Relationship between cleft severity and dentocraniofacial morphology in Japanese subjects with isolated cleft palate and complete unilateral cleft lip and palate.

Relationships between the width of the palatal cleft measured at palatoplasty and the craniofacial morphology or the occlusal conditions present at approximately 4 years of age were studied in 25 cleft palate (CP) and 39 complete unilateral cleft lip and palate (UCLP) subjects treated at the Dental Clinic of Kyushu University. Posteroanterior cephalograms and dental casts showed that the width of the palatal cleft was significantly correlated with wider upper facial width and posterior dental arch width in UCLP, but not in CP subjects. Cleft width was not significantly correlated with the buccolingual occlusal relationship in either subject type. The anterior occlusal relationship in UCLP was not as good as in CP subjects. On lateral cephalograms, the width of the palatal cleft was significantly correlated with vertical hypoplasia of the upper face in UCLP, but not in CP subjects. The cleft palate width appears to be related to the lateral displacement and the retardation of the downward and forward growth of the nasomaxillary complex in UCLP subjects.

A revised method of conservative palatoplasty.

A revised method of conservative palatoplasty was performed on 21 patients with isolated cleft palate. The operation was principally based on von Langenbeck's method. The major modifications were that the mucosal layer was dissected instead of the mucoperiosteum and lateral mucosal deficits produced by medial displacement of the dissected mucosal flaps were covered with transpositioned buccal mucosal flaps. Postoperative early results were compared with those of the 23 patients treated by Perko's mucosal flap operation. Our method was found to bring about a relatively long velum comparable to Perko's method and wound healing was more uneventful. Results at the age of 5 years were compared with those of the patients treated by Wardill's mucoperiosteal flap operation as well as with those treated by Perko's method. There were no statistically significant differences among the three groups in the maxillofacial development and speech results.

Acute gingival necrosis caused by drug-induced agranulocytosis.

A case of acute gingival necrosis, which was caused by drug-induced agranulocytosis, is reported. The patient had classic signs and symptoms, and the treatment of oral lesions was symptomatic. Regeneration of the gingival mucosa was almost complete 20 days after the onset of the disease.