Articulation-function-associated brain developmental changes in cleft lip and palate patients.

This study compares 30 cleft lip and palate (CLP), 55 cleft palate (CP) and 28 cleft lip (CL) children in terms of descriptive speech data, nasalance data and the frequency of secondary surgery performed on patients. The CLP children had less hypernasality and audible nasal air emissions than CP children. The groups were equal with respect to articulation proficiency. The CLP and CL children generated similar nasalance scores, which were significantly lower than those of the CP children. Secondary surgery was equally common in the CLP and CP children.

Orofacial clefts: treatment based on a multidisciplinary approach

This study presents a comprehensive assessment of sinus pathologies in cleft lip and palate (CLP) patients utilizing cone-beam computed tomography (CBCT). Cleft lip and palate patients often exhibit abnormalities in the maxillary sinus region due to congenital malformations and surgical interventions. The objective of this analysis is to investigate the prevalence, types, and severity of sinus pathologies in CLP patients using CBCT imaging. A retrospective review of CBCT scans from CLP patients was conducted, and sinus abnormalities such as mucosal thickening, sinus opacification, and anatomical variations were identified and analyzed. The findings shed light on the spectrum of sinus pathologies in CLP patients and underscore the importance of comprehensive evaluation in treatment planning and management.

This cross-sectional study aimed to compare subjective assessments among patients with cleft lip and palate (CLP), cleft surgeons, and lay people regarding the soft tissue lateral profile of CLP patients. We also investigated the correlations between subjective assessments and photogrammetric measurements. A total of 150 CLP patients who wished to have treatment for their unattractive appearance were randomly selected. A standard lateral profile color photograph was taken. Panels of three cleft surgeons, ten CLP patients, and ten lay people were selected to be assessors. They rated nasal tip projection, nasolabial esthetics, upper and lower lip esthetics, and the profile for each photograph. Three angular measurements (nasal prominence angle, nasolabial angle, and lip angle) were measured for each photograph. Kendall's coefficient of concordance and logistic regression were used for statistical analysis. Kendall's coefficient of concordance of nasal tip projection, nasolabial esthetics, upper and lower lip esthetics, and the profile were 0.734, 0.683, 0.828, and 0.747, respectively (p < 0.001). Lip angle was associated with the profile scores for cleft surgeons and CLP patients (p < 0.001). The nasal prominence angle and lip angle were associated with the profile scores for lay people (p < 0.001). CLP patients, cleft surgeons, and lay people have similar attitudes to the appearance of CLP patients. Upper and lower lip esthetics is associated with the assessment of the cleft profile that is provided by CLP patients, cleft surgeons, and lay people. In addition, nasal tip projection is another determining factor for lay people. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The nasopalatine canal (NPC) is a critical anatomic structure in maxillofacial surgery. Variations in its morphology among individuals with cleft lip and palate (CLP) may increase the risk of neurovascular injury and adversely affect surgical outcomes. This study aimed to investigate the anatomic characteristics of the NPC in CLP patients using cone beam computed tomography (CBCT). This retrospective cross-sectional study was conducted at a Turkish university hospital, based on CBCT scan data collected between 2016 and 2024. The primary predictor variable was cleft status (yes/no), and the main outcome variables included NPC shape, number of canaliculi, canal length, diameters, and number of the incisive (IF) and nasopalatine foramen (NF), and buccal bone thickness. Appropriate statistics were computed using a significance threshold of P≤0.05. A total of 78 unilateral CLP patients (29 females and 49 males; mean age 16.23) and 78 matched controls were included. Tree-branch, needle-shaped, and funnel-shaped canals, as well as type 1 and 2 canaliculi, were significantly more common in the CLP group (P<0.001, P=0.012). CLP patients exhibited significantly fewer NF, shorter canal length, and smaller IF diameters (P<0.001). Buccal bone thickness differed by location, with the CLP group showing higher values at points B to D, and the control group at point A (P≤0.05). Anatomic variability of the nasopalatine canal in CLP patients underscores the importance of individualized radiographic assessment. Incorporating CBCT into preoperative planning can enhance procedural safety and improve outcomes in maxillofacial interventions such as Le Fort I osteotomy, implant placement, and orthodontic procedures involving anterior tooth movement.

Rehabilitation of cleft lip and palate (CLP) patients is a challenge for all the concerned members of the cleft team, and various treatment modalities have been attempted to obtain aesthetic results. Presurgical infant orthopaedics (PSIO) was introduced to reshape alveolar and nasal segments prior to surgical repair of cleft lip. However, literature reports lot of controversy regarding the use of PSIO in patients with CLP. Evaluation of long-term results of PSIO can provide scientific evidence on the efficacy and usefulness of PSIO in CLP patients. The aim was to assess the scientific evidence on the efficiency of PSIO appliances in patients with CLP and to critically analyse the current status of PSIO. A PubMed search was performed using the terms PSIO, presurgical nasoalveolar moulding and its long-term results and related articles were selected for the review. The documented studies report no beneficial effect of PSIO on maxillary arch dimensions, facial aesthetics and in the subsequent development of dentition and occlusion in CLP patients. Nasal moulding seems to be more beneficial and effective in unilateral cleft lip and palate patients with better long-term results.

Morphometric assessment of greater palatine canal and foramen variations in cleft lip and palate patients using CBCT.

Cleft lip (CL) and cleft palate (CP) are two of the most frequent congenital malformations. Many epidemiologic studies on this deformity have been conducted worldwide, often producing inconsistent results. This study assessed epidemiology and some genetic aspects of cleft lip and palate in a Chinese sample from the Smile Train Program and to compare with other methodologically sound surveys. The general information, family history, classification of cleft and associated malformations of 8000 CL and CP surgery patients were analyzed. Of the 8000 cases, 7812 had complete data. The distribution of cleft types is 17.04% with CP, 23.39% with CL and 59.58% with cleft lip and palate (CLP). Unilateral clefts were more common than bilateral, with unilateral to bilateral ratios being 10.4:1 for CL, and 3.42:1 for CLP. The overall male:female ratio was 2.01:1. Left sided defects were more common than right sided regardless of sex, 1.90:1 for CL and 1.96:1 for CLP. CLP and CL were more common in males than in females with sex ratios (SR) of 2.88:1 and 1.85:1 respectively, whereas CP was more common in females with SR of 0.76:1. Associated malformations (2.89%), involved 29 CP cases, 41 CL and 156 CLP. The frequency of associated malformations in CLP (3.35%) was higher than CL (2.24%) and CP (2.22%) (P < 0.05). Patients with CP or CLP were born less often in the winter than in the summer (P < 0.05). A history of family members having clefts occurred in 6.84% of patients. The proportion of CLP cases (7.56%) was significantly higher than that of CL cases (5.64%) (P < 0.05). The different types of clefts appeared in the highest proportion in CLP and lowest proportion in CP. Males are more common with CL and CLP and less common with CP. These characteristics are the same as those of other Chinese surveys but different from some European reports.

Editor's Summary and Q&A: Impact of facial asymmetry in visual perception: A 3-dimensional data analysis

Introduction: To assess the effects of cleft lip and palate (CLP) on the temporomandibular joint (TMJ) components using cone-beam computed tomography (CBCT). Methodology: This historical cohort study evaluated 20 CBCT scans of the TMJ area of patients with unilateral CLP as the test group and 20 CBCT scans of the TMJ area of non-CLP controls with class I occlusion. The morphological properties and dimensions of the condyle, the thickness of the glenoid fossa and articular eminence, and the articular eminence angle were measured and recorded. The two groups were compared regarding the above-mentioned variables by the Chi-square or t test (alpha=0.05). Results: The left and right axial condylar angles in CLP patients were significantly lower than the corresponding values in the control group by 1.8 degrees in the left and 2 degrees in the right side (p=0.005). The mediolateral condylar dimension at both sides was significantly lower in CLP patients than in the controls (p=0.001). The differences between the two groups were not significant in the anteroposterior condylar dimension, glenoid fossa thickness, and articular eminence thickness (p&gt;0.05). The CLP patients had significantly lower articular eminence angle in the right side (p=0.016) but not in the left side (p&gt;0.05), compared with the controls. Conclusion: Unilateral CLP patients have lower axial condylar angle and mediolateral condylar dimension at both sides, and lower articular eminence angle in the right side than the controls.

Introduction To assess the effects of cleft lip and palate (CLP) on the temporomandibular joint (TMJ) components using cone-beam computed tomography (CBCT). Methodology This historical cohort study evaluated 20 CBCT scans of the TMJ area of patients with unilateral CLP as the test group and 20 CBCT scans of the TMJ area of non-CLP controls with class I occlusion. The morphological properties and dimensions of the condyle, the thickness of the glenoid fossa and articular eminence, and the articular eminence angle were measured and recorded. The two groups were compared regarding the above-mentioned variables by the Chi-square or t test (alpha=0.05). Results The left and right axial condylar angles in CLP patients were significantly lower than the corresponding values in the control group by 1.8 degrees in the left and 2 degrees in the right side (p=0.005). The mediolateral condylar dimension at both sides was significantly lower in CLP patients than in the controls (p=0.001). The differences between the two groups were not significant in the anteroposterior condylar dimension, glenoid fossa thickness, and articular eminence thickness (p&gt;0.05). The CLP patients had significantly lower articular eminence angle in the right side (p=0.016) but not in the left side (p&gt;0.05), compared with the controls. Conclusion Unilateral CLP patients have lower axial condylar angle and mediolateral condylar dimension at both sides, and lower articular eminence angle in the right side than the controls.

BackgroundThe most prevalent congenital abnormality in the head and neck area is an orofacial cleft. These abnormalities can have a major effect on facial development, especially in the maxilla, pharyngeal airway, and midface. Additionally, children with cleft lip and palate (CLP) have been found to have medical conditions such as velopharyngeal insufficiency, adenoid hypertrophy, respiratory constriction, sleep issues, and obstructive sleep apneas (OSAs), significantly affecting the quality of life.This review aims to evaluate the literature for pharyngeal airway changes using cone-beam computed tomography (CBCT) in individuals with unilateral and bilateral cleft palates (ULCP and BLCP) and controls.Materials and methodsA systematic review (PROSPERO#CRD42024595549 and PRISMA 2020 checklist) was planned to evaluate the literature according to the norms prescribed by the Handbook of Systematic Reviews of Interventions by searching from the electronic databases of Medline, Embase, PubMed, and WOS involving studies only in human and text in English literature. Independently, the data and risk of bias/assessment of quality were reviewed by two investigators (JNZ and JL) for inclusion.ResultsA chart that adheres to the PRISMA declaration presents the findings of the literature search, including the inclusion and removal of publications. The articles for evaluation were those that were released between 2012 and 2025; only 34 articles were taken into consideration for further review.ConclusionThere are currently few studies comparing cleft and noncleft situations that use 3D radiography to examine the pharyngeal airway in CLP patients. Several recent studies have evaluated the pharyngeal airway in cleft patients using CBCT, yielding conflicting results. Based on the current limited evidence, a further high-quality study is required.How to cite this articleRai S, Bhateja S. Pharyngeal Airway Architecture in Patients with Cleft Lip and Palate by Cone-beam Computed Tomography: Review of Literature. Int J Clin Pediatr Dent 2025;18(9):1168–1180.

Brain functional changes and gut microbiota dysbiosis have been observed in perimenopausal syndrome (PMS). We evaluated the effects of a plant-based daily diet enriched with Raphanus sativus L. (RSL, radish seed) on the gut microbiota composition, gastrointestinal symptoms, resting-state local spontaneous brain activity, and neuropsychology in perimenopausal women. For 12 weeks, the participants were instructed to adhere to a controlled, Raphanus sativus L.-rich plant-based diet (a mean RSL intake of 5 g/day). Two test days were organized: before and after the nutritional intervention. The fecal microbiota composition, gastrointestinal symptoms, resting-state brain function, and neuropsychology were assessed twice. A longitudinal single-arm study was conducted on 24 perimenopausal women. The Montreal Cognitive Assessment (MoCA) scores tended to improve in the visuospatial/executive function subitem and in the total score after the diet. The participants presented elevated amplitude of low-frequency fluctuation (ALFF) values in the left middle occipital gyrus, the left precentral gyrus, and the left middle cingulum gyrus. The abundances of the phyla Synergistetes and Verrucomicrobia were positively correlated with the ALFF values of the left middle occipital gyrus, left precentral gyrus, and left middle cingulum gyrus. These data suggest that specific gut microbes may modulate intrinsic brain activity and cognitive function in perimenopausal women. A plant-based RSL-rich diet has beneficial effects on the gut microbial composition and brain function of perimenopausal women.

Introduction: Cleft lip and cleft palate are one of the most common craniofacial malformations that occur in children. Congenital heart diseases are more prevalent among children with cleft lip and cleft palate. Early intervention is necessary to improve the survival and for proper development of children.&#x0D; Materials and Methods: A retrospective study is conducted at Paediatrics Department in Saveetha medical College for a period of one year. In the present study medical records of patients with cleft lip and palate are evaluated and analysed for the incidence of heart diseases.&#x0D; Results: In the present study medical records of patients with cleft lip and palate are evaluated and analysed for the incidence of heart diseases. Out of 163 children with cleft lip and cleft palate, 56 children (71.42% male and 28.57% female) had cleft lip, 30 children (66.66% male and 33.33% female) had cleft palate, 77 children (66.23% male and 33.76% female) had both cleft lip and cleft palate.VSD is reported as the most common cardiac anomaly (42.86%) in children with cleft lip and cleft palate.&#x0D; Conclusion: There is an increased incidence of congenital heart diseases in children with cleft lip and cleft palate. Echocardiography is an important investigation done for early identification and proper management.

To determine the prevalence of treatment of early childhood caries (ECC) using general anesthesia (GA) in children with cleft lip and/or palate (CL/P). Retrospective chart review of children followed by the Manitoba Cleft Lip and Palate Program (MCLPP) to determine the frequency of treatment for ECC under GA. Children's Hospital, Winnipeg, Canada (a tertiary care centre). Children registered with MCLPP between January 1, 2008- December 31, 2019. The chart review collected data on the following variables: sex, date of birth, postal code, type of cleft, whether child had treatment of ECC using GA, age at the time of GA, and cost of treatment. Association of CL/P with ECC. Overall, 441 children had CL/P. 17% had isolated cleft lip (CL), 46% had isolated cleft palate (CP), and 37% had both cleft lip and palate (CLP). Overall, 24.3% of children with CL/P underwent dental surgery using GA while 14.5% underwent dental surgery to treat ECC between 12-59 months of age. When compared to a reference of Canadian healthy children 12-59 months of age, a child with CL/P was 15 times more likely to require GA to treat ECC. Treatment for caries under GA in children with CL/P is common. In the children with CL/P the rates of GA for treatment of ECC are significantly higher when compared to the general population. Children with CL/P require comprehensive oral health prevention to reduce the risk for caries and the need for treatment under GA.