Oral hygeine status of children with henoch-schonlein purpura (HSP) disease Backround: Henoch-Schonlein Purpura (HSP) disease is an inflammatory disease in which capillaries, venules, and arterioles are dominated by microvessels due to the accumulation of Ig-A immunity in the walls. Eighty percent of children with HSP have chronic infections such as chronic tonsillitis, otitis media, dental caries, and gingivitis.1-8 However, no research has yet been conducted to determine the prevalence and severity of tooth decay in children with Shenlein-Genoch disease, and to assess gingivitis and oral hygiene. Materials and methods: The survey was conducted from 50 children with the HSP from the Department of Cardiovascular Connective Tissue Pathology of Pediatric Consultant Polyclinic of the National Center for Maternal and Child Health and was conducted in using cross-sectional survey accordance with the number 07- 2021/3, Principles of the Research Ethics Review Committee of the Mongolian National University of Medical Sciences and, the results of the study were processed using the statistical software SPSS 25. Results: The prevalence of tooth decay among children with HSP was high at 95% for mixed dentition and 100% for each stage of primary and permanent dentition, while the intensity of tooth decay was 7,304.64 (caries+ fillings+extraction/ tooth) during primary dentition, 7,303.46 (caries+fillings / tooth) + (caries+fillings+extaction / tooth) during mixed dentures and 11,294.13 (caries+fillings+extraction / tooth) during permanent dentition. It is noteworthy that the level is very high at all.In the study of children with gingivitis, 50% of them had gingivitis with primary dentition, 60.9% with mixed dentition, and 58.8% with permanent dentition. The proportion of healthy children without gingivitis was 50% for primary dentition, 39.1% for mixed dentition, and 41.2% for permanent dentition. The proportion of “good” condition in the study was 30% for primary dentition, 39.1% for mixed dentition, 35.3% for permanent dentition. The “mean” rate was highest for 70% for primary dentition, 56.5% for mixed dentition and 58.8% for permanent dentition. The “insufficient” rate was 4.3% for mixed dentition and the lowest for 5.9% for permanent dentition. Conclusions: 1. The prevalence of tooth decay among children with HSP was high at 95% for mixed dentition and 100% for each stage of primary and permanent dentition, while the intensity of tooth decay was 7,304.64 (caries+ fillings+extraction/ tooth) during primary dentition. 7.303.46 (caries+ fillings+extraction/ tooth)+ ( caries+ fillings+extraction/ tooth) during mixed dentition and 11.294.13 (caries+ fillings+extraction/ tooth) for permanent dentition means that all of the level is at high intensity. 2. In the study of children with gingivitis, 50% of them had gingivitis with primary teeth, 60.9% with mixed teeth, and 58.8% with permanent teeth. The proportion of healthy children without gingivitis was 50% for primary dentition, 39.1% for mixed dentition, and 41.2% for permanent dentition. However, there is a statistically significant result (p <0.001) of the more increase in tooth plaque of poor oral hygiene the more increase in gingivitis. 3. The proportion of “good” condition in the study was 30% for primary dentition, 39.1% for mixed dentition, 35.3% for permanent dentition, the “mean” rate was 70% for primary dentition, 56.5% for mixed dentition and 58.8% for permanent dentition. The “insufficient” rate was 4.4% for mixed dentition, or the lowest for 5.9% for permanent dentition. There were no statistically significant differences (p> 0.05) between oral health and the HSP status of the children in the study. According to the results of the survey, it is observed that the oral health status among the respondents is insufficient.

Surgical result of velopharyngeal insufficiency Background: The main purpose of primary cleft palate (CP) repair is to reconstruct anatomical structure with minimal impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of the most common complications after the primary CP repair is velopharyngeal insufficiency (VPI), which leads to the subsequent surgery. The velopharyngeal function assessment characterizes speech development in children. Researches noted that VPI causes in 5-86% after primary CP repair. Early diagnosis of VPI and prompt surgical treatment are essential to prevent the development of speech disorders in children. Methods and Material: A retrospective longitudinal study was completed. The patients who diagnosed VPI after primary CP repair in the Department of Maxillo-facial surgery of the National Center for Maternal and Child Healt and had velopharyngeal function assessment were recruited to the study. The results were compared with pre and postoperative nasopharyngoscopy ratio. Results: A total of 133 patients with VPI were included: 75.9% had Furlow Z plasty, 24.1% had pharyngeal flap surgery. The patients ranged in age from 3 years 6 months to 17 years. VPI ratio was 17.3% - severe, 19.5% - moderate. Postoperative VPI ratio were 97.0% normal in the Furlow group and 84.4% in the pharyngeal surgery group (p=0.02). Nasal emission was 94.0% before surgery and 31.6% after surgery, a statistically significant difference (t = -14.2, p <0.0001). Conclusions: The Furlow Z plasty and pharyngeal flap surgeries were superior for maintaining velopharyngeal function.

The prevalence and type of congenital cleft of the lip and palate in mongolia, affiliation of the patients Background: The prevalence of congenital cleft lip and palate is different internationally. There are some research papers which identifying the rate of this abnormality in Mongolia, the latest one shown the result that one cleft case for 1072 live births (Ayanga GN et all, 2012). Aim: to determine/update the prevalence and types of congenital cleft lip and palate in Mongolia Materials and methods: we include the data from all cleft patients who were born between 01 of January, 2011-31 of December, 2021 to this survey retrospectively. We used the e-history for cleft patients, which developed by the department of Maxillofacial surgery since 2011. Results: Totally 1308 cleft patients included to our survey. The prevalence is one cleft cases for 652 live births in Mongolia, and 34,1% is cleft of the lip, 41,4% is cleft of the lip and palate, and 24,5% is cleft palate only of all cases. Also the rate was differently among provinces, as one for 429 live births in Khuvsgul province, and one for 1223 live births in Uvs province. Conclusions: the prevalence of cleft lip and palate in Mongolia 1000:1.5 or one for 652 live births. The highest rate established in Khuvsgul province, and the lowest in Uvs province.

Background: The main purpose of primary cleft palate repair is to reconstruct anatomical structure with minimal impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of the most common complications after the primary cleft palate repair is velopharyngeal insufficiency, which leads to the subsequent surgery. The velopharyngeal function assessment characterizes speech development in children. Researches noted that velopharyngeal insufficiency causes in 5-86% after primary cleft palate repair. Therefore, it is essential to choose an adequate primary surgical method for each particular type of cleft palate. Objective: To compare velopharyngeal function using nasopharyngoscopy after primary CP repair Materials and Methods: The patients who with congenital cleft palate and, underwent primary cleft palate repair in the Department of Maxillo-facial surgery of the National Centre for Maternal and Child Health and had velopharyngeal function assessment were recruited to the study. Patients with wound dehiscence and oronasal fistula postoperatively were excluded from the study.
Cleft palate was classified according to the Veau system and Golding-Kushner scale of nasopharyngoscopy was used to assess patient’s velopharyngeal function in order to associate with cleft types and the primary palatoplasty techniques. Pearson’s chi-squared analysis and Fisher exact test were used for statistical analysis. Results: A total of 335 patients were included in the study. The mean age at primary palate repair was 22.9±13.6 months. There were 56, 42, 177, and 60 patients with Veau-I type, Veau-II type, Veau-III type and Veau- IV type respectively, whereas for primary palatoplasty 65 patients underwent Furlow technique, 148 patients – Mongolian technique, 108 patients – Two flap technique, 34 patients – Von Langenbeck technique.
Nasopharyngoscopy assessment of adequate velopharyngeal function was as followed as by “Furlow” technique in 89.4% cases, ”Mongolian” technique in 62.2% cases but by “Two flap” technique only in 48.1% and Von Langenbeck technique in 47.1% cases. Conclusion The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after primary palatoplasty.

Velopharyngeal function: a comparison result of primary palatoplasty by various techniques Introduction: The main purpose of primary cleft palate repair is to reconstruct anatomical structure with minimal impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of the most common complications after the primary cleft palate repair is velopharyngeal insufficiency, which leads to the subsequent surgery. The velopharyngeal function assessment characterizes speech development in children. Researches noted that velopharyngeal insufficiency causes in 5-86% after primary cleft palate repair. Therefore, it is essential to choose an adequate primary surgical method for each particular type of cleft palate. To compare velopharyngeal function using nasopharyngoscopy after primary CP repair Materials and methods: The patients who with congenital cleft palate and, underwent primary cleft palate repair in the Department of Maxillofacial surgery of the National Centre for Maternal and Child Health and had velopharyngeal function assessment were recruited to the study. Patients with wound dehiscence and oronasal fistula postoperatively were excluded from the study. Cleft palate was classified according to the Veau system and Golding-Kushner scale of nasopharyngoscopy was used to assess patient’s velopharyngeal function in order to associate with cleft types and the primary palatoplasty techniques. Pearson’s chi-squared analysis and Fisher exact test were used for statistical analysis. Results: A total of 335 patients were included in the study. The mean age at primary palate repair was 22.9±13.6 months. There were 56, 42, 177, and 60 patients with Veau-I type, Veau-II type, Veau-III type and Veau- IV type respectively, whereas for primary palatoplasty 65 patients underwent Furlow technique, 148 patients – Mongolian technique, 108 patients – Two flap technique, 34 patients – Von Langenbeck technique. Nasopharyngoscopy assessment of adequate velopharyngeal function was as followed as by “Furlow” technique in 89.4% cases, ”Mongolian” technique in 62.2% cases but by “Two flap” technique only in 48.1% and Von Langenbeck technique in 47.1% cases. Conclusions: The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after primary palatoplasty.

Introduction: The department of Maxillofacial surgery of the National Center for Maternal and Child Health (NCMCH) has a nationwide tertiary medical service for the children who is with congenital orofacial anomalies, facial injury, nonmalignant tumors of this area, and inflammations of maxillofacial area following odontogenic infection and other reasons as well. For the last years the number of the patients who are with odontogenic inflammation on the department has been growing constantly meaning that the necessity of medical care for our countries for children is also growing. Therefore by studying and analyzing the structure of the odontogenic inflammation and to determine the most frequent odontogenic inflammation among children in our country, to prevent them, define the treatment plan. Aim: To clarify what kind of odontogenic maxillofacial inflammatory diseases mainly occurs among Mongolian children. Materials and Method: We included all patients who are with odontogenic inflammation and underwent emergency and planned surgery in the department of Maxillofacial surgery, NCMCH between 2014-2018.
We used descriptive method based on the information of inpatients history record between 2014.01.01- 2018.12.31 at the department of Maxillofacial surgery, NCMCH and using our own –designed, prescreened survey card.
Statistical data processing is done using Microsoft Office-2019, SPSS for windows and STATA programs, and the results are shown illustrated method. The survey identified the incidence and frequency of each disease classification, and analyzed the characteristics of the child’s age, sex, and residency. Result : In total 3533 children with odontogenic inflammation, whom age range is 0-18 years old, admitted at the department of Maxillofacial surgery for the surgical treatment were involved in this study.
Among which 1452(41.1%) male, 2081(58.9%) female. Considering the residency 2918(82.5%) children from Ulan-Bator and 615 (17.5%) children from countryside. The most of patients, who involved in this study were with odontogenic periostitis of maxillofacial area (67.5%), most were girls and preschool age (3-5 ages). Conclusion Based on the result of our study the most frequent inflammation was odontogenic periostitis of maxilla and mandible bone with 67.5%. The odontogenic phlegmon of orofacial area was the 2nd most frequent with 25.1%.
Inflammation of maxillofacial area was most frequent in 3-5 age group (preschool age) with 41.4%, and mostly in male. Considering the residency with 82.5% highest in Ulanbator.

BACKGROUND. Congenital Cleft Lip and/or Palate (CL/P) is a common craniofacial birth defect and occurs 1 per 500-700 live births in average. Children with CL/P at a higher risk for speech/language problems due to the anatomical and structural differences in the oral and nasal cavities, Velopharyngeal Insufficiency causing speech disorders with articulation, phonation, and resonance, respectively. It leads to long-lasting adverse outcomes, influencing quality of life and causes obstacles in child’s socialization. Speech in 2007 Therapy team of School of Dentistry ( G. Ariuntuul , B. Bulgan, U. Azzaya, B. Batsukh, M. Bat-Erdene), Mongolian National University of Medical Sciences (MNUMS) (former Health Sciences University of Mongolia) established and successfully conducted a first clinical speech therapy sessions for children with clefts in Mongolia based on the Department of Oral and Maxillofacial Surgery (G. Ayanga et al.) of National Maternal and Children’s Health Center (NMCHC). Since 2012 the speech therapy team of School of Dentistry, officially transferred the equipped operating speech room to NMCHC and speech pathologist B. Bulgan, supervised and trained by Ariuntuul G. recruited by NMCHC for a full time position and working as a member of multidisciplinary team till present. OBJECTIVES. To assess and analyze registry data of children with clefts, visited speech therapy sessions of speech pathology team of School of Dentistry, MNUMS during 2007 through 2012. MATERIAL AND METHODS. Registry based retrospective study was conducted to obtain demographic and speech disorder related data of children with clefts, visited speech therapy sessions between 2012-2017 at the NMCHC. RESULTS. In total 203 participants are attended the speech therapy sessions: 103 male (51%), 100 female (49%). Out of total 203 children 144 (71%) had Cleft Lip and Palate (CLP), 44 had cleft palate only (22%), 15 had cleft lip (7%), respectively. Average age for primary cleft surgery was 1y13m, where as for secondary was 4y22m. CONCLUSION. For speech therapy session for children with clefts boys were dominant compared to girls (1:1.03). By the types of clefts children diagnosed with Cleft Lip and Palate was prevalent to attend treatment classes. There is a need in early CL/P diagnosis, using birth screening and furthermore, traning of speech therapists/pathologists are important for development of multidisciplinary team, surgery outcome and improvement of quality of life of children with clefts.

Introduction: The department of Maxillofacial surgery of the National Center for Maternal and Child Health (NCMCH) has a nationwide tertiary medical service on the patients who is with congenital orofacial anomalies, facial injury, nonmalignant tumors of this area, and inflammations of maxillofacial area following dental caries and other reasons as well. For the last years nationwide the number of inpatient of the department has been growing constantly meaning that the necessity of medical care for our countries for children is also growing. Therefore by studying and analyzing the structure of the illness of the department will be able to determine the most frequent orofacial illness among children in our country, to prevent them, define the treatment plan. Aim: To clarify what disease in the Maxillofacial area mainly occurs among Mongolian children. Materials and Method: We included all patients who underwent emergency and planned surgery in the department of Max-illofacial surgery, NCMCH between 2014-2015.
We used descriptive and case-control method based on the information of inpatients history record between 2014.01.01-2015.01.01 at the department of Maxillofacial surgery, NCMCH and using our own –designed, pre-screened survey card.
Statistical data processing is done using Microsoft Office-2017 and SPSS for windows programs, and the results are shown illustrated method. The survey identified the incidence and frequency of each disease classification, and analyzed the characteristics of the child’s age, sex, and residency. Result: The most of patients, who involved in this study were with the inflammation of maxillofacial area (57%), and the congenital orofacial clefts (24.4%).
In total 3300 children from 0-18 years old admitted at the department of Maxillofacial surgery and Infants study for orofacial surgery treatment were involved in this study.
Among which were 1803(54.6%) male, 1497(45.4%) female. Considering the residency, 2525(76.5%) children from Ulaanbaatar and 775 (23.5%) children from countryside. The most of patients, who involved in this study, were with the inflammation of maxillofacial area (57%), and the congenital orofacial clefts (24.4%). Conclusion Based on the result of our study the highest incidence among the participants was inflammation of maxillofacial area with 57% in which odontogenic periostitis was the most frequent with 21.6%. Congenital orofacial clefts and disorders was the 2^nd most frequent with 24.4%. Inflammation of maxillo-facial area was most frequent in 0-2 age group with 33.7%, and mostly in male. Considering there were residency with 83.2% highest in Ulaanbaatar and mostly in Bayanzurkh district with 24.7%.

Prevalence rate of congenital cleft lip and palate is different among countries, approximately 0.87-1.03 per 1000 live births. Several studies conducted in our country showed 1 per 1314 live births in 2005 ( Ariuntuul.G et al.), 1 per 1072 live births in 2012 (Ayanga et al.). According to the published review, children with cleft lip and palate are more prone to dental caries compared to the healthy group. The loss of oral physiological function such as eating, breathing, chewing eventually results loss of oral self-cleansing process in children with cleft lip and palate. Aim:To evaluate the oral status in children with cleft lip and palate. Our cross sectional study included 70 children with a congenital cleft lip and palate, aged 2-16 years, who admitted to the Department of Maxillofacial surgery, National Center of Maternal and Child Health. All participants had an oral examination performed by one dentist in a dental office, used only single-use instruments. Incidence of dental caries was determined by WHO method, bleeding from gum and gingivitis was reported along with the CPI, oral hygiene status was determined by the Green Vermillion index. 59% of participants were girls and 41% were boys. Prevalence rate of dental caries in children with cleft lip and palate was 100% during each occlusion period, but intensity of the dental caries was 10.2±4.8 cs/t (SN) in a primary bite, 9.1±3.9 in a mixed bite and 7.7±2.7 in a permanent bite period, respectively. Incidence of gingivitis was 100% in a primary bite period. Prevalence rate of dental caries was 100% among 2-16 year-old children with congenital cleft lip and palate. Dental caries intensity rate among children with congenital cleft lip and palate was significantly higher (6.5) compared to the WHO’ s dental caries intensity rate. Compared to healthy children, incidence of gingivitis was higher, and oral hygiene status was poorer in children with congenital cleft lip and palate, which could have increased the risk of periodontitis and dental caries among these children.

Hemangiomas are common benign vascular tumors which about 70% to 80% of the lesions are found in the head and neck region. This study was conducted on 36 children with hemangioma who were referred to Orofacial Surgery Cabinet of Dental School of Health Sciences University of Mongolia and Orofacial Surgery Cabinet of National Center for Maternal and Child Health of Mongolia between 2013 and 2015.Of the 36 children referred for assessment, 72% were female, 55% were infants of 4 to 9 months old, and 83% of them were citizens. 58% of patients underwent cryotherapy,and 57% of patients underwent cryotherapy had 2 therapy sessions. 25% of patients receiver sclerotic therapy, and 67% of them had 2 therapy sessions. According to the locations of hemangiomas 30% of them were localized in infraorbital area. 72% of the participants are women and 55% are children age of 4-9 month which 83% of all participants were living in city. 58% of children with hemangioma are treated with cryotherapy which 57%of treatment finished by second visit. And 25% were treated by dehydration treatment which 67% were finished by second visit.