Applications of dental implant and autotransplantation have been used to replace missing teeth. These treatments have been applied in conjunction with orthodontic treatment, especially for cleft lip and palate patients with congenitally missing teeth.
The objective of the present study was to determine if pre-extraction orthodontic jiggling would affect the replantation of teeth, a basic experimental model of autotransplantation.
In 7 adult male beagle dogs, labio-lingual or mesio-distal jiggling was applied to the hi-maxillary first premolars (P1) and mandibular second (I2) and third (I3) incisors, unilaterally, for 4 weeks. The corresponding contralateral teeth (P1, I2, and I3) served as control teeth. All of the treated and control teeth were extracted with forceps by the same operator. Periodontium of extracted P1 was evaluated histologically. Splinting was performed for a week after replantation of mandibular incisors and the animals were fed a soft diet. All of the animals (n=7) were sacrificed 7 weeks after replantation, and the dissected mandibular incisors were prepared for histological study (decalcified, n=4) and fluorescence study (undecalcified, n=3). The mobility of treated and control teeth was measured by Periotest® throughout the entire experimental period.
Jiggling significantly increased tooth mobility and decreased the amount of time required for extraction. Various histological studies indicated that jiggling tended to be associated with more periodontium from extracted P1. Jiggling also tended to inhibit root resorption and gingival loss at the cervical region after replantation.
These results suggest that the application of pre-extraction jiggling might stimulate the regeneration of periodontium and the surrounding tissues.

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The purpose of this study was to examine the effect of maxillary advancement by Le Fort I osteotomy on velopharyngeal function, in patients with cleft lip and palate (CL/CP), and in patients with non-CL/CP. A total of 15 patients (8 CL/CP patients and 7 non-CL/CP patients) were studied according to three headings, as follows, at 6 moths postoperatively.
1. Measurement of the amount of advancement at the standard point on the nasal side of the soft palate (NSP ), by lateral cephalograms at the rest position.
2. The contact pattern of the soft palate and the posterior pharyngeal wall, on lateral cephalograms, at pronunciation of (a: ), (i: ), and (∫: ).
3. Evaluation of velopharyngeal function by a speech therapist.
The results were as follows;
1. The ratio of the advancement of NSP to the maxillary advancement was 31 % in the CL/CP group, and 46% in the non-CL/CP group. There was no significant difference between the two groups.
2. Aggravation was seen in 5 out of 8 patients of the CL/CP group after surgery according to the contact pattern of the soft palate and the posterior pharyngeal wall. However, no change was seen in the patients of the non-cleft group.
3. One out of 8 patiets in the CL/CP group showed aggravation of velopharyngeal function in the evaluation by the speech therapist. However, no patient showed aggravation in the non-CL/CP group.

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The purpose of this study was to examine whether mean power frequency (MPF) might reflect physiologic fatigue of the levator veli palatini muscle (LVP) in postsurgical cleft palate speakers with velopharyngeal incompetence. Six patients with postsurgical cleft palate identified to have VPI by nasopharyngeal fiberscopy, were used as subjects. Each subject was asked to blow at maximum intensity for more than 10 seconds. Electromyograms (EMG) of LVP and oral air pressure were recorded. EMG signals were sampled at 2000Hz for 10 seconds, from the time the oral air pressure curve was stabilized on a monitor display. MPF was obstained using power spectral analysis with 0.5 second width of the analytic window. Single linear regression analysis identified that there was a significant negative correlation between MPF of LVP EMG and the time progress of sustained blowing. The result of the current study suggested that MPF might be useful to determine muscle fatigue in LVP.

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Transitional changes were statistically surveyed in patients with cleft lip/palate in the department of orthodontics, Kagoshima University Dental Hospital, during the 20 years from April 1980 to March 2000.
1. Patients total 624, which accounted for 7.8% of all firstvisit patients, and for 18.4% of all patients who started orthodontic treatment.
2. The number of patients showed a general decrease, although there were peaks in 1980,1984,1990, and 1995.
3. The mean age of patients at the first visit was 7.5 years old. Ages at the first visit ranged from ages 4 to 7, from the late deciduous dentition to the early mixed dentition.
4. Patients from 6 years old to 11 years old were dominant in the first 8 years, while those from 0 to 5 years old were dominant in the last 8 years.
5. Over 80% of patients were referred from the First and the Second Departments of Oral and Maxillofacial Surgery of the same hospital.
6. Percentages of patients with cleft lip (CL), cleft lip and alveolus (CLA), cleft lip and palate (CLP), and isolated cleft palate (CP) were 5.6 %,21.4%,55.8%, and 17.0% respectively. The percentage of CLP decreased from 78.0% to 36.1%, while that of CP increased from 6.3% to 33.7%, during the 20 years. Percentages of cleft sides as bilateral, unilateral left, and unilateral right were 20.1%,54.4%, and 25.5%, respectively.
7. Males were dominant in CL and CLP, while females were in CP. However, the male/ female ratio was about 1: 1 in CLA.
8. As to the malocclusions, percentages of anterior crossbite, Class I crowding, and maxillary protrusion were 68.8%,12.5%, and 10.4%, respectively. Percentage of anterior crossbite decreased from 84.9 % to 44.6%, while that of maxillary protrusion increased from 2.5% to 16.9%, during the 20 years.

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Data from our division (Division for Oral-Facial Disorders, Osaka University Faculty of Dentistry) have been used to make a clinicostatistical analysis of cleft palate. From 1995 to 2000,429 cases were registered in our division. The date of birth, cleft type, address, and referred department were studied in these cases.
The results were as follows:
1. The mean number of cases registered in our division was 85.8 per year.
2. The resident distribution of the patients was 92.1% from the Kinki area; in particular,70.8% were from around our hospital address.
3. Cleft morphology was classified into five categories: BCLP in 83 cases (19.3% ), UCLP in 162 cases (37.8% ), ICP in 139 cases (32.4% ), SMCP in 36 cases (8.4% ), and BU in 9 cases (2.1% ).
4. The laterality in CLP cases was unilateral in 66.1%, and bilateral in 33.9%. The laterality in UCLP cases was the left side in 64.2%, and the right side in 35.8%.
5. Referral from inside the hospital is found in 72.9% of all cases.

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A clinicostatistical analysis was carried out on primary cases with cleft lip and/or palate patients treated at our clinic (Oral Surgery II ) for the 20-year period since 1981, and the results of integrated treatment by a team composed of oral surgery II, preventive dentistry, orthodontics, and prosthodontics II, were evaluated.
The results were as follows:
1. The total number of primary cases was 718 (males,356: females,362). This corresponded to 3.8% of all new patients (19,085) in our department (Oral Surgery II ). Those were 252 (35.1%) with cleft lip and palate,244 (34.0%) with cleft lip, and 222 (30.9%) with cleft palate.
2. The total number of hospitalized patients was 1,451, which corresponded to 35.6% of all hospitalized patients (4,080). Included were 145 cases of accidental discharge.
3. The total number of surgical operations related to cleft lip and/or palate was 1,303. This corresponded to 38.8% of all surgical operations (3,355) in our department. Among 1,303 operations,556 (42.7%) were for lip repair, and 388 (29.8%) were for palate repair.
4. At first examination, bottle-feeding was being used most frequently (66.2% of 672 patients). Hotz plates have been used for 149 patients since 1988.
5. At the age of 4 years,247 (96.9%) of 261 cleft palate patients had acquired normal velopharyngeal closure. The patients that acquiered normal /pa/ pronunciation accounted for 95.8% of 261 patients. Articulation disorders were observed in 43 (16.5%) of 261 patients. Speech appliances were set for 11 patients, and the average age of setting was 4 years and 6 months.
6. To preventive dentistry,606 patients were referred, at an average age of 11 months. The number of decayed and filled teeth of 131 patients at the age of 3 years was 1.78, on average, which was less than normal children in Kagoshima prefecture (2.82) or in Japan (1.83).
7. To orthodontics,285 patients were referred, at an average of 5 years and 2 months, Iliac bone grafting was carried out on 92 patients. The mean age for grafting was 10 years and 11 months. Six months following surgery,26 of 49 cases were judged as successful. Orthognatic surgery was carried out on 13 patients.

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