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

Rapid palatal expansion is commonly uesd to correct maxillary transverse deficiency. The timing and effects of palatal expansion, and the choice of palatal expansion devices are related to the condition of midpalatal suture. Nowadays, there are several methods to assess the condition of midpalatal suture, including physiological age, skeletal age, occlusal film, CT, ultrasonography and so on. This narrative review seeks to review these methods for assessment of midpalatal suture.
Palatal Expansion Technique ; Cranial Sutures/diagnostic imaging* ; Maxilla/diagnostic imaging* ; Palate/diagnostic imaging*

OBJECTIVETo evaluate the inconformity between soft tissue defect and bony defect by observing the cleft extent of palate with complete secondary palate bony cleft in incomplete cleft palate patient.

METHODSThe patients with incomplete cleft palate treated in Hospital of Stomatology Peking University from July 2012 to June 2013 were reviewed, of which 75 cases with complete secondary palate bony cleft were selected in this study. The CT scan and intraoral photograph were taken before operation. The patients were classified as four types according to the extent of soft tissue defect. Type 1: soft tissue defect reached incisive foremen region, Type 2 was hard and soft cleft palate, Type 3 soft cleft palate and Type 4 submucous cleft palate. Type 1 was defined as conformity group (CG). The other three types were defined as inconformity group (ICG) and divided into three subgroups (ICG-I), (ICG-II) and (ICG-III).

RESULTSFifty-seven patients were in ICG group, and the rate of inconformity was 76% (57/75). The percentage of ICG-I, ICG-II and ICG-III was 47% (27/57), 23% (13/57) and 30% (17/57), respevtively.

CONCLUSIONSThere are different types of soft tissue deformity with complete secondary palate bony cleft. The inconformity between soft tissue and hard tissue defect exits in 3/4 of isolated cleft palate patients.

Cleft Palate ; classification ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Palate, Hard ; diagnostic imaging ; pathology ; Palate, Soft ; abnormalities ; diagnostic imaging ; pathology ; Photography, Dental ; Tomography, X-Ray Computed

Bone Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Middle Aged ; Osteoma ; diagnostic imaging ; pathology ; Palate ; diagnostic imaging ; pathology ; Radiography

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

OBJECTIVESTo evaluate the naso-maxillary complex width and pharyngeal airway volume changes after rapid maxillary expansion (RME).

METHODSThirty-five patients were selected (18 males, 17 females, mean age, 12.1 ± 1.1 years). All patients underwent orthodontic treatment with Hyrax palatal expanders. Cone-beam CT (CBCT) scan was taken before treatment (T0), 16 days (T1) and three months (T3) after RME. Naso-maxillary complex width and pharyngeal airway volume were measured.

RESULTSAfter treatment the width of piriform aperture and maxillary width were significantly increased compared with that before treatment (P < 0.05). Three months after RME, no statistical difference was found in maxillary width compared with that before treatment. The nasopharyngeal volume significantly increased by 29.9% compared with that before treatment (P < 0.05), and the volume remained relatively stable after three months.

CONCLUSIONSRME resulted in a significant increase in the naso-maxillary complex width and nasopharyngeal volume.

Cone-Beam Computed Tomography ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Maxilla ; diagnostic imaging ; Nose ; diagnostic imaging ; Palatal Expansion Technique ; Palate ; diagnostic imaging ; Pharynx ; diagnostic imaging

OBJECTIVETo explore the relationship ol lingual region upper airway stricture and lingua-palate position type in obstructive sleep apnea hypopnea syndrome (OSAHS) patients.

METHODSOne hundred patients with OSAHS were included in the study and divided into 4 groups by lingua-palate age, AHI, BMI and lowest SaO2, the dimensions and area of lingual region airway, the thickness of retropharyngeal and lateral pharyngeal tissue, the tongue width, tongue length and tongue area were compared among four groups. The multinomial step regression process was performed with SPSS software to explore the effects of lingua-palate position type on lingual region upper airway stricture.

RESULTSThere were no statistical difference of age, BMI, AHI and lowest pulse oxygen among four groups OSAHS patients (P > 0.05). And the CT results showed: starting from type I to type IV, the area, coronal and arrowe diameter of lingual region upper airways were decreasing, tongue length, tongue area and the percentage of lingual region airway stricture were increasing, the percentage of lingual region airway stricture were 0/25, 3/39, 7/22, 14/14, respectively (P < 0.05). The multinomial step regression analysis showed that the area of lingual airway was the most important factor of lingua-palate position type, the unstandardized coefficient was -0.39, and standardized coefficient was -0.545.

CONCLUSIONSThe study suggests that there is evident correlation between lingual region airway stricture and lingua-palate position type, and lingual region airway stricture can be roughly determined by lingua-palate position type.

Adult ; Aged ; Airway Obstruction ; diagnosis ; Humans ; Male ; Middle Aged ; Palate ; diagnostic imaging ; Pharynx ; diagnostic imaging ; Radiography ; Sleep Apnea, Obstructive ; diagnostic imaging ; Tongue ; diagnostic imaging ; Young Adult

OBJECTIVE: To examine the location, extent and cause of collapsed airway in Müller maneuver in OSAHS patients with CT scan, and provide the evidence for surgery. METHOD: Thirty patients with moderate or severe OSAHS were measured with 64 slice CT in quiet breathing and in Müller maneuver. After three-dimensional reconstruction and virtual endoscope handing of the upper airway, we compare the cross-section area and the dimensions of five levels as well as the thickness of retropharyngeal and lateral pharyngeal tissue in two conditions. The evaluation values include the length and thickness of soft palate and uvula, soft-hard palate angle and hyoid hard palate distance. RESULT: The lateral distance, anterior - posterior distance, cross - sectional area, but AP of RG and EPG region, were statistically different in quiet breathing and in Müller maneuver. The thickness of retropharyngeal and lateral pharyngeal tissue were statistically different in two conditions, and the length and thickness of soft plate and uvula, soft-hard angle and hyoid hard palate distance were statistically different. CONCLUSION Three-dimensional reconstruction and virtual endoscope of 64 slice CT can clearly show the location, extent and cause of occlusion of the upper airway, which helps well clinical application.
Adult ; Humans ; Male ; Middle Aged ; Palate, Soft ; diagnostic imaging ; Pharynx ; diagnostic imaging ; Sleep Apnea, Obstructive ; diagnostic imaging ; Tomography, Spiral Computed ; methods ; Uvula ; diagnostic imaging

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*