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Biomedical subjects

A Rintala

Publications and source records attributed to A Rintala.

At least 19 recordsLinked to original sources
PubMed2002

Skeletal stability of Le Fort I osteotomy in patients with isolated cleft palate and bilateral cleft lip and palate.

The skeletal stability of Le Fort I osteotomy was evaluated retrospectively in 14 patients with isolated cleft palate (CP, mean age 27.2 years) and 11 patients with bilateral cleft lip and palate (BCLP, mean age 23.7 years). The osteotomy was fixed with titanium plates and the osteotomy gap was grafted with autologous bone. Neither intermaxillary fixation nor occlusal splints were used postoperatively. Skeletal stability was analysed both horizontally and vertically by cephalograms taken shortly before operation, immediately afterwards, and at six months and at one year postoperatively. In the CP group the mean maxillary horizontal advancement (point A) was 4.7 mm (range 0.3-7.8) and the mean vertical lengthening 3.6 mm (range 0.7-6.1). One year postoperatively the mean relapse was 8.5% (0.4 mm) horizontally and 16.7% (0.6 mm) vertically. In the BCLP group the mean horizontal advancement was 5.3 mm (range 0.2-10.7) and the mean vertical lengthening 7.3 mm (range 0.6-11.8). The mean postoperative relapse was 9.4% (0.5 mm) horizontally and 17.8% (1.3 mm) vertically. The skeletal stability and relapse were similar in both cleft types although BCLP patients had more residual cleft problems and their mean surgical advancement was greater. There was great individual variation.

Adolescent↗
PubMed2001

Skeletal stability of Le Fort I osteotomy in patients with unilateral cleft lip and palate.

The skeletal stability of Le Fort I osteotomy was evaluated cephalometrically in 40 consecutive patients with unilateral cleft lip and palate (UCLP) (27 male and 13 female) who were operated on between 1987-1995. Their mean age at the time of operation was 23.7 years (range 16.3-40.4). The one-piece Le Fort I osteotomy was fixed with titanium plates and the osteotomy line was bone-grafted. Neither intermaxillary fixation nor occlusal splints were used postoperatively. Skeletal stability was analysed both horizontally and vertically on cephalograms taken shortly before operation, immediately afterwards, and at six months and at one year postoperatively. The mean maxillary advancement (point A) during the Le Fort I was 3.9 mm (range 0-8.9) and mean vertical lengthening 4.5 mm (range -0.6-10.5). One year postoperatively the mean maxillary horizontal relapse was 20.5% (0.8 mm, range 0-3.7) whereas the mean vertical relapse was 22.2% (1 mm, range 0-5.7). The vertical relapse reduced from 38% to 8.3% between 1987 and 1995, and there was a positive correlation between the amount of maxillary advancement and relapse both horizontally and vertically.

Adolescent↗
PubMed2001

Changes in soft tissue thickness after Le Fort I osteotomy in different cleft types.

The soft tissue thickness before and after Le Fort I osteotomy was evaluated in 46 cleft patients. The sample consisted of 10 patients with isolated cleft palate (CP, mean age 25.5 years); 10 patients with bilateral cleft lip and palate (BCLP, mean age 21.7 years); and 26 patients with unilateral cleft lip and palate (UCLP, mean age 22.9 years). Patients with bimaxillary surgery, simultaneous rhinoplasty, or V-Y plasty of the upper lip were excluded. Soft tissue changes were analyzed by cephalograms taken shortly before surgery and at 6 months postoperatively. Horizontal advancement varied from 4.1 mm in the UCLP group to 5 mm in the BCLP group. The vertical lengthening varied from 3.7 mm in the CP group to 7.2 mm in the BCLP group. In all cleft types, thinning of the subnasal area, superior labial sulcus, and upper lip (anterior nasal spine-subnasale, point A-soft tissue point A, and prosthion-labrale superius) took place. Significant thinning of the upper lip occurred in the UCLP and BCLP patients. Surgical changes of the lower lip and mandibular area were small and insignificant. There were significant differences in soft tissue thicknesses between different types of clefts. The subnasal area and superior labial sulcus were significantly thicker in the CP group than in the BCLP or UCLP groups, both pre- and postoperatively. The upper lip was thickest in the BCLP group preoperatively but thickest in the CP group postoperatively. The upper lip was thinnest in the UCLP group both before and after the operation.

Adolescent↗
PubMed2000

Soft tissue profile changes after Le Fort I osteotomy in UCLP patients.

The changes in soft tissue profile after Le Fort I osteotomy were evaluated cephalometrically in 38 consecutive UCLP patients (25 males, 13 females) operated on between 1987 and 1995. Mean age at operation was 23.5 years. The one-piece Le Fort I osteotomy was fixed with titanium plates and the osteotomy site was bone grafted. Neither intermaxillary fixation nor occlusal splints were used postoperatively. Soft tissue changes were analyzed both horizontally and vertically by cephalograms taken shortly before surgery, 6 months and 1 year postoperatively. The mean maxillary skeletal advancement (point A) during surgery was 3.8 mm and mean vertical lengthening 4.4 mm. One year postoperatively the horizontal change in the upper lip profile (point a) was 80% of the skeletal change. Vertically, the soft tissue change in the upper lip was smaller 40%, but increased significantly (to 58%) if V-Y plasty was used. The V-Y plasty also increased the anteroposterior thickness of the upper lip. No significant soft tissue changes were observed between 6 months and 1 year postoperatively.

Adolescent↗
PubMed1993

One-stage closure of isolated cleft palate with the Veau-Wardill-Kilner V to Y pushback procedure or the Cronin modification. I. Comparison of operative results.

The long term operative results of one-stage closure of isolated cleft palate with either the Veau-Wardill-Kilner V to Y pushback procedure or the Cronin modification were evaluated and compared retrospectively. A total of 116 consecutive patients with isolated cleft palate who had been operated on at the age of 18-24 months were followed up until 17-20 years of age. Twenty-four of the patients needed one or more additional operations on the palate, mainly pharyngeal flaps (20%) and repair of fistulas (10%). There was no significant difference in the number of patients who needed further operations, either between the two different operations or between the sexes, but the patients who presented with the most extensive clefts required the most operations.

Adolescent↗
PubMed1991

Cephalometric analysis of the obstructive sleep apnea syndrome.

The cephalometric measurements of 33 Finnish OSAS patients showed a fairly normal relationship between the base of the skull and the maxilla (SNA 82.3), whereas the mandible was slightly smaller than average (SNB 78.0). In 58% of the patients the mandible was significantly retrognathic and/or small in relation to the maxilla, even if dental occlusion was satisfactory. The sagittal lengths of the anterior cranial base and the maxilla were fairly normal. The hyoid bone was constantly situated more inferiorly and posteriorly than on average (MP-H 32.6). UPPP, genioplasty and advancement of the floor of the mouth and hyoid suspension were found to be effective in severe OSAS. The changes caused by the operation could best be verified cephalometrically by a more anterior position of the hyoid bone (average change of 11.1 mm).

Adult↗
PubMed1988

Oblique lateral oro-ocular facial cleft. Case report.

2 patients are presented, and the oblique lateral oro-ocular clefts discussed with emphasis on classification, dentition and microforms. A review of the literature revealed 10 patients with oblique lateral oro-ocular facial cleft (no. 5 in Tessier's classification), 3 bilateral and 7 unilateral. 5 unilateral cases had a median oblique facial cleft (no. 4) on the other side. 3 cases had a cleft lip and palate. The site of the alveolar cleft was in the region of the first and second premolar in 2 and slightly posterior to the canine tooth in 3 of 5 reliably documented cases. The dentition was documented only in 1 child with a lateral and median oblique facial cleft, resulting in full permanent dentition. The author's 2 cases had a bilateral oblique lateral oro-ocular facial cleft with the alveolar defect in the region of the first and second premolar. An isolated cleft (no. 6 in Tessier's classification) has to our knowledge not been reported at all. Furthermore, there are transitional forms between Tessier's clefts 5-8. Based upon our observations, it is also evident that variations inside one type occur as well. More attention should be paid to the exact location of the cleft and especially to the skeletal deformity, alveolar site and dentition. This would facilitate both classification and diagnosis of microforms.

Alveolar Process↗
PubMed1987

Collagen gene expression in keloids: analysis of collagen metabolism and type I, III, IV, and V procollagen mRNAs in keloid tissue and keloid fibroblast cultures.

Regulation of collagen gene expression was studied in keloids and fibroblast cultures established from keloid biopsies from 9 patients. The collagen concentration in keloid tissue was not different from that in normal skin. The activities of 2 enzymes catalyzing intracellular collagen biosynthesis, prolyl 4-hydroxylase (PH) and galactosylhydroxylysyl glucosyltransferase (GGT) were significantly elevated in the keloids, the mean increase in the former enzyme being 5-fold and in the latter 3-fold with respect to the controls. The mean procollagen production rate in the keloid fibroblasts was at the control level, with only 1 keloid cell line showing a procollagen synthesis rate higher than the mean value + 2 SD of the controls. The mean PH and GGT activities of the keloid fibroblasts were not elevated, but PH activity in 2 cell lines and GGT activity in 1 cell line were higher than the mean + 2 SD for the controls. Cellular type I, III, IV, and V procollagen mRNAs were measured by slot blot hybridization using specific human cDNA clones for the various collagen types. The amounts of type I, III, and V procollagen mRNAs corresponded to the ratios in which these collagen types are produced by fibroblasts. No synthesis of type IV procollagen mRNA by keloid fibroblasts was observed. The total amount of type I and III procollagen mRNAs correlated significantly (p less than 0.01) with the procollagen synthesis rate measured after radioactive labeling of the cells in the keloid and control fibroblasts, indicating that collagen production in these cells is mainly controlled by regulating the final steady state levels of collagen mRNA. The results suggest that fibroblasts isolated from keloids often synthesize normal amounts of collagen.

Cells, Cultured↗
PubMed1986

Bacteriological investigation of secretory otitis media in children with cleft palate.

Altogether 92 middle ear effusion samples from 89 children with cleft (lip) palate and secretory otitis media aged from two months to 15 years were cultured and analyzed bacteriologically. Known middle ear pathogens were isolated from 49 (53%), these accounted for 68% of all positive cultures. The frequency of occurrence of middle ear pathogens was significantly higher in the age group younger than 36 months. The most common bacteria found were S. pneumoniae, B. catarrhalis and H. influenzae. The only anaerobe was a strain of B. fragilis. We believe that by defining culture methods, more pathogens can be isolated from the middle ear of cleft children than has previously been reported. Pathogenic bacteria seem to be found with a higher frequency in children with cleft palate, when compared to normal children.

Adolescent↗
PubMed1986

Cleft palate in diastrophic dysplasia. Morphology, results of treatment and complications.

Forty-one of 95 Finnish patients (43%) with diastrophic dysplasia had open cleft palate (CP). Submucous CP or its microforms were observed in an additional 30 patients (32%). Even though most of the patients have micrognathia, the high frequency of submucous clefts speaks against the role of the interposed tongue in the pathogenesis of CP in the Pierre Robin sequence. There was no hypernasality of speech in 27 of the 30 patients with submucous CP or its microforms, and the spontaneous speech of the other three was good. This is in contrast with observations in isolated submucous CP in general. No operative treatment was indicated in any case. Results after treatment of open CP and speech problems were in good agreement with results from the patients with isolated CP from the same period of time. As newborns 11 of the patients (12%) had severe respiratory difficulties caused by glossoptosis, and a Douglas operation was performed in three patients. Spinal compression due to abnormalities in cervical vertebrae and to dorsiflexion necessitated by intubation and velopharyngeal surgery may be a dangerous operative complication of patients with diastrophic dysplasia.

Adolescent↗
PubMed1985

Nasomaxillary hypoplasia--Binder's syndrome. Morphology and treatment of two separate varieties.

Two varieties of nasomaxillary dysplasia are presented in 13 patients; one with a nose of normal length and another with a short nose. Several cephalometric and soft tissue differences and similarities are found between these groups. Orthodontic treatment of the malocclusion and nasal reconstruction with an L-shaped iliac bone graft composed of two pegs is the treatment of choice. In the short nose variety, the tight nasal mucosa has to be lengthened with an auricular composite graft.

Adolescent↗
PubMed1985

Midline sinuses of the upper lip. Case report.

Nine midline sinuses of the upper lip in eight patients have been described previously. They have been located from the skin under the columella to the frenulum, and have always been directed towards the frenulum. Three new cases are presented: a sinus reaching from the skin of the philtrum to the frenulum in a child with Pierre Robin syndrome, another one in the frenulum of a patient with two separate midline sinuses of the nose, and a third in the frenulum of a child with a partial median cleft lip. The midline sinus is probably caused by disturbed development of the nasofrontal process. The combination of upper lip sinus and Pierre Robin's syndrome is hardly coincidental and supports the concept that the latter is not caused solely by a foetal malposition.

Adult↗
PubMed1984

Separate clefts of the lip and the palate. A variant of cleft lip and palate.

Separate clefts of the lip and of the palate (CL-CP) may belong to the same etiological class as the cleft lip with or without cleft palate CL(P), or a child may have two separate anomalies, CL and CP. This theory was tested in Finnish cleft patients. Among 2471 cleft cases, there were 66 CL-CP (2.7%). Adequate medical records were available for 62 children: 45 boys (73%) and 17 girls (27%). Familial occurrence was recorded in 6 cases (10%). Of the cleft cases among the near relatives, 5 were CL(P) and one CP. The prevalence of hypodontia was 37% among 38 subjects studied, as compared with 8.2% in the CL-, 29.8% in the CP- and 48.1% in the CLP controls. Conical elevations of the lower lip were observed in none, as compared with 0.8% of the CL(P)- and 39% of the CP controls. It was therefore assumed that the CL-CP belongs to the same etiological class as the CL(P).

Adolescent↗
PubMed1984

On the pathogenesis of cleft palate in the Pierre Robin syndrome.

In a series of Pierre Robin syndrome (PRS) and isolated cleft palate patients (ICP) both U- and V-formed clefts were observed with equal frequency, but the PRS clefts were in average slightly wider. There were totally submucous clefts among the PRS patients. There was no statistical difference between the groups in the prevalence of clefts in the relatives of the patients. The incidence of (genetically influenced) conical elevations in the lower lip was lowest in the noncleft subjects, high in ICP and highest in PRS children. The incidence of hypodontia, which acceptedly is genetically influenced, was also highest in the PRS group. Thus the foetal malposition with the tongue between the palatal shelves does not seem to play any decisive role in the pathogenesis of most PRS clefts. The cause for the PRS is more likely a genetically influenced growth disturbance in the maxilla and the mandible, which due to the organogenetic differences leads to diverging end results, micrognathia and cleft.

Anodontia↗
PubMed1983

Cleft lip and palate in Finland in 1948-75: correlations to infections, seasonal and yearly variations.

Comparison of the patient records of the Finnish Red Cross National Cleft Center and the Central Register of Congenital Malformations showed a statistically significant yearly fluctuation as well as an increasing trend in the incidence of both cleft lip (and palate) and isolated cleft palate during the period 1948-1975. Almost significant difference was found in the monthly incidence of CL(P) with the peak in children born in April, while no such difference could be noticed in CP or both groups combined. The rapid increase and similarity of the incidence curves of both CL(P) and CP is suggestive of the action of simultaneous and similar exogenous agents in the pathogenesis of both types. In patients with CL(P) the etiological factor was considered to have been active 35 weeks and in CP 31 weeks before delivery. The monthly number of clefts was compared to the number of serologically verified infections (influenza A, respiratory syncytical, mumps, measles, rubeola, parainfluenza, adenoviruses as well as Mycoplasma pneumoniae) in the years 1971-75. No statistically significant correlation was found in this respect.

Cleft Lip↗