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"Pasien dengan sumbing bibir dan/atau lelangit mungkin menghadapi tantangan berupaperubahan secara fisik dan perkembangan pascaoperasi yang akan mempengaruhikualitas hidup mereka. Evaluasi pascaoperasi perlu dilakukan untuk menilai keluaranfisik, bicara, dan fungsi psikososial. Praktisi klinis perlu memahami perspektif pasiendengan menggunakan instrumen patient-reported yang didesain secara khusus dan telitiuntuk meningkatkan pelayanan dan perawatan di masa depan. CLEFT- Q© didesainsecara spesifik untuk pasien sumbing bibir dan/atau lelangit untuk mendapatkan umpanbalik dari pasien terkait kesehatan fisik dan psikologis, namun belum tersedia dalambahasa Indonesia. Studi ini bertujuan untuk menerjemahkan CLEFT- Q© ke dalambahasa Indonesia guna mengembangkan instrumen yang terstandarisasi untukmengevaluasi perubahan kualitas hidup pasien sumbing dengan cara yang mudahdimengerti dan dikerjakan, serta meningkatkan pelayanan di masa depan. Prosespenerjemahan dilakukan sesuai protokol penerjemahan CLEFT- Q© dan panduanvalidasi dari ISPOR. Pasien dibagi menjadi 3 kelompok usia berdasarkan perkembanganpsikososialnya agar dapat menilai sejauh mana pemahaman pasien terhadap instruksi,pertanyaan, dan respon pada kuesioner. Setelah diterjemahkan, dilakukan cognitivedebriefing pada peserta dari berbagai kelompok usia. Hasil debriefing digunakan untukmembuat modifikasi serta adaptasi budaya pada kuesioner agar dapat dibuat terjemahanyang mudah dimengerti target pasien. Dari uji kelayakan CLEFT- Q©, didapatkan nilaiCronbach's α tertinggi 0. 959, dan terendah 0.266; dari 13 skala, hanya 4 yang masihdipertanyakan reliabilitasnya sehingga versi terjemahan CLEFT- Q© dapat digunakansehari-hari di institusi pusat sumbing. Versi akhir terjemahan kemudian didistribusikanpada 30 peserta usia 8-29 tahun dengan jenis sumbing yang berbeda-beda. Hasil skorterendah pada kelompok usia yang lebih tua (>10 tahun) menunjukkan ketidakpuasanterhadap tampilan fisik (khususnya wajah, lubang hidung, dan bekas luka bibirsumbing) dibandingkan usia muda (<10 tahun). Fungsi psikologis, sosial, dan bicarakurang dipermasalahkan. Data yang ada menunjukkan bahwa CLEFT- Q© versiIndonesia pantas digunakan sebagai instrumen untuk membantu evaluasi kualitas hiduppasien sumbing bibir dan/atau lelangit, dan memfasilitasi pusat sumbing di Indonesiamengevaluasi dan menyesuaikan rencana tatalaksana pada pasien, serta diharapkandapat digunakan secara luas oleh pusat sumbing di seluruh Indonesia

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Patients with cleft lip and/or palate may experience physical and developmental

changes, pre and postoperatively − which will affect their quality of life. Postoperative

evaluation must be done to assess physical outcomes, speech outcomes, and

psychosocial function. Clinicians can understand the patients' perspectives by using

carefully-designed patient-reported instruments to provide better clinical practice and

future treatments. CLEFT- Q© is tailored specifically for cleft lip and/or palate patients

to obtain feedbacks from patients, concerning their physical health and psychological

well-being. When we get to identify and understand the problems found in CLEFT-Q©

filled by the patients, we will be able to sort out which problem is the priority in

different age groups, and create customized program needed by cleft lip and/or palate

patients. CLEFT-Q© is not yet available in Indonesian language. By translating

CLEFT-Q© into Indonesian language, we aim not only to develop an effective and

standardized tool to evaluate improvement in our patients' quality of life in a simplest

and easiest way to be understood by the patients; but also to improve our service in cleft

care in the future. Translation protocol set by the CLEFT-Q© team and validation

guideline set by International Society for Pharmacoeconomics and Outcomes Research

were followed. Based on reliability test, the scales the lowest Cronbach's α value was

0.266, and the highest was 0.959; only 4 out of 13 scales were questionable for its

reliability. Therefore, the translated CLEFT-Q© is valid and applicable for use in daily

clinical setting. The approved final translated version was distributed to 30 participants

aged 8−29 years old with various cleft types. The lowest scores in older participants (>

10 years old) showed that they are bothered by their physical appearance (particularly

face, nostrils, and cleft lip scar), compared to the younger ones. Psychological, social,

and speech function were not as much of a concern. In conclusion, the scales in

Indonesian CLEFT-Q© is helpful to determine cleft lip and/or palate patients' quality of

life and may facilitate the cleft center to design suitable treatment plans based on the

patients' feedback, and provide better cleft care service in the future"

"Bibir sumbing dengan atau tanpa sumbing langit-langit adalah cacat bawaan kraniofasial yang paling banyak ditemukan. Penyebabnya kompleks dan melibatkan banyak faktor genetik dan lingkungan. Cacat bawaan ini dapat menyebabkan banyak morbiditas, serta beban ekonomi yang berat; karena pasien sumbing membutuhkan intervensi medis setidaknya selama 18 tahun pertama yang mencakup beberapa aspek kehidupan pasien. Derajat dan kompleksitas sumbing sangat bervariasi, yang nantinya akan menentukan tatalaksana dan hasil akhir rekonstruksi untuk tiap individu. Identifikasi dan klasifikasi sangat berperan dalam penilaian awal kasus sumbing yang masing-masing unik, selanjutnya menjadi panduan untuk pemilihan metode yang tepat untuk mengoreksi defek. Beberapa klasifikasi yang ada dapat mengukur derajat keberhasilan rekonstruksi setelah operasi. Upaya yang telah dilakukan dan tantangan untuk dapat memformulasikan suatu klasifikasi yang ideal dan mencakup semua jenis sumbing ditelaah dalam tulisan ini.

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AbstractCleft lip with or without cleft palate is the most occurring craniofacial anomaly in human, resulting from a complex etiology involving multiple genetic and environmental factors. The defect carries lifelong morbidity and economic burden. Children with clefts will require continuous medical interventions for at least the first 18 years of life, affecting many aspects of their lives. The extent and complexity of clefts vary infinitely, later determining individual management and outcome. Identification and classification play significant roles in initial assessment of these unique cleft cases, which affect options for following correctional attempts. Some classifications even allow measurement of progress after anatomical repositioning, and success rate after surgical repairs. The challenge of developing one such widely inclusive classification is discussed."

"Indonesian Journal of Dentistry 2006. Edisi Khusus KPPIKG XIV: 412-415The purpose of this study was to analyze the effect of hotz plate appliance to maxillary arch development of complete unilateral cleft lip and palate patient. The subjects were divided into two groups. The first group consisted of 6 patients, aged under two years with hotz appliance, recruited from Hasan Sadikin Hospital Bandung, and the second group, as control group, consisted of 6 patients, aged under two years, without hotz appliance, recruited from Haji Hospital Makassar. It was showed that in group with hotz plate appliance, no difference found on the size of anterior maxillary arch and minor maxillary arch. On the other hand, in the control group, minor maxillary arch was longer than mayor maxillary arch. It was concluded that hotz plate appliances affected the palatal development of patient with complete unilateral cleft lip and palate."

"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: Epigenetik lingkungan merupakan faktor yang masih dapat dikontrol dalam kejadian celah bibir dan lelangit. Masyarakat diharapkan dapat mengetahui apa saja epigenetik lingkungan yang berpengaruh terhadap kejadian celah bibir dan lelangit sehingga masyarakat sadar akan pentingnya tata laksana yang baik pada penderita celah bibir dan lelangit. Tujuan: Mengetahui gambaran epigenetik lingkungan pada penderita celah bibir dan lelangit. Metode: Penelitian deskriptif dengan desain potong lintang dengan sampel 184 rekam medis pasien celah bibir dan lelangit di RSAB Harapan Kita. Data menunjukkan gambaran epigenetik lingkungan pada anak dengan celah bibir dan lelangit yang sudah selesai menjalani perawatan bedah primer di RSAB Harapan Kita. Hasil: Nilai rerata usia ibu saat hamil adalah 30,5 tahun. Terdapat riwayat konsumsi obat pada 77,7 persen subjek. Tidak diketahui adanya kebiasaan merokok pada ibu. Tingkat pendidikan ibu sedang (SMP, SMA, Diploma 1–3) dan tingkat pendidikan ayah tinggi (Sarjana 1–2) memiliki persentase terbesar. Mayoritas ibu pasien berdomisili di Jabodetabek. Nilai rerata berat badan lahir, lingkar kepala lahir, dan panjang badan lahir sebagai parameter dari nutrisi ibu termasuk dalam kategori normal. Sebanyak 79,9% subjek menjalani recall pasca perawatan primer. Kesimpulan: Epigenetik lingkungan menunjukkan gambaran yang normal pada pasien celah bibir dan lelangit di RSAB Harapan Kita.

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Background: Environmental epigenetics are controllable elements in the occurrence of cleft lip and palate. The community is expected to understand the environmental epigenetics that influence the incidence of cleft lip and palate, raising awareness of the importance of proper management in cleft lip and palate. Objective: This study aims to understand the overview of environmental in epigenetics individuals with cleft lip and palate. Methods: Descriptive research with a cross-sectional design involving a sample of 184 medical records of cleft lip and palate patients at RSAB Harapan Kita. The data illustrates the overview of environmental epigenetics in children with cleft lip and palate who have completed primary surgical treatment at RSAB Harapan Kita. Results: The average maternal age during pregnancy is 30,5 years. About 77,7% of subjects have a history of drug consumption, and smoking habits are unknown. Mothers typically have a moderate education level, while fathers have a higher education level. Most mothers reside in Jabodetabek. Birth weight, head circumference, and birth length fall within normal ranges. A recall after primary care was conducted for 79,9% of the subjects. Conclusion: The environmental epigenetics indicate a normal overview in patients with cleft lip and palate at RSAB Harapan Kita."

"Latar Belakang: Sumbing bibir dan langit-langit merupakan kelainan kongenital yang paling banyak dijumpai di bidang bedah plastik. Terdapat beragam tekhnik operasi dalam sumbing bibir unilateral. Salah satu tekhnik operasi sumbing bibir unilateral yang umum digunakan dan dikenal luas di RSCM adalah tekhnik ldquo;rotation advancement rdquo; oleh Millard yang dimodifikasi oleh Gentur. Saat ini, tekhnik fisher juga mulai umum digunakan dalam operasi sumbing bibir. Tekhnik Fisher merupakan modifikasi yang berdasar pada aproksimasi tiap subunit anatomi bibir. Tujuan dari penelitian ini adalah untuk membandingkan dan mengevaluasi secara objektif simetrisitas bibir dari kedua tekhnik tersebut. Metode: Dua dokter bedah plastik menggunakan tekhnik operasi bibir sumbing unilateral yang berbeda, yaitu tekhik Gentur dan Fisher. Penelitian ini dilakukan secara prospektif dengan menganalisa sebelum dan sesudah operasi pasien yang dipilih secara random untuk menjalani operasi bibir sumbing unilateral pada tahun 2016. Dengan menggunakan kaliper, titik-titik pengukuran ditandai pada sisi sumbing maupun normal, termasuk di dalamnya tinggi dan simetrisitas Cupid rsquo;s bow rdquo;, lebar dan tinngi vestibula, tebal vermillion, serta posisi dasar alae. Rasio antara sisi cleft dan normal dari bibir diukur dan dihitung untuk standarisasi perbandingan diantara kedua tekhnik. Hasil: Juli ndash;Oktober 2016, dilakukan operasi pada 14 pasien sebagai data preliminary. Dari analisa statistik didapatkan perbedaan bermakna pada lama desain dan operasi serta perbedaan ketebalan vermillion preoperatif, sedangkan rasio postoperatif secara statistik tidak bermakna. Kesimpulan: Simetrisitas bibir pada tekhnik Gentur maupun Fisher memberikan hasil yang tidak berbeda.

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Background: Cleft lip and palate are the most common congenital anomalies that found in plastic surgery. There are so many techniques for unilateral cleft lip repair. Rotation advancement method by Gentur based on Millard technique has become the most widely used in unilateral cleft lip repair in RSCM. The Fisher technique repair is a modified technique based on approximation of anatomical subunit of the lip. The purpose of this study is to objectively compare and evaluate the lip symmetry of these two techniques.

Methods: Two senior board certified surgeons will perform different surgical techniques for the unilateral cleft lip rotation advancement technique by Gentur and Fisher technique. This study prospectively analyzed preoperative and postoperative of randomized single blinded patients who underwent unilateral cleft lip repair performed by each surgeon in 2016. Using caliper, facial points on the cleft and non cleft sides were measured, including height and symmetry of Cupid's bow, width and height of the nasal vestibule, height of the vermilion, and alar base position. Ratios of cleft side to non cleft side measurements were calculated to standardize comparisons between patients.

Result: From July October 2016, 14 patients performed surgery as preliminary data, showed that there are statistically difference in length of design and surgery time. Preoperative, comparable of cupid's bow vermillion showed statistically difference. Although, we found no statistically difference in postoperative ratio.

Conclusion: Lip symmetry outcomes after cheiloplasty procedure is same between Gentur method and Fisher technique. "

"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%)."

"Studi mengenai pengukuran dental cast telah beberapa kali dilakukan namun sedikit sekali yang terkait dengan Celah Bibir dan Langit-langit Bilateral karena jumlah kasus yang sangat jarang. Tujuan dari studi ini untuk mengevaluasi pertumbuhan maksila pasien Celah Bibir dan Langit-langit Bilateral menggunakan beberapa perlengkapan alat dan software menggunakan landmark yang sama dengan studi pengukuran lengkung maksila dan sudut palatal shelves. Penelitian Retrospektif ini diselenggarakan di RS Harapan Kita Cleft Center Jakarta, Indonesia. 35 dental cast sebelum labioplasti dan 35 dental cast setelah labioplasti dari pasienyang sama didigitisasi menggunakan scanner desktop 3D E4 dari 3shape. Lebar lengkung maksila dengan pengukuran linear dan palatal shelve dilakukan pada penelitian ini. Pengukuran dilakukan sebanyak dua kali oleh orang yang sama (intra observer) dan measurement error dihitung menggunakan dahlberg test. Laju pertumbuhan linear pada pasien ini baik, 45,1% pasien mengalami laju pertumbuhan positif setelah pembedahan, 34,3% laju pertumbuhan positif antar kaninus, dan 14,3% pasien mengalami laju pertumbuhan negatif pada interkaninus maksila dan intertuberositas. Laju pertumbuhan angular 22,9% mengalami hasil negatif dan 5,7% mengalami laju pertumbuhan positif. Laju pertumbuhan relatif normal pada penelitian ini. Palatal shelve mengalami pendangkalan pada penelitian ini namun pada tuber maksila kiri ada peninggian.

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There were several studies regarding to measure the growth from dental cast, but it is severely limited study which is related to Bilateral Cleft Lip and Palate (BCLP) since the case is quite rare. The aim of this study is to evaluate the maxillary growth of BCLP patients using different tools and software with the same landmark to the previous methods for dental arch width and palatal shelves angle. This retrospective study was held in Children and Maternal Cleft Center Harapan Kita Hospital, Jakarta, Indonesia. 35 dental casts before labioplasty and 35 dental casts before palatoplasty from the same patients were digitized using 3D desktop scanner E4 from 3shape. Dental arch width of BCLP maxillary growth rate with linear measurement and palatal shelf angle were conducted in this study. The measurements were performing twice by same person (intra observer) and the measurement error was calculated by Dahlberg test. The growth rate linear in this patients results are good, 45.1% of patients experiencing positive growth rate post surgery, 34.3% positive growth surgery intercanine, but negative growth rate on intertuberosity, 14.3% patients have negative maxillary intercanine results and positive intertuberosity growth rate, and finally 14,3% patients experiencing negative growth rate in both maxillary intercanine and intertuberosity . Angular growth rate 22.9% have negative results and 5.7% have positive growth rate results. The dental arch linear growth rate relatively normal in this research. The palatal shelves were elevated in this research but in left tuber maxillary the degree is increasing."

"Tesis ini membahas tentang pengaruh labioplasti dan palatoplasti terhadap morfologi mandibula sisi cleft dan sisi normal pada pasien celah bibir dan langit-langit unilateral di RSAB Harapan Kita yang berusia 13 tahun atau lebih. Penelitian ini adalah penelitian observasi krosseksional dengan mengukur morfologi dari data CBCT dan membandingkan sisi cleft dan sisi normal. Hasil penelitian memperlihatkan adanya perbedaan signifikan secara statistik pada panjang korpus dan inklinasi frontal ramus antara sisi cleft dan sisi normal. Sisi cleft biasanya lebih kecil daripada sisi normal. Evaluasi CBCT sangat penting untuk dilakukan terutama pada pasien celah bibir dan langit-langit untuk menentukan rencana perawatan selanjutnya, contohnya osteodistraksi atau orthognatik.

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This thesis will discuss about the effect of labioplasty and palatoplasty on Morphology of Mandible on cleft side and non-cleft side in more than 13 years old cleft lip and palate patient at Harapan Kita Hospital. Using Cross sectional observation study by measuring and comparing morphological anatomy on cleft side and non-cleft side with CBCT. Based on statistical analysis showed there is a significant different in corpus length and frontal ramus inclination on cleft side and non-cleft side. it showed that the size is smaller on the cleft side than non-cleft side. CBCT evaluation is important as diagnostic tools for cleft lip and palate patient in order to make further treatment plan, as in osteodistraction or orthognatic surgery."