The association between interactive health literacy and dietary behaviors among Chinese college students: a large-scale cross-sectional study.

Background: The association between health literacy and healthy dietary behaviors has been explored in the European population. However, there is currently no evidence available specifically pertaining to Chinese college students particularly for interactive health literacy. Aims: The objective of this study was to investigate the association between interactive health literacy (IHL) and dietary behaviors in Chinese college students. Methods: This study included 11,856 Chinese college students (mean age = 18.8 years, SD = 1.2 years). We defined nine healthy dietary behaviors as consumption of water, egg, milk and milk products, vegetables, fruit, red meat, soy and soy products, seafood, and sugar-sweetened beverages. For each food group, participants who met the criterion for being a regular consumer of the item were assigned a score of 1, and otherwise were assigned a score of 0. Thus, the dietary behaviors score ranged from 0 to 9, with higher scores indicating healthier dietary behaviors. We used the revised 28-item Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ) to evaluate IHL; a higher score on this scale indicates a greater health literacy. Multivariate logistic regression was used to analyze the association between IHL level and frequency of different numbers of dietary behaviors. Results: After adjusting for sex, age, annual family income, place of residence, father's education level, and mother's education level, there was a clear and significant positive association between IHL and the likelihood of exhibiting diverse dietary behaviors. The adjusted odds ratio (95% CI) of exhibiting given nine dietary behaviors with reference to tertile 1 according to categories of IHL was as follows: 1.055 (0.694, 1.603) for tertile 2 and 1.849 (1.269, 2.696) for tertile 3 (p for trend = 0.001). Similarly, there are significant positive associations between IHL and the likelihood of exhibiting 2-8 dietary behaviors, except for exhibiting any one dietary behavior. We further found that, in addition to the health awareness factor, there were significant positive associations between physical activity and nutrition factors, and healthier dietary behaviors. Further, there was a significant negative association between interpersonal relationships and dietary behavior. Conclusion: The findings indicate a positive relationship between IHL and dietary behavior, such that the higher the level of IHL among college students, the healthier the dietary behavior they tend to adopt in their daily lives. These findings suggest the importance of developing stages of change-based educational interventions, which could help individuals with limited IHL to not only acquire necessary health-related knowledge but also to strengthen their motivation to engage in healthy dietary behaviors. Future studies should employ longitudinal prospective designs or randomized controlled trials to establish a causal association between IHL and healthy dietary behaviors.

Characterization and functional prediction of the dental plaque microbiome in patients with alveolar clefts.

Introduction: Alveolar cleft (AC) is a common congenital defect in people with cleft lip and palate (CLP). Alveolar bone grafting (ABG) is typically performed during adolescence, resulting in the fissure remaining in the mouth for a longer length of time. Patients with AC have a greater rate of oral diseases such as dental caries than the normal population, and the precise characteristics of the bacterial alterations caused by AC are unknown. Methods: We recruited a total of 87 subjects and collected dental plaque samples from AC adolescents (AAP), post-operative ABG adolescents (PAP), healthy control adolescents (CAP), AC young adults (AYP), post-operative ABG young adults (PYP), and healthy control young adults (CYP). The sequencing of 16S rRNA genes was performed. Results: The microbial composition of plaque from alveolar cleft patients differed significantly from age-matched healthy controls. Linear discriminant analysis effect size (LEfSe) analysis revealed that AAP was enriched for Neisseria, Haemophilus, Fusobacterium, Rhodococcus, Aggregatibacter, Gemella, and Porphyromonas, whereas AYP was enriched for Capnocytophaga, Rhodococcus, and Actinomyces-f0332. There were phenotypic differences in facultatively anaerobic, Gram-negative, Gram-positive, and oxidative stress tolerance between the AYP group with longer alveolar cleft and the healthy control group according to Bugbase phenotypic predictions. Alveolar bone grafting did not alter the functional phenotype of alveolar cleft patients but reduced the number of differential genera between alveolar cleft patients and healthy controls at both ages. Conclusions: Our study systematically characterized the supragingival plaque microbiota of alveolar cleft patients, post-alveolar bone grafting patients, and matched healthy controls in two ages to gain a better understanding of plaque ecology and microbiology associated with alveolar clefts.

A multi-level analysis on the causes of train-pedestrian collisions in Southwest China 2011-2020.

Collisions between trains and pedestrians are the primary cause of railway casualties. However, there remains a lack of comprehensive understanding regarding the underlying causes of this phenomenon. This study employs a multi-level approach to investigate the factors associated with the occurrence and severity of train-pedestrian collisions. The investigation is based on 2160 independent cases that occurred in southwest China from 2011 to 2020. Multiple contributing factors related to the victim, train, track, and socio-economic status of the surrounding district were examined, utilizing information from various sources. At the county level, several risk factors were identified in predicting the occurrence rate. These factors include higher population density and a greater number of normal-speed stations. However, the presence of high-speed train stations did not exhibit any significant impact. Additionally, the study found that regulations pertaining to protective fences were highly effective in reducing the occurrence rate. Regarding the prediction of collision severity, certain factors were found to increase the death rate. These factors include young men as victims, engaging in lying down or crossing behaviors, higher train speeds, gentle downhill slopes, lower education levels, and a higher proportion of the labor force. These findings emphasize the necessity of adopting a comprehensive perspective when examining the causes of train-pedestrian collisions. Furthermore, it underscores the significance of considering the notable differences between rapidly developing countries such as China and developed countries. Based on our findings, we also provide corresponding policy suggestions.

Zygomaticotemporal suture maturation evaluation in Chinese population using cone-beam computed tomography images.

Objective: This study aimed to evaluate the zygomaticotemporal suture (ZTS) maturation, analyze the age distribution patterns of ZTS maturation stages, and investigate the relationship between ZTS and cervical vertebral maturation (CVM). Methods: A total of 261 patients who underwent cone-beam computed tomography (112 males, mean age, 13.1 ± 3.3 years; 149 females, mean age, 13.7 ± 3.1 years) were examined to evaluate the ZTS stages. The ZTS stages were defined based on a modified method from previous studies on zygomaticomaxillary sutures. Differences between groups and correlations between indicators were analyzed using the Spearman correlation test, intraclass coefficient of correlation (ICC), one-way analysis of variance and rank sum test. Statistical significance was set at p < 0.05. The diagnostic value of CVM stages in identifying ZTS maturation stages was evaluated using positive likelihood ratios (LRs). Results: A positive relationship was found between the ZTS and CVM stage (r = 0.747, ICC = 0.621, p < 0.01) and between the ZTS stage and chronological age (r = 0.727, ICC = 0.330, p < 0.01). Positive LRs > 10 were found for several cervical stages (CSs), including CS1 and CS2 for the diagnosis of stage B, CS1 to CS3 for the diagnosis of stages B and C, and CS6 for the diagnosis of stages D and E. Conclusions: The ZTS maturation stage may be more relevant to the CVM stage than to the chronological age. The CVM stages can be good indicators for clinical decisions regarding maxillary protraction, except for CS4 and CS5.

FGF9 Promotes Expression of HAS2 in Palatal Elevation via the Wnt/ß-Catenin/TCF7L2 Pathway.

BACKGROUND: Fgf9 mutation was found in cleft palate patients. Our previous study indicated that Fgf9 promotes timely elevation of palate by regulating hyaluronic acid (HA) accumulation at embryonic day 13.5 (E13.5). HA is synthesized by hyaluronic acid synthases (HAS) isoforms 1, 2, or 3. However, how FGF9 regulates HA in palatogenesis is still unclear. METHODS: Using Ddx4-Cre mice, we generated the Fgf9-/- mouse model (with exon 2 deletion). Immunohistochemistry was used to detect the location and expression of HAS2 in WT and the Fgf9-/- palate at E13.5. We also predicted the association between Fgf9 and Has2 within the developing palate by performing a bioinformatics analysis. The expression of ß-catenin, HAS2, and TCF7L2 were verified by Western blotting after knockout of Fgf9. Rescue experiments were performed by ELISA in vitro. RESULTS: Fgf9-/- mice exhibited 100% penetrance of the cleft palate. A knockout of Fgf9 confirmed that HAS2 and TCF7L2 expression was positively correlated with FGF9. TCF7L2 binds to the Has2 promoter, exhibiting the high specificity predicted by JASPAR. Additionally, increased HA expression by BML-284, TCF-dependent agonist, was blocked in Fgf9-/- palate because of the significant decline in TCF7L2 expression. CONCLUSIONS: FGF9 promotes HAS2 expression via Wnt/ß-catenin/TCF7L2 pathway with TCF7L2 activating transcription of Has2 in the palate.

Zygomaticomaxillary suture maturation evaluation in patients with and without cleft lip and palate.

INTRODUCTION: The zygomaticomaxillary suture (ZMS) maturation evaluation is a reliable method for predicting the optimal timing of maxillary protraction. The objective of this study was to compare age distribution patterns of ZMS maturation stages between cleft lip and palate (CLP) patients and non-cleft lip and palate (non-CLP) patients to aid our comprehension in choosing the optimal timing of maxillary protraction. METHODS: Samples of 216 non-CLP and 220 CLP Asian patients without orthodontic and orthognathic treatment aged 5-25 years were scanned to evaluate the ZMS maturation stage by 2 evaluators blindly. Evaluators' agreements and bilateral ZMS maturation consistency were assessed by weighted kappa tests. Age distribution patterns of each ZMS maturation stage were described. Gender effect and age distribution differences between groups were analyzed using an independent t-test. RESULTS: Evaluators' agreements and bilateral ZMS maturation consistency were satisfying (weighted kappa coefficient >0.90). At stages A and B, patients with CLP were 1.3 and 0.4 years older than patients in the non-CLP group (P <0.001 and P = 0.01). In contrast, at stage C, patients with CLP were approximately 1.2 years younger (P = 0.004). Gender barely played a role in the divergence of ZMS maturation (P >0.05). No statistically significant difference was observed between ZMS maturation of patients with unilateral or bilateral cleft lip and palate (UBCLP) and patients with unilateral or bilateral cleft lip (UBCL) (P >0.05). CONCLUSIONS: The ZMS development of patients with CLP was premature at stage C, whereas delayed at stages A and B.

Characteristics of Train-Pedestrian Collisions in Southwest China, 2011-2020.

Although train-pedestrian collisions are the primary source of railway casualties, the characteristics of this phenomenon have not been fully investigated in China. This study examined such collisions in the Greater Sichuan-Chongqing area of China by conducting a thorough descriptive analysis of 2090 incident records from 2011 to 2020. The results showed that such collisions have declined gradually over the past decade, but the fatality rate remains high. We found that such collisions were more likely to happen to men, senior citizens and people crossing the tracks and that they occurred more frequently in the morning. While collision rates dropped in February, collisions were more likely to occur in December. In contrast to the situation in Western countries, weekends were not related to increased occurrence. The absence of a protective fence led to a higher collision rate, but level crossings are no longer a concern since most such structures in China have been rebuilt as overpasses. Mild slopes and extreme curvatures were also found to increase the occurrence of such collisions. Freight trains were most likely to be involved in train-pedestrian collisions, and collisions caused by high-speed trains were rare both absolutely and relatively. However, when collisions did occur, higher train speeds were linked with higher fatality rates. The findings suggest that patterns of train-pedestrian collisions in China differ from those in the Western world. This difference might be caused by differences in culture, geography, weather and railway development policies. Future research directions and possible preventive measures are also discussed.

Assessment of Skeletal Maturation in Male Children With Unilateral Cleft Lip and Palate.

OBJECTIVES: To assess the skeletal maturation in male children with unilateral cleft lip and palate (UCLP) in comparison to that of noncleft peers using the cervical vertebral maturation (CVM) method. METHODS: A sample of 149 male UCLP patients aged from 8- to 16-year-old and 447 age-matched orthodontic individuals without clefts was retrospectively compiled. Cervical vertebral maturation was assessed based on the cephalometric radiographs. RESULTS: The proportion of children in CVMSI and CVMSII was higher in the UCLP group compared to that in the noncleft group, but there was no significant difference in the CVM stage of the cleft patients compared to their noncleft peers. In the 12- to 14-year-old group, children with UCLP showed significantly delayed skeletal maturity in comparison with their noncleft peers. No significant difference was found in the other 3 age groups. There was a statistically significant correlation between the skeletal age and chronological age in both the UCLP group and the noncleft group. There was no significant difference in the mean age at CVMII and CVMIII between the cleft patients and noncleft peers. CONCLUSIONS: Males with UCLP aged 12- to 14-year-old have a statistically significant increased risk of delayed skeletal maturity in comparison with their noncleft peers. The chronological age is not an accurate indicator to assess the degree of skeletal maturation.

Association of genetic polymorphisms of VAX1, MAFB, and NTN1 with nonsyndromic cleft lip with or without cleft palate in Chinese population.

Nonsyndromic cleft lip with or without palate (NSCL/P) is a common birth defect involving genetic factors. We conducted this case-control study to verify the association of ten single-nucleotide polymorphisms (SNPs) of six genes (VAX1, MAFB, PAX7, ABCA4, NTN1, and NOG) with NSCL/P in the Chinese population. The study included 249 NSCL/P patients, 62 nonsyndromic cleft palate only (NSCPO) patients and 480 controls. Three loci, namely, VAX1 rs7078160, MAFB rs11696257, and NTN1 rs4791774, were associated with NSCL/P (Bonferroni method adjusted p values were 0.020, 0.00031, and 0.030, respectively). We also found that the disease risk of individuals carrying both VAX1 rs7078160 and NTN1 rs4791774 was higher than those carrying only one of them (p = 4.50 × 10-4 and 6.03 × 10-3, respectively). SNPs of genes VAX1 rs7078160, MAFB rs11696257, and NTN1 rs4791774 increased NSCL/P risk in the Chinese population.

[Impact of maxillary sinus floor on the mesial movement of maxillary first molar].

PURPOSE: To investigate the impact of maxillary sinus floor on the mesial movement of maxillary first molar. METHODS: Orthodontic patients with maxillary first premolars extracted were selected. Their maxillary first molars were divided into case group and control group according to whether their roots were in contact with the maxillary sinus floor. The case group was further divided into three subtypes according to the depth of the root extruded into the maxillary sinus. A total of 64 maxillary first molars from 32 patients were enrolled in this study, including 34 in the case group (five in subtype Ⅱ, fourteen in subtype Ⅲ, and 15 in subtype Ⅳ) and 30 in the control group. The mesial movement distance of each root and crown and the inclination of each root long axis were measured, and resorption of each root was evaluated. SPSS 22.0 software package was used for data analysis. RESULTS: After orthodontic treatment, the mesial movement distance of roots from both groups were all lager than 2 mm. The mesial movement distance of the crown was not statistically different between the two groups (P＞0.05), while the mesial movement distance of the roots in the control group was significantly larger than in the case group（P＜0.05）. Inclined movement towards the mesial direction was found in both groups, and the inclination angle was significantly larger in the case group（P＜0.05）. The inclination angle of the first molars in the subtype Ⅳ was significantly larger than that in the subtype Ⅲ and the control group. Most of the maxillary first molars from both groups had no obvious root resorption（P＞0.05）. CONCLUSIONS: With the proper force system, maxillary first molars with roots extruded into the maxillary sinus floor can be moved mesialy with mild or no root resorption, while a larger inclination can be found compared with maxillary first molars without root extruding into the maxillary sinus floor. The deeper the root extruding into the maxillary sinus, the larger the inclination angle will be.

The Fibroblast Growth Factor 9 (Fgf9) Participates in Palatogenesis by Promoting Palatal Growth and Elevation.

Cleft palate, a common global congenital malformation, occurs due to disturbances in palatal growth, elevation, contact, and fusion during palatogenesis. The Fibroblast growth factor 9 (FGF9) mutation has been discovered in humans with cleft lip and palate. Fgf9 is expressed in both the epithelium and mesenchyme, with temporospatial diversity during palatogenesis. However, the specific role of Fgf9 in palatogenesis has not been extensively discussed. Herein, we used Ddx4-Cre mice to generate an Fgf9-/- mouse model (with an Fgf9 exon 2 deletion) that exhibited a craniofacial syndrome involving a cleft palate and deficient mandibular size with 100% penetrance. A smaller palatal shelf size, delayed palatal elevation, and contact failure were investigated to be the intrinsic causes for cleft palate. Hyaluronic acid accumulation in the extracellular matrix (ECM) sharply decreased, while the cell density correspondingly increased in Fgf9-/- mice. Additionally, significant decreases in cell proliferation were discovered in not only the palatal epithelium and mesenchyme but also among cells in Meckel's cartilage and around the mandibular bone in Fgf9-/- mice. Serial sections of embryonic heads dissected at embryonic day 14.5 (E14.5) were subjected to craniofacial morphometric measurement. This highlighted the reduced oral volume owing to abnormal tongue size and descent, and insufficient mandibular size, which disturbed palatal elevation in Fgf9-/- mice. These results indicate that Fgf9 facilitates palatal growth and timely elevation by regulating cell proliferation and hyaluronic acid accumulation. Moreover, Fgf9 ensures that the palatal elevation process has adequate space by influencing tongue descent, tongue morphology, and mandibular growth.

Fibroblast Growth Factor 9 (FGF9) negatively regulates the early stage of chondrogenic differentiation.

Fibroblast growth factor signaling is essential for mammalian bone morphogenesis and growth, involving membranous ossification and endochondral ossification. FGF9 has been shown to be an important regulator of endochondral ossification; however, its role in the early differentiation of chondrocytes remains unknown. Therefore, in this study, we aimed to determine the role of FGF9 in the early differentiation of chondrogenesis. We found an increase in FGF9 expression during proliferating chondrocyte hypertrophy in the mouse growth plate. Silencing of FGF9 promotes the growth of ATDC5 cells and promotes insulin-induced differentiation of ATDC5 chondrocytes, which is due to increased cartilage matrix formation and type II collagen (col2a1) and X (col10a1), Acan, Ihh, Mmp13 gene expression. Then, we evaluated the effects of AKT, GSK-3ß, and mTOR. Inhibition of FGF9 significantly inhibits phosphorylation of AKT and GSK-3ß, but does not affected the activation of mTOR. Furthermore, phosphorylation of inhibited AKT and GSK-3ß was compensated using the AKT activator SC79, and differentiation of ATDC5 cells was inhibited. In conclusion, our results indicate that FGF9 acts as an important regulator of early chondrogenesis partly through the AKT/GSK-3ß pathway.

Beta-tricalcium phosphate promotes osteogenic differentiation of bone marrow-derived mesenchymal stem cells through macrophages.

Macrophages are vital regulators of skeletal remodeling and osseous repair. Beta-tricalcium phosphate (ß-TCP) is a synthetic ceramic biomaterial that has shown promise as bone substitute. However, whether and how ß-TCP affects osteogenesis-related responses of macrophages has rarely been studied. The aims of this study were to explore (a) the effects of ß-TCP on osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs) co-cultured with macrophages and (b) on macrophage polarization as well as macrophage gene and protein expression profiles. BMSC osteogenic differentiation capacity in vitro was enhanced in ß-TCP-induced co-cultured BMSCs compared to that in BMSC monocultures. We also found that macrophages induced with 25 mg ml-1 ß-TCP extract had more significant immune responses and switched to the M2 phenotype. Expression levels of the Wnt signaling pathway modulators wingless-type MMTV integration site family, member 6 (WNT6) and Wnt inhibitory factor 1 (WIF1) were upregulated and downregulated, respectively, in macrophages treated with ß-TCP extract. Our findings suggest that ß-TCP enhances osteogenic differentiation of BMSCs by inducing macrophage polarization and by regulating the Wnt signaling pathway, thereby highlighting its therapeutic potential for bone healing through osteoimmunomodulatory properties.

Difference and Commonness Among CLP, NON-CLP Patients and Their Parents Seeking for Orthodontic Treatment: A Questionnaire Applying Q Methodology to Investigate Motives.

PURPOSE: Based on Q methodology, this study investigated the motivation of orthodontic treatment for patients and their parents. Through investigation, this paper attempts to explore the motivational factors of CLP and NON-CLP children and their parents, which are different or general. PATIENTS AND METHODS: Q methodology involves 4 phases. (1) Interviews of CLP (N=5), NON-CLP (N=5) patients generated 30 statements (Q-set 1) and CLP (N=5), NON-CLP (N=5) patients' parents produced 36 statements (Q-set 2) about different reasons to pursue orthodontic care. (2) P-set: recruitment participants. The sample comprised 40 CLP patients (G1) and 40 NON-CLP patients (G2) aged 9-16 years, 40 CLP patients' parents (G3) and 40 NON-CLP patients' parents (G4) wanting their children to have orthodontic treatment. (3) Q-sort: 4 groups ranked statements in order of comparative significance using enforced distribution grids (G1, G2 ranked Q-set 1; G3, G4 ranked Q-set 2). (4) Analysis: using the PQMehtod 2.35 vision to analyze data. RESULTS: Three factors in each group were identified as representing the most widespread views of the majority of the participants, described as G1: (1) aesthetics, (2) preparation for other oral treatments, (3) timely. G2: (1) admiration of others, aesthetics, (2) oral function, (3) oral hygiene and improvement of smile. G3: (1) worrying about the future of children, parents' responsibilities, children's feelings; (2) mental health, timely; (3) parents' responsibilities, ready for treatment. G4: (1) aesthetics, children's will; (2) future problems, timely; (3) timely, parents' responsibility and no need to worry about physical problems. CONCLUSION: CLP and NON-CLP patients and parents have different orthodontic treatment motives, yet, they still shared 3 global motivation themes, respectively. Consideration of these motives may help clinicians develop their treatment discussions with patients and parents, which could consequently improve their cooperation and may achieve a more satisfactory outcome.

Study on Tooth Movement After the Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate.

OBJECTIVES: The aim of the study was to explore the effectiveness of the cleft-adjacent teeth moved into the grafted alveolar bone in unilateral cleft lip and palate (UCLP) patients, and to evaluate the alveolar bone support of the teeth. METHODS: Twenty unilateral cleft lip and palate patients were recruited in this study. The average age was 12 years and 8 months. Periapical radiographs were taken for the cleft-adjacent teeth 3 months after bone grafting (T1) and after teeth moving into the grafted bone (T2), and for the contralateral teeth (T3) when teeth aligned. Alveolar bone support of the moved teeth and the contralateral teeth were measured using the ratio of bone support height to root length. Paired t test was performed for statistical analysis with SPSS17.0 software package. RESULTS: All the cleft-adjacent teeth were bodily moved into the grafted area. Average alveolar bone support ratio for the moved teeth was 86.48% (T1), 87.11% (T2), and 90.81% (T3) for the contralateral teeth. There was no statistically significant difference between T1 and T2 (P > 0.05). Although the contralateral teeth had the highest alveolar bone support ratio, significant differences were found between T3 and T2 (P < 0.05). CONCLUSIONS: Cleft-adjacent teeth could be bodily moved into the grafted bone from the iliac crest in UCLP patients. A successful level of alveolar bone support for the moved teeth was achieved. Moved-in teeth could be functionally loaded and may be benefit to the reduction of the resorption of grafted bone.

[Using Q methodology to investigate motives of seeking orthodontic treatment from parents' perspectives of cleft lip and/or palate patients].

PURPOSE: This study was aimed to use Q methodology to find out why parents of cleft lip and/or palate (CLP) patients want their children to undergo orthodontic treatment. METHODS: Q methodology involved five phases.①concourse, collecting all viewpoints from CLP patients' parents on seeking orthodontic treatment. ②Q sample, Selecting 36 items from the concourse. ③P sample, forty varieties of parents whose children were CLP patients and want to have braces. ④Q sort, participant- ranked statements (Q sample) in order of relative significance using an enforced distribution grid (Q grid). ⑤analysis: using PQMehtod 2.35 vision to analyze the data. RESTULTS: Three factors were identified as representing the most widespread views of the majority of the parents. Group 1 consisted of parents of 13 CLP patients marked as factor 1: responsibility as parents. The parents of 8 participants made up group 2 designated as factor 2: parents' anxiety for their children's wellbeing. Group 3 was made up of parents of 9 CLP patients marked as factor 3: oral function. The opinions of the remaining participants did not fit into any of the outlined three groups. CONCLUSIONS: Parents' motives to seek orthodontic treatment for their children are complicated. Most CLP patients' parents are categorized into three different groups. Understanding these motives will help orthodontists frame their treatment discussions with parents and improve cooperation of both patients and parents.

Three-Year Follow-Up of a Patient With Unilateral Cleft Lip and Palate Treated With Maxillary Protraction and Alveolar Bone Grafting: An Approach Exploring the Potential Power of Growth.

Clinically, patients with operated unilateral cleft lip and palate always present with a concave profile, depressed midface, maxillary hypoplasia, narrow upper dental arch, and class III malocclusion. In this clinical report, the authors describe the successful orthodontic treatment of a patient with unilateral cleft lip and palate. A boy, 7 years 11 months of age, with a history of unilateral cleft lip and cleft palate presented with a Class I malocclusion on Skeletal Class III base. A satisfactory occlusion and a favorable lateral profile were achieved after maxillary protraction (face mask) combined with fixed appliance treatment, including alveolar bone grafting surgery. An acceptable occlusion and facial proportion were maintained after a 3-year retention period. These results suggest orthodontic treatment with growth interference is an effective option for a patient with cleft lip and palate.

Correction of Deep Overbite by Using a Modified Nance Appliance in an Adult Class II Division 2 Patient with Dehiscence Defect.

A modified Nance Appliance (MNA) is introduced as a treatment option for an adult class II division 2 malocclusion (CII/2) patient with deep overbite and dehiscence on the facial root surface of retroclined upper incisors through the cone-beam computed tomography (CBCT). Indications for this modified MNA as well as a brief description of fabrication procedure and biomechanical analysis of the treatment effects are shown in detail. Root control and absolute intrusion without enlarging the bony defect were achieved. The treatment results were satisfying and favorable.

Effects of Palate Repair on Cranial Base and Maxillary Morphology in Patients With Unilateral Complete Cleft Lip and Palate.

OBJECTIVE: To identify the effects of palate repair on cranial base and maxillary morphology in patients with unilateral cleft lip and palate (UCLP) and to discover the relevance between cranial base and maxilla through cephalometric analysis. DESIGN: Retrospective. PATIENTS: Thirty-seven UCLP patients with operated lip (OL) and unoperated palate constituted OL group and were classified into 5 cervical vertebral maturation (CVM) stages. Thirty-seven UCLP patients with operated lip and palate (OLP) and 37 noncleft people with skeletal class I malocclusion were CVM- and sex-matched with the OL group as OLP group and control group, respectively. CVM stage I and II were combined into group 1, CVM stage III to V were combined into group 2. INTERVENTIONS: Lateral cephalograms of all participants were obtained. MAIN OUTCOME MEASURES: Cephalometric analysis was employed, and data were compared among groups. RESULTS: Length of posterior cranial base (Ba-S) of the OL group was shorter than controls in group 1; Ba-S and the ratio between length of posterior and anterior cranial base (Ba-S/S-N) of the OL and OLP groups were smaller than controls in group 2. No significant differences in cranial base were found between the OL and OLP groups. In group 1, patients of the OLP group showed smaller SNA, ANS-Ptm, and ANS-Ptm/S-N, and patients of the OL group showed smaller ANS-Ptm. In group 2, both OL and OLP groups had smaller sella-nasion-A point angle (SNA), projection distance between ANS and Ptm points on FH plane (ANS-Ptm), and the ratio between ANS-Ptm and anterior cranial base length (ANS-Ptm/S-N). CONCLUSIONS: Palate repair seems to have no obvious effects on cranial base morphology in patients with UCLP. Those patients with lip operated, whether cleft palate operated or not, tend to have a smaller length of maxilla sagittally and this deformity progresses with age.

A review of FGF signaling in palate development.

The fibroblast growth factors (FGFs) play a critical role during palatogenesis by mediating a variety of cellular responses. Extensive epidemiological and genetic studies over several decades in humans have revealed members of the FGF family function as candidate genes for syndromic and nonsyndromic cleft lip and cleft palate. The findings that FGFs signaling work delicately in the development of palate have been confirmed in mice carrying targeted mutations. Here we try to review recent progress toward a detailed understanding of FGF signaling including FGF7, FGF8, FGF9, FGF10, FGF18 and their receptors FGFR1, FGFR2 in palate development studies and discuss how they interact with other factors on the basis of animal studies regarding cleft palate.