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Volume 34 (2009)
- Issue 3 Pages 253-
- Issue 1 Pages 1-
Volume 34, Issue 3
Displaying 1-8 of 8 articles from this issue
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Yohei ODA, Tadaharu KOBAYASHI, Msanori NAGAI, Naoya IZUMI, Michiko YOS ...2009 Volume 34 Issue 3 Pages 253-260
Published: October 30, 2009
Released on J-STAGE: March 07, 2012
JOURNAL RESTRICTED ACCESSThe skeletal stability after Le Fort I osteotomy and bilateral sagittal split osteotomy in 12 patients with cleft palate was evaluated using lateral cephalograms and was compared with that in 71 non-cleft palate mandibular prognathism patients surgically corrected by the same operative procedure. Lateral cephalograms taken before surgery, immediately after surgery, and at least one year after surgery were used for evaluation. Changes in the positions of anterior nasal spine (ANS), point A, the incisal edge of the upper central incisor (U1), pogonion, point B, and the incisal edge of the lower central incisor (L1) were examined. The postoperative changes of the maxilla and the mandible were less than 1 mm on cephalograms except the vertical change at L1 in non-cleft palate patients. There was no statistical difference in the postoperative skeletal stability between the two groups. In the cleft palate group, the mean horizontal and vertical relapses were not correlated to the magnitude of their surgical movements though there were correlations between the parameters in the non-cleft palate group. It is concluded that the postoperative skeletal stability after bimaxillary orthognathic surgery in cleft palate patients was similar to that in non-cleft palate patients.View full abstractDownload PDF (434K)
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Kazuyuki KURATA, Rina MURAOKA, Noritoshi TOMINAGA, Shunsuke YUZURIHA, ...2009 Volume 34 Issue 3 Pages 261-272
Published: October 30, 2009
Released on J-STAGE: March 07, 2012
JOURNAL RESTRICTED ACCESSA clinico-statistical investigation was performed on 228 patients with cleft lip and/or palate in the Department of Orthodontics, Matsumoto Dental University Hospital, during the 10 years from April 1997 to April 2007.
1. The number of cleft lip and/or palate patients was 228, accounting for 7.4% of all orthodontic patients(3,085 cases). The patients consisted of 106 males and 122 females with a male to female ratio of 1:1.15.
2. Cleft morphology was classified as follows: Cleft lip and palate (CLP) was 56.6% (BCLP 28.7%, UCLP(L) 46.5%, UCLP(R) 24.8%; Cleft palate (CP) was 24.6%; Cleft lip and alveolus (CLA)was 11.8%; and Cleft lip (CP) was 7.0%.
3. The mean age of patients at the first visit was 7.6 years. The peak age at the first visit was 8 years (27.6%).
4. By referral source, the Department of Plastic & Reconstructive Surgery Shinshu University School of Medicine was 45.6%, the Department of Plastic Surgery Nagano Childrens' Hospital was 22.4%, and other departments in Matsumoto Dental University accounted for 11.8%.
5. As for the resident distribution, patients from Nagano Prefecture were 99.2%.
6. Of malocclusion from the aspect of first molar relationships, Class III was most frequent, being 36.4%. Class I was 34.0% and Class II was 29.6%. From the terminal plane of the second deciduous molar, mesial step type was most frequent, being 64.8%. Distal step type was 23.0%, and vertical type was 12.2%.
7. In classification of crossbite, cases of type 2 (total crossbite) were most frequent (28.9%). The patients with crossbite were 79.8%. It was confirmed that maxilla had a tendency forward constricted arch.View full abstractDownload PDF (824K) -
—During the Seven-Year Period from April 2002 to March 2009—Mayumi YAMAMOTO, Kiichi INAGAWA, Katsuyuki URUSHIHARA, Mika SHINOYAMA, ...2009 Volume 34 Issue 3 Pages 273-282
Published: October 30, 2009
Released on J-STAGE: March 07, 2012
JOURNAL RESTRICTED ACCESSCleft lip and/or palate patients treated in our department during the seven-year period from April 2002 to March 2009 were analyzed statistically.
1) We studied 311 primary operative cases which included 236 patients with cleft lip and/or palate (unilateral 184, bilateral 52) and 75 patients with isolated cleft palate.
2) Since 2002, the annual numbers of surgical operations and primary operations performed on cleft lip or cleft palate in our clinic have increased.
3) One hundred and fifty-three patients (49.2%) were from Okayama Prefecture, 77 (24.8%) from Hiroshima Prefecture, 20 (6.4%) from Tottori Prefecture and 16 (5.1%) from Ehime Prefecture. The remaining patients came from other prefectures, but most of them were residents of the Chugoku and Shikoku districts.
4) Complete forms (135 patients) were more common than incomplete forms (101 patients). Cleft lip was more frequent in incomplete forms. Cleft of the lip and alveolus was equally frequent in incomplete forms (1.7:1), whereas cleft of the lip, alveolus and palate was more frequent in complete forms (1:7).
5) The left-right ratio of the cleft side in unilateral cleft cases was 1.4:1 with left side predominance in every cleft type without incomplete cleft lip forms.
6) Cleft lip and cleft palate was more frequent in males while most isolated cleft palate patients were females.
7) The frequency of familial expression was 12.9%.
8) Concomitant malformation was found in 15.9% of all patients. Patients with isolated cleft palate were associated with a variety of anomalies and regarded to be high risk.View full abstractDownload PDF (671K)
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Experience of 30 Consecutive CasesMaki MIZUNO, Hiromitsu NABESHIMA, Atsushi NAKAYAMA, Mikio SHIMIZU, Mas ...2009 Volume 34 Issue 3 Pages 283-290
Published: October 30, 2009
Released on J-STAGE: March 07, 2012
JOURNAL RESTRICTED ACCESSAutogenous cancellous bone graft is a common procedure for alveolar cleft. The iliac crest is the most commonly used donor site for harvesting sufficient bone. However, postoperative complications such as pain or walking disturbance due to harvesting bone from the iliac have been reported. Recently, the tibia has been used as an alternative source because the postoperative damage is less compared with iliac harvesting. This report evaluated 30 cases of alveolar cleft treated by secondary bone grafting from the tibia.
We reviewed 30 consecutive patients (20 males and 10 females), who underwent alveolar cleft grafting from the tibia in the First Department of Oral and Maxillofacial Surgery, Aichi-Gakuin University. The mean patient age was 14.4 years. Twenty-one patients had unilateral alveolar cleft, and 9 patients had bilateral alveolar cleft.
We evaluated the following: 1) length of the incision line on the tibia, 2) surgical duration, 3) blood loss, 4) grafted bone weight, 5) complications, and 6) post alveolar bone height.
1) The average incision line measured 8.9 mm; 2) the average surgical duration was 18.8 minutes; 3) the average blood loss was 23.8 g; 4) the average grafted bone weight was 5.5 g; 5) there were no major complications, such as fracture or wound infection, in any case; and 6) the alveolar bone height maintained a satisfactory postoperative level in 27 patients (90%).
The proximal tibia offers a suitable donor site for secondary bone graft of alveolar cleft graft.View full abstractDownload PDF (719K) -
Kazumi KUBOTA, Yoko NAKANO, Ryu HAYAKAWA, Yoshiaki KAWAMOTO, Hisao OGA ...2009 Volume 34 Issue 3 Pages 291-298
Published: October 30, 2009
Released on J-STAGE: March 07, 2012
JOURNAL RESTRICTED ACCESSObjective: To investigate the feeding condition and the start of weaning food for cleft lip and/or palate patients.
Participants: Fifty-eight cleft lip and/or babies (31 cleft lip babies and 27 cleft lip and palate babies) who were examined by a pediatric dentist at the Department of Plastic and Reconstructive Surgery, first registered at Keio University Hospital from September 2007 to December 2008.
Results:
1. 88.8% cleft lip and palate patients used the nipples developed for infants with suckling disorders. Only one cleft lip and palate patient was able to do direct breast feeding.
2. The suckling condition of cleft lip and/or alveolar bone patients was considered relatively good because all of them could do direct breast feeding and/or feeding with an ordinary nipple before/after the first surgical correction.
3. The feeding condition after the first surgical correction was good and all patients were able to start the weaning food without any problems.View full abstractDownload PDF (479K)
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Rena TOGAWA, Shoichiro IINO, Aya MAEDA, Takako OOKAWACHI, Etsuro NOZOE ...2009 Volume 34 Issue 3 Pages 299-312
Published: October 30, 2009
Released on J-STAGE: March 07, 2012
JOURNAL RESTRICTED ACCESSThe patient was a 9-year 3-month-old girl at the first examination in our department. She showed an anterior crossbite, unilateral cleft lip and palate, maxillary hypoplasia, and marked narrow maxillary arch width. At the age of 15 years 10 months, an alveolar bone graft was performed after transpalatal expansion with a Rapid Maxillary Expander (RME). Presurgical edgewise treatment was started immediately after the alveolar bone graft, and the maxilla was advanced by Le Fort I osteotomy. An acceptable good facial profile and occlusion were achieved following those surgeries and orthodontic treatment. The patient showed stable occlusion with the remaining grafted bone 3 years after the maxillary advancement. Thus, maxillary advancement with Le Fort I osteotomy after transpalatal expansion with RME may be effective for improving patients with unilateral cleft lip and palate and patients with maxillary hypoplasia and marked narrow maxillary arch width.View full abstractDownload PDF (968K) -
Yohei ODA, Michiko YOSHIZAWA, Tadaharu KOBAYASHI, Naoya IZUMI, Chikara ...2009 Volume 34 Issue 3 Pages 313-319
Published: October 30, 2009
Released on J-STAGE: March 07, 2012
JOURNAL RESTRICTED ACCESSCongenital constriction band anomalies are a constellation of malformations associated with annular groove, amputation, and syndactyly. We report a case of constriction band anomalies with bilateral cleft lip and palate. The patient had syndactyly of upper limbs and amputation of a lower limb with cleft lip and palate at birth. At one month, the child was referred to Niigata University Medical and Dental Hospital for cleft lip and palate. A Hotz plate was set for nursing at two months. Multiple surgical procedures were subsequently performed during the initial 8 years and 3 months, including cheiloplasty, palatoplasty and alveolar bone graft for cleft lip and palate. In addition, orthopedic surgical procedures for limbs were performed to improve their deformity. Orthodontic treatment has been performed since the patient was 12 years old.
Constriction band anomalies are a rare condition in which it is hypothesized that a fibrous band of amniotic tissue results in variable soft tissue derangements. Other terms that have been used to describe this condition are amniotic band syndrome and amnion rupture sequence. These have been used to describe the fact that the patient may present with craniofacial, thoracic, abdominal, and/or limb involvement. In this report, we discuss the relationship between constriction band anomalies and cleft lip and palate from the viewpoint of their etiology. The mechanical effect of the amniotic band may inhibit fusion of prominences for organogenesis of the lip or palate in the fetus.View full abstractDownload PDF (902K)
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Kenichiro SUGA, Takeshi UCHIYAMA, Teruo SAKAMOTO, Shuji YOSHIDA, Kyout ...2009 Volume 34 Issue 3 Pages 320-325
Published: October 30, 2009
Released on J-STAGE: March 07, 2012
JOURNAL RESTRICTED ACCESSWe previously reported the usefulness of surgical techniques performed with the labial approach for surgical repositioning of the displaced premaxilla in bilateral cleft lip and palate patients. However, it was found that this technique is needed to care for the osteotomy line and blood flow to the premaxilla, because it is not easy to see the operative field widely.
We performed repositioning of the premaxilla with the palatal approach for 17 patients with bilateral cleft lip with or without cleft palate to verify the utility of this technique during a 13-year period from April 1996 to March 2009.
We found that the palatal approach is an appropriate surgical technique for repositioning the displaced premaxilla in patients with bilateral cleft lip with or without cleft palate. The results were as follows:
1. The palatal approach facilitated the surgical procedure of repositioning the displaced premaxilla, and all cases were performed by this technique surely and safely.
2. It was possible to perform osteotomy quite a distance away from the apex of the incisor's roots.
3. Contact points of bone fragments could be reduced correctly by bending the patient's head back when moving the premaxilla into the new position.
4. We confidently recommend using this technique to reposition the displaced premaxilla in bilateral cleft lip and palate patients.View full abstractDownload PDF (432K)
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