Caregiver responses to early cleft palate care: A mixed method approach.

This study sought to understand caregivers’ (CGs’) responses to early cleft lip/palate care for their infants

Coping with Cleft: A Conceptual Framework of Caregiver Responses to Nasoalveolar Molding

To present a conceptual framework of caregiver coping and adaptation to early cleft care using nasoalveolar molding

Concurrent validity of the COHIP

This study examined the relationship between children’s perception of their OHRQOL and their perceptions of their dentofacial image, social anxiety, and self-concept as an assessment of the concurrent validity for the Child Oral Health Impact Profile (COHIP)

The North Carolina Medicaid Program: Participation and perceptions among practicing orthodontists

Limited provider participation in the Medicaid program is a barrier to access to orthodontic care for Medicaid-eligible patients. The goals of this study were to determine the participation level of North Carolina (NC) orthodontists in the Medicaid program, to examine NC orthodontists’ perceptions of the Medicaid program and its beneficiaries, and to determine whether there are differences between practitioners who do and do not accept Medicaid patients

Surgeon’s and Caregivers’ Appraisals of Primary Cleft Lip Treatment with and without Nasoalveolar Molding: A Prospective Multicenter Pilot Study

Despite the increasing use of nasoalveolar molding (NAM) in early cleft treatment, questions remain about its effectiveness. This study examines clinician and caregiver appraisals of primary cleft lip and nasal reconstruction with and without NAM in a non-randomized, prospective multicenter study

Three-dimensional cone-beam computed tomography for assessment of mandibular changes after orthognathic surgery

The purpose of this study was to assess alterations in the 3-dimensional (3D) position of the mandibular rami and condyles in patients receiving either maxillary advancement and mandibular setback or maxillary surgery only

Impacts of Skeletal Anterior Open Bite Malocclusion on Speech

Introduction: Articulation problems are seen in 80% to 90% of dentofacial deformity (DFD) subjects compared with 5% of the general population, impacting communication and quality of life, but the causal link is unclear. We hypothesize there are both qualitative (perceptual) and quantitative (spectral) differences in properties of stop (/t/ or /k/), fricative (/s/ or /ʃ/), and affricate (/tʃ/) consonant sounds and that severity of anterior open bite (AOB) jaw disharmonies correlates with degree of speech abnormality. Methods: To test our hypotheses, surgical orthodontic records and audio recordings were collected from DFD patients (n = 39 AOB, 62 controls). A speech pathologist evaluated subjects, and recordings were analyzed using spectral moment analysis (SMA) to measure sound frequency distortions. Results: Perceptually, there is a higher prevalence of auditory and visual speech distortions in AOB DFD patients when compared to controls. Quantitatively, a significant (P < .01) increase in the centroid frequency (M1) was seen in the /k/, /t/, /tʃ/, and /s/ sounds of AOB subjects compared to the controls. Using linear regression, correlations between AOB skeletal severity and spectral distortion were found for /k/ and /t/ sounds. Conclusions: A higher prevalence of qualitative distortions and significant quantitative spectral distortions in consonant sounds were seen in AOB patients compared to controls. Additionally, severity of skeletal AOB is correlated with degree of distortion for consonant sounds. These findings provide insight into how the surgical and/or orthodontic treatment of AOB may impact speech

Caregiver responses to early cleft palate care: A mixed method approach.

OBJECTIVE: This study sought to understand caregivers’ (CGs’) responses to early cleft lip/palate care for their infants. METHOD: A prospective, mixed methods multicenter longitudinal study was conducted among CGs (N=118) seeking treatment for their infants’ cleft lip and palate or cleft lip only at one of six cleft treatment centers in the United States. Participants were in one of two treatment groups: traditional care only or nasoalveolar molding (NAM) plus traditional care. The CGs completed semi-structured interviews and standardized questionnaires assessing psychosocial well-being and family impact at three time points: the beginning of treatment (~1 month of age), pre-lip surgery (~3–5 months of age), and post-palate surgery (~12–13 months of age). Multi-level modeling was used to longitudinally assess CGs’ psychosocial outcomes. RESULTS: While the first year was demanding for all CGs, NAM onset and the child’s lip surgery were particularly stressful times. CGs used optimism, problem-solving behavior, and social support to cope with this stress. Qualitatively, CGs’ ability to balance cleft treatment demands with their psychosocial resources and coping strategies influenced family adaptation. Qualitative and quantitative results indicated CGs of NAM-treated infants experienced more rapid declines in anxiety and depressive symptoms and better coping skills over time than CGs whose infants had traditional care. CONCLUSION: CGs of NAM-treated infants experienced more positive psychosocial outcomes than CGs whose infants had traditional care. Results from the mixed model support the Family Adjustment and Adaptation Response Model as used in pediatric chronic condition research

Three-dimensional cone-beam computed tomography for assessment of mandibular changes after orthognathic surgery

INTRODUCTION: The purpose of this study was to assess alterations in the 3-dimensional (3D) position of the mandibular rami and condyles in patients receiving either maxillary advancement and mandibular setback or maxillary surgery only. METHODS: High-resolution cone-beam computed tomography scans were taken of 21 patients before and after orthognathic surgery. Ten patients with various malocclusions underwent maxillary surgery only, and 11 Class III patients received maxillary advancement and mandibular setback. Presurgery and postsurgery 3D models were registered on the surface of the cranial base. A new tool was used for graphical overlay and 3D display with color maps to visually assess the locations and to quantify positional changes in the posterior border of the mandibular rami and condyles between superimposed models. RESULTS: The average displacements in condylar position were small—0.77 mm (SD, 0.12 mm) and 0.70 mm (SD, 0.08 mm)—for 2-jaw and 1-jaw surgeries, respectively (not significant, P >.05). All 2-jaw surgery patients had backward rotational displacements of the mandibular rami (mean, 1.98 mm; SD, 1.03 mm), with a maximum surface distance change of ≥2 mm in 8 of 11 subjects. For the 1-jaw surgery, all subjects had small backward rotational displacements of the mandibular rami (mean, 0.78 mm; SD, 0.25 mm), with only 1 subject having a maximum surface distance change ≥2 mm. The difference in mean backward rotational displacement was statistically significant (P <.01). CONCLUSIONS: The visualization of 3D model superimposition clearly identified the location, magnitude, and direction of mandibular displacement. The 3D imaging allowed quantification of vertical, transverse, and anteroposterior ramus displacement that accompanied mandibular, but not maxillary only, surgery