{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:23:10Z","timestamp":1777522990598,"version":"3.51.4"},"reference-count":62,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2018,4,13]],"date-time":"2018-04-13T00:00:00Z","timestamp":1523577600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate-Craniofacial Journal"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Previously, a new embryological classification was introduced subdividing oral clefts into fusion and\/or differentiation defects. This subdivision was used to classify all subphenotypes of cleft lip with or without alveolus (CL\u00b1A). Subsequently, it was investigated whether further morphological grading of incomplete CLs is clinically relevant, and which alveolar part is deficient in fusion\/differentiation defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Three hundred fifty adult unoperated Indonesian cleft patients presented themselves for operation. Cephalograms, dental casts, and intraoral and extraoral photographs\u2014eligible for the present study\u2014were used to determine morphological severity of CL\u00b1A.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Patients with unilateral or bilateral clefts of the primary palate only were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>Clefts were classified\u2014according to developmental mechanisms and timing in embryogenesis\u2014as fusion and\/or differentiation defects. Grades of incomplete CLs were related to the severity of alveolar clefts (CAs) and hypoplasia, and permanent dentition was used to investigate which alveolar part is deficient in fusion\/differentiation defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>One hundred eight adult patients were included. All subphenotypes\u201496 unilateral and 12 bilateral clefts\u2014could be classified into differentiation (79%), fusion (17%), fusion-differentiation (2%), or fusion and differentiation (2%) defects. The various grades of incomplete CLs were related to associated CAs and hypoplasia, and all alveolar deformities were located in the premaxillae.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study showed that all CL\u00b1A including the Simonart bands can be classified, that further morphological grading of incomplete CLs is clinically relevant, and that the premaxilla forms the deficient part in alveolar deformities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665618767106","type":"journal-article","created":{"date-parts":[[2018,4,13]],"date-time":"2018-04-13T12:41:51Z","timestamp":1523623311000},"page":"1267-1276","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Subphenotyping and Classification of Cleft Lip and Alveolus in Adult Unoperated Patients"],"prefix":"10.1177","volume":"55","author":[{"given":"Christl","family":"Vermeij-Keers","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna M.","family":"Rozendaal","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonius J. M.","family":"Luijsterburg","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benny S.","family":"Latief","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Indonesia, Jakarta, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Costas","family":"Lekkas","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Kragt","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edwin M.","family":"Ongkosuwito","sequence":"additional","affiliation":[{"name":"Unit of Orthodontics, Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC-Sophia Children\u2019s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,4,13]]},"reference":[{"key":"bibr1-1055665618767106","doi-asserted-by":"publisher","DOI":"10.1597\/14-080"},{"key":"bibr2-1055665618767106","doi-asserted-by":"publisher","DOI":"10.1177\/0022034517723326"},{"key":"bibr3-1055665618767106","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s00429-003-0366-x","volume":"207","author":"Barteczko K","year":"2004","journal-title":"Anat Embryol 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