We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Topics |

Changing Perspectives in Cleft Lip and Palate From Acrylic to Allele

Travis T. Tollefson, MD; Craig W. Senders, MD; Jonathan M. Sykes, MD
Arch Facial Plast Surg. 2008;10(6):395-400. doi:10.1001/archfaci.10.6.395.
Text Size: A A A
Published online


Cleft lip and palate deformities are the most common congenital abnormalities of the head and neck. Advancements in the various multidisciplinary fields involved in cleft management have substantially improved functional and aesthetic outcomes. The legitimacy of such controversial topics as gingivoperiosteoplasty, primary rhinoplasty, and presurgical nasoalveolar molding is heavily contested. Bone morphogenetic protein and other recombinant growth factors may play important roles in future cleft care. As the candidate alleles that contribute to cleft lip and palate are further elucidated, the complex interplay of environmental influence and genetic predisposition is emphasized. Translational research from fields such as fetal wound healing, tissue engineering, and gene therapy may have clinical applications as cleft care continues to evolve.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?


Place holder to copy figure label and caption
Figure 1.

Schematic timeline for treatment of children with cleft lip and palate. PNAM indicates presurgical nasal alveolar molding.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Use of presurgical nasal alveolar molding. A, Presurgical nasal alveolar molding appliance with nasal prongs to the left. Arrow marks where elastic bands are secured and taped to the cheeks. B, Six-week-old infant with bilateral cleft lip and palate demonstrating asymmetric protruding premaxilla. C, Same patient 2 weeks after primary cleft lip repair and rhinoplasty.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.

Neonatal mandibular distraction osteogenesis. A, Lateral 3-dimensional radiograph of a neonate with Pierre Robin sequence demonstrating severe micrognathia leading to airway obstruction. B, Postoperative view of the mandible after distraction osteogenesis.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

7 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections