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Objectives: This investigation aimed to assess the optimal timing for lip repair in children with cleft lip and palate via 3D anthropometric analysis to evaluate their maxillofacial structures., Methods: The sample comprised 252 digitized dental models, divided into groups according to the following timing of lip repair: G1 (n = 50): 3 months; G2 (n = 50): 5 and 6 months; G3 (n = 26): 8 and 10 months. Models were evaluated at two-time points: T1: before lip repair; T2: at 5 years of age. Linear measurements, area, and Atack index were analyzed., Results: At T1, the intergroup analysis revealed that G1 had statistically significant lower means of I-C', I-C, C-C', and the sum of the segment areas compared to G2 ( p = 0.0140, p = 0.0082, p = 0.0004, p < 0.0001, respectively). In addition, there was a statistically significant difference when comparing the cleft area between G2 and G3 ( p = 0.0346). At T2, the intergroup analysis revealed that G1 presented a statistically significant mean I-C' compared to G3 ( p = 0.0461). In the I-CC' length analysis, G1 and G3 showed higher means when compared to G2 ( p = 0.0039). The I-T' measurement was statistically higher in G1 than in G2 ( p = 0.0251). In the intergroup growth rate analysis, G1 and G2 showed statistically significant differences in the I-C' measurement compared to G3 ( p = 0.0003). In the analysis of the Atack index, there was a statistically significant difference between G1 and the other sample sets ( p < 0.0001)., Conclusion: Children who underwent surgery later showed better results in terms of the growth and development of the dental arches. more...

Objective: This study analyzed the systemic and oral abnormalities in individuals with Kabuki syndrome (KS) that might be investigated to enhance the early diagnosis and treatment by a multidisciplinary team, minimizing the consequences to the individual's health., Study Design: Clinical examination was conducted on 15 individuals to investigate orodental alterations such as tooth abnormalities and cleft lip and/or palate, and the patient records were also reviewed to investigate systemic diseases such as cardiopathies, infectious and immunologic diseases, nephropathies, and delayed neuropsychomotor development., Results: All individuals with KS presented cleft lip and/or palate, 11 (73.34%) tooth abnormalities, 5 (33.34%) congenital cardiopathies, 12 (80%) infectious or immunologic diseases, 1 (6.67%) nephropathy, and 14 (93.34%) had an intellectual disability., Conclusion: Individuals with KS often have dental anomalies such as hypodontia, cleft or palate, and systemic disorders such as congenital heart disease and infectious diseases. Intellectual disability is present in most cases. These alterations should be investigated as early as possible to prevent the increase in morbidity in these individuals., Competing Interests: Declaration of interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.) more...

Statement of Problem: Reports on the impact of fixed partial denture treatments on the quality of life of patients with cleft lip and palate are lacking., Purpose: The purpose of this cross-sectional clinical study was to assess the impact of fixed partial dentures on the quality of life of adults with cleft lip and palate., Material and Methods: A total of 52 participants (23 women and 29 men) with cleft lip and palate, aged between 20 and 50 years old, and who required treatment with fixed partial dentures were enrolled in the study. They responded to the Oral Health Impact Profile (OHIP)-14 questionnaire before and 30 days after the fixed prosthodontic treatment. The final value from the OHIP-14 was generated by totaling the 14 answers, giving a range from 0 to 56, with higher values indicating a worse relationship between oral health and the quality of life. Nonparametric statistical analysis was performed with the Wilcoxon test (α=.05)., Results: Forty-six participants reported some negative experience before the fixed partial denture, and 48 indicated an improved quality of life 30 days after delivery. All domains assessed showed significant quality of life improvements between the periods compared (P≤.014)., Conclusions: Oral treatment with fixed partial dentures improved the quality of life in adults with cleft lip and palate., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.) more...

Introduction: The association of the periodontium with the fixed prosthesis is the basis of prosthetic rehabilitation. This prospective case series aimed to evaluate periodontal health through the relation between periodontal/peri-implant disease progression and the use of fixed partial dentures (FPDs)., Methods: Probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) on either teeth or implants were evaluated at up to 25-year follow-up and compared with the baseline. Statistical analysis was performed using the Kaplan-Meier test (p⟨0.05)., Results: The prospective evaluation showed that the patients maintained adequate periodontal health. Failure (severe periodontal stages) occurred in 12.5% of patients. The survival rate for 107 teeth/implants was 80.48%. The comparisons for clinical parameters revealed no statistically significant difference (p⟩ 0.05). At T1, the measurements for anterior and posterior regions, respectively, were PD =2.7mm and 3.1mm; CAL= 3.3mm and 3.6mm; GI=0.5 (both regions); and PI=0.79 and 0.62. Periodontal/peri-implant disease progression did not relate to the use of prostheses., Conclusions: Patients with more frequent follow-up appointments and lower GI and PI showed periodontal health for longer periods. Patients with different oral hygiene levels present different periodontal disease progression. Periodic hygiene control and motivation are vital factors for extensive oral rehabilitation success., (Copyright© 2024 Dennis Barber Ltd.) more...

This study aimed to evaluate the survival rate of osseointegrated implants installed in the cleft area. An extensive data survey was conducted using the medical records of individuals who had implants installed in the cleft area between 1999 and 2020. The variables assessed were age, sex, implant follow-up time, implantation procedures, and rehabilitation with implant-supported prostheses. Data were analyzed in terms of implant survival time, correlating with the factors: age, sex, execution, or no-execution of bone regrafting, the time interval between secondary alveolar bone grafting and regrafting, the time interval between regrafting and implant installation, and the time interval between implant installation and provisional and definitive prosthesis. Data were analyzed with respect to implant survival. χ 2 and Student t tests were used with a 5% significance level. A total of 1295 medical records were analyzed, of which 688 reported implants in cleft areas (56.1% in females, 43.9% in males) with a success rate of 92.73% and a mean follow-up time of 53.2 (±45.0) months. There were no statistically significant differences in the correlation between the survival rate and sex ( P = 0.895, χ 2 test), between the implant survival rate and regrafted area ( P = 0.904, χ 2 test), or between the survival rate and patient age ( P = 0.246, Student t test). The survival rate of implants in the cleft area was 92.73%. Age, sex, and the need for regrafting did not influence the survival rate of implants installed in the cleft area. Clinical studies that evaluate the survival rate of implants installed in patients with cleft maxilla are of great relevance to the dental field., Competing Interests: C.C.V.d.S. received a scholarship from São Paulo Research Foundation (FAPESP) (#2010/10538-0). The remaining authors report no conflicts of interest., (Copyright © 2023 by Mutaz B. Habal, MD.) more...

The objective of this systematic review was to identify the available scientific evidence on bone substitutes (BSs) compared with autogenous bone grafts (ABGs) for regeneration of horizontal bone resorption in the anterior maxillary alveolar process, aiming at rehabilitation with endosseous implants. This review was performed according to the PRISMA guidelines (2020) and registered in the database PROSPERO (CRD: 42017070574). The databases searched were PUBMED/MEDLINE, EMBASE, SCOPUS, SCIENCE DIRECT, WEB OF SCIENCE, and CENTRAL COCHRANE, in the English language. The Australian National Health and Medical Research Council (NHMRC) and Cochrane Risk of Bias Tool were used to assess the study's quality and risk of bias. A total of 524 papers were found. After the selection process, 6 studies were selected for review. A total of 182 patients were followed for a period of 6 to 48 months. The mean age of patients was 46.46 years, and 152 implants were installed in the anterior region. Two studies achieved a reduced graft and implant failure rate, whereas the remaining 4 studies had no losses. It may be concluded that the use of ABGs and some BSs is a viable alternative for the rehabilitation with implants in individuals with anterior horizontal bone loss. However, additional randomized controlled trials are warranted due to the limited number of papers. more...

Background: It is necessary to analyze and monitor the facial growth of orofacial cleft patients. The documentation should therefore begin before and after primary surgeries. Technological evolution has transformed plaster models into 3D images through scanners that allow rational storage, manipulation, and rotation without the possibility of breakage or damage. Based on this fact, this narrative review aims to provide a feature on the three-dimensional tools available for the assessment of dental arches in children with orofacial cleft and mixed dentition., Material and Methods: Three databases were chosen (PubMed, ScienceDirect, and Scopus) and keywords were used to select papers., Results: During the database screening, 292 potentially relevant papers were found. After removing duplicates, titles, and abstracts, 32 papers presented qualifications for analysis. Through evaluating each document by reading it one by one, 24 papers fulfilled the eligibility criteria., Conclusions: It was concluded that digital tools-i.e., benchtop scanners which evaluate the dental arches of children with cleft lip, palate, and mixed dentition-are reproducible and reliable, without the use of ionizing radiation, allow storage, manipulation with sustainability, and help preserve the environment. more...

This retrospective observational study aimed to evaluate and identify the relapse rate after orthognathic surgery for maxillary advancement (Le Fort I maxillary osteotomy) in oral cleft patients through digitized cephalograms and 3D dental models, following 2 years. Lateral cephalograms and dental casts of 17 individuals, enrolled in Orthodontics Department in Hospital of Rehabilitation of Craniofacial Anomalies, were carried out. The digital cephalometric tracings were evaluated in: T1-before surgery, T2-immediate after surgery, T3-6-month to 1-year after surgery. The dental study casts were digitized and evaluated in: F1-before surgery; F2-3-month to 1-year after surgery; F3-1 to 2 years after surgery. The analyses of the dental arches were performed directly on the scanned images. A single examiner previously trained and calibrated performed all the assessments. Repeated measures ANOVA was applied to study the variables and compare the periods, followed by Tukey test to evaluate the statistically significant differences, with level of significance of 5%. The digital cephalogram results showed that the vertical movement statistically differed from T2 to T3 (p = 0.002). The right and left premolar relationship in digitized models revealed that at F2 the individuals exhibited ¼ Class II and Class I, in 29.4 and 23.5% of the cases, respectively; and at F3, Class I, 58.8 and 70.6% of the cases, respectively. The cephalometry showed the relapse in the vertical movement after orthognathic surgery for maxillary advancement, but no relapse in the other evaluated parameters. more...

Objective: This study assessed the prevalence of orofacial dysfunctions (ODs) and quality of life (QoL) in adults with and without a cleft lip and palate., Design: Cross sectional., Setting: Craniofacial Center, Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, São Paulo, Brazil., Methods: The study was composed of a sample of 120 patients: 60 adults in the cleft lip and palate group (CLPG) and 60 adults in the control group with no craniofacial anomalies. Each patient underwent an interview and clinical examination, using the Nordic Orofacial Test-Screening (NOT-S) and the 36-Item Short Form Survey. Data were analyzed using Mann-Whitney U test, χ 2 , and the Spearman correlation coefficients., Results: There was a higher prevalence of OD in CLPG ( P < .001) on the NOT-S. The adults in the CLPG had higher QoL in the areas of general health ( P = .003), physical function ( P = .014), social function ( P < .001), and vitality ( P = .006). The CLPG had significant associations between higher OD and lower QoL for general health ( P = .004), emotional role function ( P = .028), and vitality ( P = .05)., Conclusion: Orofacial dysfunctions were more prevalent in adults with a cleft, negatively impacting their QoL in general health, emotional role function, and vitality. However, adults with a cleft also had significantly higher QoL, reflecting possible resiliency when compared to adults without a cleft. more...

Background: There are numerous methods to measure the dimensions of the gingival tissue, but few have compared the effectiveness of one method over another., Objective: This study aimed to describe a new method and to estimate the validity of gingival biotype assessment with the aid of computed tomography scanning (CTS)., Materials and Methods: In each patient different methods of evaluation of the gingival thickness were used: transparency of periodontal probe, transgingival, photography, and a new method of CTS). Intrarater and interrater reliability considering the categorical classification of the gingival biotype were estimated with Cohen's kappa coefficient, intraclass correlation coefficient (ICC), and ANOVA (P < .05). The criterion validity of the CTS was determined using the transgingival method as the reference standard. Sensitivity and specificity values were computed along with theirs 95% CI., Results: Twelve patients were subjected to assessment of their gingival thickness. The highest agreement was found between transgingival and CTS (86.1%). The comparison between the categorical classifications of CTS and the transgingival method (reference standard) showed high specificity (94.92%) and low sensitivity (53.85%) for definition of a thin biotype., Conclusion: The new method of CTS assessment to classify gingival tissue thickness can be considered reliable and clinically useful to diagnose thick biotype., (© 2018 Wiley Periodicals, Inc.) more...

Background: The concern to restore and evaluate bilateral cleft lip and palate (BCLP) patients' quality of life, after rehabilitation, is an issue that has been discussed in the literature because it is the ultimate goal of any proposed treatment., Objective: To evaluate the overall and oral quality of life of BCLP patients who had completed their treatment with orthognathic surgery (OrSg) compared to those who completed theirs with prosthetic rehabilitation in the form of overlay prosthesis (OP)., Materials and Methods: The study comprised 40 patients, 20 in OrSg group and 20 in OP group. Epidemiological survey and application of two questionnaires (World Health Organization Quality of Life-brief [WHOQOL-bref] and Oral Health Impact Profile-14 [OHIP-14]) were done. The final results were evaluated statistically by the Mann-Whitney test., Results: Regarding the comparison with the WHOQOL-bref, no significant statistical differences between groups were found. In the analysis of the OHIP-14, only in "psychological limitation" field difference could be observed, where OrSg group showed more negative impact when compared to the OP group., Conclusion: Both rehabilitations provide a satisfactory quality of life for patients., Competing Interests: There are no conflicts of interest. more...

Introduction: The purpose of this study was to evaluate the thickness and height of buccal and lingual alveolar bone of mandibular teeth moved to edentulous areas with a remodeled alveolar ridge., Methods: The sample included 18 adult patients with unilateral or bilateral absence of mandibular permanent first molars with a mean age of 36.1 years before treatment. The mandibular hemiarches were divided into 3 groups: reopening group (15 hemiarches), closure group (12 hemiarches), and control group (9 hemiarches with no missing teeth). Cone-beam computed tomography scans with a 0.2-mm voxel size were performed 4 months after space closure or reopening. Cross sections 0.2 mm thick passing through the center of the mandibular permanent second molar and second premolar roots were used for measurements of the buccal and lingual bone plate thickness and level. Intergroup comparisons were performed with 1-way analysis of variance followed by Tukey tests (P <0.05)., Results: No intergroup differences were found for the alveolar bone statuses of the mandibular second premolar. For the mandibular second molar, the closing group showed significantly smaller buccal and lingual crest levels compared with the control group., Conclusions: Space closure of missing mandibular first molars caused slight buccal and lingual dehiscences at the mandibular second molar areas., (Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.) more...