The purpose of the presened study is to test the hypothesis to possible to move teeth to a site filled with an artificial bone filling material (new ceramic material). Six adult dogs were used as experimental animals. After the extraction of anterior teeth, a bone filling material was implanted into cavities. Teeth adjacent to these extraction wounds were moved using an orthodontic appliance, and this tooth movement was evaluated on dental X-ray films and histological findings. The results obtained were as follows
1. Teeth were able to be moved to tooth extracti on cavities after the cavities were filled with an artificial material.
2. Mo vement of teeth to artificial material-filled cavities took a slightly longer period of time and caused less tipping, as compared with the control side.
3. It was histologically observed that bone fillin g materials were moved toward the tooth cervix by tooth movement, and new bone was formed around the materials. Because of this, the new alveolar bone had a larger width at the cervix, as compared with the control side. The periodontal membrane in contact with bone filling materials ran irregularly, while that on the control side showed a regular running pattern. The tooth root surface in contact with bone filling materials was slightly resorbed.

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The relationship between unilateral cleft lip and palate (UCLP) and craniofacial pattern is not clear. The purpose of this study was to compare and evaluate facial asymmetry in post operative children with complete unilateral cleft lip and palate, using frontal cephalogram. Forty-nine UCLP patients (boy 37, girl 12, average age 6.9 years old) were selected from the Dental Clinic of Niigata University Hospital. Twenty-one linear and six angular measurements from frontal cephalogram were calculated and statistical analysis was done. The following results were obtained:
1. The widths of the basal and alve olar bones of the maxilla and the antegonion of the mandible were significantly wider on the cleft side than on the non-cleft side.
2. The menton deviated to the cleft side (1.5±0.8mm).
3. The vertical height of the maxilla significantly decreased on the cleft side than on the noncleft side.
4. The correlation between the inclinations of the basal bone of the maxilla and the antegonion of the mandible was positive. Also there was a positive correlation between the ratio of the cleft side/non-cleft side on the heights of the basal bone of the maxilla and the antegonion.
The results of this study suggested that the maxilla and mandible tend ed to deviate to the cleft side and the mandibular growth might adapt the deficiency of vertical growth in minor segment of the the maxilla in cleft lip and palate patients.

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Folded flap operation is a popular procedure in pharyngeal flap surgery. It is characterized by a superiorly-based-pharyngeal flap folded anteroposteriorly, of which the ridge is fused to the nasal side of the velum after deepithelization of either shoulder of the fold and the corresponding area of the nasal membrane of the velum. When the elevated flap is not tightly folded or the connection between the ridge of the flap and the nasal side of the velum is loose, scar contracction within the flap may Rhorten flip folded flan. allowino- recurrence of velonhnrynoreal incomnetence in the unsutured area between the velum and the flap ridge. This report described a case that had been suffering from hypernasality caused by the recurrence of velopharyngeal incompetence induced by poor connection of the ridge of the folded flap and the nasal side of the velum after the folded flap operation. In this case, unified velopharyngoplasty (UVP) was successfully performed by means of unfolding the original flap and resetting the flap base on the basis of findings of a cephalogram and nasopharyngeal fiberscopy. One-year postoperative findings of nasopharyngeal fiberscopy identified that complete and normal closure of the velopharynx was exhibited during speech and blowing. The obtained results suggested that determination of the pharyngeal flap base in relation to the velopharyngeal closure level for individuals and choice of proper surgical procedure so as not to induce scar contraction of the flap are required. In addition, it was also suggested that UVP procedure is effective as a strategy for revised pharyngeal flap operation for recurrence of velopharyngeal incompetence following pharyngeal flap surgery.

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Movements of articulation and velopharyngeal closure during phonation [ka] [pa] [a] were analyzed with the use of videofluorography in cleft lip and palate children who recived a twostage palatoplasty followed by Perko's mothod. A total of 38 children were assigned to each of the four experimental groups: 12 children before hard palate closure (Group I ), the same children after hard palate closure but not enough speech therapy (Group II), another 13 children who were within one year after achievement of normal speech (Group III), and the other 13 children who were at more than two years later after achievement of normal speech following hard palate closure (Group IV). The re sults shown below were obtained.
1) Consonant articulatory movements were found to have improved following hard palatoplasty surgery. Following the completion of speech therapy, normal or nearly normal articulation movements were obtained.
2) Following hard palatoplasty, velopharyngeal closure was seen in approximately 90 % of the patients. Following the completion of speech therapy, velopharyngeal closure was confirmed in almost all of the patients.
3) Although the articulatory movements and velopharyngeal closure were performed almost simultaneously following hard palatoplasty, the articulatory movements preceded the velopharyngeal closure following the completion of speech therapy.
4) The amount of time required to produce the consonants and the vowel were shortened following hard palatoplasty, and they were further shortened following the completion of speech therapy.
5) During the phonation of the consonants [ka], the approach and separation time of the tongue and soft palate in the group II was shortened more than that in the group I. Furthermore, the approach and separation time of the tongue and soft palate in the group IV was shortened more than in the group
6) The amount of time re quired to complete velopharyngeal closure was clearly shortened by hard palatoplasty.
7) The velopharyngeal-closed length clearly increased following hard palatoplasty. It was also significantly extended in the group IV, to approximately twice that of the group I.
8) Following hard palatoplasty by two-stage palatoplasty according to Perko's method, the results of the videofluorography showed that the articulatory movements and velopharyngeal closure naturally and markedly improved.
They were further improved by speech therapy, and the coordination between the two was found to have increased.

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The mucosal grafts and flaps method (MGF method) has been developed to minimize growth impairment, following cleft palate repair, and to obtain adequate speech results.
This study was conducted to clarify the influence of the MGF method on m axillary dental arch growth and dental occlusion.
A total of 15 cases of unilateral cleft lip and palate was analyzed using plaster models of the upper dental arch and compared with 15 cases of non-cleft patients as the control group.
The incidence of crossbite and survival rates of mucosa grafts and the correlation there of were examined on 30 UCLP patients.
The results were as follows:
1) There was no significant statistical difference in maxillary dental arch growth at 4 ∼ 5 years old between the UCLP group and the control group.
2) The incidence of crossbite at 4 ∼ 6 years old was 13.6% for the deciduous central incisor,3.3%for the first deciduous molar on the non-cleft side, and 13.3% for the first deciduous molar on the cleft side.
3) The incidence of crossbite at for 7 ∼ 9 year-old was 21.7% for the central incisor, 0 % for the first molar on the non-cleft side, and 3.3% for the first molar on the cleft side.
4) The survival rates of the mucosal graft was 73% on the average and correlated with the incidence of crossbite.
To obta in good maxillary growth after cleft palate repair, not only use of for MGF method but also successful mucosal grafts is mandatory.

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A rare case of adult cleft lip and palate was reported. A 76-year-old female had bilateral cleft lip and palate, and had not been treated for complete bilateral cleft palate. She had complete cleft of her right lip, and she had an incomplete cleft with a scar on her left lip, probably caused by treatment.
Operations for cleft lip and cleft palate were performed simultaneously.
The growth of the maxilla in the cleft palate patient is controversil. In this case, the growth of the maxilla was not retarded anteroposteriorly in the cephalometric analysis.
This case was important for the argument about the growth of the maxilla.
She was the oldest patient who had undergone primary palatoplasty in Japanese literature.

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Cleft lip and/or palate is a malformation of relatively high incidence in Japan. Many studies have reported its incidence, however, there were little of recent surveys based on a large size of population. Since it is expected to have some changes of social environmental factors such as maternal aging, present study is aimed to investigate current rate of incidence using a questionnaire at the maternity hospitals in Niigata Prefecture from November,1994 to October,1995.
A total of 20566 new born infants were examined, and 36 had cleft lip and /or palate (0.175 %). Among those 36 infants with cleft lip and/or palate,13 had cleft lip,15 had cleft lip and palate, and 8 had cleft palate. Of the 13 infants with cleft lip,11 were unilateral and 2 were bilateral type of cleft. Of the 15 infants with cleft lip and palate,11 were unilateral and 4 were bilateral.
As for the sex,6 males and 7 females were in infants with cleft lip,10 males an d 5 females in infants with cleft lip and palate, and 1 male and 7 females in infants with cleft palate only.
Association of malformations were recognized in 9 out of the 36 infants (25.0 %) includi ng syndromes of Pierre-Robin, Opitz, Down,18 trisomy, and defects of the brain, skull, heart, limbs, and auricle.

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