[in Japanese]

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The spontaneous cleft malformation in three strains of CF#1 mice (CF#1/0hu, CF#1/Jms, and CF#1/Jah) was studied. The strains of A/J and SM/J mice were used as control.
The results were as follows
1. In three strains of CF#1 mice, the number of development with cleft palate averaged 3% and no development of cleft lip (or cleft lip, alveoral bone and palate) was found. In A/J mice, the number of development of cleft malformation averaged 2.2% in cleft palate, and 6.5% in cleft lip, alveoral bone and palate. In SM/J mice, no cleft malformation was developed.
2. The cleft pattern in CF#1 mice showed cleft soft and hard palates.
3. The spontaneous and independent developments of cleft pala te in CF 1 mice was the same as the genetical pattern of development of cleft palate in humans.
Therefore CF#1 mice seemed to be an available dis ease model for the analysis of the cleft palate gene.

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Shape and function show good recover after lip and palatoplasty in cleft lip and palates. However due to mid face underdevelopment, deformity of the jaw and malocclusion are common.
This reports Le FORT I osteotomy of an adult bilateral cleft lip and palate patient as a result of malocclusion. Oral habilitation with prosthetic treatment was good after improved occlusion and isolation of the oronasal fistula with the tongue flap.

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To treat the collapsed maxillary dental arch of the cl eft subject, the author published the newly designed expansion appliance report, “A jointed fan-type expander” in 1989. This report presents two cases treated with the appliance. Case 1: a girl with oblique facial cleft, bi-lateral cleft lip and palate,8 years and 8 months old. Case 2: a boy with uni-lateral cleft lip and palate,12 years and 4 months old.

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Statistical analyses were carried out on 444 patients (237 males and 207 females) with cleft lip and/or palate for prosthodontic treatment
The results were as follows:
1. The number of the patien ts with cleft was 444, and it was 25.0% of total patients.
2. Half of the patients was from 16 to 20 years old at their first visit to our c linic.
3. The patietns who were refered from other clinic occupied 87.4% of the pa tients.
4. The patients who were refered from dental clinic occupied 80.9% of th e patients. The patients who were refered from orthodontic clinic occupied 57.7% of the patients.
5. Distributions of cleft type were;
Cleft tip and palate (CLP) 83.1%
Cleft lip and alveolos (CLA) 7.9%
Cleft palate (CP) 9.0%
6. Distributions of cleft site were;
Bilateral cleft 21.3%
Left side cleft 47.8%
Right side cleft 30.9%
7. Sex ratio (ma le: female) were;
Total 1.14: 1
CLA and CLP 1.27: 1
CP 1: 2.64
8. The patients who were finished prosthodontic treatment occupied 62.6% of the patients. The patients whom we refer another clinic after their first visit to our clinic occupied 14.9% of the patients.

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Prosthodontic treatment of the cleft palate patient involves not only the restoration of function and appearance but also the maintenance of oral health for life.
So, a clinical investigation was carried out on 228 patients with c l eft lip and/or palate who had received prosthodontic treatment during the past 10 years from 1979 to December 1989.
The results were as follows:
1. About half of the patients was from 16 to 20 years old at the start of the prosthodontic treatment.
2. Fixed prostheses were made. for 141 patients.
3. Collaboration of the prosthodontist w ith the orthodontist and/or the plastic or oral surgeon made the ensuing prosthodontic procedures much simpler.
4. Two abutment teeth in each segment were also desirable from the point of prognosis.
5. It seemed that a half crown was not desirable procedure for fixed prostheses.

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A clinico-statistical examination was made on 61 patients wan cneilognatnopaiarUSCIllblb who were examined at our Department during a period of 14 years from April,1975 to March,1989. The following results were obtained;
1. Patients were distributed mostly in Tochigi Prefecture, especially its central part where our Hospital is situated, representing 41.7% of all patients.
2. These patients were 47 boys and 40 gi rls (sex ratio,1.2: 1) with male predominance.
3. By type, clefts were represented by cheilognathopalatoschisis (41.1%), cleft palate (38.2%), and cleft lip (gnathoschisis) (26.4%) in this order.
4. By laterality, cleft palate was unila teral in 76.3% and bilateral in 23.7% with unilateral predominance. Left laterality (1.5: 1) was noted.
5. Cleft palate was complete in 71.2% and incomplete in 28.8% with " incomplete " predominance, and such tendency was higher for cheilognathopalatoschisis.
6. By birth order, the 1st and 2 nd children represented 43.7%, respectively and comprised all cases, together with the 3rd children.
7. By birth weight,3,001-3,500g represented the most (36.8%) and low-weight children were also noted in 9.2%.
8. By b irth age (parent),26-30 years (36.8%) and 26-30 years (40.2%) were most noted for father and mother, respectively.
9. By age at the 1st examination,1-3-postnatal-month-old (40.2%) was noted most; cases accompanied with cleft palate tended to come to our Hospital comparatively early.
10. Via visiting our Hospital,36.8 and 26.4% represeted introduc tions from extra-hospital departments of gynecology and from intra-hospital department of pedirics, respectively, with a predominance of introductions from extra-hospital departments.
11. Complicated malformations we re noted in 25.3%, with a predominance of tetania frenulum linguae (5 cases).
12. Fa milial incidence was 6.9%, all cases being cheilognathopalatschisis.
13. Inter-pregnant maternality included disease co ntraction (17.2%), drug abuse (6.9%) and others.
14. Questionnaire about the prognosis revealed patients' satisfactions with cheilostomatoplasty (48.3%)and platoplasty (79.4%).

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Abstract: We experience clinically associated anomalies with cleft lip & cleft palate most often. The incidence of associated anomalies has been reported in many monographs. The percentage from 2 to 3% at the lowest and approximately over 30% at the highest is reported. It is considered that definite percentage cannot be obtained because newborns and fetuses for treatment are subjected, and the standard for anomalies is not established. In total,1,267 patients with cleft lip, cleft palate, cleft lip & palate who were in our hospital from January,1980 to December,1990. At this time, we investigated and totaled the associated anomalies in not only external epidermises but also in internal organs which were recognized during diagnosis or surgery.
The following results were obtained.
1. The associated anomalies with the skull, face, trunk, extremities and internal organ system including mental retardation was observed in 353 patients, and observed in 27.9% overall. This percentage was comparatively high so far as we investigated.
2. The associated anomalies were observed in the order of cleft palate, cleft lip & palate, and cleft lip, and the same order as all previous reports.
3. Among the associated anomalies, congenital heart disease was most often observed, followed by mental retardation, Pierre-Robin syndrome, umbilical hernia, ear malformation, extremity malformation, hydrocele testis, and inguinal hernia.

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A statistical survey on the treatment stage and the occlusal condition after active orthodontic treatment was carried out on 532 cleft lip and/or palate patients (288 males and 244 females)whose diagnostic data were taken in the Orthodontic Clinic of Hiroshima University Dental Hospital from April 1968 to March 1989.
The results were as follow s:
1. The incidence of each tre a tment stage in March,1991 was as follows; before or during treatment 34.0%, during or after retention 37.8%, transfer or discontinuance 26.8%.
2. The incidence of each occlusal condition at the end of active trea t ment in 186 cases during or after retention patients was as follows: good occlusion in both anterior and posterior teeth (GOOD) 55.9%, poor occlusion with cross bite or open bite in more than two adjacent anterior or posterior teet h (POOR) 12.4% and others (MEDIOCRE) 31.7%. When the cases whose occlusion was evaluated as MEDIOCRE but was considered as the limit of the present orthodontic treatment result because of alveolar bone defects at the cleft site were included in GOOD, good occlusion was acquired in 71.0%of cleft patients at the end of active orthodontic treatment.
1) The occlusion of cleft lip patients and cleft lip and alveolous patients was not evaluated as POOR, but the occlusion of 18.1% of unilateral cleft lip and palate patients,12.5% of bilateral cleft lip and palate patients and 7.7% of cleft palate patients were evaluated as POOR.
2) When only the patients whose ative treatment was finished afte r 1981 were evaluated, the incidence of GOOD increased to 59.9%.
3. The incidence of maxi l lary retainers which were known to be in 200 patients was as follows: resin plate-122 patients, bonded lingual retainer-38 patients, bonded lingual retainer with resin plate or lingual arch-23 patients, other retainers-12 patients and without retainer-5 patients.
4. After the end of active treatment (during retention), the occlusion wa s changed to POOR in 19.3% of GOOD patients and 29.2% of MEDIOCRE patients.
5. The incidence of maxillary prosthesis which were known to be in 61 patients was as follows: bridge-24 patients, metal plate-16 patients, bridge and metal plate-7 patients and others-14 patients. Maxillary prosthesis was not indicated in 19 patients.
6. After prosthetic treatment, the occlus ion became worse in three patients: the causes of the changes for the worse were the detachment of a bonded bridge in one patient and mandibular growth in the other two.

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