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"Latar Belakang : Operasi bibir sumbing merupakan prosedur operasi paling pertama pada pasien sumbing bibir dan langit-langit. Prosedur ini berdampak pada fungsi dan estetik penampilan. Teknik Gentur merupakan teknik operasi bibir sumbing yang dikembangkan oleh beliau dan telah digunakan di Rumah Sakit Cipto Mangunkusumo/Fakultas Kedokteran Universitas Indonesia. Teknik ini menggunakan rotation-advancement, flap segitiga, mencegah takik dengan beberapa detail untuk mengatasi defek yang lebar. Maka hipotesis kami, apakah teknik Gentur dapat memberikan hasil yang simetris ada pengukuran antropometri. Metode : Analisis cross sectional dilakukan pada 14 pasien sumbing bibir satu sisi yang telah dilakukan operasi dengan menggunakan teknik Gentur. Pengukuran antropometri direk sebelum dan sesuadah prosedur dilakukan analisa dengan SPSS 17. Data kemudian diklasifikasikan menjadi cupud?s bow, tinggi vertical, tinggi horizontal, merah bibir dan hidung. Hasil : Dari 14 pasien, ditemukan kebanyakan pasien dilakukan operasi pada umur 3 bulan (64,3%), kebanyakan bayi perempuan (64,3%), sumbing komplit (85,8%), dan pada sisi kiri (57,1%). Teknik ini dapat memberikan simetri bibir dan hidung yang signifikan (CI 95%, pvalue <0.005) pada cupud?s bow, tinggi vertical, tinggi horizontal, merah bibir dan hidung. Dengan melakukan teknik ini, penulis dapat membuat simetri pada bibir dan hidung yang baik (78,57%) bahkan pada defek yang lebar (64,3%) dan langit-langit yang jatuh (57,1%).

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Background: Cheiloplasty is the earliest surgical procedure in cleft lip and palate patient. This procedure has impact on functional and aesthetical appearance1. The Gentur?s technique is method of cleft lip surgery that has been developed by him and has been used in Cipto Mangunkusumo Hospital/Faculty of Medicine University of Indonesia. It uses the rotation-advancement, small triangular, preventing notching with some other details to overcome the wide cleft. Thus gives us hypothesis, does the Gentur's technique give symmetrical result in anthropometric measurement.

Methods: cross sectional analytic study will be taken from medical record in 14 unilateral cleft lip patients undergo cheiloplasty procedure. Direct anthropometric data before and after procedure is analyzed using SPSS17. Datas were classified in cupid?s bow, vertical height, horizontal height, vermillion and nostril.

Result: From 14 patients, we found that most patient whose undergone surgery in 3 month (64.3%) are mostly female (64,3%), complete defect (85,8%) and in left side (57,1%). This technique is able to produce significant lip and nose symmetry (CI 95%, pvalue <0.005) in cupid?s bow, vertical height, horizontal height, thickness of vermillion and nose. By doing this technique, the author able to create good lip and nose symmetry (78.57%) even in wide defect (64.3%) and collapse palate (57.1%)."

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Tesis ini membahas mengenai penggunaan model tiga dimensi sebagai sarana belajar operasi sumbing bibir satu sisi dengan teknik fisher. Tujuan studi ini adalah mengevaluasi pengalaman membuat desain pra-operasi menggunakan model tiga dimensi dibandingkan dua dimensi. Dilakukan studi eksperimental menggunakan randomized sampling untuk menentukan akurasi anatomis dan kepuasan penggunaan model tersebut. Data menunjukkan bahwa penggunaan model tiga dimensi dapat menjadi sarana belajar tunggal untuk mencapai pemahaman dan persepsi dalam hal desain pra operasi. Penelitian lanjutan dapat mengevaluasi akurasi hasil pembelajaran pada pasien.

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The focus of this study is on evaluating three dimensional model as a learning tool for unilateal labioplasty using fisher technique. This study aim to evaluate the experience in preoperative marking of unilateral cleft lip repair on three-dimensional model compared to two-dimensional model. An experimental study conducted using randomized sampling to measure the anatomical accuracy and satisfaction of pre operative marking of unilateral cleft lip repair  using fisher modification technique on three dimensional model over two dimensional model. Result shows that three dimensional model could be used as an efficient single learning tools to have the same level of perceptive and understanding of the design points. Further research should evaluate the effectivenes of this learning tool by assessing its accuracy result in real patients.

 

 

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"ABSTRACTThe objective of this study is to characterize and compare tooth agenesis codes and their prevalence in a population of Spanish patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP), and to determine if the extent of the cleft (BCLP or UCLP) was associated with the number of absent teeth. This retrospective cross-sectional human study included 118 patients with complete BCLP (29) or UCLP (89) and permanent dentition from first molar to first molar. Congenitally missing teeth were identified on panoramic radiographs using the tooth agenesis code (TAC) to identify agenesis codes. Agenesis prevalence was 50.6 and 51.7% for UCLP and BCLP patients, respectively. The lateral upper incisor was the most frequently absent tooth, especially in the cleft quadrant. Numbers of absent teeth ranged from 1 to 6. This study represents a different approach from previous agenesis investigations in cleft patients. These Spanish patients showed a high number of ageneses, presenting nineteen different tooth agenesis codes. A total of five TACs were unique, in other words, observed in a single patient in the sample. No statistically significant relationship was found between the extent of the cleft and the number of absent teeth. The TAC system makes it possible to identify agenesis codes with simultaneous absence of teeth not detected in general prevalence studies."

"Latar Belakang: Celah bibir dan langit-langit merupakan kelainan bawaan yang umum ditemukan yang terjadi saat perkembangan janin karena kegagalan proses pertumbuhan organ wajah. Defisiensi pertumbuhan maksila secara tiga dimensi (3D) sering ditemukan pada penderita celah bibir dan langit-langit terutama pada kasus unilateral. Pasien yang telah menjalani prosedur operasi menunjukkan adanya penurunan tinggi basis kranial, maksila yang lebih pendek, retrograntik maksila berlebihan dan inklinasi gigi insisif atas dan bawah yang lebih ke lingual. Perawatan bertahap dibutuhkan untuk penanganan pasien dengan celah bibir dan langit-langit seperti bedah perbaikan tulang alveolar, restorasi prostodontik, dan koreksi dental definitif. Tujuan: Menganalisis pengaruh labioplasti dan palatoplasti terhadap tinggi maksila, volume sinus maksilaris dan ukuran sella turcica pada pasien celah bibir dan langit-langit unilateral. Material dan Metode: Penelitian analitik observasional dengan desain potong lintang. Subjek penelitian ini adalah anak berusia ³13 tahun dengan celah bibir dan langit-langit unilateral, telah dilakukan labioplasti dan palatoplasti, serta tidak mengikuti prosedur perawatan ortodontik cekat di RSAB Harapan Kita, Jakarta dalam kurun waktu 2011-2013. Berdasarkan kriteria inklusi dan eksklusi diperoleh jumlah samepl sebanyak 12 subjek. Setiap subjek dilakukan pengambilan gambaran radiografi CBCT untuk penilaian tinggi maksila, volume sinus maksilaris dan ukuran sella turcica. Perbandingan tinggi maksila dan volume sinus maksilaris dilakukan pada sisi celah dan sisi normal, sedangkan perbandingan ukuran sella turcica dilakukan secara deskriptif menggunakan data sekunder. Hasil penelitian: Terdapat perbedaan tinggi maksila dan volume sinus maksilaris yang signifikan antara sisi celah dan sisi normal (p=0,00 dan p=0,01). Terdapat perbedaan ukuran lebar dan kedalaman sella turcica antara subjek dengan kelompok kontrol. Kesimpulan: Labioplasti dan palatoplasti mempengaruhi tinggi maksila, volume sinus maksilaris dan ukuran sella turcica pada pasien dengan celah bibir dan langit-langit unilateral

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Background: Cleft lip and palate is a common congenital disorder that formed during fetal development due to failure of the developmental processes of the face. Three-dimensional (3D) maxillary growth deficiency is often found in patients with cleft lip and palate, particularly in unilateral cases. Patients who had undergone surgical procedures show a decrease on cranial base height, shorter maxilla, severe maxillary retrograntic and more lingual inclination of upper and lower incisor teeth. Multistage treatment is neccessary for patients with the lips and palate such as alveolar bone repair, prosthodontic restoration, and definitive dental correction. Objective: To analyze the effect of labioplasty and palatoplasty to maxillary height, maxillary sinus volume and sella turcica size in patients with unilateral cleft lip and palate. Materials and Methods: Observational analytic study with cross-sectional design. The subjects of this study were children ³13-years-old with unilateral cleft lip and palate, had undergone labioplasty and palatoplasty, and did not undergo fixed orthodontic treatment procedures at RSAB Harapan Kita, Jakarta in the period of 2011-2013. Based on the inclusion and exclusion criteria, a total of 12 subjects were obtained. Each subject took a CBCT radiographic to assess the maxillary height, maxillary sinus volume and sella turcica size. Comparison of maxillary height and maxillary sinus volume was performed on the cleft and normal sides, while the comparison of the size of the sella turcica was performed descriptively using secondary data. Results: There are significant differences in the maxilla height and maxillary sinus volume between the cleft side and the normal side (p = 0.00 and p = 0.01). There is a difference in width and height of the sella turcica between the subject and the control group. Conclusion: Labioplasty and palatoplasty affect maxillary height, maxillary sinus volume and sella turcica size in patients with unilateral cleft lip and palate."

"Pendahuluan: mengetahui perbedaan ukuran angular dentokraniofasial antara anak dengan celah bibir dan langit-langit unilateral dan bilateral komplit pasca labiopalatoplasti dibandingkan dengan anak tanpa celah bibir dan langit-langit. Material dan metode: Subyek penelitian terdiri dari 16 anak dengan celah bibir dan langit-langit unilateral komplit pasca labiopalatoplasti, 16 anak dengan celah bibir dan langit-langit bilateral komplit pasca labiopalatoplasti, 16 anak tanpa celah bibir dan langit-langit yang berada pada status maturasi vertebra servikalis I dan II. Tahap maturasi vertebra servikalis ditentukan dengan metode oleh Baccetti dkk (2002). Uji statistik yang dilakukan meliputi uji untuk distribusi data yang normal, uji t berpasangan, dan anova dengan tingkat signifikansi p < 0,5. Hasil: Terdapat perbedaan bermakna pada sudut insisif atas – bidang maksila antara kelompok unilateral dan normal; terdapat perbedaan bermakna pada sudut ANB, sudut SN/MP, dan sudut insisif atas – bidang maksila antara kelompok bilateral dan normal; terdapat perbedaan bermakna pada sudut SNA, sudut insisif atas – bidang maksila antara kelompok unilateral dan bilateral. Kesimpulan: Inklinasi insisif atas paling terpengaruh oleh celah bibir dan langit-langit. Inklinasi maksila ditemukan sedikit retrusif untuk kelompok celah bibir dan langit-langit unilateral komplit, sedangkat sedikit protrusif untuk kelompok celah bibir dan langit-langit bilateral komplit. Hubungan sagital kelompok bilateral ditemukan paling protrusif, diikuti kelompok normal, dan selanjutnya kelompok unilateral. Kecuraman bidang mandibula ditemukan pada kelompok bilateral

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Introduction: To evaluate dentocraniofacial morphology of children with complete unilateral and bilateral cleft lip and palate following labioplasty and palatoplasty. Analysis was made when the children were at first and second stages of cervical vertebral maturation stage, before the peak of maxillary growth. Materials and methods: Sixteen digital cephalometric images of subjects with complete unilateral and bilateral cleft lip and palate following labioplasty and palatoplasty were compared with 16 normal stage-matched controls. Cervical vertebral maturation stage was determined by Method of Baccetti et al (2002). Statistics included tests for normal distribution, paired t test, and anova with the significance level p < .05. Results: There were significant cephalometric differences in UI/MxPl angle between unilateral and normal group; ANB angle, SN/MP angle, UI/MxPl angle between bilateral and normal group; SNA angle, UI/MxPl angle between unilateral and bilateral group. Conclusion: The inclination of upper incisor was most affected by cleft lip and palate. The maxilla inclination was found a little retrusive for unilateral cleft lip and palate, while a little protrusive for bilateral. Sagittal relationship of bilateral was found the most protrusive followed by normal and unilateral group. Mandibular steepness was found for bilateral cleft lip and palate."