OBJECTIVE: To study the comprehensive impact of scar and maxillary expansion combined with protraction on the development of maxilla with cleft lip and palate after repair operation. METHODS: In the original finite element model of the maxilla with cleft palate, a finite element model of the maxilla with cleft lip and palate was established by using Boolean operation in ANSYS. Scar force after cleft lip and palate repair and maxillary expansion force combined with protraction were added simultaneously to process the stress analysis. RESULTS: Maxillary deformation occurred in the three-dimensional direction. The comparison of displacements was as follows: X-axis>Z-axis>Y-axis. CONCLUSIONS Maxillary growth is significantly inhibited in the three-dimensional direction under the comprehensive impact of scar and maxillary expansion combined with protraction after repair operation, especially transverse and sagittal growth.
Cicatrix/pathology* ; Cleft Lip/surgery* ; Cleft Palate/surgery* ; Finite Element Analysis ; Humans ; Maxilla/surgery* ; Palatal Expansion Technique

Low-grade myofibroblastic sarcoma (LGMS) is a rare, malignant tumor with myofibroblastic differentiation. Despite it being classified as a distinct entity by the World Health Organization, a few cases were reported in the oral and maxillofacial region. Here, a LGMS developed on the palate of a 73-year-old man who presented with a 1-cm tumor on the posterior border of the palate. Based on the histological and immunohistochemical features, a diagnosis of LGMS was established. The tumor was resected, and no recurrence was observed over 2 years. Although the tongue is the most preferred site for LGMS, it may occur in any region of the oral cavity.
Aged ; Humans ; Male ; Myofibroblasts ; pathology ; Osteosarcoma ; pathology ; surgery ; Palatal Neoplasms ; pathology ; surgery ; Palate, Hard ; pathology

Adult ; Bacteremia ; pathology ; Humans ; Male ; Otorhinolaryngologic Surgical Procedures ; adverse effects ; Palate ; surgery ; Pharynx ; surgery ; Postoperative Complications ; microbiology

OBJECTIVETo study the feasibility and authenticity of repairing alveolar defects in alveolar cleft patients with osteoinduction active material (OAM) in clinic.

METHODSTwenty-seven cases of alveolar defect chosen from clinic were divided into two groups (test group and control group). For test group (12 cases), OAM was transplanted to repair the alveolar cleft. For control group (15 cases), autogenous ilium cancellous bone were transplanted into the defect region to repair alveolar cleft. At 6 months after operation, CT and three-dimensional reconstruction were used to observe alveolar appearance, and the effect and clinical success rate of recover alveolar cleft by using different repair material were compared.

RESULTSIn the 27 cases, all the maxillary continuity was restored except two of test group and two of control group. There was no significant difference between test group and control group regarding the clinical success rate of the alveolar cleft repair (P = 1.000).

CONCLUSIONOAM was used to repair the alveolar cleft that can result in new bone formations and the burgeon of canines from the bone grafted areas. There is no significant difference between OAM and autogenous ilium cancellous bone regarding the effect of the alveolar cleft repair.

Alveolar Process ; pathology ; surgery ; Biocompatible Materials ; therapeutic use ; Bone Regeneration ; Bone Transplantation ; Cleft Palate ; surgery ; Humans ; Ilium ; transplantation

OBJECTIVETo study the ultrastructure and Ca/P element spectrometry of distraction osteogenesis (DO) for reconstruction of cleft palate (CP), so as to explore the osteogenesis and remodeling of new bone in situ.

METHODS23 rhesus macaques were operated to establish animal models of CP. 2 monkeys didn't received DO as controls. The other 21 monkeys in experimental group underwent DO to correct both bony and soft tissue defects in palate. The distraction was performed at a rate of 0.8 mm/d, twice a day until the cleft was closed. After fixation for 1, 2, 4, 6, 8, 12, 24 weeks, every 3 animals were sacrificed to get the specimens at the distraction gap. The scanning electron microscopic study and Ca, P elements spectrometric analysis were adopted. There were also two unoperated animals as sham group.

RESULTSAfter fixation for 1-2 weeks, the distraction gap was full of collagen fibers oriented along vector of distraction. Few trabeculae was seen at the margin area. After fixation for 4-6 weeks, active osteogenesis was presented with new formed bone trabeculae and abundant cellular component. After fixation for 8-12 weeks, the new formed bone became mature and couldn't distinguish from the normal bone. 24 weeks later, the bone between the distraction gap had a similar structure to the normal bone. Elements spectrometric analysis results indicated that in early stage of osteogenesis, the P and S peaks were relatively high while the Ca peak was much lower. During the late stage, the S peak was obviously decreased, and Ca/P ratio increased to normal level as in the empty control group.

CONCLUSIONSThe CP can be corrected by DO. The new bone between the distraction gap is formed and remodeled through intramembraneous osteogenesis.

Animals ; Cleft Palate ; metabolism ; pathology ; surgery ; Disease Models, Animal ; Female ; Macaca mulatta ; Male ; Microscopy, Electron, Scanning ; Osteogenesis ; Osteogenesis, Distraction ; methods ; Palate ; surgery ; ultrastructure

OBJECTIVETo investigate the mechanism of new bone formation in the distraction osteogenesis (DO) for correction of cleft palate (CP) in rhesus.

METHODSCP was created by operation in 23 rhesus. The CP was corrected with DO in 21 animals as experimental group. The distraction rate was 0.8 mm per day, two times a day. The bone fragments were fixed after cleft closure, every 3 animals were sacrificed to get specimen after 1, 2, 4, 6, 8, 12, 24 weeks of fixation. 6 days before sacrifice, tetracycline was administrated for labeling (30 mg/kg).

RESULTSThe hard and soft tissue def of fixation. At the same time, the bone volume and calcification between the distraction gap increased. The cleft in the control group could not b ect was successfully closed with DO by intramembrane osteogenesis. The new formed bone was remodeling and became maturation during the period e corrected spontaneously.

CONCLUSIONSThe DO can successfully correct both the soft and hard tissue defect in CP by intramembrane osteogenesis. The fixation is important for remodeling and maturation of the new formed bone.

Animals ; Biomarkers ; Cleft Palate ; pathology ; surgery ; Macaca ; Osteogenesis, Distraction ; Palate, Hard ; pathology ; Palate, Soft ; pathology

A malignant myoepithelioma is one of the rarest salivary gland neoplasms which may either arise de novo or develop within a preexisting pleomorphic adenoma or benign myoepithelioma. The parotid gland is the most common primary site and the palate the most common intra-oral site of occurrence. Herein is present a case of a malignant myoepithelioma arising in the hard palate of a 79-year-old woman. The lesion had been examined by biopsy at another hospital, and diagnosed as a poorly differentiated squamous cell carcinoma. The patient underwent a wide local tumor resection. Examination of the resection specimen showed the characteristic histopathological and immunohistochemical features of a malignant myoepithelioma. Five months after the operation, the patient was well without evidence of recurrence or metastasis.
Aged ; Female ; Humans ; Immunohistochemistry ; Myoepithelioma/*diagnosis/*pathology/surgery ; Palatal Neoplasms/*diagnosis/*pathology/surgery ; Palate/*pathology/*surgery

OBJECTIVETo observe the therapeutic effects of Le Fort III osteotomy and midface distraction osteogenesis (DO) on the upper-airway narrow.

METHODSSince 2000, 11 cases (10 cases of Crouzon syndrome and 1 case of Apert syndrome) with severe midface deficiency were treated with Le Fort III osteotomy and midface DO. The section area of different parts of upper-airway were tested by computer assistants image measurement preoperatively and postoperatively. Some patients received sleep function monitoring.

RESULTSThe face appearance and the function of upper-airway improved significantly after Le Fort III osteotomy and Midface DO. The section area at the level of posterior nasal spine and uvula increased obviously after treatment (P < 0.05), however the section area at the level of epiglottis and separation between airway and esophagus were not obviously enlarged (P > 0.05).

CONCLUSIONSMidface DO after Le Fort III osteotomy can effectively improve the upper-airway narrow, especially the upper part from uvula.

Adolescent ; Airway Obstruction ; etiology ; surgery ; Child ; Child, Preschool ; Craniofacial Dysostosis ; complications ; surgery ; Epiglottis ; pathology ; Female ; Humans ; Male ; Nasopharynx ; pathology ; Osteotomy, Le Fort ; methods ; Palate, Soft ; pathology ; Postoperative Period ; Sleep Apnea, Obstructive ; etiology ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the craniofacial morphology of patients with isolated cleft palate in the mixed dentition after palatoplasty.

METHODSTwenty patients (7 to 11 years old) with isolated cleft palate in the mixed dentition were selected. The control group comprised 35 age-matched non-cleft children without orthodontic treatment. Cephalometric analysis was carried out to evaluate craniofacial morphology.

RESULTSThe mean values of total cranial base length, maxillary depth, mandibular effective length in cleft patients were 86.48 mm, 44.79 mm and 65.45 mm, respectively. Those in control group were 91.27 mm, 48.84 mm and 70.49 mm, respectively (P < 0.001).

CONCLUSIONSUnderdeveloped maxilla and class III skeletal profile were presented in patients with isolated cleft palate.

Case-Control Studies ; Cephalometry ; Child ; Cleft Palate ; pathology ; surgery ; Dentition, Mixed ; Female ; Head ; diagnostic imaging ; pathology ; Humans ; Male ; Mandible ; diagnostic imaging ; pathology ; Maxilla ; diagnostic imaging ; pathology ; Postoperative Period ; Radiography ; Skull Base ; diagnostic imaging ; pathology

OBJECTIVETo develop a three-dimensional (3-D) comparison and measuring techniques to analyze changes in palatal forms of the serial maxillary alveolar cast and to evaluate the significance of the different reference change indexes.

METHODSFollowing digitizing the casts with a 3-D laser scanner and using reverse engineering software Geomagic Studio 7.0 for a pair of 3-D digital maxillary alveolar cast of an infant of UCLP before and after cheiloplasty, a pair of cast surfaces were reconstructed. The reference points and the character lines were extracted.

RESULTSThe model coordinate system and the datum planes were established on the basis of reference points extracted. The newly developed analysis technique completed 3-D comparison of palatal forms of UCLP infants before and after cheiloplasty. Distances and volumes changes between the surfaces were determined and expressed graphically.

CONCLUSIONSWith establishing the model coordinate system and the datum plane, it is possible to visualize the comparison outcome of the reference change indexes longitudinally. The various reference change indexes may reflect the trend of the infant maxillary growth.

Alveolar Process ; growth & development ; pathology ; Cleft Lip ; pathology ; surgery ; Cleft Palate ; pathology ; surgery ; Dental Models ; Humans ; Imaging, Three-Dimensional ; methods ; Infant ; Male