Academic literature on the topic 'Uclhp'

Objective The purpose of this study was to examine the three-dimensional characteristics of the palatal configurations in incomplete unilateral cleft lip and palate (UCLP) patients and to determine whether there are differences in the effect of early orthopedic treatment between complete and incomplete UCLP patients. Design Eight infants with incomplete UCLP and 12 infants with complete UCLP, selected at random, wore Hotz plates, and 8 other infants with complete UCLP did not. Palatal impressions were taken of these patients immediately after birth and at 1, 2, 3, 4 (just before cheiloplasty), 6, and 18 months of age (just before palatoplasty). Using our measuring system, the palatal casts were measured and compared three-dimensionally. Results and Conclusions The palate of the incomplete UCLP patients measured immediately after birth, compared with complete UCLP, showed: (1) smaller posterior arch width; (2) sagittal arch length did not differ; (3) incisal point was located more mesially; (4) the gap between the alveolar arch forms of the major and minor segments was smaller; and (5) the curvature of the palatal surface forward the nasal cavity in the minor segment was less. At 18 months of age, the following characteristics could be observed: (1) the difference observed at birth in the posterior arch width between the incomplete and complete UCLP infants vanished; (2) a significant difference in the location of the incisal point was observed only between the incomplete UCLP infants and the complete UCLP infants with a Hotz plate; and (3) the curvature was less in the incomplete UCLP infants than in the complete UCLP infants. Furthermore, the morphological change of the palatal surface was less in the incomplete UCLP infants than in the complete UCLP infants. This suggested that any influence of the Hotz appliance might be less in incomplete UCLP than in complete UCLP.

The finding that the vomer plays a crucial role in maxillary growth suggests that the bilateral cleft configuration of unilateral cleft lip and palate (UCLP), in which the vomer is detached from the non-cleft-side secondary hard palate, negatively influences palatal development, and this hypothesis was tested. Sixty persons with complete UCLP, including those with the vomer detached from (n = 30, b-UCLP) and attached to (n = 30, u-UCLP) the secondary hard palate, were analyzed morphologically, with the use of cast models taken at 10 days, 3 mos, and 12 mos of age. The anterio-posterior palatal length at 12 mos of age in those with b-UCLP was significantly shorter than that in those with u-UCLP, by 8.7% (p < 0.05). In addition, palatal width development in the first year in those with b-UCLP was also significantly retarded. These results suggest that the uncommon bilateral cleft subtype in UCLP should be included in the cleft classification.

Objective The objective of this study was to three-dimensionally evaluate the pharyngeal dimensions of individuals with complete nonsyndromic unilateral cleft lip and palate (UCLP) using cone beam computed tomography. Design This was a cross-sectional prospective study. Setting The study took place at the Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru-SP, Brazil. Patients and Participants The control group (CON) consisted of 23 noncleft adults with class III malocclusion, and the cleft group (UCLP) consisted of 22 individuals with UCLP and class III malocclusion. Two subgroups of individuals with class III malocclusion as a result of maxillary retrusion with (UCLP'; n = 19) and without (CON'; n = 8) clefts were also assessed. Interventions Pharyngeal volume, pharyngeal minimal cross-sectional area (CSA), location of CSA, pharyngeal length, sella-nasion-A point angle (SNA), sella-nasion-B point angle (SNB), and A point-nasion-B point angle (ANB), and body mass index were assessed using Dolphin software. Main Outcome Measure The pharyngeal dimensions of UCLP individuals are smaller when compared with controls. Results Mean pharyngeal volume (standard deviation) for the UCLP patients (20.8 [3.9] cm3) and the UCLP’ patients (20.3 [3.9] cm3) were significantly decreased when compared with the CON (28.2 [10.0] cm3) and CON’ patients (29.1 [10.2] cm3), respectively. No differences were found in the pharyngeal minimal CSA, ANB, or pharyngeal length values between groups (CON versus UCLP and CON’ versus UCLP'). CSAs were located mostly at the oropharynx, except in the UCLP’ patients, which were mainly at the hypopharynx. Mean SNA in the UCLP (76.4° [4.6°]) and UCLP’ groups (75.1 [3.1°]) were significantly smaller than those in the CON (82.8° [4.1°]) and CON’ groups (78.6° [1.2°]). SNB values were statistically smaller only for the comparison of CON versus UCLP patients. Conclusion The pharynx of individuals with UCLP and class III malocclusion is volumetrically smaller than that of individuals with class III malocclusion and no clefts.

P-A cephalometric analysis was performed on the craniofacial morphology in 88 Brazilian men with nonoperated and operated cleft lip and palate. For the comparative study, these subjects were divided into the following four groups: (1) 31 nonoperated unilateral cleft lip and palate (UCLP), (2) 24 nonoperated bilateral cleft lip and palate (BCLP), (3) 16 operated UCLP, (4) 17 operated BCLP. Thirty Brazilian men without cleft lip and palate were used as control subjects. In comparison with the control subjects, nonoperated BCLP and UCLP showed remarkable facial deformity characterized by Increased width of various facial parts. Facial morphology of surgically treated BCLP and UCLP, however, was very similar to that of noncleft subjects, apart from the Immediate cleft region. There was no remarkable difference in the facial morphology between nonoperated BCLP and UCLP, except for the cleft width and the deviation of nasal septum base, while the only significant difference between operated BCLP and UCLP was in the cleft width.

Objective: To investigate intrinsic palatal and alveolar tissue deficiency in patients with unilateral cleft lip and palate (UCLP) as compared to age-matched individuals without UCLP using surface area measurements on 3D scans of plaster casts. Methods: 22 maxillary casts of infants with UCLP from the Wyss Department of Plastic Surgery of NYU Langone Medical Center and 37 maxillary casts from infants without clefts from Sillman’s longitudinal study were scanned by Ortho Insight 3D by Motion View Software, LLC (Chattanooga, TN) and measured using Checkpoint software (Stratovan, Davis, CA). The palatal and alveolar surface areas of each cast were measured. The most superior point of the alveolar ridge in front of the incisive papilla and the most superior point of each maxillary tuberosity were connected by a line that ran along the highest part of the alveolar ridge. This line was used to set boundaries for the palatal surface area measurements. The surface areas of greater and lesser segments were measured independently on UCLP casts. A total palatal surface area for the UCLP sample including width of the cleft gap was also measured. Results: There was a statistically significant difference in surface area ( P > .001) when we compared the UCLP area of the cleft segments alone with the non-cleft sample. There was a positive correlation (determine the statistical significance) between the surface area of the cleft segments and cleft gap. In addition, there was a statistically significant difference between UCLP plus cleft area and the non-cleft samples in surface area ( P < .0001). Conclusion: An intrinsic palatal and alveolar tissue deficiency exists in patients born with UCLP. The amount of tissue deficiency for a patient with UCLP should be considered when developing and executing a patient-specific treatment plan.

Objective. The aim was to evaluate differences in the cervical vertebral skeletal maturity of unilateral cleft lip and palate (UCLP) and non-cleft lip/palate (non-CLP) Saudi male orthodontic patients. Method. This cross-sectional multicenter study took place at the dental school, King Saud University and King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, between October 2014 and September 2015. The records of Saudi male orthodontic patients with UCLP n=69 were collected. Cervical vertebral maturation was assessed using their cephalometric radiographs. The records of 138 age-matched non-CLP Saudi male orthodontic patients served as controls. Results. There was a significant difference in skeletal maturity between the UCLP and non-CLP groups, as evident in the delayed skeletal development among the UCLP participants. Moreover, pubertal growth spurt onset was significantly earlier in the non-cleft participants in comparison with the UCLP participants p=0.009. Conclusions. There is delayed skeletal maturity among the UCLP Saudi male population in comparison with their non-CLP age-matched peers.

Objective To determine whether asymmetric antigonial notching is associated with the development of mandibular and lower facial asymmetry in individuals with unilateral cleft lip and palate (UCLP). Design Retrospective mixed-longitudinal investigation including UCLP and nonaffected orthodontic patients. Participants All (24) available patients with UCLP treated in our clinic with complete longitudinal records, and 72 skeletal maturation matched noncleft orthodontic patients that served as controls. Subject records included hand-wrist, panoramic, frontal, and 45° oblique cephalometric radiographs. Main outcome Measures The development of mandibular asymmetry, measured on oblique cephalometric radiographs, as well as lower facial asymmetry, measured on frontal cephalometric radiographs, was monitored in individuals with UCLP in relation to antigonial notching asymmetry, assessed on panoramic and oblique cephalometric radiographs. Results First, no statistical differences were found in antigonial notching asymmetry between patients with UCLP and noncleft controls. Second, antigonial notching asymmetry, observed on panoramic and oblique cephalometric radiographs, significantly correlated with the attendant development of mandibular and lower facial asymmetry in individuals with UCLP. Third, the development of mandibular and lower facial asymmetry at pubertal and post-pubertal growth spurt stages significantly correlated with antigonial notching asymmetry, measured on panoramic radiographs, at prepubertal and pubertal growth spurt stages, respectively. Conclusions The degree of antigonial notching noted on panoramic radiographs can be used as an early indicator of developing mandibular and lower facial asymmetry in individuals with UCLP.

L’objectif de la thèse est une mise au point des espèces de Stephania répertoriées au Cambodge par l’étude systématique, phytochimique et pharmacologique. Du point de vue systématique, les travaux ont permis de répertorier sept espèces et deux variétés de Stephania au Cambodge : S. cambodica, S. japonica var. discolor et var. timoriensis, S. oblata, S. pierrei, S. rotunda (espèce-type), S. suberosa, et S. venosa. La clef de détermination établie lors de ce travail de thèse permet d’identifier ces espèces. D’après les résultats phylogénétiques, seul S. pierrei est monophylétique, ce qui représente moins de 10% des espèces de Stephania. L’étude chimique de cinq espèces a été réalisée par des méthodes chromatographiques (CLHP, UCLHP) et des méthodes spectroscopiques. Différents alcaloïdes ont été proposés comme marqueurs : la palmatine, la roémérine et la tétrahydropalmatine pour S. cambodica et S. rotunda, la cépharanthine, la tétrahydropalmatine et la xylopinine pour S. suberosa, la cépharanthine pour S. pierrei, la crébanine, et la tétrahydropalmatine pour S. venosa. Neuf alcaloïdes ont été isolés à partir du tubercule de S. cambodica, dont un nouveau composé dénommé «angkorwatine ». Une méthode d’éco-extraction des alcaloïdes assistée par ultrasons a été mise au point et optimisée par un plan d’expérience pour cette espèce. Une méthode analytique par UCLHP a été développée et validée pour le contrôle qualité de S. cambodica. Les résultats montrent que les extraits hydroéthanoliques obtenus par macération à partir du tubercule de S. suberosa, S. venosa et S. rotunda présentent une activité anti-inflammatoire importante (in vitro) avec un ratio anti-inflammatoire élevé
The thesis aims to provide update on species of the genus Stephania recorded in Cambodia by systematic, phytochemical and pharmacological studies.The systematic study allowed to list seven species and two varieties of Stephania in Cambodia: S. cambodica, S. japonica var. discolor and var. timoriensis, S. oblata, S. pierrei, S. rotunda (type species), S. suberosa and S. venosa. The presence of S. japonica var. timoriensis and S. oblata is reported for the first time in Cambodia. According to the phylogenetic results, only S. pierrei is monophyletic, which represents less than 10% of species in the genus Stephania. Chemical studies on the tubers of five species were carried out using chromatographic methods (HPLC, UHPLC) and spectroscopic methods. Different isolated alkaloids have been proposed as markers: palmatine, roemerine and tetrahydropalmatine for S. cambodica and S. rotunda, cepharanthine, tetrahydropalmatine, and xylopinine for S. suberosa, cepharanthine for S. pierrei, crebanine, and tetrahydropalmatine for S. venosa. Nine alkaloids belonging to five classes were isolated from the tuber of S. cambodica and a new compound namely "angkorwatine" was described. Ultrasound assisted extraction of alkaloids was developed and optimized by Design of Experiment for this species. This innovative extraction is a good alternative to conventional methods. An analytical UHPLC method was developed and validated for the quality control of S. cambodica. Results show that hydroethanolic extracts obtained by maceration of S. suberosa, S. rotunda and S. venosa exhibit significant anti-inflammatory activity with high anti-inflammatory ratio (selectivity index)

Introduction Modern society is passionate about beauty and aesthetics. According to a 2016 survey by the International Society of Aesthetic and Plastic Surgery, the demand for aesthetic surgery is more than ever. People’s perception and awareness of facial aesthetics has increased. Orofacial cleft is the most common facial dysmorphology, with prevalence about 1.46:1000 in Scotland. The aim of the initial surgical repair of cleft lip is to improve facial aesthetics and function, without interrupting facial growth. Nevertheless, facial asymmetry is a stigma in cleft patients, and revision surgery due to a patient or their parents’ dissatisfaction with the outcomes is not uncommon. Objective evaluation of facial asymmetry after primary surgical repair is valuable. It is an indication of the success of surgery, and it informs the surgeon of the magnitude and location of residual asymmetry. The evaluation of facial asymmetry has evolved significantly from landmark-based assessment to surface-based analysis. The latter provides a comprehensive evaluation of facial asymmetry by superimposing the original 3D model on its mirror copy. This permits the quantification and the visualisation of the disparity between the two halves of the face. Many studies evaluated facial asymmetry a few years after primary surgical repair. Longitudinal monitoring and quantifying of facial shape changes can potentially guide the surgeon to the optimal surgical technique. Only a few studies evaluated facial asymmetry before and after primary surgery, and their analysis was dependent on a set of facial landmarks that did not describe the asymmetry of facial surfaces between these landmarks. Unfortunately, the existing literature does not provide comprehensive longitudinal evaluation of facial asymmetry of cleft patients, and the impact of facial expression on residual facial asymmetry has not been fully investigated. Aim The aim of this study was the longitudinal evaluation of facial asymmetry of UCLP patients using an advanced facial analysis tool, and to compare the postoperative residual asymmetry with the control group. The study was carried out to assess the impact of growth and facial expression on residual facial asymmetry. Methodology This study was carried out on 30 UCLP patients. All the patients were Caucasian and underwent the same surgical protocol, which was carried out by the same surgeon at the Royal Hospital of Sick Children, Edinburgh. 3D facial images were captured for the patients, before surgery, at about 4 months after surgery and at four-year follow-up, at rest and at maximum smile using 3dMDface system. Historical data of 70 3D facial images of six-month-old non-cleft infants were also analysed in this study. Facial asymmetry was evaluated using a generic mesh. A generic facial mesh is a mathematical facial mask that consists of 7,190 vertices. The mesh was conformed on each 3D facial image. The conformed meshes were utilised to evaluate facial asymmetry using two methods: the average asymmetry, the total and regional facial asymmetry. The average asymmetry method involved the creation of four average faces for cleft patients: an average preoperative face, an average postoperative face, and two average faces at the four-year follow-up (one at rest and one at a maximum smile). The fifth average face was that of six-month-old non-cleft infants. A mirror copy for each average 3D facial model was created by reflecting it on a lateral arbitrary plane. The original and mirror models were superimposed, the absolute distances between corresponding points on the two surfaces were calculated and analysed in three directions (mediolateral, vertical and anteroposterior), to quantify facial asymmetry. The results were displayed in colour-coded maps. Asymmetry scores were obtained by calculating the median of the absolute distances between corresponding points for the total face, upper lip and nose. The asymmetry scores in the mediolateral, vertical and anteroposterior directions were also quantified. Statistical tests were applied to detect significant differences in asymmetry scores of the total face and each facial region between study groups (before surgery, after surgery and at four-year follow-up), and between surgically managed cleft group and the control group. The correlations of asymmetry scores of the total face, nose and upper lip before surgery, after surgery and at four-year follow-up were also investigated. Results Facial asymmetry in cleft patients was dramatically improved after surgery. However, the postoperative residual asymmetry of UCLP patients was significantly higher than the non-cleft infants in the three directions. Furthermore, facial asymmetry increased during growth, with main impact on the nose. Facial expressions accentuated the residual asymmetry. Specifically, there was considerable shifting of the upper lip toward the scar tissue of the affected side. The residual asymmetry of the nose at the four-year follow-up was correlated to initial nasal asymmetry and residual nasal postoperative asymmetry. The anteroposterior deficiency of the upper lip, nose and paranasal area was pronounced in the cleft group at all time intervals due to insufficient bony support of the cleft maxilla. Conclusions Cleft patients and their parents should be informed of the likelihood of residual asymmetry following surgery. Refinements in primary surgery are necessary. The superficial and deep fibres of the orbicularis muscle have to be accurately repaired according to the direction of the muscle fibres to avoid the shifting of the philtrum of the upper lip toward the scar tissue on the affected side. The orbicularis oris muscle has to be adequately dissected and rotated in the downward direction to eliminate the residual vertical deficiency at the corner of the mouth on the affected side. An incision in the internal lateral side of the nose should be considered to reduce this deficiency. The levator labii superioris alaeque nasi muscle of the cleft side has to be reflected and sutured to the corresponding muscle fibres on the other side, to avoid the residual shifting of the nose to the non-cleft side, and to eliminate the residual vertical deficiency of the alar base on the cleft side during smiling. Revision surgery should be delayed until completion of growth. Before lip revision surgery, it is necessary to evaluate the residual asymmetry when the face is at rest and during facial expressions. Consideration should be given to initial nasal asymmetry and residual postoperative nasal asymmetry. Patients should be informed about the expected need for revision surgery including rhinoplasty. We were able for the first time to quantify facial asymmetry in three directions which provided an insight into the cause of the residual facial asymmetry at rest and at maximum smile. The generic mesh is an innovative tool for the assessment of facial asymmetry.

The present study is concerned with development of maxilla, or moreprecisely palate,in course of first year of life in patients with unilateral cleft lip and palate (UCLP), before and after cheiloplasty. The metodology has it's center in processing of dental plaster casts of UCLP patients via classical and geometric morphometry. All the patients have been operated following same protocol in the neonatal period. The operation was conducted by the same surgeon Jiří Borský, M.D. in the teaching hospital Motol in Prague. In the trackedThe results suggest that the variability of shape was larger in cUCLP patients than in UCLP+M patients. Statistically significant differences in the palate shape were observed in both age categories within both defect categories. The variability of form (size and shape) was followed within each defect category and statistically significant differences between both age category was proven. In the light of average changes intha palate morphology, we tracked both anterior and posterior growth of both segments with increasing age in both defect categories. More distinctive aproximation of both segments, due to the pressure after the cheiloplasty and growth of both segments, was observed in cUCLP patients. Essencial influence of increasing gravity of the defect on changes...