Lips and noses in 10-year old patients with repaired complete unilateral clefts of lip, alveolus, and palate. A prospective three-centre study of the Baltic Cleft Network.

This multicenter study aimed at comparing different techniques of lip and nose repair with or without NAM and primary anterior rhinoplasty in pre-adolescent children. Patients with unilateral clefts of lip, alveolus, and palate who had undergone cleft lip and nose repair were evaluated in a prospective three-centre study using standardized monochromatic, cropped photographs. Four cleft surgeons evaluated the aesthetics of the central part of the face when the patients had reached age ten years.

Bone formation in mono cortical mandibular critical size defects after augmentation with two synthetic nanostructured and one xenogenous hydroxyapatite bone substitute - in vivo animal study.

Objectives: Healing characteristics as well as level of tissue integration and degradation of two different nanostructured hydroxyapatite bone substitute materials (BSM) in comparison with a deproteinized hydroxyapatite bovine BSM were evaluated in an in vivo animal experiment.

Material And Methods: In the posterior mandible of 18 minipigs, bilateral mono cortical critical size bone defects were created. Randomized augmentation procedures with NanoBone(®) (NHA1), Ostim(®) (NHA2) or Bio-Oss(®) (DBBM) were conducted (each material n = 12).

Centre-based statistics of cleft lip with/without alveolus and palate as well as cleft palate only patients in Aden, Yemen.

Objective: The purpose of the study was to report the types and patterns of cleft lip with/without cleft alveolus and palate as well as cleft palate only as seen in Aden, Yemen.

Design And Setting: Retrospective, centre-based study conducted at the Cleft Lip and Palate Centre, Aden University, Yemen.

Material And Methods: Statistical evaluation of the data from all cleft patients who were registered at or referred to this centre during the years 2005-2011.

The isolated mandibular ramus - a hitherto rarely described anomaly of the mandible. Pathogenesis and treatment.

Introduction: A very famous paper by Sam Pruzansky, published in 1969, was entitled "Not all dwarfed mandibles are alike". This is the topic of this paper: to describe the shape and discuss the possible pathogenesis of an extremely rare congenital dysplasia found in a unilaterally hypoplastic mandible, namely the isolated mandibular ramus.

Material And Methods: A unique malformation of the lower jaw was found in more than 75 patients with developmental abnormalities of the mandible diagnosed and treated by the two authors in two different university hospitals over the last 40 years.

Two-stage palatoplasty, is it still a valuable treatment protocol for patients with a cleft of lip, alveolus, and palate?

Introduction: Speech development is of utmost importance and requires early closure of a palatal cleft. On the other hand, it is well known that all types and timings of surgical repair of facial clefts are detrimental to maxillary growth. Nevertheless, these days one is more and more confronted with a world-wide tendency in favour of the one-in-all operation to close clefts of the lip, alveolus, and palate.

How to do clinical research in cranio-maxillo-facial surgery.

Introduction: Not many randomised controlled trials are published in surgical journals, especially those on maxillo-facial surgery. There appears to be some uncertainty on how to perform such studies. Accordingly this paper offers some information on how to plan, pursue and publish a well conducted case-control study, or the more powerful randomised control trial.

A preliminary study in osteoinduction by a nano-crystalline hydroxyapatite in the mini pig.

To test the probable osteoinductive properties of NanoBone, a new highly non-sintered porous nano-crystalline hydroxylapatite bone substitute embedded into a silica gel matrix, granules were implanted subcutaneously and intramuscularly into the back region of 18 mini pigs. After periods of 5 and 10 weeks as well as 4 and 8 months, implantation sites were investigated using histological and histomorphometric procedures. Signs of early osteogenesis could already be detected after 5 weeks.

Ankylosis of the temporomandibular joint.

Introduction: True ankylosis of the temporo-mandibular joint must be differentiated from other reasons why a patient is unable to open his mouth properly. It can be treated by various methods. It is the purpose of this paper to (a) Present various cases with different disorders that had lead to a restricted mouth opening and (b) Report upon the long-term post-operative results achieved by having applied various treatment options for true ankylosis of the temporomandibular joint (TMJ).

Presurgical orthopaedic treatment of newborns with clefts--functional treatment with long-term effects.

Aim: Presentation of an orthopaedic/orthodontic treatment protocol within the framework of complex rehabilitation of patients with clefts of lip, alveolus and palate. Presurgical orthopaedic treatment aims at reduction of cleft size by guiding growth and functional rehabilitation. Long-term results of maxillary development and occlusion at young adult age are reported.

Epidemiological studies on the frequency of clefts in Europe and world-wide.

Background: Most textbooks present data on the various frequencies of clefts in different human "races". This was studied in more detail.

Material And Methods: In a major literature study the frequencies of clefting reported in more than 100 publications were studied and the following data was collected: Incidences of clefts in Mongolians, Caucasians and Negroids; relative frequencies of clefts of the primary (and secondary) palate versus that of clefts of the secondary palate (only); data on cleft location (right, left, bilateral) and on genders affected.

Macroscopical, histological, and morphometric studies of porous bone-replacement materials in minipigs 8 months after implantation.

Objective: The aim of this investigation was to test the induction of bone formation and biodegradation of different biomaterials based on calcium phosphate (CaP). Up to now, hydroxyapatite and beta-tricalcium phosphate ceramics have routinely been sintered at temperatures of 1300 degrees C. The new CaP biomaterials tested are fabricated by a sol-gel process at only 700 degrees C.

Ossification of the frontal sinus in juvenile minipigs following water jet application.

Background: Obliteration of the frontal sinus is a generally accepted management for patients with severe craniofacial trauma in whom the sinus cannot be repaired or adequately drained. Effective obliteration requires complete removal of mucosa, sufficient filling of the sinus cavity as well as effective occlusion of the nasofrontal duct. The use of various filling materials for sinus obliteration has been described and include autologous fat, bone, muscle and lyophilized cartilage.

Does avascular necrosis of the jaws in cancer patients only occur following treatment with bisphosphonates?

Introduction: In the last decade, bisphosphonates were regularly used to treat osteoporosis and bone pain from diseases such as metastatic breast cancer, multiple myeloma and Paget's disease. Currently, the influence of bisphosphonates in development of avascular osteonecrosis of the jaws has been recognized by various authors. In many cancer patients chemotherapy and medications like steroids have also to be applied.

Expansion of the socket and orbit for congenital clinical anophthalmia.

Background: Congenital clinical anophthalmia requires fitting an artificial eye, achieving a pleasing aspect of the palpebral apparatus, and stimulating growth of the orbit, as well as of the entire midface.

Methods: Out of 25 patients with clinical anophthalmia, 22 were treated according to a new protocol (first described by Wiese et al. in 1999) and followed for up to 6 years.

Initial findings on teratological and developmental relationships and differences between neural tube defects and facial clefting. First experimental results.

Unless genetically caused, the occurrence of neural tube defects and clefts of the lip, alveolus and palate are not associated. These malformations do, however, share some common causes, one of which is folic acid deficiency. Nevertheless, it is not known why a neural tube defect resulting from folic acid deficiency does not occur in combination with facial clefts.

Pneumosinus dilatans frontalis: two case reports.

Introduction: Pneumosinus dilatans was described first in 1898 by Meyes. Up to now only 60 cases have been published worldwide dealing mainly with young men between 20 and 30 years of age. The aetiology remains unknown.

Repair of bone defects by applying biomatrices with and without autologous osteoblasts.

Question: Is it possible to stimulate osteoconduction and osteogenesis to improve bone formation in critical-size defects in order to avoid bone grafting?

Material And Methods: Full thickness, critical-sized defects were created in the anterior mandible of 16 adult mini-pigs. The defects were filled with a new bioactive matrix (60% hydroxyapatite and 40% beta-tricalciumphosphate), produced by an innovative low temperature sol-gel-process (120 degrees C). The biomatrix was tested alone and in combination with cultured autologous osteoblasts.

Veloplasty using the wave-line technique versus classic intravelar veloplasty.

Objective: A well-known problem in primary surgery of the soft palate is its shortness and the deficit of local soft tissue. This article introduces a modification of the primary intravelar veloplasty, allowing lengthening of the soft palate, and compares this alternative technique to the classic intravelar veloplasty.

Method: The soft palate wave-line technique adds a wavy incision at the velar cleft margins to the intravelar veloplasty.

Reconstruction of the frontal calvarian continuity in a child using a freeze-preserved autogenous bone graft.

Today, extended craniofacial defects in childhood can be treated by using modern techniques of bone banking and osteosynthesis, of particular importance when the restoration needs to consider calvarial growth. This is a report of an 8-year-old boy whose right frontal bone was removed during primary multidisciplinary trauma care. The bone was stored at a tissue bank using sterilization and freeze-dried preservation.

Position of the hyoid bone in cleft lip, alveolus, and palate: variation of normal anatomy or sign accompanying the malformation?

Objective: To compare the hyoid bone position in patients with clefts of lip, alveolus, and palate with orthodontic patients with no cleft.

Design: Retrospective cephalometric long-term study.

Patients: Lateral cephalograms of 23 patients with a complete unilateral cleft were compared with those of 24 orthodontic patients with no cleft with an Angle class 1 occlusion.

Experimental and comparative study of the blood supply to the mandibular cortex in Göttingen minipigs and in man.

Introduction: Since the blood supply to the mandibular cortex is an important factor for bone growth and bone repair, experimental studies on the blood supply in animal models (such as Göttingen minipigs) applicable to man are necessary. Their value depends on the requirement that the patterns of blood supply in the two species are similar.

Material And Methods: Twelve Göttingen minipig mandibles (24 halves) and four human mandibles (eight halves) were investigated for the blood supply to the mandibular cortex.

Blood supply of the mandibular cortex: an experimental study in Göttingen minipigs with special reference to the condyle.

Introduction: Blood supply of the mandible is an important factor that influences bone growth and bone repair.

Material And Methods: An experimental study was carried out in 24 mandibles of 12 Göttingen minipigs to study the blood supply of the mandibular cortex.

Results: Endosteal blood supply prevails in the cranial part of the mandible including the condyle, whilst periosteal blood supply predominates in the caudal part of the mandible, the body.