{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:36:05Z","timestamp":1787801765753,"version":"build-2784847793"},"reference-count":40,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2018,12,9]],"date-time":"2018-12-09T00:00:00Z","timestamp":1544313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/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":[[2019,8]]},"abstract":"<jats:p>\n                    Presurgical infant orthopedic manipulation is utilized prior to cleft lip\/nasal repair to facilitate a gingivoperiosteoplasty (GPP) and primary nasolabial repairs. The Latham dentomaxillary advancement appliance uses a screw that must be tightened daily to approximate the cleft segments in unilateral complete clefts. Our cleft center has been utilizing a \u201cmodified Latham\u201d appliance since 1987, including an orthodontic elastic power chain to close the gap in a shorter amount of time. We performed a retrospective chart review of all patients undergoing treatment at Johns Hopkins All Children's Hospital (JHACH) with a unilateral complete cleft lip and palate between 1987 and 2017. Patients were identified by the\n                    <jats:italic>International Classification of Diseases, Ninth Revision<\/jats:italic>\n                    code (749.21). The majority of the patients represent the experience of the senior authors (E.R. and R.F.). Two hundred and eighty-one patients with unilateral complete cleft lip\/palate were identified. Seventy-five patients were treated with a \u201cmodified Latham\u201d appliance prior to their lip repair. The \u201cmodified Latham\u201d appliance remained in place on average 20.6 days (range: 4-82), and average hospital stay after placement was 1.18 days. Nearly 96% of patients underwent a successful GPP at the time of nasolabial repair. Modification of the Latham appliance by utilizing an elastic power chain and eliminating the screw allows rapid closure of the alveolar cleft with limited need for adjustments and outpatient visits. Direct approximation of the palatal segments allows successful completion of a GPP in 95.9% of patients with limited dissection.\n                  <\/jats:p>","DOI":"10.1177\/1055665618816892","type":"journal-article","created":{"date-parts":[[2018,12,10]],"date-time":"2018-12-10T00:32:20Z","timestamp":1544401940000},"page":"929-935","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical Outcomes Utilizing a \u201cModified Latham\u201d Appliance for Presurgical Infant Orthopedics in Patients With Unilateral Complete Cleft Lip and Palate"],"prefix":"10.1177","volume":"56","author":[{"given":"Diana S.","family":"Jodeh","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Johns Hopkins All Children\u2019s Hospital, St Petersburg, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Ruso","sequence":"additional","affiliation":[{"name":"Cleft and Craniofacial Team, Johns Hopkins All Children\u2019s Hospital, St Petersburg, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy","family":"Feldman","sequence":"additional","affiliation":[{"name":"Cleft and Craniofacial Team, Johns Hopkins All Children\u2019s Hospital, St Petersburg, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Ruas","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Johns Hopkins All Children\u2019s Hospital, St Petersburg, FL, USA"},{"name":"Cleft and Craniofacial Team, Johns Hopkins All Children\u2019s Hospital, St Petersburg, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Alex","family":"Rottgers","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Johns Hopkins All Children\u2019s Hospital, St Petersburg, FL, USA"},{"name":"Cleft and Craniofacial Team, Johns Hopkins All Children\u2019s Hospital, St Petersburg, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,12,9]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1597\/11-030"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1597\/13-294"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000096710.08123.93"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181ec21e4"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e318200d874"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199106000-00005"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e318270fd21"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1597\/06-009"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198901000-00007"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31828bd541"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1597\/06-075.1"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2001_038_0193_pnomip_2.0.co_2"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(03)00140-8"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-925902"},{"key":"e_1_3_3_16_1","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.4103\/0970-0358.57188","article-title":"Presurgical nasoalveolar moulding treatment in cleft lip and palate patients","volume":"42","author":"Grayson BH","year":"2009","unstructured":"Grayson BH, Shetye PR. Presurgical nasoalveolar moulding treatment in cleft lip and palate patients. Indian J Plast Surg. 2009;42(suppl):S56\u2013S61.","journal-title":"Indian J Plast Surg"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001340"},{"key":"e_1_3_3_18_1","volume-title":"Grabb and Smith\u2019s Plastic Surgery","author":"Hopper R","year":"2007","unstructured":"Hopper R, Cutting C, Grayson B. Part III\u2014Congenital anomalies and pediatric plastic surgery. chapter 23\u2014Cleft lip and palate. In: Thorne C, Beasley R, Aston S, Bartlett S, Gurtner G, Spear S, eds. Grabb and Smith\u2019s Plastic Surgery. Philadelphia, PA: Lippincott Williams & Wilkins; 2007."},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1597\/08-207"},{"key":"e_1_3_3_20_1","first-page":"253","article-title":"An extraorally activated expansion appliance for cleft palate infants","volume":"13","author":"Latham RA","year":"1976","unstructured":"Latham RA, Kusy RP, Georgiade NG. 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