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

OBJECTIVE: To assess the reproducibility of non-verbal facial expressions (smile lips closed, smile lips open, lip purse, cheek puff) in normal persons using dynamic three-dimensional (3D) imaging and provide reference data for future research. METHODS: In this study, 15 adults (7 males and 8 females) without facial asymmetry and facial nerve dysfunction were recruited. Each participant was seated upright in front of the 3D imaging system in natural head position. The whole face could be captured in all six cameras. The dynamic 3D system captured 60 3D images per second. Four facial expressions were included: smile lips closed, smile lips open, lip purse, and cheek puff. Before starting, we instructed the subjects to make facial expressions to develop muscle memory. During recording, each facial expression took about 3 to 4 seconds. At least 1 week later, the procedure was repeated. The rest position (T0) was considered as the base frame. The first quartile of expressions (T1), just after reaching the maximum state of expressions (T2), just before the end of maximum state of expressions (T3), the third quartile of expressions (T4), and the end of motion (T5) were selected as key frames. Using the stable part of face such as forehead, each key frame (T1-T5) of the different expressions was aligned on the corresponding frame at rest (T0). The root mean square (RMS) between each key frame and its corresponding frame at rest were calculated. The Wilcoxon signed ranks test was applied to assess statistical differences between the corresponding frames of the different facial expressions. RESULTS: Facial expressions like smile lips closed, smile lips open, and cheek puff were reproducible. Lip purse was not reproducible. The statistically significant differences were found on the T2 frame of the repeated lip purse movement. CONCLUSION The dynamic 3D imaging can be used to evaluate the reproducibility of facial expressions. Compared with the qualitative analysis and two-dimensions analysis, dynamic 3D images can be able to more truly represent the facial expressions which make the research more reliable.
Adult ; Face/diagnostic imaging* ; Facial Expression ; Female ; Humans ; Imaging, Three-Dimensional ; Lip/diagnostic imaging* ; Male ; Photogrammetry ; Reproducibility of Results ; Smiling

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

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*

OBJECTIVETo propose a new three-dimensional method or grading scale in the evaluation of the secondary alveolar bone grafting, thus modifying the Bergland grading scale.

METHODSA total of 40 patients (26 male, 14 female) with unilateral cleft lip and palate (UCLP), who underwent secondary alveolar bone grafting at least 3 months ago, were enrolled. Regional cone-beam CT (CBCT) scans were taken to evaluate the height and thickness of the postoperative bone bridges. A new three-dimensional grafting scale was established, including four grades respectively in alveolar height and thickness.

RESULTSAccording to the new three-dimensional scale in this study, 15 grafted sites were rated grade T-I or T-II in the alveolar thickness among 18 sites of grade H-I in height, and 10 among 15 of grade H-II in height. Therefore, 25 grafted sites were considered as clinical success in the alveolar thickness (grade T-I or T-II) among 33 sites with clinical success in alveolar height (grade H-I and H-II). There were 24% of 33 sites with clinical success in height, which were considered as clinical failure in the alveolar thickness.

CONCLUSIONSIt is necessary to establish a new three-dimensional method or grading scale for evaluating the secondary alveolar bone grafting. The three-dimensional scale can take comprehensive view of the bone-grafted alveolar clefts and thus modify the Bergland grading scale.

Alveolar Bone Grafting ; Alveolar Process ; diagnostic imaging ; surgery ; Cleft Lip ; diagnostic imaging ; surgery ; Cleft Palate ; diagnostic imaging ; surgery ; Cone-Beam Computed Tomography ; Female ; Humans ; Male ; Postoperative Period

OBJECTIVETo investigate the nasolabial muscle anatomy and biomechanical characteristics.

METHODSMicro-computed tomography scan was performed in 8 cases of spontaneous abortion fetus lip nasal specimens to construct a three-dimensional model. The nasolabial muscle structure was analyzed using Mimics software. The three-dimensional configuration model of nasolabial muscle was established based on local anatomy and tissue section, and compared with tissue section. Three dimensional finite element analysis was performed on lip nasal muscle related biomechanics and surface deformation in Application verification was carried out in 263 cases of microform cleft lip surgery.

RESULTSThere was close relationship between nasolabial muscle. The nasolabial muscle tension system was constituted, based on which a new cleft lip repair surgery was designed and satisfied results were achieved.

CONCLUSIONSThere is close relationship among nasolabial muscle in anatomy, histology and biomechanics. To obtain better effect, cleft lip repair should be performed on the basis of recovering muscle tension system.

Aborted Fetus ; Biomechanical Phenomena ; Cleft Lip ; surgery ; Facial Muscles ; anatomy & histology ; diagnostic imaging ; physiology ; Finite Element Analysis ; Humans ; Lip ; anatomy & histology ; diagnostic imaging ; Muscle Tonus ; Nose ; anatomy & histology ; diagnostic imaging ; Software ; X-Ray Microtomography

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 determine the agreement between two-dimensional radiograph and three-dimensional CT in the evaluation of the secondary alveolar bone grafting.

METHODSNine complete cleft lip and palate patients (8 UCLP, 1 BCLP) at least 6 months post secondary alveolar bone grafting were selected. The mean age of the patients was 15.5 years with a range of 12 to 26 years. Occlusal radiographs were taken and the interdental septal height was determined using Bergland criteria. There were 2 type I sites, 2 type II sites, 5 type III sites and 1 type IV site. All the patients had undergone CT scan of the cleft within two months after the radiograph was taken. The plane of scan was parallel to the occlusal plane. Cuts of 2 mm were taken from the infraorbital rim to the gingival third of the crown of the teeth. Three-dimensional reconstruction was performed.

RESULTSThe interdental septal height on the occlusal radiograph was conformed by the CT scan. Labial and palatal notch was found on CT scan at two grafting sides.

CONCLUSIONSThe study provided some evidence to support the continued cautious use of anterior occlusal radiograph in the evaluation of bone-graft success before the orthodontic treatment. When the X-ray examination is not in line with the clinical examination, CT scan is indicated.

Adolescent ; Adult ; Alveolar Process ; diagnostic imaging ; surgery ; Bone Transplantation ; Child ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Tomography, X-Ray Computed ; methods

Herpetic meningoencephalitis is a devastating disease with significant morbidity and mortality. One of the most serious clinical sequelae is aphasia, usually of sensory type, whereas, Broca's or motor aphasia is not a common manifestation. We report a case of herpetic meningoencephalitis diagnosed by polymerase chain reaction (PCR) and viral culture with Broca's aphasia as a neurologic sequela. A 35-year old male patient was admitted due to fever and altered mentality for 3 days. He was accompanied by nausea, vomiting, disorientation, and memory defect. Several vesicular eruptions were noted around the lips. Neck stiffness was present, but Kernig's and Brudzinski signs were not observed. Herpetic meningoencephalitis was confirmed with PCR and other diagnostic tests such as EEG, brain MRI, brain CT scan, and viral culture. His overall clinical condition was improved after acyclovir therapy, but Broca's aphasia remained as a sequela.
Acyclovir ; Adult ; Aphasia* ; Aphasia, Broca ; Brain ; Diagnostic Tests, Routine ; Electroencephalography ; Encephalitis, Herpes Simplex* ; Fever ; Herpes Simplex* ; Humans ; Lip ; Magnetic Resonance Imaging ; Male ; Memory ; Mortality ; Nausea ; Neck ; Polymerase Chain Reaction ; Tomography, X-Ray Computed ; Vomiting