{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T10:07:24Z","timestamp":1762164444553,"version":"build-2065373602"},"reference-count":27,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Dental Traumatology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cleft lip and palate (CLP) is a common craniofacial anomaly that predisposes affected children to orofacial trauma due to altered anatomy. Among the subtypes of CLP, patients with bilateral cleft lip and palate (BCLP) present with a prominent protruding premaxilla, which significantly increases their vulnerability to trauma during early development. Despite this, data on trauma patterns and anatomical risk factors in infants and toddlers with BCLP remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the prevalence, mechanisms and severity of oral and facial trauma in BCLP patients aged 0\u20133\u2009years and to assess the association between Premaxillary Position and Trauma (PPT) Risk using a structured scoring system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of 13,975 cleft cases over a 10\u2010year period (2015\u20132025) was performed at a tertiary cleft center. A total of 4388 patients who underwent primary cheiloplasty, 513 BCLP patients aged 0\u20133\u2009years were included. Trauma incidence, injury characteristics, and premaxillary position were assessed using the PPT Risk score, which includes transverse, anteroposterior, and vertical position assessments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010five BCLP patients sustained trauma, with age\u2010specific differences in injury mechanisms: falls from heights and vehicular incidents were common in preoperative infants (\u2264\u20096\u2009months), whereas ground\u2010level falls predominated in postoperative toddlers (6\u201336\u2009months). Soft tissue injuries were most common (45.71%), followed by premaxillary mobility disorders (17.14%) and dental trauma (17.14%). Patients with a highly protruding premaxilla (Type 1b, 2b, and 3a) had the highest trauma incidence (54.29%), indicating a strong correlation between premaxillary position and injury risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BCLP patients, especially those with anteriorly and vertically prominent premaxilla, have a significantly increased risk of trauma in early childhood. The PPT score is an effective tool for trauma risk stratification and supports the implementation of early interventions such as presurgical orthopedics and targeted caregiver education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/edt.70029","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T11:17:29Z","timestamp":1761736649000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of Premaxillary Position on Oral Trauma in Early Childhood: A 10\u2010Year Study of Cleft Lip and Palate Patients"],"prefix":"10.1111","volume":"41","author":[{"given":"Hemwati","family":"Nandan","sequence":"first","affiliation":[{"name":"GSR Institute of Cranio\u2010Maxillofacial and Facial Plastic Surgery  Hyderabad Telangana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2442-7618","authenticated-orcid":false,"given":"Prasad","family":"Nalabothu","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery University Hospital Basel  Basel Switzerland"},{"name":"Department of Pediatrics Oral Health and Orthodontics, University Center for Dental Medicine UZB  Basel Switzerland"},{"name":"Facial and Cranial Anomalies Group, University of Basel  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pragjyoti","family":"Jha","sequence":"additional","affiliation":[{"name":"GSR Institute of Cranio\u2010Maxillofacial and Facial Plastic Surgery  Hyderabad Telangana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srinivas Gosla","family":"Reddy","sequence":"additional","affiliation":[{"name":"GSR Institute of Cranio\u2010Maxillofacial and Facial Plastic Surgery  Hyderabad Telangana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2009-4393","authenticated-orcid":false,"given":"Anand","family":"Marya","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry University of Puthisastra  Phnom Penh Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600\u20109657.2001.170403.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2003.05.013"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-9785(72)80020-6"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/edt.12389"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jobcr.2017.09.006"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/adj.12395"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20109657.2008.00696.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/edt.12966"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/edt.12744"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1590\/pboci.2023.035"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20109657.2004.00249.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/edt.12527"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/edt.12882"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1378180"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221104028"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1597\/04\u2010114r.1"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1995.01890120026005"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199005000-00010"},{"volume-title":"WHO Injury Surveillance Guidelines","year":"2001","author":"Holder Y.","key":"e_1_2_10_20_1"},{"key":"e_1_2_10_21_1","unstructured":"World Health Organization \u201cInternational Classification of Diseases 10th Revision (ICD\u201010). 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