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Clinical Oral Investigations Apr 2024To identify the characteristics of the oral microbiota and the relationship of the dental caries and periodontal status in patients aged 0 to 18 years with non-syndromic... (Meta-Analysis)
Meta-Analysis
Characterization of the oral microbiota and the relationship of the oral microbiota with the dental and periodontal status in children and adolescents with nonsyndromic cleft lip and palate. Systematic literature review and meta-analysis.
OBJECTIVE
To identify the characteristics of the oral microbiota and the relationship of the dental caries and periodontal status in patients aged 0 to 18 years with non-syndromic cleft lip and palate (CLP).
MATERIALS AND METHODS
A systematic review of the literature was carried out. Five databases were consulted, including publications in English, Spanish and Portuguese. The evaluations of the quality of the observational studies and the experimental studies were carried out with the Newcastle-Ottawa scale and CONSORT guidelines, respectively. The risk of bias of the studies was determined using Rev Manager 5.4, and 5 publications were meta-analyzed.
RESULTS
The cariogenic microbiota of children and adolescents with cleft lip and palate was similar to that of children without clefts, although with higher counts of Streptococcus mutans and Lactobacillus spp. The periodontopathogenic microbiota was related to the presence of Campylobacter spp, Fusobacterium spp, Fusobacterium nucleatum, Prevotella intermedia/nigrescens, Parvimonas micra and Porphyromonas gingivalis, considered microorganisms with high pathogenic capacity. Heterogeneity was shown in relation to the microbiota and the type of fissure, presenting numerous microorganisms associated with the pre- and post-surgical condition (cheilorrhaphy and palatorrhaphy) such as Staphylococcus aureus, Streptococcus beta hemolyticus, Klebsiella pneumoniae and Klebsiella oxytoca, Moraxella catarrhalis, Candida spp, Candida albicans, Candida krusei and Candida tropicalis. The meta-analysis revealed that patients with cleft lip and palate were 2.03 times more likely to have caries than the control group (p<0.005).
CONCLUSION
In the microbiota, there was a great diversity of microorganisms that can vary according to the type of fissure and surgical interventions predisposing patients to a greater probability of dental caries, it is important to take into account the technique used to describe the oral microbiota in order to be able to compare the different studies.
CLINICAL RELEVANCE
Studying the microbiota and the relationship of dental caries and periodontal status in children and adolescents with cleft lip and palate can facilitate the comprehensive care of patients with these conditions.
Topics: Child; Humans; Adolescent; Cleft Lip; Cleft Palate; Dental Caries; Microbiota
PubMed: 38587683
DOI: 10.1007/s00784-024-05624-3 -
The Journal of Craniofacial Surgery Sep 2023To explore the speech outcomes of adult patients with repaired cleft palate through subjective perception evaluation and objective acoustic analysis, and to compare the...
OBJECTIVE
To explore the speech outcomes of adult patients with repaired cleft palate through subjective perception evaluation and objective acoustic analysis, and to compare the differences in pronunciation characteristics between speakers with complete velopharyngeal closure (VPC) and velopharyngeal insufficiency (VPI) patients.
PARTICIPANTS AND INTERVENTION
Subjective evaluation indicators included speech intelligibility, nasality and consonant missing rate, for objective acoustic analysis, we used speech sample normalization and objective acoustic parameters included normalized vowel formants, voice onset time and the analysis of 3-dimensional spectrogram and spectrum, were carried out on speech samples produced by 3 groups of speakers: (a) speakers with velopharyngeal competence after palatorrhaphy (n=38); (b) speakers with velopharyngeal incompetence after palatorrhaphy (n=70), (c) adult patients with cleft palate (n=65) and (d) typical speakers (n=30).
RESULTS
There was a highly negative correlation between VPC grade and speech intelligibility (ρ=-0.933), and a highly positive correlation between VPC and nasality (ρ=0.813). In subjective evaluation, the speech level of VPI patients was significantly lower than that of VPC patients and normal adults. Although the nasality and consonant loss rate of VPC patients were significantly higher than that of normal adults, the speech intelligibility of VPC patients was not significantly different from that of normal adults. In acoustic analysis, patients with VPI still performed poorly compared with patients with VPC.
CONCLUSIONS
The speech function of adult cleft palate patients is affected by abnormal palatal structure and bad pronunciation habits. In subjective evaluation, there was no significant difference in speech level between VPC patients and normal adults, whereas there was significant difference between VPI patients and normal adults. The acoustic parameters were different between the 2 groups after cleft palate repair. The condition of palatopharyngeal closure after cleft palate can affect the patient's speech.
Topics: Adult; Humans; Cleft Palate; Speech; Pharynx; Velopharyngeal Insufficiency; Pharyngeal Muscles
PubMed: 36949035
DOI: 10.1097/SCS.0000000000009301 -
The Journal of Craniofacial SurgeryBy measuring velopharyngeal structure and evaluating speech intelligibility, to explore and observe the association between velopharyngeal anatomy and speech outcomes in... (Observational Study)
Observational Study
OBJECTIVE
By measuring velopharyngeal structure and evaluating speech intelligibility, to explore and observe the association between velopharyngeal anatomy and speech outcomes in these patients.
METHODS
Thirty-one adult patients with velopharyngeal insufficiency after the primary palatoplasty aged 18 to 35 years (mean 22.03 years) were enrolled as the study group. The patients had significant hypernasality and audible nasal emission. The degree of velopharyngeal closure assessed by electronic nasopharyngeal fiberoptic endoscopy was grade III. Cephalometric analysis was performed on lateral cephalograms to measure velopharyngeal structure, including hard palate length (ANS-PNS), velar length (PNS-U), pharyngeal depth (PNS-PPW), and oropharyngeal airway space (U-MPW). Their speech intelligibility was evaluated through the Mandarin Chinese speech intelligibility test, and each speech sample was examined by 2 speech and language pathologists. The results were assessed with the SPSS 23.0 software package, and regression analysis was used to examine the relationship between velopharyngeal structure and speech outcomes.
RESULTS
A significant negative correlation was confirmed between speech intelligibility and pharyngeal depth. Pharyngeal depth also showed a linear relationship with speech intelligibility, and there was no significant correlation between speech intelligibility and other measures (hard palate length, velar length, oropharyngeal airway space).
CONCLUSIONS
In the velopharyngeal anatomy, only pharyngeal depth was associated with speech intelligibility in adult patients with severe velopharyngeal insufficiency, this is consistent with our clinical observation. It suggests that appropriate reduction of pharyngeal depth during palatopharyngoplasty may have a good effect on the speech recovery in patients with cleft palate and patients with velopharyngeal insufficiency after palatorrhaphy.
Topics: Adult; Cephalometry; Cleft Palate; Humans; Palate, Hard; Palate, Soft; Pharynx; Speech; Speech Intelligibility; Treatment Outcome; Velopharyngeal Insufficiency
PubMed: 34238870
DOI: 10.1097/SCS.0000000000007853 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Apr 2001The aims of this study are to investigate the working mechanism, the characteristics, the clinical application and the suggested modification of the Quad Helix appliance.
OBJECTIVE
The aims of this study are to investigate the working mechanism, the characteristics, the clinical application and the suggested modification of the Quad Helix appliance.
METHODS
A 7-year-old, female patient with Pierre-Rokin syndrome, who was preformed with palatorrhaphy at 21-month-old treated by using a Quad Helix appliance for one year.
RESULTS
After one-year treatment, the wide between the maxillary first molars increased 9.65 mm, and the wide between maxillary canines increased 5.20 mm. The wide between the mandibular first molars also increased 3.60 mm, however the wide between mandibular canines decreased 5.20 mm.
CONCLUSION
The Quad-helix appears to be a successful Orthodontic appliance to expand the narrow maxillary or mandibular arches.
Topics: Child; Female; Humans; Orthodontic Appliance Design; Orthodontic Appliances; Palatal Expansion Technique; Pierre Robin Syndrome
PubMed: 12539421
DOI: No ID Found -
Journal of Oral and Maxillofacial... Dec 2001
Topics: Adipose Tissue; Cheek; Cleft Palate; Female; Humans; Infant; Oral Surgical Procedures; Surgical Flaps
PubMed: 11732045
DOI: 10.1053/joms.2001.28294 -
Zhonghua Hu Li Za Zhi = Chinese Journal... Dec 1996
Topics: Child, Preschool; Cleft Palate; Female; Humans; Hydrocarbons, Iodinated; Infant; Male; Postoperative Care; Tampons, Surgical
PubMed: 9304939
DOI: No ID Found -
The British Journal of Oral &... Feb 1996We have developed a new operation for the surgical treatment of obstructive sleep apnoea, which we called functional palatorrhaphy. This preserves the posterior border...
We have developed a new operation for the surgical treatment of obstructive sleep apnoea, which we called functional palatorrhaphy. This preserves the posterior border of the soft palate and allows a controlled repair of the aponeurosis of the soft palate muscle. We combine the palatorrhaphy with a standard or a modified chin osteotomy with advancement of the base of tongue. In our first five treated and re-evaluated patients with severe obstructive sleep apnoea syndrome, who did not respond to conservative treatment, the operation was successful. All patients but one were considerably improved or cured of their symptoms.
Topics: Chin; Humans; Osteotomy; Palatal Muscles; Sleep Apnea Syndromes; Tongue; Treatment Outcome
PubMed: 8645690
DOI: 10.1016/s0266-4356(96)90142-4 -
Plastic and Reconstructive Surgery Nov 1988A 10-year review of 39 patients who underwent a superiorly based pharyngeal flap for severe velopharyngeal insufficiency was performed. The effectiveness of the...
A 10-year review of 39 patients who underwent a superiorly based pharyngeal flap for severe velopharyngeal insufficiency was performed. The effectiveness of the operation, as scored by standardized preoperative and postoperative evaluations, was related to age at operation, type of defect, and duration of velopharyngeal inadequacy. There was no statistical difference between those who were under the age of 6 years (100 percent were improved) at the time of the operation versus those 6 years and older (74 percent improved). Likewise, there was no difference between those patients who received an early flap (92 percent were improved) versus those who received a flap 2 or more years after initial palatorrhaphy (90 percent were improved). The type of palatal defect also was not a significant factor, and none of the patients exhibited a postoperative decrease in function (p less than or equal to 0.001). The operation offered reliable salvage of velopharyngeal competency regardless of the above-mentioned factors.
Topics: Adolescent; Adult; Age Factors; Child; Child, Preschool; Evaluation Studies as Topic; Female; Follow-Up Studies; Humans; Male; Patient Care Team; Pharynx; Reoperation; Retrospective Studies; Speech Articulation Tests; Surgical Flaps; Velopharyngeal Insufficiency
PubMed: 3174867
DOI: 10.1097/00006534-198811000-00005 -
Annals of Plastic Surgery Jun 1984Sixty-two patients with cleft lip and palate or cleft palate were randomly assigned an operative technique for primary palatorrhaphy: V-Y pushback, Langenbeck, or... (Comparative Study)
Comparative Study
Sixty-two patients with cleft lip and palate or cleft palate were randomly assigned an operative technique for primary palatorrhaphy: V-Y pushback, Langenbeck, or Langenbeck with pharyngeal flap. Early speech results were evaluated in 52 patients. There were no differences among the treatment groups in late complications, hearing, middle ear disease, velopharyngeal competence, or need for speech therapy, speech bulbs, or secondary pharyngeal flaps. As previously reported, the in-hospital morbidity in these patients was greater with V-Y pushback (more blood transfusions) and Langenbeck plus pharyngeal flap (more upper airway obstruction) palatorrhaphies than with the Langenbeck procedure. The addition of a pharyngeal flap to primary palatorrhaphy seems unnecessary in at least 75% of patients. Therefore, we currently recommend the Langenbeck palatorrhaphy for primary cleft palate repair, although further longitudinal studies of these patients are needed to assess later speech results and maxillary growth.
Topics: Cleft Lip; Cleft Palate; Humans; Infant; Methods; Prospective Studies; Random Allocation; Speech Disorders; Surgical Flaps
PubMed: 6465808
DOI: 10.1097/00000637-198406000-00004 -
The Cleft Palate Journal Jan 1979We report the first randomized prospective comparison of different techniques of palatorrhaphy. The in-hospital morbidity of the Wardill-Kilner repair (Group I), von... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
We report the first randomized prospective comparison of different techniques of palatorrhaphy. The in-hospital morbidity of the Wardill-Kilner repair (Group I), von Langenbeck repair (Group II), and von Langenbeck repair with superiorly based pharyngeal flap (Group III) was evaluated in 47 patients. There were no deaths. Transfusion was needed only in Group I patients (p less than 0.01). Postoperative airway obstruction was significantly more common in Group III patients than in Group I (0 per cent or II (6 per cent) (p less than 0.05). Thus the in-hospital morbidity was least following the von Langenbeck repair.
Topics: Airway Obstruction; Cleft Palate; Hemorrhage; Humans; Infant; Methods; Palate; Postoperative Complications; Prospective Studies; Respiratory Tract Infections
PubMed: 282028
DOI: No ID Found