The cleft lip and palate (CLP) is one of the most common craniofacial malformations in humans. We collected functional magnetic resonance data of 23 CLP patients before rehabilitation training (Bclp) and 23 CLP patients after rehabilitation training (Aclp), who were performing Chinese character pronunciation tasks, and performed brain activation analysis to explore the changes of brain mechanism in CLP patients after articulation disorder rehabilitation training. The study found that Aclp group had significant activation in the motor cortex, Broca area, Wernicke area and cerebellum. While the Bclp group had weak activation in the motor cortex with a small activation range. By comparing the differences and co-activated brain regions between the two groups, we found that rehabilitation training increased the activity level of negatively activated brain areas (cerebellum, left motor area, Wernicke area, etc.) to a positive level. At the same time, the activity level of weakly activated brain areas (right motor area, Broca area, etc.) was also increased. Rehabilitation training promoted the activity level of articulation-related brain regions. So that the activation intensity of articulation-related brain regions can be used as a quantifiable objective evaluation index to evaluate the effect of rehabilitation training, which is of great significance for the formulation of rehabilitation training programs.
Humans ; Articulation Disorders/therapy* ; Brain/diagnostic imaging* ; Cleft Lip/diagnostic imaging* ; Cleft Palate/diagnostic imaging* ; Magnetic Resonance Imaging ; Speech Therapy/psychology*

OBJECTIVES: Currently, the research results regarding the bilateral temporomandibular joint symmetry in patients at different ages with unilateral complete cleft lip and palate (UCLP) are still controversial. In this study, the position of condyle in the articular fossa and morphology of condyle in UCLP patients at different developmental stages was measured and analyzed to explore the asymmetry difference, which can provide a new theoretical basis for the sequential therapy. METHODS: A total of 90 patients with UCLP were divided into a mixed dentition group (31 cases), a young permanent dentition group (31 cases) and an old permanent dentition group (28 cases) according to age and dentition development. Cone beam computed tomography (CBCT) images were imported into Invivo5 software for 3D reconstruction, and the joint space, anteroposterior diameter, medio-lateral diameter, and height of condylar were measured, and its asymmetry index was calculated. RESULTS: The asymmetry index of condylar height and anteroposterior diameter among the 3 groups, from small to large, was the mixed dentition groupP<0.05). There was no significant difference in condylar anteroposterior diameter and asymmetry index between the mixed dentition group and the young permanent dentition group (both P>0.05), all of them were lower than those in the old permanent dentition group (both P<0.05). Compared with the normal side, the height of fracture condyle was smaller among the 3 groups (all P<0.05), and the anterior joint space was smaller (P<0.05) and the posterior joint space was larger (P<0.05) in the mixed dentition group. CONCLUSIONS In patients with UCLP, the asymmetry of condylar morphology increases with age, but the condylar position tends to normal. These results suggest that early treatment has important clinical significance for the morphologic development of temporomandibular joint in UCLP patients.
Humans ; Cleft Lip/diagnostic imaging* ; Cleft Palate/diagnostic imaging* ; Temporomandibular Joint/diagnostic imaging* ; Clinical Relevance

Cleft lip and/or palate (CLP) are the most common craniofacial malformations in humans. Speech problems often persist even after cleft repair, such that follow-up articulation training is usually required. However, the neural mechanism behind effective articulation training remains largely unknown. We used fMRI to investigate the differences in brain activation, functional connectivity, and effective connectivity across CLP patients with and without articulation training and matched normal participants. We found that training promoted task-related brain activation among the articulation-related brain networks, as well as the global attributes and nodal efficiency in the functional-connectivity-based graph of the network. Our results reveal the neural correlates of effective articulation training in CLP patients, and this could contribute to the future improvement of the post-repair articulation training program.
Brain/diagnostic imaging* ; Cleft Lip/surgery* ; Cleft Palate/surgery* ; Humans ; Magnetic Resonance Imaging ; Reading

Objective: To analyze the morphological changes of gray matter in clefts lip and palate (CLP) children using voxel-based morphometric (VBM) and surface-based morphometric (SBM) methods. So as to provide a reference for the neural mechanism of cleft palate speech disorder (CPSD) in CLP population. Methods: A total of 29 CLP children with CPSD who were admitted to Department of Oral & Maxillofacial Plastic & Tramuma Surgery, Capital Medical University School of Stomatology from January 2017 to January 2022 were selected (CLP group), including 9 males and 20 females, aged (9.6±3.2) years (5-17 years old). During the same period, 33 healthy children (healthy control group) were recruited in Beijing Children's Hospital, including 9 males and 24 females, aged (9.6±2.4) years (5-16 years). Results: There were no significant differences in age and gender between the healthy control group and the CLP group (t=-0.07, P=0.944; χ²=0.11, P=0.745). Compared with the healthy control group, the left inferior temporal gyrus, right inferior parietal angular gyrus, and left upper cerebellar gray matter volume in the CLP group were significantly decreased (P<0.05), and the volume of the right medial superior frontal gyrus was significantly increased (P<0.05). The left inferior frontal gyrus insula and the right insula cortical thickness of the subjects in the CLP group were significantly thinner [family-wise error rate (FWER) correction, P=0.035]. The right hemisphere cingulate gyrus isthmus sulcus index increased in the CLP group (FWER correction, P=0.040). Conclusions: CLP children with speech disorder have multiple language-related brain regions with reduced gray matter (GM) volume, decreased cortical thickness, and increased gyrificaition index. The abnormal changes in GM morphology in these brain regions may be related to the characteristics of cleft palate speech disorder in the CLP population.
Adolescent ; Brain ; Child ; Child, Preschool ; Cleft Palate ; Female ; Gray Matter/diagnostic imaging* ; Humans ; Magnetic Resonance Imaging/methods* ; Male ; Speech

OBJECTIVE: To analyze clinical and genetic features of a family affected with Van der Woude syndrome. METHODS: The umbilical cord blood of the proband and the peripheral blood of the parents were used for the whole exon sequencing to find the candidate gene.Peripheral blood of 9 members of the family were collected for Sanger sequencing verification, bioinformatics analysis and genotype-phenotype correlation analysis. RESULTS: The proband was diagnosed with cleft lip and palate by ultrasound. His father and grandmother had hollow lower lip and all other family members did not have the similar phenotype. A missense c.263A>G (p.N88S) mutation was found in exon 4 of gene in the proband, his father and his grandmother.The mutation was not found in other family members. CONCLUSIONS A missense c.263A>G (p.N88S) mutation in gene probably underlies the pathogenesis of Van der Woude syndrome in the family and the mutation has been firstly discovered in China.
Abnormalities, Multiple ; genetics ; China ; Cleft Lip ; complications ; diagnostic imaging ; etiology ; genetics ; Cleft Palate ; complications ; diagnostic imaging ; etiology ; genetics ; Cysts ; complications ; genetics ; Female ; Humans ; Interferon Regulatory Factors ; genetics ; Lip ; abnormalities ; Male ; Mutation ; Pedigree ; Ultrasonography

OBJECTIVETo evaluate the craniofacial morphology of patients with isolated cleft palate in the mixed dentition after palatoplasty.

METHODSTwenty patients (7 to 11 years old) with isolated cleft palate in the mixed dentition were selected. The control group comprised 35 age-matched non-cleft children without orthodontic treatment. Cephalometric analysis was carried out to evaluate craniofacial morphology.

RESULTSThe mean values of total cranial base length, maxillary depth, mandibular effective length in cleft patients were 86.48 mm, 44.79 mm and 65.45 mm, respectively. Those in control group were 91.27 mm, 48.84 mm and 70.49 mm, respectively (P < 0.001).

CONCLUSIONSUnderdeveloped maxilla and class III skeletal profile were presented in patients with isolated cleft palate.

Case-Control Studies ; Cephalometry ; Child ; Cleft Palate ; pathology ; surgery ; Dentition, Mixed ; Female ; Head ; diagnostic imaging ; pathology ; Humans ; Male ; Mandible ; diagnostic imaging ; pathology ; Maxilla ; diagnostic imaging ; pathology ; Postoperative Period ; Radiography ; Skull Base ; diagnostic imaging ; pathology

To investigate the biomechanical influences on two different cleft maxillary 3D finite element models pre- and post-alveolar bone graft, we developed a cleft palate bony model from a 17 year cleft palate male CT scan data and built an alveolar bone-grafted cleft maxillary 3D finite element model through gluing the graft model. Apply vector lip force on the anterior face of the models. Study the press (including S3 principal, S1 principal, von Mises and shear) distribution properties and localized area. The results suggested that the press principal spreads along the alveolar ridge and formed several focused areas. After bone grafted, the shear stress tends to be evenly. The grafted alveolar could resist the medially deformation of alveolar crest and the shear stress to the nasal base bony structure. The conclusions from results demonstrated that the deformation of alveolar ridge is possibly due to the lip pressure after the lip repair. The shear stress along the alveolar ridge could cause the severity of the dentition. The grafted bony structure could even the shear stress distribution evenly other than the distribution properties.
Adolescent ; Alveolar Process ; surgery ; Alveolar Ridge Augmentation ; methods ; Biomechanical Phenomena ; Bone Transplantation ; Cleft Palate ; diagnostic imaging ; physiopathology ; surgery ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Male ; Maxilla ; diagnostic imaging ; physiopathology ; surgery ; Models, Biological ; Tomography, Spiral Computed

OBJECTIVETo establish a method for assist design of the posterior pharyngeal flap (PPF).

METHODSThe width, length of velopharyngeal space in repose and phonation of "i" in 26 cases with VPI were measured with CT. The width and length of PPF needed, the location of the pedicle and the contact position with the soft palate were analyzed.

RESULTSThe width of velopharyngeal space in repose ranged from 15.10 to 37.25 mm, with the average of 27.01 mm, the length was 12.54 to 30.39 mm, with the average of 22.10 mm. The width in phonation of "i" was 9.11 to 34.06 mm, with the average of 17.69 mm, the position of the pedicle wasall located at the level of the first cervical vertebra or above and the contact area of the flap with the soft palate was in the middle posterior 1/3 mostly.

CONCLUSIONAs a method to quantitatively evaluate velopharyngeal function, CT can assist in design for the PPF.

Adolescent ; Adult ; Child ; Cleft Palate ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Pharynx ; diagnostic imaging ; surgery ; Surgical Flaps ; Tomography, X-Ray Computed ; Velopharyngeal Insufficiency ; diagnostic imaging ; surgery

OBJECTIVETo compare the transverse growth of the dental cast following palatal surgery with or without osteogenesis in palatal gap.

METHODS31 patients at 13 - 28 years old with repaired palate were selected to take the dental cast, the width of the dental arch, alveolar base and the matching degree between arches were measured and the average was calculated. After the length of the bone bridge in palate was measured through CT scan, the relationship between the osteogenesis in palatal gap and the transfers growth of dental cast was studied.

RESULTSThe critical length of the bone regeneration in palatal gap to affect the dental growth is 4 mm, mean while the sufficient length is 8 mm. The group of sufficient bone bridge has a better development in both the width of dental alveolar base and that of dental arch and the matching degree than the group of unsurficience. And this intendance was more obvious in premolar region than in molar region.

CONCLUSIONSThe osteogenesis in palatal gap following palatal surgery can strongly support the transfers growth in the width of dental arch, the width of alveolar base and the matching degree between upper and lower dental arch.

Adolescent ; Adult ; Cleft Palate ; diagnostic imaging ; physiopathology ; surgery ; Dental Occlusion ; Female ; Humans ; Male ; Osteogenesis ; Tomography, X-Ray Computed

OBJECTIVETo investigate the insertion position of the levator veli palatini in the soft palate with SMCP comparing normal group and find out reliance diagnosis methods for SMCP.

METHODSExperimental group: lateral skull radiography film were taken in 50 patients with SMCP at rest and "i" phonation. Five parameters were measured which are relative length of soft palate and hard palate; levatorveli palatini insertion in the soft palate; elongation and angle of soft palate when lifting up on phonation.

CONTROL GROUPTen sets (rest and pronouncing "i") of lateral skull radiography were used as control group. X-rays were taken for ten normal subjects without speech disorder or other abnormal physical situations. All data were subjected to the t-test of statistical significance.

RESULTSThe difference of measures between patients with SMCP and normal control was significant (P

CONCLUSIONIt was obvious that both absolute and relative length of soft palate are short and levator muscle insert into soft palate arterially in patients with SMCP comparing with normal group, which caused VPI and become one of the criterias for SMCP.

Adolescent ; Adult ; Cephalometry ; Child ; Child, Preschool ; Cleft Palate ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Palatal Muscles ; diagnostic imaging ; Palate, Soft ; diagnostic imaging ; Radiography ; Retrospective Studies