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31 May 2023, Volume 26 Issue 3 Previous Issue    Next Issue

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Orthodontic Treatment of Patients with Cleft Lip and Palate during Mixed Dentition Weiran Li 2023, 26(3):  161-165.  DOI: 10.12337/zgkqjxjyzz.2023.03.001 Abstract ( 71 )   PDF (777KB) ( 47 )   The mixed dentition period is one of the most active periods of occlusal and maxillofacial growth and development. It is the period when the problems of malocclusion appear and aggravate in patients with cleft lip and palate, and an important treatment stage in the sequential treatment of cleft lip and palate. Due to congenital malformation, surgical trauma and scarring, patients with cleft lip and palate often suffer from maxillary underdevelopment, which causes abnormal intermaxillary transverse and sagittal relationships, manifesting as anterior and posterior crossbite. Congenital missing teeth and early tooth loss due to poor tooth development and poor oral hygiene further complicate the malocclusion in patients with cleft lip and palate. During the mixed dentition period, orthodontic treatment of abnormal intermaxillary transverse and sagittal relationship and the treatment of the tooth abnormalities in patients with cleft lip and palate can alleviate occlusal and maxillofacial deformities, improve the function of the stomatognathic system, and be beneficial to the occlusal and maxillofacial development. The alveolar bone grafting during the mixed dentition period is vital in the sequential treatment of cleft lip and palate, which lays a good foundation for the subsequent orthodontic treatment of malocclusion. The necessary orthodontic treatment before bone grafting is expected to improve the treatment effect of bone grafting. In this article, we will address the common malocclusion and the corresponding orthodontic treatment in patients with cleft lip and palate during the mixed dentition period. References | Related Articles | Metrics

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Research progress on surgical training with simulator for cleft palate Jiali Chen, Ni Zeng, Chao Yang, Qian Zhen, Bing Shi, Hanyao Huang 2023, 26(3):  166-173.  DOI: 10.12337/zgkqjxjyzz.2023.03.002 Abstract ( 51 )   PDF (2075KB) ( 32 )   Cleft palate is a common congenital developmental malformation of the maxillofacial region, manifested by defect of the palate, leading to problems such as food reflux, unclear pronunciation and impaired hearing, which seriously affect the life quality of patients. Currently, surgery is the main treatment for cleft palate, which maxillofacial surgeons should master skillfully. However, the complexity of the surgery and the narrow field of view makes it extremely challenging to observe and learn. In addition, there are fewer opportunities for medical students to operate on patients. Therefore, surgery simulators for the cleft palate are needed to help medical students understand the pathological structure of the cleft palate and master the surgery procedures and surgical techniques. This review aims to introduce the current simulators for cleft palate surgery to provide a reference for clinical teaching and training in cleft palate surgery. References | Related Articles | Metrics

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Evolution and interpretation of the parameters for evaluation and treatment of patients with cleft lip / palate or other craniofacial differences in the United States Zhu Hongping 2023, 26(3):  174-178.  DOI: 10.12337/zgkqjxjyzz.2023.03.003 Abstract ( 77 )   PDF (779KB) ( 91 )   Cleft lip and palate is a common birth defect in oral and maxillofacial regions. Good outcomes could not be achieved unless after long-term interdisciplinary team care. The diagnosis and treatment guidelines for cleft lip and palate in the United States have been revised and evolved for 30 years since their promulgation in 1993, and have important guiding value for the treatment of cleft lip and palate. This article focuses on introducing the key content of this guide, including principles and team responsibilities for the treatment of cleft lip and palate, precautions for newborns and infants, cleft lip and palate repair, timing of correction for cleft lip and palate nasal deformities, alveolar bone grafting repair and craniofacial surgery, ear, nose, throat, and hearing problems and management, orthodontic treatment for cleft lip and palate patients, speech/language assessment and treatment, and psychological and social services. References | Related Articles | Metrics

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Current status and progress of research on Quality of Life scales in patients with cleft lip and palate Xinyu Zhang, Yuzhe Ding, Wenying Kuang, Yanyu Guo, Wenjun Yuan 2023, 26(3):  179-185.  DOI: 10.12337/zgkqjxjyzz.2023.03.004 Abstract ( 25 )   PDF (1220KB) ( 9 )   Improving the quality of life of patients with cleft lip and palate is the main goal of the cleft lip and palate team approach, so it is important to be able to assess the quality of life of patients with cleft lip and palate accurately. This article introduces the commonly used quality of life scales for patients with cleft lip and palate, provides an objective comparison of different scales, and discusses the current status and progress of research on quality of life in patients with cleft lip and palate with the aim of providing a reference for future clinical work. References | Related Articles | Metrics

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Research progress on digital applications of presurgical nasoalveolar molding for infants with cleft lip and palate Rong Liang, Yuxia Hou 2023, 26(3):  186-190.  DOI: 10.12337/zgkqjxjyzz.2023.03.005 Abstract ( 19 )   PDF (1393KB) ( 4 )   Cleft lip and/or palate (CL/P) is the most common disorder in the oral, and maxillofacial region, which significantly affects the appearance and function of the oral system in infants. Complete cleft lip and palate (CCLP) is one of the most severe phenotypes of CL/P. Presurgical nasoalveolar molding (PNAM) is an important part of the sequence of treatments for infants with cleft lip and palate and is currently a crucial technique adopted for presurgical orthodontic treatment in infants with unilateral or bilateral CCLP. PNAM can reshape the nose, alveolar bones, and lips to a certain extent and creates the conditions for surgical repair, reduces surgical complexity, and improves postoperative aesthetic outcomes. With the advancements in computer technology, computer- aided design, and 3D printing technology have been gradually introduced into the treatment of PNAM in infants with cleft lip and palate. Here, we summarize the recent research progress in the digital application of PNAM in infants with cleft palate and lip. References | Related Articles | Metrics

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Clinical treatment research on secondary rhinoplasty of unilateral cleft lip nasal deformity Jiaqi Zhao, Di Wu 2023, 26(3):  191-196.  DOI: 10.12337/zgkqjxjyzz.2023.03.006 Abstract ( 27 )   PDF (790KB) ( 12 )   We performed a literature review focusing on advances in the rhinoplasty of unilateral cleft nasal deformity. The nasal deformity of unilateral cleft lip can be manifested as nasal base collapse, tip deviation, columella shortening and deviation, septal deviation, alar collapse, bilateral nostril asymmetry, etc. Timing of rhinoplasty can be divided into primary,intermediate and definitive surgery. It is accepted that the final operation should be carried out in mature stage, while timely and early adjustment is conducive to the later correction effect. Treatment concept mainly focuses on structural remodeling and biomechanical reconstruction of nasolabial muscle tension system,which aims to guarantee long-term nasal symmetry and aesthetics. Detailed treatment contains flap transfer, biomechanical muscle reconstruction, graft material filling(autologous cartilage, biomaterials and artificial bone included) and osteotomy used for severe cases. Present surgical plan is individualized according to the characteristics of nasal deformities, which often combines multiple areas and methods. This article summarizes treatment concepts and therapeutic methods of unilateral cleft nasal deformity aiming to provide useful guidance for the selection and improvement of surgical trails. References | Related Articles | Metrics

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Skeletal age of cleft lip and palate individuals Xiaoyi Wu, Wenying Kuang, Cui Huang, Wenjun Yuan 2023, 26(3):  197-203.  DOI: 10.12337/zgkqjxjyzz.2023.03.007 Abstract ( 14 )   PDF (1211KB) ( 8 )   For patients with cleft lip and palate, a development-oriented multidisciplinary team approach is regarded as the most effective treatment at the present stage. It is of great significance to correctly evaluate the development stage for selecting the timing of treatment and prognoses. Skeletal age is widely applied as an effective biologic indicator for development stage. The development pattern of children with cleft lip and palate may different from that of non-cleft children. Through skeletal age, the development pattern of children with cleft lip and palate can be revealed, which is of great significance for sequential treatment protocol design. This paper will present the general skeletal age assessment methods of cleft lip and palate, and review the research progress on the skeletal age of patients with cleft lip and palate. References | Related Articles | Metrics

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Progress in the application of endoscope in cleft palate repair and velopharyngoplasty Chen Haotian, Zhou Lian 2023, 26(3):  204-208.  DOI: 10.12337/zgkqjxjyzz.2023.03.008 Abstract ( 24 )   PDF (766KB) ( 30 )   Endoscopy has become more and more important in the diagnosis and treatment with the development of clinical medicine and technology, especially in narrow space without direct sight. The endoscopy has made the surgery less invasive and more efficient. Cleft palate repair and velopharyngoplasty surgery have a narrow sight, which make it difficult in operation and not conducive to teaching. Therefore, this review briefly summarizes the development of endoscopy in stomatology and its application in cleft palate and palatopharyngeal surgery, summarizes its advantages and disadvantages, and puts forward the development of endoscopy in the treatment of cleft palate, palatal fistula, and velopharyngeal insufficiency. References | Related Articles | Metrics

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Early speech and language development and intervention in children with nonsyndrom cleft lip and/or palate: a review Siwei Ma 2023, 26(3):  209-214.  DOI: 10.12337/zgkqjxjyzz.2023.03.009 Abstract ( 16 )   PDF (781KB) ( 8 )   Speech and language rehabilitation in children with cleft palate is unique due to the interaction of surgical intervention, language development, and individual differences in craniofacial structure. This paper reviews the speech developmental characteristics of infants and toddlers and the early interventions programs for the speech and language development with cleft lip and/or palate, which would help to build up intervention plan and evidence-based strategies to promote the implementation of EI on the improvement of speech and language development delay among Mandarin speaking young children with cleft lip and/or palate in China. References | Related Articles | Metrics

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Postoperative evaluation of bilateral micro-form cleft lip: 23 cases Wu Yilai, Liang Yun, Wang Teng, Wang Guomin, Yang Yusheng, Chen Yang 2023, 26(3):  215-220.  DOI: 10.12337/zgkqjxjyzz.2023.03.010 Abstract ( 27 )   PDF (2533KB) ( 17 )   Objective: To investigate the surgical approach to bilateral micro-form cleft lip and to evaluate the results. Methods: A total of 23 patients who underwent the bilateral micro-form cleft lip revision in our cleft lip and palate treatment and research center between January 2009 and December 2020 were evaluated by photographic data for symmetry of cupid's bow, vermilion symmetry, and vermilion notching. Results: The cleft lip was repaired by the linear method in 11 cases, the V-Y advanced flap in 2 cases, and the bilateral vermilion musculomucosal sliding flaps (VMSF) in 10 cases. From the results of the follow-up, the patients with VMSF had the highest scores, followed by those with linear sutures, and V-Y procedure, although only 2 cases, had low scores in all postoperative evaluations. Conclusions: The vermilion notching is the biggest postoperative problem in patients with bilateral micro-form clefts, and the repair method with VMSF is more desirable than the postoperative results achieved by the simple linear suture and V-Y procedure. References | Related Articles | Metrics

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Application of diced costal cartilage wrapped in rectus abdominis fascia for nasal dorsum augmentation in secondary unilateral cleft lip nasal deformity Yang Yu, Zhe Dong, Jiegang Yang, Yuchuan Fu, Jian Li 2023, 26(3):  221-226.  DOI: 10.12337/zgkqjxjyzz.2023.03.011 Abstract ( 42 )   PDF (8814KB) ( 19 )   Objective: To evaluate the effectiveness of diced costal cartilage wrapped in rectus abdominis fascia as nasal dorsum graft in the correction of secondary unilateral cleft lip nasal deformity. Methods: A retrospective study was performed on 35 patients with secondary unilateral cleft lip nasal deformity between January 2020 and April 2022. The patients admitted to the Hospital of Stomatology of Wuhan University, including 21 males and 14 females; aged 16-32 years. The autologous costal cartilage-based open rhinoplasty was used for the treatment, and nasal dorsum augmentation using the diced costal cartilage wrapped in rectus abdominis fascia technique. Preoperative and postoperative photos were taken in the anteroposterior position and lateral positions, and the facial profile aesthetic angle indicators were measured. Patients'subjective satisfaction, complications including graft resorption, warping, and visibility were recorded and evaluated. Results: The incisions healed by the first intention after the operation, and no complications such as cartilage exposure or acute infection occurred. All 35 patients were followed up for 6 to 16 months. During the follow-up, the patient's nasal shape remained good, the nasal dorsum was raised, and improvement of dorsal aesthetic lines was achieved. The nasal tip and columella were basically centered, the tip definition was improved, and the collapse of the affected side of the nasal alar was lessened significantly than preoperatively. None of the patients had cartilage warping, visibility, and absorption. The indexes of nasofacial angle, nasomental angle, tip rotation, and the ratio of bilateral nostril axis angle were significantly improved after the operation when compared with preoperatively(P<0.05). All of the patients' nasal deformities were greatly improved, and they were satisfied with the effectiveness. Conclusion: Diced costal cartilage wrapped in rectus abdominis fascia can be used for nasal dorsum augmentation in secondary unilateral cleft lip nasal deformity. The postoperative efficacy was stable and patients' satisfaction rate was high. This technique has promotion significance in clinics. References | Related Articles | Metrics

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Cleft palate in patient with congenital heart disease and breath-holding spells: a case report Lanrui Luo, Nan Li, Shuang Yang, Keying Liu, Hongping Zhu 2023, 26(3):  227-232.  DOI: 10.12337/zgkqjxjyzz.2023.03.012 Abstract ( 38 )   PDF (1726KB) ( 18 )   Objective: Exploring the key points of perioperative clinical management for children with cleft palate accompanied by breath holding syndrome and congenital heart disease. Diagnosis and treatment: After conducting specialized examinations on the child with cleft palate and congenital heart disease, it was confirmed that his heart function was normal and that he was accompanied by breath holding syndrome. After analyzing the condition, a treatment plan was developed and cleft palate repair surgery was performed. Results: The surgery was successful. At 8 months of follow-up, the velar morphology was good and the patient had a clear articulation. Conclusions: Surgical operation can be considered in cleft palate patient with breath-holding syndrome and congenital heart disease under strict evaluation, delicate surgical manipulation and close protection. References | Related Articles | Metrics