• 제목/요약/키워드: Cleft lip palate

검색결과 533건 처리시간 0.116초

Preliminary study of Korean orthodontic residents' current concepts and knowledge of cleft lip and palate management

  • Cho, Il-Sik;Shin, Hyo-Keun;Baek, Seung-Hak
    • 대한치과교정학회지
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    • 제42권3호
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    • pp.100-109
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    • 2012
  • Objective: A national survey was conducted to assess orthodontic residents' current concepts and knowledge of cleft lip and palate (CLP) management in Korea. Methods: A questionnaire consisting of 7 categories and 36 question items was distributed to 16 senior chief residents of orthodontic department at 11 dental university hospitals and 5 medical university hospitals in Korea. All respondents completed the questionnaires and returned them. Results: All of the respondents reported that they belonged to an interdisciplinary team. Nineteen percent indicated that they use presurgical infant orthopedic (PSIO) appliances. The percentage of respondents who reported they were 'unsure' about the methods about for cleft repair operation method was relatively high. Eighty-six percent reported that the orthodontic treatment was started at the deciduous or mixed dentition. Various answers were given regarding the amount of maxillary expansion for alveolar bone graft and the estimates of spontaneous or forced eruption of the upper canine. Sixty-seven percent reported use of a rapid maxillary expansion appliance as an anchorage device for maxillary protraction with a facemask. There was consensus among respondents regarding daily wearing time, duration of treatment, and amount of orthopedic force. Various estimates were given for the relapse percentage after maxillary advancement distraction osteogenesis (MADO). Most respondents did not have sufficient experience with MADO. Conclusions: These findings suggest that education about the concepts and methods of PSIO and surgical repair, consensus regarding orthodontic management protocols, and additional MADO experience are needed in order to improve the quality of CLP management in Korean orthodontic residents.

Transforming Growth Factor-β3 Gene SfaN1 Polymorphism in Korean Nonsyndromic Cleft Lip and Palate Patients

  • Kim, Myung-Hee;Kim, Hyo-Jin;Choi, Je-Yong;Nahm, Dong-Seok
    • BMB Reports
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    • 제36권6호
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    • pp.533-537
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    • 2003
  • The nonsyndromic cleft lip and palate (NSCL/P) is a congenital deformity of multifactorial origin with a relatively high incidence in the oriental population. Various etiologic candidate genes have been reported with conflicting results, according to race and analysis methods. Recently, the ablation of the TGF-${\beta}3$ gene function induced cleft palates in experimental animals. Also, polymorphisms in the TGF-${\beta}3$ gene have been studied in different races; however, they have not been studied in Koreans. A novel A $\rightarrow$ G single nucleotide polymorphism (defined by the endonuclease SfaN1) was identified in intron 5 of TGF-${\beta}3$ (IVS5+104 A > G). It resulted in different genotypes, AA, AG, and GG. The objective of this study was to investigate the relationship between the SfaN1 polymorphism in TGF-${\beta}3$ and the risk of NSCL/P in the Korean population. The population of this study consisted of 28 NSCL/P patients and 41 healthy controls. The distribution of the SfaN1 genotypes was different between the cases and controls. The frequency of the G allele was significantly associated with the increased risk of NSCL/P [odds ratio (OR) = 15.92, 95% confidence interval (CI) = 6.3-41.0]. The risk for the disease increased as the G allele numbers increased (GA genotype: OR = 2.11, 95% CI = 0.38-11.68; GG genotype: OR = 110.2, 95% CI = 10.67 - 2783.29) in NSCL/P. A stratified study in patients revealed that the SfaN1 site IVS5+104A > G substitution was strongly associated with an increased risk of NSCL/P in males (p < 0.001), but not in females. In conclusion, the polymorphism of the SfaN1 site in TGF-${\beta}3$ was significantly different between the NSCL/P patients and the control. This may be a good screening marker for NSCL/P patients among Koreans.

전전뇌증(Holoprosencephaly)의 증례보고 (A Case Report of Holoprosencephaly)

  • 송승한;강낙헌
    • Archives of Plastic Surgery
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    • 제34권4호
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    • pp.528-530
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    • 2007
  • Purpose: Holoprosencephaly(HPE) is a rare developmental defect due to incomplete cleavages of the prosencephalon during the third week of fetal development. Chromosomal anomalies, genetic syndrome, teratogen, or genetic disorder of non-syndromic HPE are usually accepted as etiology. The consequences of prechordal mesoderm defect are varying degrees of deficit of midline facial development, especially the median nasal process(premaxilla), and incomplete morphogenesis of the forebrain. We experienced a case of lobar HPE with complete cleft lip and palate. Methods: A female newborn infant was born at $38^{+6}$ weeks' gestational age via NSVD. The infant's birth weight was 3.6 kg, height 52 cm, and head circumference 32.5 cm, showing microcephaly, flat nose, median complete cleft lip & palate, and hypotelorism, along with defects of midfacial development including losses of premaxilla, philtrum, nasal septum, and columella. Results: There were no specific findings noted from the head and neck X-ray and tests for endocrine and metabolic disorders, but clinical characteristics of midface and dysgenesis corpus callosum on brain MRI were seen, so that this case was diagnosed with HPE. Conclusion: HPE is divided into three categories of alobar, semilobar, and lobar prosencephaly according to the degree of cerebral hemisphere separation. Assesment of patient's brain abnormality and malformation is essential in determining the extent and benefit of surgical intervention. This case was included in the lobar type HPE which shows relatively good prognosis compared with other types and reconstruction of median complete cleft lip & palate and midfacial defects will be performed.

구순 구개열 환자에서의 새로운 구강내 접근 Le Fort II 골절단술 (A New Method of Intraoral Le Fort II Osteotomy for Correction of Midface in Cleft Patients)

  • 정필훈;김광호
    • 대한구순구개열학회지
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    • 제4권2호
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    • pp.29-35
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    • 2001
  • Midfacial retrusion is one of characteristics of cleft patients due to underdevelopment of the midface. In this case, Le Fort II advancement is indicated. But there has not been reported on intraoral approach to Le Fort II osteotomy for correction of midface, which traditional technique resulted in facial scar. To overcome the problems, Le Fort II osteotomy via only intraoral approach named 'Intraoral Le Fort IT osteotomy' was developed by Choung in 1994, this technique was applied to cleft patients. A new technique of Intraoral Le Fort IT osteotomy for correction of midface in cleft patients was successfully carried out with good results. This technique showed no noticeable relapse nor complications, which is reported.

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삼각피판법을 이용한 편측 불완전 구순열 환자의 구순 교정 수술-증례 보고 (Repair of the Cleft Lip using Triangular Cheiloplasty-A Case Report)

  • 송인석;홍종락;정필훈;서병무
    • 대한구순구개열학회지
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    • 제10권2호
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    • pp.67-74
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    • 2007
  • After Tennison introduced a triangular flap method which, for the first time, preserved the Cupid's bow, Randall gave this method a sound mathematical basis. This method is also called as an inferior triangular cheiloplasty which is characterized by making a small triangular flap from the lateral border of cleft destined to be fitted into an incision on the medial side of cleft. He postulated that the height obtained was equal to the sum of the median of the two triangles used in the cheiloplasty. Using this technique, a 22 month-old male patient with incomplete unilateral cleft lip was corrected primarily. The deviation of the columella and flattening of the nostril on the cleft side were minimal. The operation was done under general anesthesia and patient was healed uneventfully. We tried to improve the symmetry and esthetic feature of philtrum, nostril sill, alar-facial groove, preventing the notch formation on the nostril floor, and to reconstruct the muscle sling in the upper part of lip. The shape of Cupid's bow was restored, and the symmetry of columella was regained as a result. In summary, the inferior triangular cheiloplasty is effective to correct the primary unilateral cleft lip, results in the restoration of favorable anatomy and function.

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A Study on the Change of the Palatal Length after Palatoplasty

  • 유선열;김선국;김태희;황웅;국민석;한창훈
    • 대한구순구개열학회지
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    • 제7권1호
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    • pp.25-34
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    • 2004
  • 본 연구는 선천성 구개열 환자에서 구개성형술후 구개 길이가 어느 정도 연장되는지 알아보기 위하여 시행되었다. 199i년 4월부터 2004년 4월까지 10년동안 전남대학교병원 구강악안면외과에서 치료 받은 구개열 환자 중 추적조사가 가능한 112명을 대상으로 역학적 특성, 사용된 구개성형술식, 구개 길이의 연장 정도 및 술후 합병증에 대하여 임상기록을 조사하고 분석하였다. 불완전구개열 및 완전구개열 환자의 비는 1.6:1이었다. 성별분포는 완전구개열에서는 남자가 2.1배 많았고, 불완전구개열에서는 여자가 1.2배 많았다. 불완전구개열에서는 Dorrance법과 Wardill법을, 완전구개 열에서는 Wardill법과 Furlow법, two flap법, Perko법을 많이 사용하였다. 구개열 형태별 구개 길이의 연장 정도는 불완전구개열에서 평균 5.84 m(11.295) 연장되어 완전구개열에서의 평균 4.71 w(9.f%)보다 1.13 mm(1.6%) 더 많이 연장되었으나 통계학적 유의성은 없었다. 구개성형술식에 따른 구개 길이의 연장 정도는 Furlow법에서 5.70 m(10.9%) 연장되어 push back법에서의 5.33 in(10.7%)보다0.37 mm(0.2%) 더 많이 연장되었으나 역시 통계학적 유의성은 없었다. 술후 합병증으로 구개누공이 27예(24%b)로 가장 많이 발생하였다. 이상의 결과에서 구개성형술후 구개 길이가 3.5%부터 24.0%까지 평균 10.8% 연장되어 언어 기능에 기여함을 알 수 있다.

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