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Biomedical subjects

K Mølsted

Publications and source records attributed to K Mølsted.

10 recordsLinked to original sources
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 1. Principles and study design.

This article describes the design of an intercenter comparative study of treatment outcome in the treatment of children with a unilateral complete cleft of the lip and palate. The rationale and aims of this study are defined and treatment schemes of the participating centers are described. The findings are presented in a series of three papers (Parts 2, 3, and 4) dealing with the comparison of craniofacial form, dental arch relationships, and nasolabial appearance. In Part 5, conclusions and general recommendations regarding future research are discussed.

Child↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 2. Craniofacial form and soft tissue profile.

The craniofacial morphology and the soft tissue profile were evaluated in this part of the intercenter study of the European Cleft Lip and Palate Research Group. The sample was comprised of cephalometric x-rays of the full cohort of 151 cases from the six European cleft palate centers. The facial morphology in complete unilateral cleft lip and palate patients was evaluated by means of roentgen cephalometry. Approximately 25 consecutive cases from each of six European cleft palate centers were compared. Only one center showed notable and consistent differences from the others. A contributing factor for these differences may be an inconsistent treatment regimen with many surgeons involved. Analysis of the soft tissue profile between the centers showed more pronounced differences than analysis of the skeletal profile. The treatment outcome in centers with more complex or expensive programs was no better than those centers using simpler management approaches.

Analysis of Variance↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 3. Dental arch relationships.

One hundred and forty-nine dental casts of subjects with complete unilateral clefts of the lip and palate from six European cleft palate centers were assessed by means of the Goslon Yardstick. The Yardstick proved capable of discriminating between the quality of the dental arch relationships between the six centers. Two centers showed especially poor results. Three centers obtained satisfactory results although differing surgical techniques were used in these centers. One of the centers showing satisfactory dental arch relationships employed a more complex and expensive treatment program than the other two centers, which both used simpler centralized treatment regimens.

Analysis of Variance↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 4. Assessment of nasolabial appearance.

One hundred and fifteen frontal and profile photographs of the nasolabial area of subjects with complete unilateral clefts of the lip and palate from six European centers were assessed. Four components of the nasolabial area were rated separately by a panel of judges using a five-point scale of attractiveness. The Tukey multiple comparison test showed significant differences between the centers. The relative position of the six centers in this study followed a similar pattern to their respective positions in the cephalometric and dental cast studies.

Child↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 5. General discussion and conclusions.

Part 5 is the final part of a series of five articles reporting on an international, multicenter clinical audit of treatment outcome for complete UCLP. A number of recommendations for the methodology of future studies is made especially with respect to entry criteria, sample size, assumptions of homogeneity, and the reproducibility and validity of outcome measures. The findings of the present study regarding clinical procedures are presented tentatively, and improvement and extension of the methodology are required. It appears, however, that acceptable results can be achieved by different programs and ultimately clinical choices may be based on factors such as complexity, costs, and demands of treatment. Standardization, centralization, and the participation of high volume operators were associated with good outcomes, and nonstandardization and the participation of low volume operators with poor outcomes. Therapeutic factors associated with good outcomes were the employment of a vomer flap to close the anterior palate, and poor outcomes with primary bone grafting and with active presurgical orthopedics.

Bone Transplantation↗
PubMed1992

The need for long-term multicenter treatment assessment of craniofacial developmental disorders including cleft lip and palate.

There has been an increase of interest in recent years in comparing treatment outcome in patients with craniofacial anomalies, including cleft lip and palate. When a treatment result is to be evaluated, it is important that it is multifaceted, taking all aspects into account. A comparison between treatment outcome in six centers showed that those with simple procedures and few surgeons involved in the primary operations had as good treatment results as those with more complicated treatment procedures. The center that used presurgical orthopedics with extraoral strapping in its treatment program ranked low as did the center employing primary bone grafting as part of the treatment program when compared with the other centers.

Cleft Lip↗
PubMed1992

[Ceramic brackets].

Because of the many drawbacks of the hard and brittle material, ceramic brackets should not be used uncritically for orthodontic treatments. If ceramic brackets are used, the following guidelines should be observed: 1. If large and complicated tooth movements are involved, conventional bracket systems should be considered. 2. Occlusion on ceramic brackets is to be avoided. 3. Sharp instruments should be used with extreme care to avoid scratching the ceramic surface. Metal ligatures must not be used. 4. The length of the treatment is extended, probably because of the increased friction. 5. The problems connected with removing the brackets have not yet been solved. Be particularly careful of weakened teeth. 6. Esthetically, ceramic brackets function satisfactorily, but transparent elastic ligatures do not. They rapidly become discoloured and need frequent replacement. Nor are there as yet any "invisible arch wires", apart from some few, extremely flexible "white" arch wires. The ceramic bracket has no doubt come to stay, but there have been many difficulties in the "running-in" period, and the problems are far from solved yet. New ceramic brackets are coming onto the market all the time, and only future clinical studies can show whether they will become a genuine alternative to the conventional bracket.

Ceramics↗
PubMed1990

Asymmetry of the maxilla in children with complete unilateral cleft lip and palate.

Craniofacial asymmetry was analyzed in 31 children with unilateral cleft lip and palate (UCLP) and compared to a group of 24 children with incomplete clefts of the lip (CL). Symmetry was evaluated from 32 variables on posteroanterior cephalometric radiographs. Two types of asymmetry were identified: In the first, there was a positional deviation and a change of arch shape of the maxillary segment on the cleft side. The basal maxillary width was similar in the two groups. At the dentoalveolar level a decrease in width was localized to the cleft side in the UCLP group. Maxillary height of the cleft segment was reduced. The second type was related to the anterior part of the maxilla and the nasal septum. The inferior border of the bony part of the nasal septum deviated towards the cleft side. The anterior nasal spine and the midpoint between the upper central incisors deviated toward the noncleft side, but to a different degree indicating a vertical tilting of the premaxillary region.

Cephalometry↗
PubMed1987

Malocclusion in complete unilateral and bilateral cleft lip and palate. The results of a change in the surgical procedure.

In 1972 the surgical interference with the cleft in the hard palate was changed to a one-layer closure by a vomer flap. The purpose of the present investigation was to examine the effect of this change in the surgical management on the width of the maxillary dental arch and the frequency of malocclusion. Two groups of CLP children were examined: group 1 consisted of 58 children operated on before and in 1972. Group 2 consisted of 72 children operated on after 1972. All of the children had been operated on by the same surgeon. The remainder of the surgical procedures was the same in the two groups. No significant differences were observed, either in the maxillary dental arch width or in the frequency of malocclusion. A minor decrease in the frequency of mandibular overjet and crossbite was seen in the vomer group. Less need for closure of fistulas in the anterior part of the hard palate was seen in group 2.

Cleft Lip↗