The role of folic acid in oral clefting.

The objective of this study is to describe the role of periconceptional folic acid supplementation and assess it's potential in the prevention of foetal abnormalities, and consists of a review of the literature undertaken using an electronic and hand search. This includes research trials and methodology associated with folic acid supplementation. It is recommended that all women planning to conceive should supplement their diet with folic acid in order to prevent abnormalities in neural tube development, particularly if there is a history of a previously affected pregnancy. There is increasing evidence that folic acid supplementation may, in addition, reduce the incidence of oral facial clefting. Further research with multi-disciplinary approaches in biochemistry, genetics, gene/environment interactions, and embryology are indicated.

Congenital sinus of the upper lip. A case report.

A case report of a congenital midline sinus in the upper lip of a 13-year-old girl is presented. Theories proposed regarding the aetiology of this rare anomaly are discussed.

A prospective evaluation of Bass, Bionator and Twin Block appliances. Part I--The hard tissues.

A prospective clinical study with a random allocation of 47 adolescent patients to three different functional appliance groups was established and compared with an untreated control group over a 9-month period. Treatment was undertaken with either a Bionator, Twin Block, or Bass appliance. Pre- and post-treatment cephalograms were used to quantify the skeletal and dentoalveolar changes produced by the appliances and compared with those observed in the control group as a result of growth. Both the Bionator and Twin Block appliances demonstrated a statistically significant increase in mandibular length (3.9 +/- 2.7 mm; 3.7 +/- 2.1 mm, respectively) compared with the control group (P < 0.05), with an anterior movement of pogonion and point B. Highly statistically significant increases (P < 0.01) were seen in lower face heights for all the appliance groups compared with the control group. The Twin Block group showed the least forward movement of point A due to a change in the inclination of the maxillary plane. The Bionator and Twin Block groups showed statistically significant reductions in the inclination of the upper incisors to the maxillary plane (P < 0.05). The Bass group showed minimal change in the inclination of the lower labial segment to the mandibular plane. The Bionator group demonstrated the greatest proclination of the lower labial segment (4.0 +/- 3.6 degrees). Clinically important changes were measured in all the appliance groups when compared with the control group. Differences were also identified between the functional appliance groups. The Twin Block appliance and, to a lesser extent, the Bionator appeared the most effective in producing sagittal and vertical changes.

A prospective evaluation of Bass, Bionator and Twin Block appliances. Part II--The soft tissues.

A prospective clinical study with a random allocation of 47 patients to three different functional appliance groups was established and compared with a slightly younger control group over a 9-month period. The cephalometric hard tissue changes were assessed in relation to the soft tissue changes produced and the patients were also assessed by three-dimensional (3D) laser scanning of the facial soft tissues. Each 'averaged' appliance group scan was compared with the 'averaged' control group face. Statistically and clinically significant changes occurred in the group treated with the Twin Block appliance, and to a lesser extent in the group treated with the Bionator appliance. No statistically significant facial soft tissue changes could be demonstrated in the Bass appliance group. Upper lip position remained stable despite the significant overjet reduction attained in the three appliance groups. Lower lip protrusion (up to 3.8 mm), lower lip length (up to 4.0 mm), and soft tissue lower and total face height increased significantly in all appliance groups by varying amounts. The long-term effect of these changes needs to be fully evaluated. The laser scanning system was found to be a sensitive and accurate method of quantitatively assessing small changes in the soft tissue facial form. Significant changes of the facial tissues in the transverse plane were highlighted by this technique.