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*

The prevention, prenatal diagnosis and postnatal treatment of cleft lip and palate form a comprehensive treatment process requiring multidisciplinary participation. Prevention and treatment of cleft lip and palate involve multiple disciplines. The timing of professional intervention often cross and overlap, intervention and the sequence of treatment had a great influence on the outcome of the treatment. In the meantime, under the premise of the change of national fertility policy, the reproductive needs of families with cleft lip and palate, such as fertility intervention and diagnosis etc., should be paid attention to through the whole chain of pre-pregnant, prenatal and post-natal interventions. Therefore, this paper proposes a multidisciplinary treatment process for the comprehensive diagnosis and treatment of cleft lip and palate. It primarily combs and standardizes the discipline composition, data preparation, consultation contents, personnel, time and technical points of the consultation records of the multidisciplinary treatment in antenatal, postnatal, infant, adolescent, adult and reproductive stages of cleft lip and palate.
Adolescent ; Cleft Lip/therapy* ; Cleft Palate/therapy* ; Female ; Humans ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography, Prenatal

OBJECTIVETo evaluate the effectiveness of hypnotic and musical relaxation therapy and psychological consultation for parents of children with cleft lip and/or palate (CLP) and to provide a scientific basis of clinical-psychological treatment options.

METHODSSixty-six subjects with children with CLP participated in this study. The subjects were randomly assigned to a test group (n = 33) and a control group (n = 33). The test group was treated with hypnotic and musical relaxation therapy; the control group were subjected to psychological consultation. Anxiety and depression states were evaluated by using a self-rating anxiety scale (SAS) and a self-rating depression scale (SDS) before and after treatment was administered.

RESULTS1) The test group demonstrated a significant decrease in SAS and SDS scores (t = 2.855, P < 0.01; t = 2.777, P < 0.01). The control group showed a significant decrease in the SAS score (t = 1.831, P < 0.05) but failed to show a significant change in the depression score (t = 0.909, P > 0.05). 2) The test group yielded a higher percentage of remission indicated by the SDS scores than the control group (test group = 75.76%; control group = 60.61%; P < 0.05). The test group also displayed a higher percentage of remission indicated by the SAS scores than the control group (test group = 78.79%, test group = 69.70%; P < 0.05).

CONCLUSIONHypnotic and musical relaxation therapy can more effectively reduce the scores of the anxiety and depression states of the parents of patients with cleft lip and/or palate than psychological consultation.

Anxiety ; psychology ; therapy ; Child ; Cleft Lip ; psychology ; Cleft Palate ; psychology ; Depression ; psychology ; therapy ; Humans ; Hypnosis ; Music ; Parents ; psychology ; Relaxation Therapy ; methods ; Self-Assessment

The five major areas of concern in craniofacial surgery are the cleft lip and palate, hemifacial microsomia, craniosynostosis and its accompanying craniofacial syndromes, maxillofacial surgery, and breakthrough research on the each of these. Furlow's double opposing Z-plasty and 2-flap palatoplasty are often used to correct the cleft palate. Hereafter, the most appropriate surgical timing and methods must be determined through a prospective randomized control study. Currently, Millard's rotation advancement flap technique is generally used to correct the cleft lip. The repair of a cleft lip and especially a bilateral cleft lip is supplemented by presurgical orthodontics. Effort toward mastering the simultaneous repair of the nose continues. For hemifacial microsomia, distraction osteogenesis, orthognathic surgery, and fat injection is employed to correct facial asymmetry. Tissue engineering will soon be introduced as a treatment option. Currently, craniosynostosis is treated with methods such as total calvarial vault remodeling, endoscopic suturectomy, and distraction osteogenesis. In the future, a simpler and less invasive surgical technique must be developed. Maxillofacial (orthognathic) surgery generally refers to the bilateral sagittal split ramus osteotomy and LeFort I osteotomy. In the future, minimally invasive surgical techniques using endoscopes or robots will be introduced. Through the development of recombinant DNA technology, genetic research of craniofacial anomalies has identified many relevant genes. In the future, gene therapy will be plausible. Through advancements in tissue engineering, regeneration of tissue to correct congenital craniofacial deformities through autologous stem cells and scaffolds will be conceivable in the near future.
Cleft Lip ; Cleft Palate ; Congenital Abnormalities ; Craniosynostoses ; DNA, Recombinant ; Endoscopes ; Facial Asymmetry ; Genetic Research ; Genetic Therapy ; Korea ; Nose ; Orthodontics ; Orthognathic Surgery ; Osteogenesis, Distraction ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Palate ; Prospective Studies ; Regeneration ; Stem Cells ; Surgery, Oral ; Tissue Engineering

Cleft Lip ; therapy ; Cleft Palate ; therapy ; Humans

OBJECTIVE: To determine the effect of simulated protraction after maxillary fissure repair on stress and shift of maxillary bone and to provide the scientific evidence for treatment of maxilla in patients with cleft lip and palate. METHODS: Based on the establishment of 3-dimensional finite element model of maxilla with cleft lip and palate, we used ANSYS 10.0 software to simulate protraction, repair fissures of maxillary bone, and then analyzed the change of maxillary stress and shift. RESULTS: The maxillary fissures could be enlarged by protraction without reparation of maxillary. Obvious motion was observed on the uninjured side, with 500 g/per lateral protraction and 30 degree protraction angle. The major principal stress and von Mises stress of craniofacial bone distributed evenly under protraction after fissure repair. CONCLUSION The maxillary fissures have an enlarged trend by protraction without repair.The protraction treatment benefits the development of maxillary bone after repairing maxillary fissure.
Biomechanical Phenomena ; Cleft Lip ; therapy ; Cleft Palate ; therapy ; Extraoral Traction Appliances ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Malocclusion ; therapy ; Maxilla ; physiology ; Retrognathia ; therapy

OBJECTIVE: To determine the rule of simulated protraction and palate expansion on shift of maxillary bone,and to supply the scientific data for treating maxilla in patients with cleft lip and palate. METHODS: Based on the establishment of 3-dimensional finite element model of maxilla with cleft lip and palate, we used ANSYS 10.0 software to simulate protraction and expand fissures of palate, and analyzed the changes of maxillary shift. RESULTS: After the simulated protraction and pa-late expansion,an upward, forward, and outward growth occurred on maxilla, and the normal lateral bow had no internal shrinkage as well as the abnormal one. CONCLUSION Combined palate expansion with maxillary protraction treatment in patients with cleft lip and palate tend to improve the development of maxillary bone.
Biomechanical Phenomena ; Cleft Lip ; therapy ; Cleft Palate ; therapy ; Extraoral Traction Appliances ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Malocclusion ; therapy ; Maxilla ; physiology ; Palatal Expansion Technique ; Retrognathia ; therapy

OBJECTIVE: To determine the effective rule of protraction in different directions,strains, and shifts of maxillary bone,and to supply the scientific data for treatment of the maxilla in patients with cleft lip and palate. METHODS: " Based on the establishment of 3-dimensional finite element model of maxilla with cleft lip and palate,ANSYS 10.0 software was used to simulate protraction,and then we analyzed the change of maxillary stress and shift in the same force of traction in different directions. RESULTS: With 500 g per lateral protraction and the protraction angle from 20 degree to 45 degree,the maxillary shifted upward, forward, and outward, and the shape of maxillary plate bow showed internal shrinkage. There was a close relation between the internal shrinkage and the direction of protraction. The smaller the angle between the direction of protraction and the functional occlusion plane,the larger the internal shrinkage of tooth bow. The larger the angle between the direction of protraction and the functional occlusion plane,the smaller the internal shrinkage of tooth bow. CONCLUSION With protraction,the maxilla grows upward, forward, and outward, and the maxillary palate shinks internally. There is a close relation between the direction of protraction and the range of internal shrinkage.
Biomechanical Phenomena ; Cleft Lip ; therapy ; Cleft Palate ; therapy ; Extraoral Traction Appliances ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Malocclusion ; therapy ; Maxilla ; physiology ; Retrognathia ; therapy

OBJECTIVETo investigate the different changes after maxillary protraction between the cleft and non-cleft patients with anterior crossbite.

METHODSProspective controlled clinical trial was carried out. Eighteen patients (aged 9.6 +/- 1.2 years) with unilateral cleft lip and palate (UCLP) were chosen as the experimental group. Eighteen non-cleft patients (aged 9.8 +/- 1.4 years) with similar malocclusions were selected as control group. All the patients were before puberty according to the evaluation of the hand wrist radiograms. Hyrax appliance and reverse headgear were used in both experimental and control groups. Lateral cephalometric radiographs were taken before and after treatment. Computerized cephalometric analysis was carried out. Paired t tests or t test were performed using software package SAS 8.1.

RESULTSAfter treatment, the main changes in experimental group were: SNA +1.45 degrees , A-TFH +2.19 mm, SNB -2.18 degrees , ANB +3.64 degrees , MP/SN +2.78 degrees , LL-EP +0.88 mm in UCLP group. And in control group were: SNA +1.42 degrees , A-TFH +2.12 mm, SNB -1.32 degrees , ANB +2.68 degrees , MP/SN +1.47 degrees , LL-EP -1.37 mm.

CONCLUSIONSBefore puberty, maxillary protraction could accelerate maxillary forward growth in UCLP patients and the changes were similar to non-cleft patients. The occlusal relationship and soft tissue profile were improved significantly in both patients with or without cleft. The amount of mandibular posterior rotation in patients with UCLP was larger than in those with no cleft.

Cephalometry ; Child ; Cleft Lip ; surgery ; therapy ; Cleft Palate ; surgery ; therapy ; Female ; Humans ; Jaw Relation Record ; Male ; Malocclusion ; therapy ; Maxilla ; growth & development ; Osteogenesis, Distraction

Cleft Lip ; therapy ; Cleft Palate ; therapy ; Humans