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Market Research Group

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Thomas Lewis
Thomas Lewis

El Are Palate


Background: In countries which lack robust health care systems, congenital conditions such as cleft lip and/or palate deformities are often untreated in certain individuals. Many volunteer organizations have stepped in to fill this gap but certain factors, such as continuity of care, are yet to be studied for these clinics.




El Are Palate



Methods: This is a retrospective cohort study of 167 pediatric patients with cleft lip and/or palate residing in El Salvador treated by a nongovernmental organizations between 2011 and 2020. This data was used in univariate and multivariable models to associate particular patient factors to their likelihood of following up to their annual clinic visits.


Results: Each 1-year increase in duration of follow-up was associated with a 27% decrease in the odds of attending a visit. In addition, 33.7% of cleft lip and 49.7% of cleft palate/cleft lip and palate patients returned at least once. Males had 36% higher odds of attending a return visit compared with females but this difference was not statistically significant. Time spent travelling to the clinic had no effect on follow-up rates.


Our team at Golden Foothills Oral, Facial, & Dental Implant Surgery treats cleft lip and palate in El Dorado Hills, Folsom, and Auburn, CA. We understand the delicate nature of these cases and our surgeons, Dr. Liberty and Dr. Song, along with our incredible team, provide continuous support for our young patients and their families at every step. If your child requires treatment for cleft lip or palate, contact our office for a consultation with one of our board-certified specialists.


A cleft palate is an opening in the roof of the mouth. It can range from a gap at the opening of the soft palate to an almost complete separation of the roof of the mouth. A cleft palate that occurs without a cleft lip can be difficult to detect in an ultrasound and may not be discovered until the child is born.


To treat a cleft palate, our surgeons perform cleft palate repair surgery when the child is about 12 months old. Many children with a cleft palate also need tubes placed in the eardrums to drain fluid and should undergo hearing tests annually. If necessary, ear tubes are placed at the same time as the palate repair surgery.


The child will often undergo a speech assessment around the age of 5 to determine if additional surgery is necessary to improve speech. After the necessary treatment, many children born with a cleft palate resume normal lives and are able to maintain normal oral function and develop proper speaking abilities.


Our team at Golden Foothills Oral, Facial, & Dental Implant Surgery is here to provide the highest level of care and support for your entire family. We are experts at managing cleft lip and palate cases and are exceptionally talented at working with young children to create positive, comfortable oral surgery experiences and fantastic results. Contact us in El Dorado Hills, Folsom, or Auburn today if your child requires treatment for a cleft lip or cleft palate.


Cleft lip and/or palate are a split in the lip, the palate or both. This results from the inability of lip buds and palatal shelves to properly migrate and assemble during embryogenesis. By extracting primary cells from a cleft patient, we aimed at offering a better understanding of the signaling mechanisms and interacting molecules involved in the lip and palate formation and fusion. With Rho GTPases being indirectly associated with cleft occurrence, we investigated the role of the latter in both. First, whole exome sequencing was conducted in a patient with cleft lip and palate. Primary fibroblastic cells originating from the upper right gingiva region were extracted and distinct cellular populations from two individuals were obtained: a control with no cleft phenotype and a patient with a cleft lip and palate. The genetic data showed three candidate variables in ARHGEF18, EPDR1, and CUL7. Next, the molecular data showed no significant change in proliferation rates between healthy patient cells and CL/P patient cells. However, CL/P patient cells showed decreased migration, increased adhesion and presented with a more elongated phenotype. Additionally, RhoA activity was upregulated in these cells, whereas Cdc42 activity was downregulated, resulting in loss of polarity. Our results are suggestive of a possible correlation between a dysregulation of Rho GTPases and the observed phenotype of cleft lip and palate patient cells. This insight into the intramolecular aspect of this disorder helps link the genetic defect with the observed phenotype and offers a possible mechanism by which CL/P occurs.


Small RNA sequencing data. A = canonical miRNAs in nsCLP, B = canonical miRNAs in nsCPO, C = isomiRs in nsCPO. *P


For nsCPO, only hsa-miR-18a, hsa-miR-92a, and hsa-miR-93 have been linked with cleft palate in mice (19), while 92a was the only one confirmed by both RNAseq and qRT-PCR. Furthermore, miR-93 has also shown to be stably methylated in murine secondary palate development (27). Both hsa-miR-18a and hsa-miR-92a belong to the miR-17-92 cluster located in the third intron of a 7 kb primary transcript known as C13orf25 on human chromosome 13q31.3. It encodes six miRNAs (miR-17, miR-18a, miR-19a, miR-20a, miR-19b-1, and miR-92a-1) with highly conserved sequences and organization. Up-regulation in mouse palatal mesenchymal cells induces proliferation (28). Ancient gene duplications have given rise to two miR-17-92 cluster paralogs in mammals: the miR-106b-25 cluster (located on human chromosome 7) and the miR-106a-363 cluster (located on the X chromosome). Hsa-miR-93 is part of the miR-106b-25 cluster. Deletion of the cluster in mice, alone or in combination with its paralog cluster miR-106b-25, leads to several developmental defects, including cleft palate with greatly reduced cell proliferation in the palatal shelves (19). Our data, however, show that the three miRNAs are up-regulated in fibroblasts of nsCPO patients. MiRNAs of this cluster or its paralogs may, therefore, have a dose-dependent effect, similar to miR-140 (18). Perturbation of precise expression levels may, therefore, lead to disturbed proliferation in the palatal shelves and cleft palate.


Due to ethical constraints, the earliest time point we could analyse miRNA expression was during surgical primary palate closure. Furthermore, the study was performed in cultured fibroblasts and not directly in the tissue samples, because of the small biopsy size. MiRNA expression can be affected by components in the culture medium (e.g. growth factors) (51) and specific signalling pathways during palatogenesis, as highlighted by the specific temporal expression pattern (29, 52). Therefore, our study likely only detected miRNAs whose expression level is changed by cell-autonomous genetic and epigenetic differences related to clefting.


The evening brought together delicious appetizers and wine (palate), artwork from over 20 local artists (palette) and proceeds helped purchase pallets full of food that the I.V. Food Bank distributed throughout Imperial Valley!


Teeth in the upper jaw can become crowded if there is not enough space in the jaw to fit all of the teeth as they come in. Expanding the palate (the roof of the mouth) is an effective way to address this problem. With the help of Dr. Stormberg, young patients can avoid many problems that result from a narrow jaw.


A small screw located in the center of the expander is gradually tightened over the course of treatment. It is turned with the help of a special key. A gentle pressure on the left and right sides of the upper jaw allows the palate tissues to move into the correct position. The connective tissue in the mouths of young patients is quite responsive to this treatment; bone growth will increase where the two halves meet and fix the new width in place.


Once the palate has expanded to the correct position, the expander is held to stabilize, then removed about six weeks after turns have completed. Various types of follow up treatment might be required once the expander has been removed and our team at Stormberg Orthodontics will work with you and your child to help you understand any next steps. -info/instructions/expander-instructions


If you are looking for a red with oodles of juicy ripe fruit, look no further! The 2017 El Dorado Zinfandel is a ripe and extravagant expression of the varietal. The palate is just gushing with flavors of wild berries, strawberry preserves, vanilla, and candied cigar box. Despite the generosity of the fruit, the wine retains a sense of balance with a core of mouthwatering acidity and completely integrated tannins. It is seamless and delicious!


Collagenous fibroma or desmoplastic fibroblastoma is a rare benign fibrous tissue tumor. It usually presents as a painless, slowly growing mass. Collagenous fibroma arises ordinarily inside the subcutaneous tissues or skeletal muscles. Histopathologically, the tumor consists of scattered stellate and spindle cells in a hypovascular collagenous stroma without atypia or infiltration. The oral cavity is a very uncommon site for desmoplastic fibroblastoma. Only 15 published articles in the literature reported the intraoral location. We present a case of collagenous fibroma with a bilateral distribution on the hard palate. This is the second case of bilateral collagenous fibroma after a previously reported one in literature; however, our case was larger, occupying almost the whole palate. We discuss the management of this rare tumor and how we can reach definite diagnosis.


Collagenous fibroma was presented bilaterally for the first time as reported by Vasconcelos et al. [5]. We present a case of bilateral collagenous fibroma of the hard palate. This is the first time we encounter collagenous fibroma in our department.


A savory wine resulting from the small- berried Wente clone Chardonnay at this iconic Russian River site, the 2018 El Diablo Vineyard Chardonnay marries richness and acidity to mouthwatering effect. Caramel and crème brûlee notes lead into a honey-kissed palate, with lemon-oil notes, white peach and macadamia nut carrying through its lengthy finish. 041b061a72


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