Cleft Lip and Palate: Role of the Orthodontist in the Interdisciplinary Management Team

Kuijpers-Jagtman, A.M.

doi:10.1002/9781118702901.ch9

Cited by 3 publications

(2 citation statements)

References 57 publications

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“…Different determinants may play a role like the surgeon, surgical technique, timing of the surgery and other possible factors (Shaw et al, 1992). To achieve an acceptable jaw relationship, good functional occlusion, and satisfactory dental and facial aesthetics, orthodontic and orthopedic treatments are indispensable (Kuijpers-Jagtman, 2012). Nowadays, there is still no agreement on the ideal treatment protocol leading to a wide diversity of treatment approaches (Shaw and Semb, 2017).…”

Section: Introductionmentioning

confidence: 99%

Treatment Outcome in Bilateral Cleft lip and Palate Patients Evaluated With the Huddart-Bodenham Scoring System and the Bilateral Cleft lip and Palate Yardstick: A Systematic Review

Kuang

Aarts

Kuijpers-Jagtman

et al. 2021

The Cleft Palate-Craniofacial Journal

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Objectives To assess treatment outcome (transversal and sagittal dental arch relationships) and its determinants in complete bilateral cleft lip and palate (BCLP) evaluated with the modified Huddart-Bodenham scoring system and the BCLP Yardstick. Materials and methods Multiple electronic databases were searched without time limitation. Randomized clinical trials, cohort and case control studies using BCLP Yardstick and/or modified Huddart-Bodenham system to judge treatment outcome of patients with BCLP were included. The Risk of Bias in Nonrandomized Studies of Interventions tool and Grading of Recommendations, Assessment, Development, and Evaluation was used. Results Of the 528 studies identified by the electronic search, only eight retrospective studies met the inclusion criteria and were included. A total of 12 cleft centers were represented. All treatment protocols differed and background information was underreported. The results for the BCLP yardstick showed that all except the centers in New Zealand had a mean score lower than 3, indicating good treatment results. However, these studies had a moderate to high risk of bias. The modified Huddart-Bodenham scores were negative in all studies. No further meta-analysis was done due to heterogeneity and high risk of bias. The quality of evidence was graded as very low. Conclusion Results for the dental arch relationship of studies in complete BCLP and possible determinants were not synthesized due to very low quality of evidence. Clinical research for patients with BCLP should focus on sound methodological designs to enable evidence-based decision making to improve treatment for patients with BCLP and thereby hopefully their quality of life.

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Section: Introductionmentioning

confidence: 99%

Treatment Outcome in Bilateral Cleft lip and Palate Patients Evaluated With the Huddart-Bodenham Scoring System and the Bilateral Cleft lip and Palate Yardstick: A Systematic Review

Kuang

Aarts

Kuijpers-Jagtman

et al. 2021

The Cleft Palate-Craniofacial Journal

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“…Cleft lip and palate (CLP) is a serious orofacial birth defect affecting approximately 1/750 newborns worldwide with ethnic and geographical variation [ 1 ]. CLP is associated with various problems related to facial growth, feeding, speech, hearing and psychosocial status [ 2 ]. Palatogenesis is a dynamic and complex process and requires elevation, growth and adhesion of both palatal shelves, formation of the midline epithelial seam (MES), disintegration of this MES and arrangement of mesenchymal confluence.…”

Section: Introductionmentioning

confidence: 99%

Heme Oxygenase Protects against Placental Vascular Inflammation and Abortion by the Alarmin Heme in Mice

Suttorp

Rheden

Dijk

et al. 2020

IJMS

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Both infectious as non-infectious inflammation can cause placental dysfunction and pregnancy complications. During the first trimester of human gestation, when palatogenesis takes place, intrauterine hematoma and hemorrhage are common phenomena, causing the release of large amounts of heme, a well-known alarmin. We postulated that exposure of pregnant mice to heme during palatogenesis would initiate oxidative and inflammatory stress, leading to pathological pregnancy, increasing the incidence of palatal clefting and abortion. Both heme oxygenase isoforms (HO-1 and HO-2) break down heme, thereby generating anti-oxidative and -inflammatory products. HO may thus counteract these heme-induced injurious stresses. To test this hypothesis, we administered heme to pregnant CD1 outbred mice at Day E12 by intraperitoneal injection in increasing doses: 30, 75 or 150 μmol/kg body weight (30H, 75H or 150H) in the presence or absence of HO-activity inhibitor SnMP from Day E11. Exposure to heme resulted in a dose-dependent increase in abortion. At 75H half of the fetuses where resorbed, while at 150H all fetuses were aborted. HO-activity protected against heme-induced abortion since inhibition of HO-activity aggravated heme-induced detrimental effects. The fetuses surviving heme administration demonstrated normal palatal fusion. Immunostainings at Day E16 demonstrated higher numbers of ICAM-1 positive blood vessels, macrophages and HO-1 positive cells in placenta after administration of 75H or SnMP + 30H. Summarizing, heme acts as an endogenous “alarmin” during pregnancy in a dose-dependent fashion, while HO-activity protects against heme-induced placental vascular inflammation and abortion.

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Effect of Nasoalveolar Molding on Nasal Symmetry in Patients With Cleft Lip and Palate: A Systematic Review

et al. 2020

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Context: One of the main types of nasal deformity is unilateral cleft lip/palate, which affects the process of breathing and smelling. It is supposed that nasoalveolar molding (NAM) has a positive effect on the reduction of the tension in lips and helps to simplify or even eliminate the subsequent orthodontic treatment. Objective: This systematic review of papers focused on the effectiveness of NAM in patients with unilateral cleft lip/palate. Data Sources: The web search of Google Scholar, PubMed, Web of Science, and Medline databases Study Selection: The identification of 1282 articles published up to 2018. The selected papers were screened based on the eligibility criteria after the thorough investigation of the titles and abstract. In the next step, article inconsistent with our objectives were removed from the current study. Afterward, the papers were thoroughly studied and data related to our study goals were extracted and recorded in predetermined extraction forms. After the full-text evaluation of the articles, results in the selection of 22 articles. Data Extraction: The search process was performed by the following keywords in combination with nasoalveolar molding or pre-surgical nasoalveolar molding or pre-surgical orthopaedic appliances: unilateral cleft lip/palate, UCL/P, Cleft lip, Cleft palate. Results: Based on the literature review, various studies have supported the effectiveness of nasoalveolar molding appliance therapy on nasal symmetry in unilateral clefts of the lip and/or palate treatment. Conclusions: The NAM therapy is effective in decreasing the severity of the initial cleft deformity, as well as repositioning of deformed nasal cartilage and alveolar process. It has many beneficial results in surgical outcomes. However, the long-term effect of this approach has remained unclear.

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Cleft Lip and Palate: Role of the Orthodontist in the Interdisciplinary Management Team

Cited by 3 publications

References 57 publications

Treatment Outcome in Bilateral Cleft lip and Palate Patients Evaluated With the Huddart-Bodenham Scoring System and the Bilateral Cleft lip and Palate Yardstick: A Systematic Review

Treatment Outcome in Bilateral Cleft lip and Palate Patients Evaluated With the Huddart-Bodenham Scoring System and the Bilateral Cleft lip and Palate Yardstick: A Systematic Review

Heme Oxygenase Protects against Placental Vascular Inflammation and Abortion by the Alarmin Heme in Mice

Effect of Nasoalveolar Molding on Nasal Symmetry in Patients With Cleft Lip and Palate: A Systematic Review

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