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      Three-dimensional evaluation of surgical techniques in neonates with orofacial cleft

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          Abstract

          Background:

          Individuals with cleft lip and palate have many anatomic and functional alterations compromising esthetics, hearing, speech, occlusion, and development/craniofacial growth. The rehabilitative treatment of these patients is very challenging and starts at birth aiming at the best treatment for all functional demands. This study aimed to evaluate the dimensional alterations of the dental arches of neonates with cleft lip and palate after two different primary surgical techniques.

          Materials and Methods:

          The sample comprised 114 digital models of children aged from 3 to 36 months, with unilateral complete cleft lip and palate divided into two groups. Two different phases were evaluated: precheiloplasty and 1 year after palatoplasty. The evaluation was performed through the digital models of each child obtained by scanning digitalization (3D Scanner). Dental arches measurements were accomplished through Appliance Designer software. The following measurements were assessed: dental arch area, anterior amplitude of the cleft, total length of dental arch, intercanine distance, and intertuberosity distance. t-test was applied to compare differences between groups.

          Results:

          No statistically significant differences were observed between groups at precheiloplasty phase. At 1 year after palatoplasty, the groups differed in the total length of dental arch ( P = 0.002), with greater values for Group I.

          Conclusion:

          This study suggests that the results of the different surgical techniques may alter the growth and development of the dental arches of neonates with cleft lip and palate.

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          Most cited references35

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          Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 1: overall aspects

          Cleft lip and palate is the most common among craniofacial malformations and causes several esthetic and functional implications that require rehabilitation. This paper aims to generally describe the several aspects related to this complex pathology and the treatment protocol used by the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP) along 40 years of experience in the treatment of individuals with cleft lip and palate.
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            The Eurocleft study: intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 4: relationship among treatment outcome, patient/parent satisfaction, and the burden of care.

            To assess patient/parent satisfaction with the treatment they had received from their respective teams, and to explore interrelationships between satisfaction, objectively rated outcome, and the burden of care. This study reports cross-sectional data as part of the overall longitudinal cohort study reported in the other four papers of this series. Multidisciplinary cleft services in Northern Europe. 127 consecutively treated 17-year-olds with repaired complete unilateral cleft lip and palate and their parents. Patient/parent satisfaction. Generally, there was a high level of patient/parent satisfaction. There were no relationships among satisfaction, objectively rated outcomes, and the amount of care. This study highlights various challenges involved in questionnaire surveys into patient/parent satisfaction, and underlines the need for collective efforts to improve our understanding of this issue.
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              A preliminary study of facial growth and morphology in unoperated male unilateral cleft lip and palate subjects over 13 years of age.

              This paper investigates the effects of surgery on facial growth and morphology in Sri Lankan males with unilateral cleft lip and palate who were over 13 years of age at the time of study with cephalometry and dental study models. Three separate subgroups were analyzed: those who had totally unrepaired cleft lip and palate, those who received lip repair in infancy but not palatal repair, and those who had lip and palate repair in infancy. Twenty-three healthy noncleft Sri Lankan males over 13 years formed a control group from the same racial background. The results show that subjects who had no surgery had a potential for normal maxillary growth. Subjects who have had lip repair in early infancy show relatively normal maxillary growth, but maxillary hypoplasia is common when the palate has also been repaired early.
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                Author and article information

                Journal
                Ann Maxillofac Surg
                Ann Maxillofac Surg
                AMS
                Annals of Maxillofacial Surgery
                Medknow Publications & Media Pvt Ltd (India )
                2231-0746
                2249-3816
                Jul-Dec 2016
                : 6
                : 2
                : 246-250
                Affiliations
                [1 ]Pediatric Dentistry, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
                [2 ]Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry - University of São Paulo, Bauru, São Paulo, Brazil
                Author notes
                Address for correspondence: Prof. Thais Marchini Oliveira, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil. E-mail: marchini@ 123456usp.br
                Article
                AMS-6-246
                10.4103/2231-0746.200350
                5343636
                28299266
                10e2d3db-9cc9-4a63-bbbe-2b97c93469d0
                Copyright: © 2017 Annals of Maxillofacial Surgery

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Categories
                Original Article - Comparative Study

                cleft lip,cleft palate,dental arch
                cleft lip, cleft palate, dental arch

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