Assessment of Speech in Primary Cleft Palate by Two-layer Closure (Conservative Management).

Treatment of the cleft palate has evolved over a long period of time. Various techniques of cleft palate repair that are practiced today are the results of principles learned through many years of modifications. The challenge in the art of modern palatoplasty is no longer successful closure of the cleft palate but an optimal speech outcome without compromising maxillofacial growth. Throughout these periods of evolution in the treatment of cleft palate, the effectiveness of various treatment protocols has been challenged by controversies concerning speech and maxillofacial growth. In this article we have evaluated the results of Pinto's modification of Wardill-Kilner palatoplasty without radical dissection of the levator veli palitini muscle on speech and post-op fistula in two different age groups in 20 patients. Preoperative and 6-month postoperative speech assessment values indicated that two-layer palatoplasty (modified Wardill-Kilner V-Y pushback technique) without an intravelar veloplasty technique was good for speech.

Secondary alveolar bone grafting: Radiographic and clinical evaluation.

INTRODUCTION: Secondary bone grafting of maxilla and residual alveolar clefts at the stage of transitional dentition was first introduced by Boyne and Sands. The aim of this prospective case control study was to clinically and radiologically evaluate the success rate of anterior iliac crest graft in primary alveolar cleft. METHODS AND MATERIAL: In this study we evaluated 10 patients who underwent secondary alveolar bone grafting for various types of cleft palate with autologous iliac crest graft. Type of septum measured radiologically was taken as the outcome measure. RESULTS: Postoperative radiographic evaluation revealed Type I inter alveolar septum in 7 cases (87.5%), with complete unilateral cleft lip, palate and alveolus. Non-eruption of canine occurred in 5 patients (50%). Periodontal Examination revealed presence of pocket formation (less than 4 mm) and Grade II mobility in 2 cases (20%). CONCLUSIONS: In conclusion, secondary alveolar bone grafting done during the time of transitional dentition, before the eruption of permanent canine is an excellent treatment modality.

Radiographic correlation of dental and skeletal age: Third molar, an age indicator.

BACKGROUND: Age estimation plays a great role in forensic investigations, orthodontic and surgical treatment planning, and tooth transplantation. Teeth offer an excellent material for age determination by stages of development below the age of 25 years and by secondary changes after the age of 25 years. Third molar is often not included for this purpose due to its notorious developmental patterns. The aim of this study was to evaluate the development of third molar anlage in relation to skeletal maturities and the chronological age. MATERIALS AND METHODS: One hundred and fifty-six young individuals, 78 males and 78 females, were selected. The stages of development of all the third molars in every individual were determined from panoramic radiographs. The skeletal development was assessed using hand wrist radiographs. Data were analyzed statistically for mean value, standard deviation and the relationship between the recorded characteristics. RESULTS: A STRONG CORRELATION WAS FOUND BETWEEN THIRD MOLAR DEVELOPMENT AND SKELETAL MATURITY (IN MALES: r=0.88, P<0.001; in females: r=0.77 for maxillary third molar and 0.89 for mandibular third molar, P<0.001). CONCLUSION: Hence, it is concluded that a strong correlation exists between chronological age, developmental stages of third molars and maturation of epiphyses of hand. Any of the three parameters could be used for the assessment of other maturities.

Blue rubber bleb nevus syndrome: prominent oral findings.

Blue rubber bleb nevus syndrome is a rare disorder characterized by multiple cutaneous venous malformations in association with visceral lesions, most commonly affecting the gastrointestinal tract. Oral cavity lesions occur in 59 to 64% of cases. We report a unique presentation of this syndrome in a 25-year-old male patient with prominent oral findings. This is a sporadic case, started during early childhood, progressively increasing in number and size. Oral vascular lesions were part of gastrointestinal involvement. Associated cardiac abnormalities were also observed. An early diagnosis of this syndrome is required as it gets complicated with bleeding, anemia and other systemic complications.