The hearing aid incidence rate was 10.1%. The VT-related complication rate was 25.5% and the HA related complication rate was 9.1%. Conclusion. The data demonstrates that both treatments are viable, and a new protocol which combines the short term benefit of VT insertion with the lower complication rate of HA is required.

  5. Reconstruction of Drug-induced Cleft Palate Using Bone Marrow Mesenchymal Stem Cell in Rodents.

    Science.gov (United States)

    Amalraj, Julie Christy; Gangothri, Manasa; Babu, Hari

    2017-01-01

    Triamcinolone acetonide (TAC) (Kenacort*) is a commonly used synthetic glucocorticoid in today's medical practice. The drug is also a potential agent in inducing cleft palates in rats. This drug has been used to induce cleft palate in the fetus of the pregnant rats to bring out a suitable animal model for human cleft lip and palate. The drug was given intraperitoneally to induce congenital cleft palate in pregnant mother rats. The aim of this study is to induce congenital cleft palate in pregnant Wister albino rats and reconstruct the defect with bone marrow mesenchymal stem cells (BMSCs) isolated from the same species along with PLGA (poly lactic co glycolic acid) scaffold. Twenty female animals were divided into two groups. Each group contains 10 animals. The animals were allowed to mate with male rat during the esterase period and the day, in hich vaginal plug was noticed was taken to be day 0. The pregnant rats were given triamcinolone acetonide (Kenacort* 10 mg/1 ml intramuscularly/intravenous [IM/IV] injections) injection intraperitoneally at two different dosages as the existing literature. The injection was given on the 10, 12, and 14 th day of gestation. The clinical changes observed were recorded, and the change in the body weight was noted carefully. Group 1 which received 0.5 mg/kg body weight of TAC had many drug toxic effects. Group 2 which received 0.05 mg/kg body weight produced cleft palate in rat pups. The pups were divided into three groups. Group A control group without cell transplant, the cleft was allowed to close by itself. Group B containing palate reconstructed with plain PLGA scaffold (Bioscaffold, Singapore) without BMSC, Group C containing BMSC and PLGA scaffold (Bioscaffold, Singapore), Group C operated for the cleft palate reconstruction using BMSCs and PLGA scaffold. There was faster and efficient reconstruction of bone in the cleft defect in Group C while there was no defect closure in Group A and B. There was complete

  6. Encoding of Sucrose's Palatability in the Nucleus Accumbens Shell and Its Modulation by Exteroceptive Auditory Cues

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    Miguel Villavicencio

    2018-05-01

    Full Text Available Although the palatability of sucrose is the primary reason for why it is over consumed, it is not well understood how it is encoded in the nucleus accumbens shell (NAcSh, a brain region involved in reward, feeding, and sensory/motor transformations. Similarly, untouched are issues regarding how an external auditory stimulus affects sucrose palatability and, in the NAcSh, the neuronal correlates of this behavior. To address these questions in behaving rats, we investigated how food-related auditory cues modulate sucrose's palatability. The goals are to determine whether NAcSh neuronal responses would track sucrose's palatability (as measured by the increase in hedonically positive oromotor responses lick rate, sucrose concentration, and how it processes auditory information. Using brief-access tests, we found that sucrose's palatability was enhanced by exteroceptive auditory cues that signal the start and the end of a reward epoch. With only the start cue the rejection of water was accelerated, and the sucrose/water ratio was enhanced, indicating greater palatability. However, the start cue also fragmented licking patterns and decreased caloric intake. In the presence of both start and stop cues, the animals fed continuously and increased their caloric intake. Analysis of the licking microstructure confirmed that auditory cues (either signaling the start alone or start/stop enhanced sucrose's oromotor-palatability responses. Recordings of extracellular single-unit activity identified several distinct populations of NAcSh responses that tracked either the sucrose palatability responses or the sucrose concentrations by increasing or decreasing their activity. Another neural population fired synchronously with licking and exhibited an enhancement in their coherence with increasing sucrose concentrations. The population of NAcSh's Palatability-related and Lick-Inactive neurons were the most important for decoding sucrose's palatability. Only the Lick

  7. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 2: The palate of the preterm/low birthweight infant

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    Ehmer Ulrike

    2005-10-01

    Full Text Available Abstract Background Well-designed clinical studies on the palatal development in preterm and low birthweight infants are desirable because the literature is characterized by contradictory results. It could be shown that knowledge about 'normal' palatal development is still weak as well (Part 1. The objective of this review is therefore to contribute a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. Methods An electronic literature search as well as hand searches were performed based on Cochrane search strategies including sources of more than a century in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered for comparison. Results Seventy-eight out of 155 included articles were analyzed for palatal morphology of preterm infants. Intubation, feeding tubes, feeding mode, tube characteristics, restriction of oral functions, kind of diet, cranial form and birthweight were seen as causes contributing to altered palatal morphology. Changes associated with intubation concern length, depth, width, asymmetry, crossbite, and contour of the palate. The phenomenon 'grooving' has also been described as a complication associated with oral intubation. However, this phenomenon suffers from lack of a clear-cut definition. Head flattening, pressure from the oral tube, pathologic or impaired tongue function, and broadening of the alveolar ridges adjacent to the tube have been raised as causes of 'grooving'. Metrically, the palates of intubated preterm infants remain narrower, which has been examined up to the age of the late mixed dentition. Conclusion There is no evidence that would justify the exclusion of any of the raised causes contributing to palatal alteration. Thus, early orthodontic and

  8. Palate Shape and Depth: A Shape-Matching and Machine Learning Method for Estimating Ancestry from Human Skeletal Remains.

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    Maier, Christopher A; Zhang, Kang; Manhein, Mary H; Li, Xin

    2015-09-01

    In the past, assessing ancestry relied on the naked eye and observer experience; however, replicability has become an important aspect of such analysis through the application of metric techniques. This study examines palate shape and assesses ancestry quantitatively using a 3D digitizer and shape-matching and machine learning methods. Palate curves and depths were recorded, processed, and tested for 376 individuals. Palate shape was an accurate indicator of ancestry in 58% of cases. Cluster analysis revealed that the parabolic, hyperbolic, and elliptical shapes are discrete from one another. Preliminary results indicate that palate depth in Hispanic individuals is greatest. Palate shape appears to be a useful indicator of ancestry, particularly when assessed by a computer. However, these data suggest that palate shape is not useful for assessing ancestry in Hispanic individuals. Although ancestry may be determined from palate shape, the use of multiple features is recommended and more reliable. © 2015 American Academy of Forensic Sciences.

  9. Cause analysis, prevention, and treatment of postoperative restlessness after general anesthesia in children with cleft palate.

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    Xu, Hao; Mei, Xiao-Peng; Xu, Li-Xian

    2017-03-01

    Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery is significantly higher than in other types of interventions. The exact mechanism of EA is still unclear. Although restlessness after general anesthesia in children with cleft palate is self-limiting, its effects should be considered by clinicians. In this paper, the related literature on restlessness after surgery involving general anesthesia in recent years is summarized. This paper focuses on induction factors as well as prevention and treatment of postoperative restlessness in children with cleft palate after general anesthesia. The corresponding countermeasures to guide clinical practice are also presented in this paper.

  10. Cleft palate repair with the use of osmotic expanders: a preliminary report.

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    Kobus, Kazimierz F

    2007-01-01

    A new method of cleft palate repair by expansion of tissue by means of osmotic expanders implanted in the first stage of treatment is described. Self-expanding expanders manufactured by OSMED (Ilmenau, Germany) were implanted under the mucoperiosteal layer of the hard palate, on purpose to generate more tissue and provide facility for palate repair performed 24-48h later. Nineteen children aged from 2 to 3 years were operated from January 2004 to 15 April 2005. In clefts10mm, cleft palate repair was more difficult and the outcomes were less favourable. Despite more generous dissection of the neurovascular bundles and other adjunctive measures such as mucosal V-Y plasty [Bardach J, Salyer K. Surgical techniques in cleft lip and palate. Chicago, London: Year Book Medical Publishers, Inc.; 1987.] and suturing of the mucosal grafts at the border of the hard and soft palate, seven 2-4mm fistulae were noted, however. Concluding, in spite of some shortcomings and unacceptable rate of fistula in wide clefts, the above-presented method seems to be an attractive concept. Despite some technical problems related mostly to still tested optimal filling phase, tissue expansion makes palate repair easier, probably without relaxing incisions and bone denudation. Consequently, some adverse effects on facial growth may be reduced. So far, there is no evidence for it, however, and since this is a preliminary report, there is a need for longer observations and larger material.

  11. Social life aspects of young adults with cleft lip and palate: grounded theory approach.

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    Chetpakdeechit, Woranuch; Hallberg, Ulrika; Hagberg, Catharina; Mohlin, Bengt

    2009-01-01

    The findings of many questionnaire and inventory studies suggest that people with cleft lip and/or palate report a decreased quality of life. Common problems include dissatisfaction with the external appearance of the lips and nose, speech problems, depression, and anxiety. This qualitative study aimed to explore the subjective perceptions and values of young adults with clefts, particularly with regard to their social lives. Twelve persons participated in an in-depth interview. Among those, seven had a repaired isolated cleft palate involving only the hard/soft palate. Five had a repaired bilateral cleft lip and palate that had been a continuous lesion of the lip, the alveolar process, and the palate. A grounded theory approach was used to conduct and analyze the interviews. The study revealed seven important categories--hoping to be like other people, being treated differently from others, experiencing deviation from others, regarding oneself as being different from others, lack of recognition, low self-esteem, and receiving recognition from significant others--with hoping to be like other people as the core category. Young adults with either cleft lip and palate or isolated cleft palate who received recognition from significant others reported increased self-esteem and greater ability to cope with their social lives.

  12. Risk factors leading to mucoperiosteal flap necrosis after primary palatoplasty in patents with cleft palate.

    Science.gov (United States)

    Rossell-Perry, Percy; Figallo-Hudtwalcker, Olga; Vargas-Chanduvi, Roberto; Calderon-Ayvar, Yvette; Romero-Narvaez, Carolina

    2017-10-01

    Few studies have been published reporting risk factors for flap necrosis after primary palatoplasty in patients with cleft palate. This complication is rare, and the event is a disaster for both the patient and the surgeon. This study was performed to explore the associations between different risk factors and the development of flap necrosis after primary palatoplasty in patients with cleft palate. This is a case-control study. A 20 years retrospective analysis (1994-2015) of patients with nonsyndromic cleft palate was identified from medical records and screening day registries). Demographical and risk factor data were collected using a patient´s report, including information about age at surgery, gender, cleft palate type, and degree of severity. Odds ratios and 95% confident intervals were derived from logistic regression analysis. All cases with diagnoses of flap necrosis after primary palatoplasty were included in the study (48 patients) and 156 controls were considered. In multivariate analysis, female sex, age (older than 15 years), cleft type (bilateral and incomplete), and severe cleft palate index were associated with significantly increased risk for flap necrosis. The findings suggest that female sex, older age, cleft type (bilateral and incomplete), and severe cleft palatal index may be associated with the development of flap necrosis after primary palatoplasty in patients with cleft palate.

  13. [Morphological classification and velopharyngeal function analysis of submucous cleft palate patients].

    Science.gov (United States)

    Heng, Yin; Chunli, Guo; Bing, Shi; Yang, Li; Jingtao, Li

    2016-10-01

    To enhance the accuracy in diagnosis and management of submucous cleft palate via a thorough analysis of its anatomical and functional details. Two hundred seventy-six submucous cleft palate cases from 2008 to 2014 were retrospectively investigated. Subgroup analysis were performed on the basis of preoperative velopharyngeal function, palatal morphology, cleft lip concurrence, and patient motives for treatment. Among the included cases, 96 (34.78%) were presented as velopharyngeal competence (VPC), 151 (54.71%) as velopharyngeal insufficiency (VPI), and 29 (10.51%) as marginal VPI (MVPI). Eighty cases (28.99%) also demonstrated cleft lip deformity, and 196 cases (71.01%) were merely submucous cleft palate. Compared with patients with submucous cleft palate only, those with cleft lips exhibited higher rates of complete velopharyngeal closure. The pathological spectrum of submucous cleft palate varied significantly. Only 103 (37.32%) cases met all the three diagnostic criteria proposed by Calnan. Given that the velopharyngeal closure rate varies among the subgroups, the factors analyzed in this study should be considered in the personalized manage-ment of submucous cleft palate.

  14. Mucoperiosteal Flap Necrosis after Primary Palatoplasty in Patients with Cleft Palate

    Science.gov (United States)

    Cotrina-Rabanal, Omar; Barrenechea-Tarazona, Luis; Vargas-Chanduvi, Roberto; Paredes-Aponte, Luis; Romero-Narvaez, Carolina

    2017-01-01

    Background The prevalence of flap necrosis after palatoplasty in patients with cleft palate. The prevalence of mucoperiosteal flap necrosis after palatoplasty remains unknown, and this complication is rare. This event is highly undesirable for both the patient and the surgeon. We present here a new scale to evaluate the degree of hypoplasia of the palate and identify patients with cleft palate at high risk for the development of this complication. Methods In this case series, a 20-year retrospective analysis (1994–2014) identified patients from our records (medical records and screening day registries) with nonsyndromic cleft palate who underwent operations at 3 centers. All of these patients underwent operations using 2-flap palatoplasty and also underwent a physical examination with photographs and documentation of the presence of palatal flap necrosis after primary palatoplasty. Results Palatal flap necrosis was observed in 4 cases out of 1,174 palatoplasties performed at these centers. The observed prevalence of palatal flap necrosis in these groups was 0.34%. Conclusions The prevalence of flap necrosis can be reduced by careful preoperative planning, and prevention is possible. The scale proposed here may help to prevent this complication; however, further studies are necessary to validate its utility. PMID:28573096

  15. Morphological evaluation of clefts of the lip, palate, or both in dogs.

    Science.gov (United States)

    Peralta, Santiago; Fiani, Nadine; Kan-Rohrer, Kimi H; Verstraete, Frank J M

    2017-08-01

    OBJECTIVE To systematically characterize the morphology of cleft lip, cleft palate, and cleft lip and palate in dogs. ANIMALS 32 client-owned dogs with clefts of the lip (n = 5), palate (23), or both (4) that had undergone a CT or cone-beam CT scan of the head prior to any surgical procedures involving the oral cavity or face. PROCEDURES Dog signalment and skull type were recorded. The anatomic form of each defect was characterized by use of a widely used human oral-cleft classification system on the basis of CT findings and clinical images. Other defect morphological features, including shape, relative size, facial symmetry, and vomer involvement, were also recorded. RESULTS 9 anatomic forms of cleft were identified. Two anatomic forms were identified in the 23 dogs with cleft palate, in which differences in defect shape and size as well as vomer abnormalities were also evident. Seven anatomic forms were observed in 9 dogs with cleft lip or cleft lip and palate, and most of these dogs had incisive bone abnormalities and facial asymmetry. CONCLUSIONS AND CLINICAL RELEVANCE The morphological features of congenitally acquired cleft lip, cleft palate, and cleft lip and palate were complex and varied among dogs. The features identified here may be useful for surgical planning, developing of clinical coding schemes, or informing genetic, embryological, or clinical research into birth defects in dogs and other species.

  16. A Novel Approach to Determine the Prevalence of Type of Soft Palate Using Digital Intraoral Impression

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    Saurabh Chaturvedi

    2017-01-01

    Full Text Available Aim. To determine the prevalence of type of soft palate in targeted population. Materials and Methods. Using computer technology in dentistry, intraoral digital scanner, and 3D analysis software tool, study was conducted. 100 patients selected from the outpatient clinics were divided into two groups based on the ages of 20–40 years and 41–60 years with equal ratio of males and females. Each selected patient’s maxillary arch was scanned with intraoral scanner; images so obtained were sectioned in anteroposterior cross section and with the 3D analysis software; the angulation between hard and soft palate was determined. Results. The prevalence of type II soft palate (angulation between hard and soft palate is between 10 and 45 degrees was highest, 60% in group 1 and 44% in group 2. The difference between genders was statistically significant with p value <0.05 in both the groups, although females had higher angulation compared to the males in all classes of both groups. Conclusions. In targeted population of Aseer Province, Saudi Arabia, the prevalence of type II soft palate was more common, with higher soft palate angulation among females. The advanced age had no effect in the type of soft palate in the region.

  17. The development of glossopharyngeal breathing and palatal myoclonus in a 29 year old after scuba diving

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    Thomas AR

    2011-02-01

    Full Text Available Palatal myoclonus is a rare movement disorder characterized by brief, rhythmic involuntary movements of the soft palate. Palatal myoclonus is further subdivided into “essential palatal tremor” (EPT and “symptomatic palatal tremor” (SPT. EPT is characterized by involvement of the tensor veli palatini, myoclonus that might persist during sleep, as well as ear clicks, usually the patient’s presenting complaint. The MRI and neurological exam are normal in EPT. SPT is characterized by involvement of the levator veli palatini and myoclonus which consistently perseveres during sleep. The MRI shows olivary hypertrophy and clinical features may include ataxia, dysarthria and nystagmus, depending on the size of the lesion1. Glossopharyngeal breathing is a technique used by deep-sea divers to increase lung vital capacity, which is also useful in patients with ventilator dependence from poliomyelitis and Duchenne muscular dystrophy. To date there have been no reported cases of palatal myoclonus and glossopharyngeal breathing occurring simultaneously. We present the case of a 29 year-old female with palatal myoclonus and glossopharyngeal breathing after scuba-diving.

  18. The Effectiveness of Psychosocial Intervention for Individuals With Cleft Lip and/or Palate.

    Science.gov (United States)

    Norman, Alyson; Persson, Martin; Stock, Nicola; Rumsey, Nichola; Sandy, Jonathan; Waylen, Andrea; Edwards, Zoe; Hammond, Vanessa; Partridge, Lucy; Ness, Andy

    2015-05-01

    The aim of this review was to assess the effectiveness of different psychological interventions for children and adults with cleft lip and/or palate and their parents. We searched six databases including MEDLINE and EMBASE to June 2013 and checked bibliographies. We included research that evaluated any psychological intervention in studies in which at least 90% of the participants had cleft lip and/or palate or were parents of those with cleft lip and/or palate. Studies containing less than 90% were excluded unless they reported results separately for those with cleft lip and/or palate, or raw data were available upon request from the authors. Inclusion assessment, data extraction, and risk of bias assessment were carried out independently by two reviewers. Seven studies were identified as inclusions, with only two studies being included in the full data analysis (one of which failed to meet the full inclusion criteria). The five remaining studies were included only in a narrative synthesis because data were available for people or parents of those with cleft lip and/or palate only. This highlights a distinct dearth of research into psychological intervention within the field of cleft lip and/or palate. The review found no evidence to support any specific intervention. Key uncertainties need to be identified and addressed. Adequately powered, methodologically rigorous randomized controlled trials are needed to provide a secure evidence base for psychological intervention techniques in participants with cleft lip and/or palate and their parents.

  19. [Improving care for cleft lip and palate patients: uniform and patient-orientated outcome measures].

    Science.gov (United States)

    Haj, M; de Gier, H H W; van Veen-van der Hoek, M; Versnel, S L; van Adrichem, L N; Wolvius, E B; Hazelzet, J A; Koudstaal, M J

    2018-02-01

    The quality of care for patients with cleft lip and palate is extremely variable across the world. Treatment protocols differ and methods of data registration are not uniform. Improving this care by means of comparative research is challenging. The best treatment programmes can be identified by uniformly registering patient-orientated outcomes and comparing the outcomes with those of other treatment centres. That knowledge can be used to improve one's own care. An international team consisting of specialists and cleft lip and palate patients has developed a set of outcome measures that are considered by patients to be most important. This team is coordinated by the International Consortium of Health Outcomes Measurement (ICHOM). The cleft lip and palate outcome set can be used by all centres worldwide in following up on cleft lip and palate patients. In the Erasmus Medical Centre in Rotterdam, the 'Zorgmonitor Schisis' (Care Monitor Cleft Lip and Palate) has been built, an application in which these outcome measures are collected at fixed times. Implementing this set of outcome measures in other cleft lip and palate treatment centres and using the outcomes as (inter)national benchmarks will result in transparency and the improvement of the treatment of cleft lip and palate worldwide.

  20. Cone Beam Computed Tomographic Evaluation of Mandibular Asymmetry in Patients with Cleft Lip and Palate.

    Science.gov (United States)

    Paknahad, Maryam; Shahidi, Shoaleh; Bahrampour, Ehsan; Beladi, Amir Saied; Khojastepour, Leila

    2018-01-01

    Objective The purpose of the present study was to compare mandibular vertical asymmetry in patients with unilateral and bilateral cleft lip and palate and subjects with normal occlusion. Materials and Methods Cone beam computed tomography scans of three groups consisting of 20 patients with unilateral cleft lip and palate, 20 patients affected by bilateral cleft lip and palate, and a control group of 20 subjects with normal occlusion were analyzed for this study. Condylar, ramal, and condylar plus ramal asymmetry indices were measured for all subjects using the method of Habets et al. Kruskal-Wallis and Mann-Whitney tests were used to determine any significant differences between the groups for all indices at the 95% level of confidence. Results There were no significant differences regarding sex for all mandibular asymmetry indices in all three groups. All Asymmetry indices (condylar, ramal, and condylar plus ramal asymmetry) were significantly higher in the unilateral cleft group compared with the other two groups. Conclusion Cone beam computed tomography images showed that patients with cleft lip and palate suffered from mandibular asymmetry. Subjects with unilateral cleft lip and palate had a more asymmetric mandible compared with the bilateral cleft lip and palate and control groups. Therefore, the mandible appears to be the leading factor in facial asymmetry in subjects with unilateral cleft lip and palate.

  1. A Novel Approach to Determine the Prevalence of Type of Soft Palate Using Digital Intraoral Impression

    Science.gov (United States)

    Khaled Addas, Mohamed; Al Humaidi, Abdullah Saad Ali; Al Qahtani, Abdulrazaq Mohammed; Al Qahtani, Mubarak Daghash

    2017-01-01

    Aim To determine the prevalence of type of soft palate in targeted population. Materials and Methods Using computer technology in dentistry, intraoral digital scanner, and 3D analysis software tool, study was conducted. 100 patients selected from the outpatient clinics were divided into two groups based on the ages of 20–40 years and 41–60 years with equal ratio of males and females. Each selected patient's maxillary arch was scanned with intraoral scanner; images so obtained were sectioned in anteroposterior cross section and with the 3D analysis software; the angulation between hard and soft palate was determined. Results The prevalence of type II soft palate (angulation between hard and soft palate is between 10 and 45 degrees) was highest, 60% in group 1 and 44% in group 2. The difference between genders was statistically significant with p value <0.05 in both the groups, although females had higher angulation compared to the males in all classes of both groups. Conclusions In targeted population of Aseer Province, Saudi Arabia, the prevalence of type II soft palate was more common, with higher soft palate angulation among females. The advanced age had no effect in the type of soft palate in the region. PMID:28951740

  2. Mucoperiosteal Flap Necrosis after Primary Palatoplasty in Patients with Cleft Palate

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    Percy Rossell-Perry

    2017-05-01

    Full Text Available BackgroundThe prevalence of flap necrosis after palatoplasty in patients with cleft palate. The prevalence of mucoperiosteal flap necrosis after palatoplasty remains unknown, and this complication is rare. This event is highly undesirable for both the patient and the surgeon. We present here a new scale to evaluate the degree of hypoplasia of the palate and identify patients with cleft palate at high risk for the development of this complication.MethodsIn this case series, a 20-year retrospective analysis (1994–2014 identified patients from our records (medical records and screening day registries with nonsyndromic cleft palate who underwent operations at 3 centers. All of these patients underwent operations using 2-flap palatoplasty and also underwent a physical examination with photographs and documentation of the presence of palatal flap necrosis after primary palatoplasty.ResultsPalatal flap necrosis was observed in 4 cases out of 1,174 palatoplasties performed at these centers. The observed prevalence of palatal flap necrosis in these groups was 0.34%.ConclusionsThe prevalence of flap necrosis can be reduced by careful preoperative planning, and prevention is possible. The scale proposed here may help to prevent this complication; however, further studies are necessary to validate its utility.

  3. Influence of timing of delayed hard palate closure on articulation skills in 3-year-old Danish children with unilateral cleft lip and palate.

    Science.gov (United States)

    Willadsen, Elisabeth; Boers, Maria; Schöps, Antje; Kisling-Møller, Mia; Nielsen, Joan Bogh; Jørgensen, Line Dahl; Andersen, Mikael; Bolund, Stig; Andersen, Helene Søgaard

    2018-01-01

    Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. To assess the influence of different timing of hard palate closure in a two-stage procedure on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery, hearing and speech therapy. A randomized controlled trial (RCT). Early hard palate closure (EHPC) at 12 months versus late hard palate closure (LHPC) at 36 months in a two-stage procedure was tested in a cohort of 126 Danish-speaking children born with non-syndromic UCLP. All participants had the lip and soft palate closed around 4 months of age. Audio and video recordings of a naming test were available from 113 children (32 girls and 81 boys) and were transcribed phonetically. Recordings were obtained prior to hard palate closure in the LHPC group. The main outcome measures were percentage consonants correct adjusted (PCC-A) and consonant errors from blinded assessments. Results from 36 Danish-speaking children without CP obtained previously by Willadsen in 2012 were used for comparison. Children with EHPC produced significantly more target consonants correctly (83%) than children with LHPC (48%; p < .001). In addition, children with LHPC produced significantly more active cleft speech characteristics than children with EHPC (p < .001). Boys achieved significantly lower PCC-A scores than girls (p = .04) and produced significantly more consonant errors than girls (p = .02). No significant differences were found between groups regarding burden of treatment. The control group performed significantly better than the EHPC and LHPC groups on all compared variables. © 2017 Royal College of Speech

  4. Bone-borne palatal distraction to correct the constricted cleft maxilla.

    Science.gov (United States)

    Vyas, Raj M; Jarrahy, Reza; Sisodia, Manisha; Jourabchi, Natanel; Wasson, Kristy L; Bradley, James P

    2009-05-01

    Transverse maxillary hypoplasia, with or without cleft deformity, is typically treated with orthodontic expansion. However, the management of those patients who present later in life with severe uncorrected deformities or who have failed prior orthodontic care remains controversial. Tooth-borne palatal expanders have limitations in this subset of patients with scarred, constricted cleft palate. In this study, we assess the efficacy and safety of using a bone-borne palatal distraction device as an alternative treatment for this difficult subset of patients. Older children with a constricted maxilla who previously had unilateral or bilateral cleft lip and palate repairs and failed orthodontic expansion were included in the study (n = 15). Patients underwent Le Fort I corticotomy with placement of the bone-borne distraction device, expansion at a rate of 0.5 mm/d, and subsequent alveolar bone grafting. Preoperative and follow-up maxillary impressions were compared with assessed improvements in intermolar distance, intercanine distance, alveolar cleft width, and total palatal area. In addition, a small group of noncleft patients with constricted maxillas was treated with bone-borne palatal distraction without a corticotomy (n = 4). The mean amount of distraction in all patients was 14.1 mm, with a follow-up period of 19 months (range, 8-30 months). The average increase in intermolar distance was 8.4 mm, intercanine distance increased by an average of 9.5 mm, and palate surface areas were increased by a mean of 28.9 mm2. Relapse was between 4% and 7%, and all patients underwent subsequent alveolar bone grafting. In addition, the noncleft patients successfully underwent bone-borne palatal distraction without a corticotomy, with a 4% to 5% relapse. Rapid palatal expansion using a bone-borne distraction device in cleft patients with transverse maxillary hypoplasia who have failed nonsurgical orthodontic expansion provides adequate expansion necessary for alveolar bone

  5. Implications of TGFβ on transcriptome and cellular biofunctions of palatal mesenchyme

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    Xiujuan eZhu

    2012-04-01

    Full Text Available Development of the palate comprises sequential stages of growth, elevation and fusion of the palatal shelves. The mesenchymal component of palates plays a major role in early phases of palatogenesis, such as growth and elevation. Failure in these steps may result in cleft palate, the second most common birth defect in the world. These early stages of palatogenesis require precise and chronological orchestration of key physiological processes, such as growth, proliferation, differentiation, migration, and apoptosis. There is compelling evidence for the vital role of TGFβ-mediated regulation of palate development. We hypothesized that the isoforms of TGFβ regulate different cellular biofunctions of the palatal mesenchyme to various extents. Human embryonic palatal mesenchyme (HEPM cells were treated with TGFβ1, β2, and β3 for microarray-based gene expression studies in order to identify the roles of TGFβ in the transcriptome of the palatal mesenchyme. Following normalization and modeling of 28,869 human genes, 566 transcripts were detected as differentially expressed in TGFβ-treated HEPM cells. Out of these altered transcripts, 234 of them were clustered in cellular biofunctions, including growth and proliferation, development, morphology, movement, cell cycle, and apoptosis. Biological interpretation and network analysis of the genes active in cellular biofunctions were performed using IPA. Among the differentially expressed genes, 11 of them were previously identified as being crucial for palatogenesis (EDN1, INHBA, LHX8, PDGFC, PIGA, RUNX1, SNAI1, SMAD3, TGFβ1, TGFβ2, and TGFβR1. These genes were used for a merged interaction network with cellular behaviors. Overall, we have determined that more than 2% of human transcripts were differentially expressed in response to TGFβ treatment in HEPM cells. Our results suggest that both TGFβ1 and TGFβ2 orchestrate major cellular biofunctions within the palatal mesenchyme in vitro by

  6. Automatic initial and final segmentation in cleft palate speech of Mandarin speakers.

    Directory of Open Access Journals (Sweden)

    Ling He

    Full Text Available The speech unit segmentation is an important pre-processing step in the analysis of cleft palate speech. In Mandarin, one syllable is composed of two parts: initial and final. In cleft palate speech, the resonance disorders occur at the finals and the voiced initials, while the articulation disorders occur at the unvoiced initials. Thus, the initials and finals are the minimum speech units, which could reflect the characteristics of cleft palate speech disorders. In this work, an automatic initial/final segmentation method is proposed. It is an important preprocessing step in cleft palate speech signal processing. The tested cleft palate speech utterances are collected from the Cleft Palate Speech Treatment Center in the Hospital of Stomatology, Sichuan University, which has the largest cleft palate patients in China. The cleft palate speech data includes 824 speech segments, and the control samples contain 228 speech segments. The syllables are extracted from the speech utterances firstly. The proposed syllable extraction method avoids the training stage, and achieves a good performance for both voiced and unvoiced speech. Then, the syllables are classified into with "quasi-unvoiced" or with "quasi-voiced" initials. Respective initial/final segmentation methods are proposed to these two types of syllables. Moreover, a two-step segmentation method is proposed. The rough locations of syllable and initial/final boundaries are refined in the second segmentation step, in order to improve the robustness of segmentation accuracy. The experiments show that the initial/final segmentation accuracies for syllables with quasi-unvoiced initials are higher than quasi-voiced initials. For the cleft palate speech, the mean time error is 4.4ms for syllables with quasi-unvoiced initials, and 25.7ms for syllables with quasi-voiced initials, and the correct segmentation accuracy P30 for all the syllables is 91.69%. For the control samples, P30 for all the

  7. Effect of N'-nitrosonornicotine (NNN) on murine palatal fusion in vitro

    International Nuclear Information System (INIS)

    Saito, Takashi; Cui Xiaomei; Yamamoto, Tadashi; Shiomi, Nobuyuki; Bringas, Pablo; Shuler, Charles F.

    2005-01-01

    Maternal smoking has been linked to an increased risk for orofacial clefts. N'-nitrosonornicotine (NNN) is one of the tobacco-specific nitrosamines that has been shown to be linked to the deleterious effects of tobacco and could be linked to the formation of cleft palate birth defects. The effect of NNN on palatal fusion was examined using an in vitro organ culture model of palatal development. The organ cultures were exposed to NNN (0.01, 0.1, 1, 10 and100 mM) and the effects on palatal development characterized at defined points. Palatal fusion was evaluated at embryonic day 13 (E13) + 72 h by characterizing the remaining medial edge epithelium (MEE) and determining the extent of fusion compared to controls. The NNN-treated group (1 mM) had more MEE remaining in the palatal midline than the untreated group at E13 + 72 h (P < 0.05). Changes in cell proliferation in the MEE resulting from NNN exposure were examined by BrdU incorporation in replicating DNA. Changes in the pattern of MEE cell death were examined by TUNEL. BrdU incorporation and TUNEL staining showed that the NNN (1 mM)-treated palates had more MEE cell proliferation and less apoptosis than the untreated-palates at E13 + 24 h (P < 0.05). The mechanism altered by NNN was further evaluated by characterizations of extracellular signal-regulated kinase (ERK) 1/2, p38 and c-jun amino-terminal kinase (JNK). NNN at 1 mM induced ERK1/2 phosphorylation, but reduced p38 phosphorylation (P < 0.05, P < 0.01, respectively) in the MEE. The results suggest that NNN inhibited palatal fusion by effects on cell proliferation and MEE cell death

  8. Ectrodactyly, ectodermal dysplasia, and cleft lip/palate syndrome: A case report of "Incomplete syndrome"

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    P K Shivaprakash

    2012-01-01

    Full Text Available Ectrodactyly, ectodermal dysplasia, and cleft lip/palate (EEC is a rare syndrome having ectrodactyly, ectodermal dysplasia, and cleft lip/palate. So far, very few cases have been reported in literature. However, we report a case of incomplete EEC syndrome having ectrodactyly and cleft lip and palate with absence of signs of ectodermal dysplasia with no other systemic anomalies. Other feature noted is the syndactyly of toes which is reported rarely in this syndrome. A multidisciplinary approach for treatment is needed which is co-ordinated by pedodontist or pediatrician.

  9. Oblique lip-alveolar banding in patients with cleft lip and palate.

    Science.gov (United States)

    Naidoo, S; Bütow, K-W

    2015-04-01

    We report an oblique lip-alveolar band, a rare banding of soft tissue that involves the lip and alveolus, which we have found in five patients with cleft lip and palate (0.2%), compared with an incidence of the Simonartz lip-lip band of 5.7%). To our knowledge this has not been reported previously. In two patients the bands affected the cleft lip and alveolus bilaterally, with or without the palatal cleft, and in three the bands were unilateral cleft lip and alveolus with or without the palatal cleft. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Bilateral optic disc pit with maculopathy in a patient with cleft lip and cleft palate

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    Anisha Seth

    2015-01-01

    Full Text Available Optic disc pit (ODP is small, gray-white, oval depression found at the optic nerve head. It is a congenital defect that occurs due to imperfect closure of superior edge of the embryonic fissure. Cleft lip and palate are also congenital midline abnormalities occurring due to defect in the fusion of frontonasal prominence, maxillary prominence and mandibular prominence. There is only one case report describing the occurrence of ODP in a young patient with cleft lip and palate who also had basal encephalocele. We describe a 52-year-old patient with congenital cleft lip and palate with bilateral ODP with maculopathy but without any other midline abnormality.

  11. Texture analysis of T1-w and T2-w MR images allows a quantitative evaluation of radiation-induced changes of internal obturator muscles after radiotherapy for prostate cancer.

    Science.gov (United States)

    Scalco, Elisa; Rancati, Tiziana; Pirovano, Ileana; Mastropietro, Alfonso; Palorini, Federica; Cicchetti, Alessandro; Messina, Antonella; Avuzzi, Barbara; Valdagni, Riccardo; Rizzo, Giovanna

    2018-04-01

    To investigate the potential of texture analysis applied on T2-w and postcontrast T1-w images acquired before radiotherapy for prostate cancer (PCa) and 12 months after its completion in quantitatively characterizing local radiation effect on the muscular component of internal obturators, as organs potentially involved in urinary toxicity. T2-w and postcontrast T1-w MR images were acquired at 1.5 T before treatment (MRI1) and at 12 months of follow-up (MRI2) in 13 patients treated with radiotherapy for PCa. Right and left internal obturator muscle contours were manually delineated upon MRI1 and then automatically propagated on MRI2 by an elastic registration method. Planning CT images were coregistered to both MRIs and dose maps were deformed accordingly. A high-dose region receiving >55 Gy and a low-dose region receiving evaluated. A signal increase was highlighted in both T2-w and T1-w images in the portion of the obturators near the prostate, i.e., in the region receiving medium-high doses. A change in the spatial organization was identified, as an increase in homogeneity and a decrease in contrast and complexity, compatible with an inflammatory status. In particular, the region receiving medium-high doses presented more significant or, at least, stronger differences. Texture analysis applied on T1-w and T2-w MR images has demonstrated its ability in quantitative evaluating radiation-induced changes in obturator muscles after PCa radiotherapy. © 2018 American Association of Physicists in Medicine.

  12. 20 years of cleft lip and palate missions.

    Science.gov (United States)

    Lambrecht, J Thomas; Kreusch, Thomas; Marsh, Jeff L; Schopper, Christian

    2014-01-01

    Volunteer missions for cleft lip and palate (CLP) care in Indonesia (1991-1992), India (1994-2003), Bhutan (2005-2010), and Kenya (2011), took place always at the same Hospital in each country. Altogether over a thousand patients were operated using a conservative protocol: Safety first - no experiments. Five months and 5 kg were the basic rules. For the native doctors, training help for self-help was priority. In the announcements, patients with CLP were primarily addressed. Burns, contractions, tumors, and trauma-cases were the second priority. Fresh trauma was done in night shifts with the local surgeons in order not to interfere. Besides facial esthetics speech was the number one issue, following priorities fell into place. Cultural aspects played a certain role in the different countries and continents.

  13. Long-term results of the island flap palatal pushback.

    Science.gov (United States)

    Luce, E A; McClinton, M; Hoopes, J E

    1976-09-01

    We analyzed all 104 island flap pushback palatal repairs done through our Facial Rehabilitation Clinic in the period from 1965 to 1971. The results were compared to those in a group of 109 standard pushback repairs. The island flap group had a higher incidence of operative complications, of velopharyngeal insufficiency, and of secondary procedures to correct the latter. (The differences between the two groups were not statistically significant, however.) In this group of patients the island flap repair offered no particular advantage over the V-Y or the Dorrance pushback; in fact, it may have been deleterious. A hypothetical explanation for these results is offered, based on possible continuing osteogenesis by the transplanted mucoperiosteum, to produce an inflexible and poorly functioning velum.

  14. The Palatal Window for Treating an Incompletely Augmented Maxillary Sinus.

    Science.gov (United States)

    Florio, Salvatore; Suzuki, Takanori; Cho, Sang-Choon

    2017-04-01

    Maxillary sinus augmentation through a lateral window is reported as one of the most predictable bone augmentation procedures before implant placement. The elevation of the membrane represents a delicate and crucial step that allows the creation of the space for the bone graft material. If the elevation is not completed, the regenerated bone might be inadequate for the implant placement. In this case, a new intervention will be necessary to complete the bone augmentation. Reaccessing from a lateral window, however, would be challenging due to thickness of the buccal boney wall because of the first grafting procedure; therefore, a different approach has to be used. The aim of this case report is to present the palatal window technique for treating incompletely augmented maxillary sinus. The detailed step-by-step diagnostic and surgical procedures are described, and the advantages and limitations of the technique are discussed through a review of the literature.

  15. Pediatric Myofibroma of the Palate with Ulceration and Bone Destruction

    Directory of Open Access Journals (Sweden)

    Joseph A. Capo

    2016-01-01

    Full Text Available Myofibroma is a rare benign neoplasm occurring in the head and neck, arising primarily in infants and children. Frequently, myofibromas grow rapidly leading to suspicion of malignancy and the potential for overaggressive surgical excision. We aim to report a rare case of myofibroma with ulceration and bone destruction. A nine-year-old female presented with an ulcerated left hard palate mass. Open biopsy was performed with pathology suggestive of myofibroma. A left partial maxillectomy and reconstruction with a buccal advancement flap were performed. Final pathology confirmed the diagnosis of a benign myofibroma. Myofibroma is a rare benign tumor of the head and neck which must be considered in the differential diagnosis by the clinician and the pathologist in order to prevent inappropriate and/or overaggressive treatment.

  16. 20 years of cleft lip and palate missions

    Science.gov (United States)

    Lambrecht, J. Thomas; Kreusch, Thomas; Marsh, Jeff L.; Schopper, Christian

    2014-01-01

    Volunteer missions for cleft lip and palate (CLP) care in Indonesia (1991-1992), India (1994-2003), Bhutan (2005-2010), and Kenya (2011), took place always at the same Hospital in each country. Altogether over a thousand patients were operated using a conservative protocol: Safety first - no experiments. Five months and 5 kg were the basic rules. For the native doctors, training help for self-help was priority. In the announcements, patients with CLP were primarily addressed. Burns, contractions, tumors, and trauma-cases were the second priority. Fresh trauma was done in night shifts with the local surgeons in order not to interfere. Besides facial esthetics speech was the number one issue, following priorities fell into place. Cultural aspects played a certain role in the different countries and continents. PMID:25593861

  17. Velopharyngeal sphincter pathophysiologic aspects in the in cleft palat

    Directory of Open Access Journals (Sweden)

    Collares, Marcus Vinicius Martins

    2008-09-01

    Full Text Available Introduction: Cleft lip and palate are common congenital abnormalities with typical functional disorders on speech, deglutition and middle ear function. Objective: This article reviews functional labiopalatine disorders through a pathophysiological view. Method: We performed a literature search on line, as well as books and periodicals related to velopharyngeal sphincter. Our sources were LILACS, MEDLINE and SciELO databases, and we applied to the research Keywords of interest on the velopharyngeal pathophysiology, for articles published between 1965 and 2007. Conclusion: Velopharyngeal sphincter plays a central role in speech, swallowing and middle ear physiology in patients with labiopalatine cleft. At the end of our bibliographic review, pursuant to the velopharyngeal physiology in individuals with this disorder in the functional speech, deglutition and otologic function, we observed that although there is a great number of published data discussing this issue, further studies are necessary to completely understand the pathophysiology, due to the fact they have been exploited superficially.

  18. Non Syndromic Hypoglossia With Mandibular and Palatal Abnormalities

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    Shishir Ram Shetty

    2011-03-01

    Full Text Available Tongue is the most mobile organ of the body with multiple functions such as speech, mastication, taste and swallowing. Numerous congenital and developmental disorders of the tongue have been reported in literature. Hypoglossia also known as microglossia is one of the rare anomalies. Usually hypoglossia is associated with many other systemic abnormalities but rarely found as an isolated entity. Lack of tongue development leads to decreased mandibular growth. The aim of this article is to report a rare case of isolated hypoglossia and resultant micrognathia. Presence of palatal and faucial pillar abnormalities with hypoglossia which is extremely rare is also highlighted in our report. [J Contemp Med 2011; 1(1.000: 25-28

  19. Comparison of the effect of the rotation palatoplasty and V-Y pushback palatoplasty techniques on palate elongation with magnetic resonance imaging.

    Science.gov (United States)

    Isik, D; Bora, A; Yuce, S; Davran, R; Kocak, O F; Canbaz, Y; Avcu, S; Atik, B

    2015-06-01

    Most surgical techniques used in cleft palate repair require the extension of the palate to the pharynx. However, no adequate information exists regarding the extent to which this elongation obtained during operation continues in late postoperative period. In this study, we compared and measured palate elongation in patients with a cleft palate who underwent a V-Y pushback or rotation palatoplasty, by means of magnetic resonance images obtained before and 1 year after surgery. The hard palate, soft palate, and total palate lengths were measured for all of the patients, and the velopharyngeal opening area width was calculated. In patients who underwent the V-Y pushback technique (n=13), the total palate and soft palate lengths were shortened by an average of 0.10 and 0.14cm after surgery, respectively. However, the hard palate length was elongated by an average of 0.13cm. In the rotation palatoplasty group (n=13), the total palate, hard palate, and soft palate lengths were elongated by 0.57, 0.10, and 0.49cm, respectively. The velopharyngeal opening was narrowed by 0.06cm(2) using the V-Y pushback technique and by 0.29cm(2) using the rotational palatoplasty. This study demonstrated that the palate does not elongate during the V-Y pushback technique, as expected. However, rotational palatoplasty elongates the soft palate. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Analysis of dental arch relationships in Swedish unilateral cleft lip and palate subjects: 20-year longitudinal consecutive series treated with delayed hard palate closure.

    Science.gov (United States)

    Lilja, Jan; Mars, Michael; Elander, Anna; Enocson, Lars; Hagberg, Catharina; Worrell, Emma; Batra, Puneet; Friede, Hans

    2006-09-01

    To evaluate the dental arch relationships for a consecutive series from Goteborg, Sweden, who had delayed hard palate closure. Retrospective study. Sahlgrenska University Hospital, Goteborg, Sweden. The dental study models of 104 consecutive unilateral cleft lip and palate subjects. The study cohort was born between 1979 and 1994. Longitudinal records were available at ages 5 (n = 94), 10 (n = 97), 16 (n = 59), and 19 years (n = 46). Five assessors rated models according to the GOSLON Yardstick on two separate occasions each. These patients had been operated upon according to the Goteborg protocol of delayed hard palate closure (at age 8 years). 85% of subjects were rated in groups 1 and 2 (excellent or very good outcome), 12% were rated in group 3 (satisfactory), and 3% were assigned to group 4 (poor). No patients presented in Group 5 (very poor). Weighted kappa statistics for double determination of Yardstick allocation for five assessors demonstrated values between .65 and .90 for interrater agreement (good/very good) and between .70 and .90 for intrarater agreement (very good). Delayed hard palate closure as practiced in Goteborg since 1979 has produced the best GOSLON Yardstick ratings in a consecutive series of patients ever recorded worldwide, since the Yardstick was first used in 1983. However, it is noteworthy that a new protocol has been introduced in Goteborg since 1994, in which hard palate closure is done at 3 years due to concerns regarding speech.