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*

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

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*

OBJECTIVEThe purpose of this study was to observe the roentgenographic characters of distraction osteogenesis (DO) correction of cleft palate (CP), to study the expression of BMP proportional to fixation period time intervals, and to explore the new bone formation mechanism in Cleft Palate bone shelf.

METHODS12 cats were used to establish the CP animal model surgically, and then were assigned randomly to (1) Experimental group (12 cats): CP defects were DO repaired at the rate and rhythm of 0.4 mm x 2/day. Specimen retrieval at 2, 4, 6, 8, 12 weeks after completion of distraction, roentgenography and Anti-BMP immunohistochemistry studies were performed; (2) Experimental control group (2 cats): CP defects without any treatment procedures, and (3) Empty control group of 2 cats.

RESULTSAnti-BMP immunohistochemistry study showed positive DAB dye in early 2 weeks and most extensively positive expression of BMP in 4 to 6 weeks. The expression of BMP wore off gradually through 8 to 12 weeks. The roentgenography showed that the newly mineralized bone was developed from the cut bone edges bilaterally to the central transparent zone, and the newly formed bone bridged the defect area completely at the end of the study. The CP bone defect was reconstructed and the distraction gap was filled with de nove osteogenesis. No new bone formation was observed in experimental control group.

CONCLUSIONThe process of new bone formation in the distraction area is dynamic. Being stimulated primarily, the process was kept highly active till quiescence phase finally. The X-ray examination shows that there is distinctively low roentgenopeque. Nevertheless, roentgenography is so far a very effective and convenient method to evaluate and monitor the DO correction efficiency.

Animals ; Bone Morphogenetic Proteins ; biosynthesis ; metabolism ; Bone Regeneration ; Cats ; Cleft Palate ; diagnostic imaging ; metabolism ; surgery ; Osteogenesis ; Osteogenesis, Distraction ; Palate, Hard ; diagnostic imaging ; metabolism ; surgery ; Radiography ; X-Ray Film

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