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Cleft Lip and Palate Patient: New Challenges in Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (16 October 2024) | Viewed by 8201

Special Issue Editor

Prof. Dr. Vanessa Paredes-Gallardo

E-Mail Website
Guest Editor
Department of Stomatology, Orthodontics, University of Valencia, 46010 Valencia, Spain
Interests: cleft lip and palate; orthodontics; multidisciplinary treatment; NAM; miniscrews; TADS; 3D imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cleft lips and palates are congenital defects, and the incidence rates differ between populations. Apart from important aesthetic alterations, cleft patients also encounter speech, eating, breathing, gesture, and dental occlusion problems and several psychosocial disorders, such as anxiety, depression, and self-esteem problems. When addressing these problems, it is important to account for disabilities because they affect patients’ quality of life and social integration. This approach requires a multidisciplinary team composed of different specialists, including maxillofacial surgeons, orthodontists, and psychologists, among others. The early treatment of the cleft defects in the first weeks of life is decisive for patients’ progress. Various surgical approaches have been performed over the years, and their results are now being evaluated using 3D imaging.

In this Special Issue, we invite authors to submit papers on the clinical advances of cleft lip and palate diagnoses and treatments using new technologies.

Prof. Dr. Vanessa Paredes-Gallardo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cleft lip and palate (CLP)
  • orthodontics
  • multidisciplinary treatment
  • 3D imaging
  • nasoalveolar molding (NAM)

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Published Papers (6 papers)

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20 pages, 1067 KiB  
Article
Predicting Syndromic Status Based on Longitudinal Data from Parental Reports of the Presence of Additional Structural and Functional Anomalies in Children Born with an Orofacial Cleft
by Amy J. V. Davies, Yvonne E. Wren, Mark Hamilton, Jonathan R. Sandy, Evangelia Stergiakouli and Sarah J. Lewis
J. Clin. Med. 2024, 13(22), 6924; https://doi.org/10.3390/jcm13226924 - 17 Nov 2024
Viewed by 422
Abstract
Background: Orofacial clefts are the most common craniofacial congenital malformation in humans. Approximately 30% of clefts arise as part of a syndrome or sequence, characterised by co-existing structural and functional anomalies. Many syndromes are thought to be undiagnosed, although the presence of multiple [...] Read more.
Background: Orofacial clefts are the most common craniofacial congenital malformation in humans. Approximately 30% of clefts arise as part of a syndrome or sequence, characterised by co-existing structural and functional anomalies. Many syndromes are thought to be undiagnosed, although the presence of multiple anomalies may indicate the presence of a syndrome or sequence. Aim: To determine the extent to which the presence of additional structural and functional anomalies can help to identify those children with an undiagnosed syndrome. Methods: Secondary data analysis was performed using data from 1701 children born with an orofacial cleft, collected as part of a longitudinal cohort study, the Cleft Collective. Data were collected between 2013 and 2023 across the United Kingdom. The prevalence of structural and functional anomalies and syndromes were explored using descriptive statistics. Logistic regression was used to determine the extent to which anomalies can predict syndromic status. Results: A syndrome and/or sequence was reported in 20.5% children. Among children who reported five or more anomalies, the prevalence of a diagnosed syndrome was 81.5%. When adjusting for cleft subtype and sex, in 27 out of 32 anomalies tested, strong evidence was found to suggest increased odds of having a syndrome if the specific anomaly was present compared to if the anomaly was absent (p-values ranged between 1.4 × 10−30 and 0.002). Conclusions: Children born with a cleft who present with two or more anomalies are much more likely to have a syndrome than those with fewer anomalies and should be prioritised for genetic screening and counselling. Full article
(This article belongs to the Special Issue Cleft Lip and Palate Patient: New Challenges in Diagnosis and Treatment)
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14 pages, 1225 KiB  
Article
Prenatal Diagnosis of Cleft Lip and Palate: A Retrospective Study
by Anca Daniela Brăila, Constantin Marian Damian, Cristina-Crenguţa Albu, Oana Botoacă, Laurențiu Mihai Dȋră, Ştefan-Dimitrie Albu, Matei Georgian Brăila, Andreea-Mariana Bănățeanu, Cristian-Viorel Poalelungi and Claudia Florina Bogdan-Andreescu
J. Clin. Med. 2024, 13(16), 4804; https://doi.org/10.3390/jcm13164804 - 15 Aug 2024
Viewed by 1273
Abstract
Cleft lip and/or palate are prevalent congenital anomalies. Early and accurate diagnosis allows proper case management. The Objective: This retrospective cohort study aimed to investigate the association between cleft lip and palate and other congenital anomalies. Methods: This study analyzed 17 [...] Read more.
Cleft lip and/or palate are prevalent congenital anomalies. Early and accurate diagnosis allows proper case management. The Objective: This retrospective cohort study aimed to investigate the association between cleft lip and palate and other congenital anomalies. Methods: This study analyzed 17 pregnancies prenatally diagnosed with cleft lip and palate. The investigations consisted of ultrasound examination, fetal karyotyping through amniocentesis, and family tree analysis. In the presence of an abnormal fetal karyotype, the parental karyotype was also indicated. Results: Of the 17 cases identified, 9 (52.94%) were syndromic and 8 (47.06%) were non-syndromic. The genetic syndromes identified in association with cleft lip and palate in this study included translocation syndrome (one case), Patau syndrome, trisomy 13 (seven cases), and Edwards syndrome, mosaic trisomy 18 (one case). Conclusions: A comprehensive approach ensures a thorough assessment and accurate diagnosis. Early detection and a multidisciplinary approach allow appropriate case management. Full article
(This article belongs to the Special Issue Cleft Lip and Palate Patient: New Challenges in Diagnosis and Treatment)
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13 pages, 2342 KiB  
Article
Craniofacial Cephalometric Morphology in Polish Adolescents with Cleft Palate Only
by Alicja Zawiślak, Barbara Wędrychowska-Szulc, Katarzyna Grocholewicz and Joanna Janiszewska-Olszowska
J. Clin. Med. 2024, 13(15), 4507; https://doi.org/10.3390/jcm13154507 - 1 Aug 2024
Viewed by 850
Abstract
Background: Cephalometric studies indicate that craniofacial morphology in patients with cleft palate only (CPO) differs from other forms of orofacial clefts and healthy patients. Planning orthodontic treatment for patients with different craniofacial deformities requires knowledge on the craniofacial complex. The aim of [...] Read more.
Background: Cephalometric studies indicate that craniofacial morphology in patients with cleft palate only (CPO) differs from other forms of orofacial clefts and healthy patients. Planning orthodontic treatment for patients with different craniofacial deformities requires knowledge on the craniofacial complex. The aim of the present study was to describe the cephalometric craniofacial morphology in adolescents with cleft palate only compared to generally healthy orthodontic patients. Methods: The study comprised 100 lateral cephalograms (taken in the years 2003–2020) of Polish patients with cleft palate only aged from 11.1 to 14.2 (mean age 12.43 y) and a matched control group of 100 children without orofacial clefts aged 12–14 (mean age 12.25). All digital images were analyzed in specialized cephalometric software. Results: Statistically significantly lower values of both SNA (p < 0.001) and ANB (p < 0.001) were found in the study group versus the control group. Mandibular line to cranial base angle (ML-NSL) as well as maxillary base to cranial base (NL-NSL) were significantly higher in the CPO group. Both the maxilla and mandible were rotated distally in CPO. Moreover, the intermaxillary vertical angle (ML-NL) was reduced in CPO. Mandibular angle in CPO was significantly higher (p = 0.005), reflecting posterior mandibular rotation. Conclusions: In adolescents with CPO, maxillary deficiency is found, without a severe sagittal jaw discrepancy, with a slight compensatory lingual inclination of the lower incisors. Mandibular deficiency in CPO is concurrent with posterior rotation and an increased mandibular angle. Full article
(This article belongs to the Special Issue Cleft Lip and Palate Patient: New Challenges in Diagnosis and Treatment)
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13 pages, 948 KiB  
Article
Looking at the Mental Health of Children and Adolescents with Cleft Lip and/or Palate through Neuroticism and Emotional Regulation Strategies: A Case-Controlled Observational Study
by Ana Ruiz-Guillén, María José González-Olmo, Esther Castañeda-López, Martín Romero-Maroto and Cecilia Peñacoba-Puente
J. Clin. Med. 2024, 13(11), 3033; https://doi.org/10.3390/jcm13113033 - 22 May 2024
Viewed by 807
Abstract
Background: Children and adolescents with cleft lip and/or palate (CL/P) are at an increased risk of developing emotional disorders. This study aims to explore this question in greater depth by addressing three objectives: (1) the presence of neuroticism as an indicator of emotional [...] Read more.
Background: Children and adolescents with cleft lip and/or palate (CL/P) are at an increased risk of developing emotional disorders. This study aims to explore this question in greater depth by addressing three objectives: (1) the presence of neuroticism as an indicator of emotional symptomatology, (2) the use of adaptive and non-adaptive emotional regulation strategies, and (3) the relationship between these strategies and neuroticism. Methods: A case–control correlational methodology was employed, with 60 children and adolescents with CL/P (mean age = 12.80 years; 33 females) and 60 non-clinical equivalent children and adolescents. Results: The CL/P group has higher scores on neuroticism (t = −7.74; p ≤ 0.001, d Cohen = 1.43) and lower scores in almost all emotional regulation strategies. The presence of CL/P moderated the relationship between neuroticism and self-blame (Beta = −0.46, t = −2.81, p = 0.005), rumination (Beta = −0.49, t = −3.73, p < 0.001), catastrophizing (Beta = −0.61, t = −4.26, p < 0.001), and blaming others (Beta = −0.45, t = −2.84, p = 0.005). This model predicted a significant variance of neuroticism (all p < 0.005), which ranged from 39% to 41%. Conclusions: The CL/P group has worse mental health indicators. Particularly novel results about the CL/P group are the lower scores on regulation strategies (both adaptive and non-adaptive) and the fact that non-adaptive strategies contribute, contrary to their effect in the general population, to a decrease in neuroticism. It supports the need to incorporate mental health indicators in the diagnosis and treatment of children and adolescents with CL/P. Full article
(This article belongs to the Special Issue Cleft Lip and Palate Patient: New Challenges in Diagnosis and Treatment)
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14 pages, 1470 KiB  
Article
Longitudinal Three-Dimensional Stereophotogrammetric Growth Analysis in Infants with Unilateral Cleft Lip and Palate from 3 to 12 Months of Age
by Jennifer Kluge, Robin Bruggink, Nikolaos Pandis, Alexey Unkovskiy, Paul-Georg Jost-Brinkmann, Anne Marie Kuijpers-Jagtman and Theodosia Bartzela
J. Clin. Med. 2023, 12(20), 6432; https://doi.org/10.3390/jcm12206432 - 10 Oct 2023
Cited by 1 | Viewed by 1349
Abstract
This longitudinal study aimed to evaluate facial growth and soft tissue changes in infants with complete unilateral cleft lip, alveolus, and palate (CUCLAP) at ages 3, 9, and 12 months. Using 3D images of 22 CUCLAP infants, average faces and distance maps for [...] Read more.
This longitudinal study aimed to evaluate facial growth and soft tissue changes in infants with complete unilateral cleft lip, alveolus, and palate (CUCLAP) at ages 3, 9, and 12 months. Using 3D images of 22 CUCLAP infants, average faces and distance maps for the entire face and specific regions were created. Color-coded maps highlighted more significant soft tissue changes from 3 to 9 months than from 9 to 12 months. The first interval showed substantial growth in the entire face, particularly in the forehead, eyes, lower lip, chin, and cheeks (p < 0.001), while the second interval exhibited no significant growth. This study provides insights into facial soft tissue growth in CUCLAP infants during critical developmental stages, emphasizing substantial improvements between 3 and 9 months, mainly in the chin, lower lip, and forehead. However, uneven growth occurred in the upper lip, philtrum, and nostrils throughout both intervals, with an overall decline in growth from 9 to 12 months. These findings underscore the dynamic nature of soft tissue growth in CUCLAP patients, highlighting the need to consider these patterns in treatment planning. Future research should explore the underlying factors and develop customized treatment interventions for enhanced facial aesthetics and function in this population. Full article
(This article belongs to the Special Issue Cleft Lip and Palate Patient: New Challenges in Diagnosis and Treatment)
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Other

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14 pages, 750 KiB  
Systematic Review
Diagnostic Methods for the Prenatal Detection of Cleft Lip and Palate: A Systematic Review
by Ana Baeza-Pagador, Ana Tejero-Martínez, Lucas Salom-Alonso, Sara Camañes-Gonzalvo, Verónica García-Sanz and Vanessa Paredes-Gallardo
J. Clin. Med. 2024, 13(7), 2090; https://doi.org/10.3390/jcm13072090 - 3 Apr 2024
Cited by 2 | Viewed by 2919
Abstract
Background: Accurate prenatal diagnosis of cleft lip and palate is essential to discuss severity prediction, perform appropriate parental counseling, and, at last, establish long-term treatment planning. The aim of this systematic review was to analyze the accuracy of various imaging techniques for the [...] Read more.
Background: Accurate prenatal diagnosis of cleft lip and palate is essential to discuss severity prediction, perform appropriate parental counseling, and, at last, establish long-term treatment planning. The aim of this systematic review was to analyze the accuracy of various imaging techniques for the prenatal diagnosis of cleft lip and palate, assess the pregnancy phase for orofacial clefts diagnosis, and study the different cleft types in terms of diagnostic methods, timing, and predictability. Methods: A search of the PubMed, EMBASE, Scopus, and Web of Science databases was conducted to identify potentially relevant studies published until January 2024. The quality of the selected articles was assessed using the Newcastle–Ottawa scale for methodological quality assessment of cohort studies and the QUADAS-2 scale for diagnostic test studies. Results: A total of 18 studies met the eligibility criteria and were included in the review. The findings of this review indicate that the majority of studies showed improved diagnostic accuracy when supplementary techniques, such as 3D ultrasound or magnetic resonance imaging, were added to 2D ultrasound. Conclusions: The implementation of magnetic resonance imaging as a standard procedure could significantly improve the precision of diagnosing cleft lip and palate. Therefore, the diagnostic technique used will play a crucial role in the accuracy of the diagnosis. Full article
(This article belongs to the Special Issue Cleft Lip and Palate Patient: New Challenges in Diagnosis and Treatment)
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