Scientific Interpretation of the Indicators of the Decrease in Quality of Life in Children with Congenital Lip and Palate Defects

2
1
Поделиться
Халманов B. (2022). Scientific Interpretation of the Indicators of the Decrease in Quality of Life in Children with Congenital Lip and Palate Defects. in Library, 22(3), 6–10. извлечено от https://inlibrary.uz/index.php/archive/article/view/14074
Баходир Халманов, Ташкентский государственный стоматологический институт

Отделение хирургической стоматологии и дентальной имплантологии

0
Цитаты
Crossref
Сrossref
Scopus
Scopus

Аннотация

The organization and holding of this complex is possible only in the conditions of a large specialized center. Of all the presented results of studies on the influence of groups of risk factors on the development of congenital cleft lip and palate  in  children  related  to  heredity,  lifestyle,  environment,  the  influence  of  the  organization  of  medical  care  remains unexplored.

Похожие статьи


background image

American Journal of Medicine and Medical Sciences 2022, 12(9): 924-928
DOI: 10.5923/j.ajmms.20221209.16

Scientific Interpretation of the Indicators of the Decrease

in Quality of Life in Children with Congenital Lip and

Palate Defects

Khalmanov Bakhodir Abdurashidovich

Tashkent State Stomatology Institute, Department of Surgical Stomatology and Dental Implantology, Uzbekistan

Abstract

The organization and holding of this complex is possible only in the conditions of a large specialized center. Of

all the presented results of studies on the influence of groups of risk factors on the development of congenital cleft lip and
palate in children related to heredity, lifestyle, environment, the influence of the organization of medical care remains
unexplored.

Keywords

Congenital cleft lip and palate, Obturator, Maxillofacial surgery, Speech disorder, Diffusion

1. Introduction

Congenital cleft lip and palate is one of the most common

malformations in children that have a significant medical
and social impact on the self-realization of such patients in
society. Comprehensive treatment of children with cleft lip
and palate is complex and multi-stage. Treatment is carried
out by highly qualified specialists. Children's health is the
future of the state, the potential for the development of
society. However, despite the success in strengthening and
protecting children's health, congenital anomalies in the
structure of childhood morbidity, disability and mortality
still occupy a leading position [1]. A special place among
congenital anomalies in children is occupied by congenital
malformations of the maxillofacial region - cleft lip and / or
palate: this pathology is considered one of the most
common and severe among congenital anomalies and takes
3-4th place in their structure [2].

Currently, orthodontic treatment techniques have been

developed aimed at dissociating the tongue from the lower
jaw, allowing to coordinate the strength of the tongue to
stimulate the growth of the upper jaw, which contributes
to the normalization of myodynamic balance in the
maxillofacial region in patients with cleft lip and palate.
In connection with the foregoing, the study of the effect
of orthodontic appliances to normalize the position of the
tongue in the oral cavity on the function of sound
pronunciation in children with cleft lip and palate is a
hot topic. It should be noted that the isolated form of
this pathology occurs in 7.6-41.4% of cases, while in the

Received: Aug. 22, 2022; Accepted: Sep. 12, 2022; Published: Sep. 15, 2022
Published online at http://journal.sapub.org/ajmms



composition of symptom complexes (along with heart
malformations

and

other

congenital

developmental

anomalies), which are caused by various mutations,
chromosomal

disorders

(for

example,

deletion

of

chromosome 22) cleft lip and/or palate are described in
21.1-61.2% [6,7,8]. Congenital malformations of a person
cause not only medical, but also social problems: in patients,
along with severe violations of the functions of the affected
organs and div systems, difficulties arise with adaptation
in society. In the future, they face the problem of obtaining
a profession and employment (35.2% of patients indicate
that it is almost impossible to find a job with a congenital
cleft lip and palate), which determines the medical and
social significance of the problem and the relevance of the
study in this direction [8,9]. In addition, many patients with
a congenital malformation of the maxillofacial region have
a disability group due to difficulties in restoring impaired
vital functions - nutrition, breathing, speech. Considering
that congenital cleft lip and palate accounts for 18% of all
cases of congenital anomalies, the problems of anatomical
reconstruction of the upper lip, nose and upper jaw in
childhood lead to the disability of every fifth child [10-12].

2. Materials and Methods

The World Health Organization defines the solution to

the problem of disability in congenital cleft lip and palate as
a strategic task: first of all, it is the development of a quality
assessment system for the integrated medical, psychological,
pedagogical and social rehabilitation of patients in medical
organizations [13]. According to different studies, the risk


background image

American Journal of Medicine and Medical Sciences 2022, 12(9): 924-928

925

factors for the development of the pathology of congenital
cleft lip and palate have significant variability. There are
4 groups of risk factors: genetic factors, environment,
lifestyle, organization of medical care [7]. At the same time,
numerous studies are devoted to the study of risk factors,
which give their classifications. For example, exogenous
risk factors are distinguished (unfavorable material,
social, living conditions); medical and biological factors
(anthropogenic impact of the environment, occupational
hazards in parents, xenobial load); medical-organizational
factors. Endogenous factors include bad habits, impaired
reproductive function, sexually transmitted diseases, Rh
conflict, genetic factors, somatic and infectious diseases in
the child's parents. Some Russian researchers also note the
impact of the place of residence on the increase in the
number of births of children with congenital cleft lip and
palate: in particular, in families living in industrialized
regions of Russia, over the past 15 years, there has been an
increase in the frequency of births of children with this
pathology [8,9]. The results of a study conducted in the
Krasnodar Territory on a group of environmental risk
factors are interesting. It was found that the average
frequency of cases of congenital cleft lip and palate is
statistically significantly associated with an increase in the
degree of ecological trouble of the territory - the level of
pollution of the atmospheric air, sewage and soil: the average
frequency of congenital anomalies in such conditions is 20%
higher than the incidence rate in the least polluted areas [7].
Numerous studies confirm the significance of a group of
genetic risk factors, such as, for example, the presence of
congenital malformations in relatives, the age of parents at
the time of conception, the serial number of pregnancy,
childbirth, the number of children in the family, the season
of conception [11,18], and the group “image life", namely
occupational hazards (for example, working in contact with
detergents and pesticides, contact with chemicals), bad
habits of parents (alcoholism, smoking, drug addiction,
taking certain medications, such as anticonvulsants or drugs),
excess or lack of vitamin A and folic acid (both as part of
multivitamins and in the diet) [16,8]. There are practically no
studies on the group of risk factors "organization of medical
care" in the provision of medical care to children with
congenital cleft lip and palate and their families. In single
studies, attention is drawn to the imperfect organization of
medical care for such patients. For example, studies note
that the lack of a unified registration system, insufficient
awareness of doctors and parents cause untimely provision
of specialized assistance to children with congenital cleft lip
and palate [17]. The problem of an integrated approach to the
organization of specialized medical care and rehabilitation of
children with congenital cleft lip and palate continues to be
underdeveloped [12].

Dental anomalies and deformities occupy the third place

among dental diseases after caries and periodontal diseases.
Their prevalence ranges from 11.4% to 80% [20]. Congenital
bilateral cleft lip and palate (CMPA) accounts for 12–25% of

cases among other forms of facial clefts and is a severe
type of pathology of the maxillofacial region [19]. The study
of the frequency and prevalence of ADRVGN is very
relevant in modern dentistry [9]. Cleft lip and palate is one
of the most common congenital pathologies [18]. With this
anomaly, one child out of 1000 newborns is born, which is
approximately 0.04% of the total population of the planet
[17]. VDDVGN ranks second in frequency and is the most
severe malformation of the face and jaws. According to E.A.
Salmina (2018), children with cleft lip and palate need
complex, long-term and systematic treatment, they must be
registered with the dispensary for life. In patients with cleft
lip and palate, the quality of life noticeably deteriorates. To
increase the effectiveness of the subsequent work of the
psychological and pedagogical service in the system of
complex rehabilitation of children with ADHD, it is
necessary from the first days of life to plan an individual
program for the restoration of vital functions: breathing,
sucking, swallowing (Postnikov M.A. et al., 2019; Karpov
A.N. et al., 2020). Carrying out early orthodontic treatment
(ROT) for children from the first days of life is a preparatory
link in the preoperative period, which is aimed at creating
favorable conditions for subsequent surgical intervention
[20]. ROL is expedient for separating the oral cavity and the
nasal cavity, for preventing the development of secondary
deformities and normalizing the feeding process.

Timely diagnosis and treatment planning determine the

success of the rehabilitation of children with this complex
and multifaceted pathology. The result of surgical treatment
and an interdisciplinary approach depends on the timing and
scope of orthodontic care. An analysis of domestic and
foreign literature showed that there is no consensus among
practitioners about the rational timing and methods of
providing early orthodontic care to children with ADHD
in the first year of life. All of the above confirms the
relevance of the chosen direction, determines the purpose
and objectives of this study.

Cleft lip and palate is a widespread and severe

malformation of the face and jaws that occurs as a result of
a genetically determined pathology or teratogenic effects of
environmental pollution. The growing influence of the
environmental factor explains the increase in the birth of
children with this pathology. At the same time, in the
problem of habilitation and rehabilitation of patients with
congenital pathology of the face and jaws, there are still not
fully realized reserves of a complex effect on the div of a
child with a defect. Even a highly qualified surgeon cannot
always foresee postoperative complications, and they are
dangerous in terms of maladaptive changes, including social
changes [16]. Despite the large number of surgical methods
for eliminating cleft lip and palate (CLP), there is still a
large percentage of complications, manifested in speech
impairment caused by an inferior function of the structures
of the anatomical formation restored after uranoplasty - the
palatopharyngeal ring (PGC) (Ad.A. Mammadov, 2015).

The history of the development of orthodontic treatment


background image

926

Khalmanov Bakhodir Abdurashidovich: Scientific Interpretation of the Indicators of

the Decrease in Quality of Life in Children with Congenital Lip and Palate Defects

followed the path of using various devices from the arsenal
of technical means available at a particular stage in the
development of medical technology; many temporary
devices were created, the use of which made it possible to
establish natural and artificial feeding of the child. Science
and technology followed the path of developing devices for
constant wear, contributing to the improvement of breathing,
and in the future - the development of speech. In 1575,
A. Pare first called these devices "obturators". The term
"obturator" has become widespread and is still used today.

It seems that there should always be an alternative and the

possibility of choosing methods of treatment, especially in
older patients with severe, extensive soft palate defects, with
palatopharyngeal insufficiency. It is important to make a
correct and constructive choice of surgical and restorative
benefits, to offer them comprehensively to the patient, taking
into account modern standards of this care and the quality of
their implementation. At the same time, the aspect of the
quality of medical care consists of objective and subjective
components. Therefore, we emphasize once again that the
study of the problem of NGN and the search for ways to
eliminate it requires specialists to have a clear knowledge of
objective methods for registering this insufficiency, methods
for restoring the function of NGC and the development of
speech in the dynamics of observation of the patient. On the
part of the patient and his parents, a conscious understanding
of the importance of work to restore speech and difficulties
during the entire rehabilitation period is necessary.

Various modifications of temporary devices for feeding a

child proposed by many authors solved one problem -
temporary separation of the oral cavity and nose during
feeding a child. For the rest of the period, the oral and nasal
cavities freely communicated with each other, which
inevitably led to a violation of the function of breathing, and
then speech.

In parallel with the creation of temporary obturators, the

search for specialists was aimed at developing devices that
would be constantly in the mouth of a child, separating the
mouth and nose, helping to improve external breathing and
form correct speech.

3. Result and Discussion

This strategy was reflected in the main tasks set for the

teams of the Centers: surgical correction of the maxillofacial
defect in the early stages (from the neonatal period (from
0 to 29 days) to 1.5 years); full completion of surgical
correction - by 3-5 years, by the time active speech is formed;
organization and conduct of audiological and speech
screening of newborns and children of the 1st year of
life; further development and implementation of modern
medical and diagnostic complexes; organizing and
conducting training courses to improve the skills of surgeons,
audiologists, nurses, speech therapists; creation of an
effective system of reporting and evaluation of the quality of
work of medical personnel.

Anatomical disorders of the maxillofacial area in children

with cleft lip and palate (CLP) begin to form already in the
period of intrauterine development [2,11]. Even in the early
stages of fetal development, an imbalance of forces occurs
between the work of the muscles surrounding the oral
cavity and the tongue. The growth processes of the
maxillofacial region are disturbed, there are deformations of
the soft and hard tissues of the dentition [12].

In general, they can be divided into primary and

secondary deformations.

The primary deformation is due to the malformation itself,

the presence of communication between the oral and nasal
cavities, and is observed at the birth of a child. The
secondary deformity develops during the growth of the
child and after surgical interventions on the upper jaw and
soft tissues of the middle zone of the face, and thus joins the
primary deformity. Cicatricial deformity of the nose, upper
lip and palate prevent the growth of the upper jaw, and
determines the characteristic features of the deformity of the
upper jaw and underdevelopment of the middle zone of the
face [2,8].

Violation of the function of anatomical structures causes

speech disorders, which correspond to the degree of
insufficiency of the closure of the palatopharyngeal ring
[11].

The domestic and foreign literature available to us

describes in detail the primary and secondary deformations
of the jaws and soft tissues of the lips, nose and palate in
patients with RGN, and their impact on speech. Various
authors have expressed the need to act on damaged
anatomical structures in order to normalize speech.
However, the relationship between structural features,
motor language disorders and speech disorders in this group
of patients and the possibility of orthodontic correction of
the 13 position of motor activity of the tongue, their
influence on sound pronunciation and speech formation
were not considered.

4. Conclusions

In the studies of N.V. Starikova (2006-2014) described in

detail the position of the tongue in the oral cavity and the
features of its structure in patients with RGN. It is
characteristic for them that in a state of physiological rest,
the top of the tongue exerts pressure on the base of the
alveolar part of the lower jaw, while the back and root of
the tongue are high, in newborns they penetrate into the
nasal cavity through a cleft. This position of the tongue is
also observed after surgical restoration of the integrity of
the palate and separation of the oral and nasal cavities. Due
to the pathological position and function of the tongue
described above, there is excessive pressure on the alveolar
part of the lower jaw, there is no contact of the tip of the
tongue with the palate, and the myodynamic balance of the
mouth is disturbed. Stimulation of the growth of the upper
jaw does not occur, which leads to its underdevelopment in


background image

American Journal of Medicine and Medical Sciences 2022, 12(9): 924-928

927

the sagittal and transversal planes, lower promacrognathia,
and lingual inclination of the lower teeth. Patients with
RGN are characterized by a flat or concave profile,
underdevelopment of the midface [8,14]. Many authors
described the developed methods aimed at: normalizing
myodynamic balance in the oral cavity, reducing secondary
iatrogenic jaw deformities in patients with RGN. To date,
there are developments of both speech therapy methods for
correcting the position of the tongue in the oral cavity in
patients with RGN, and orthodontic appliances to perform
this task [13].

REFERENCES

[1]

Fozilov U. A. Diagnosis And Prevention Of Caries
Development In Orthodontic Treatment //World Bulletin of
Social Sciences. – 2021. – Т. 3. – №. 10. – С. 97-104.

[2]

Fozilov, U. A. (2021). Diagnosis And Prevention Of Caries
Development In Orthodontic Treatment.

World Bulletin of

Social Sciences

,

3

(10), 97-104.

[3]

Hoffmann F, Eismann D. Die yesammtflacheokklusaler
kontakte in der statischer okklusion an gebigmodellen. In:
Kirch W, Middeke M, Rychlik R, ed. Leitlinien in der Zahn-,
Mund- und Kieferheilkunde. bd. 72, No. 8. Aspekte der
Pravention; 2010. RR. 795-802.

[4]

Vasiliev Yu.A., Redko A.N., Gulenko O.V., Udina I.G.
Detection of congenital cleft lip and palate during prenatal
ultrasound examination in the Krasnodar Territory // Russian
Journal of Dentistry. - 2017. - T. 21. - No. 4. - S. 190-193.
[Vasil'ev YUA, Red'ko AN, Gulenko OV, Udina IG. Prenatal
ultrasonic detection of congenital clefts of lip and palate in
krasnodarskii krai. Rossijskij stomatologicheskij zhurnal.
2017; 21(4): 190-193. (In Russ).] doi: 10.18821/1728-2802-
2017-21-4-190-193.

[5]

Kurbatova O.L., Vasiliev Yu.A., Pobedonostseva E.Yu., et al.
Territorial distribution of the frequency of congenital cleft lip
and/or palate in the Krasnodar Territory due to environmental
pollution // Kuban Scientific Medical Bulletin . - 2013. - No. 6.
- P. 111-114.

[6]

Namazova-Baranova L.S., Ginter O.V., Polunina T.A.,
Davydova I.V., Savost'yanov K.V., Pushkov A.A., Zhurkova
N.V., Mospan T. .I. algorithm for early diagnosis and
treatment of chromosome deletion syndrome 22 (22q11.2).

[7]

Chuikin S.V., Davletshin N.A., Averyanov S.V., Chuikin O.S.
Surgical methods of treatment of children with congenital
cleft lip and palate. - Ufa: Publishing house of GOU VPO
"Bashkir State Medical University of Roszdrav", 2011. - 160
p. [Chuykin SV, Davletshin NA, Aver'yanov SV, Chuykin
OS. Khirurgicheskie metody lecheniya detey s vrozhdennoy
rasshchelinoy verkhney guby i neba. Ufa: Bashkirskiy
gosudarstvennyy meditsinskiy universitet Roszdrava; 2011.
160 rubles. (In Russian).]

[8]

Eurocat Data [Internet]. Analyze congenital anomalies and
compare performance across population groups or geographic
areas. Available from: https://eu-rd-platform.jrc.ec.europa.eu
/eurocat/eurocat-data_en.

[9]

Kabanova S.A., Kabanova A.A., Dubovets A.V., Masyuk
N.Yu. Awareness of doctors-specialists in Vitebsk in the
issues of complex rehabilitation of patients with cleft lip and
palate. Bulletin of VSMU. Dentistry. - 2013. - T. 12. - No. 4. -
S. 118-122.

[10]

Inoyatov A.Sh., Saidova M.A., Shodmonov K.E. Analysis of
factors contributing to the development of congenital
malformations of the maxillofacial region // Bulletin of the
Council of Young Scientists and Specialists of the
Chelyabinsk Region. - 2016. - T. 3. - No. 4. - S. 51-55.
[Inoyatov ASh, Saidova MA, Shodmonov KE. The analysis
of factors of the congenital defects of maxillofacial area
promoting development. Vestnik Soveta molodyh uchenyh i
specialistov Chelyabinskoj oblasti. 2016; 3(4): 51-55. (In
Russian).]

[11]

Tokarev P.V., Shulaev A.V., Plaksina L.V., Marapov D.I.
The prevalence of congenital cleft lip and/or palate in the
Republic of Tatarstan // Practical Medicine. - 2015. - No. 2-2.
— S. 101-103. [Tokarev PV, Shulaev AV, Plaksina LV,
Marapov DI. Prevalence of congenital lip and/or palate clefts
in Tatarstan Republic. Prakticheskaya Meditsina. 2015; (2-2):
101-103. (In Russian).]

[12]

Shakirova R.R., Uskova M.P., Bibik T.V. Dental anomalies
in children with congenital cleft lip and/or palate in
the Udmurt Republic // Practical Medicine. - 2009. - No. 1.
- S. 87-88. [Shakirova RR, Uskova MP Bibik TV.
Dentomaxillaris anomalies at children with congenital
crevices of a lip and/ or the sky in the Udmurt Republic.
Prakticheskaya medicina. 2009; (1): 87-88. (In Russian).]

[13]

Shakirova RR The structure of dentoalveolar anomalies in
children with congenital cleft lip and palate in the Udmurt
Republic // Collection of scientific abstracts and articles
"Health and education in the XXI century". - 2008. - T. 10. -
No. 4. - S. 701-702. [Shakirova RR. Struktura zubochelyustn
ykh anomaliy u detey s vrozhdennymi rasshchelinami guby i
neba v Udmurtskoy Respublike. Sbornik nauchnyh tezisov i
statej “Healthy i obrazovanie v xxi veke”. 2008; 10(4):
701-702. (In Russian).]

[14]

Udina I.G., Vasiliev Yu.A., Pobedonostseva E.Yu., et al.
Spatio-temporal frequency dynamics of congenital cleft lip
and/or palate in the Krasnodar Territory // Kuban Scientific
Medical Bulletin. - 2013. - No. 1. - S. 171-175.

[15]

Eshiev A.M., Darbishev E.P., Davydova A.K. Frequency and
reasons for the birth rate of children with congenital clefts in
the southern region of Kyrgyzstan // Young scientist. - 2014. -
No. 21. - S. 39-41.

[16]

Starikova, N.V. Orthodontic correction of abnormal tongue
position and function in children with unilateral cleft lip and
palate: abstracts/ N.V. Starikova, A.G. Nadtochiy, N.V.
Udalova// 9-th European Craniofacial Congress. - Salzburg,
Austria, 2011. - P. 253.

[17]

Steele, C. M. Tongue movements during water swallowing in
healthy young and older adults/ C. M. Steele, P. Van Lieshout
// Journal of Speech, Language, and Hearing Research. - 2009.
- Vol. 52, №. 5. - Р. 1255-1267.

[18]

Younkin, S. G. A genome-wide study of de novo deletions
identifies a candidate locus for non-syndromic isolated cleft
lip/palate risk/ S.G. Younkin et al. //BMC genetics. - 2014. -
Vol. 15, №. 1. - Р. 24.


background image

928

Khalmanov Bakhodir Abdurashidovich: Scientific Interpretation of the Indicators of

the Decrease in Quality of Life in Children with Congenital Lip and Palate Defects

[19]

Zharkova, N. A normative-speaker validation study of two
indices developed to quantify tongue dorsum activity from
midsagittal tongue shapes/ N. Zharkova //Clinical linguistics
& phonetics. - 2013. - Vol. 27, №. 6-7. - Р. 484-496.


Copyright

©

2022

The Author(s).

Published

by

Scientific

&

Academic

Publishing

This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/

Библиографические ссылки

Fozilov U. A. Diagnosis And Prevention Of Caries Development In Orthodontic Treatment //World Bulletin of Social Sciences. - 2021. - T. 3. - №. 10. - C. 97-104.

Fozilov, U. A. (2021). Diagnosis And Prevention Of Caries Development In Orthodontic Treatment. World Bulletin of Social Sciences, 3(10), 97-104.

Hoffmann F, Eismann D. Die yesammtflacheokklusaler kontakte in der statischer okklusion an gebigmodellen. In: Kirch W, Middeke M, Rychlik R, ed. Leitlinien in der Zahn-, Mund- und Kieferheilkunde. bd. 72, No. 8. Aspekte der Pravention; 2010. RR. 795-802.

Vasiliev Yu.A., Redko A.N., Gulenko O.V., Udina LG. Detection of congenital cleft lip and palate during prenatal ultrasound examination in the Krasnodar Territory // Russian Journal of Dentistry. - 2017. - T. 21. - No. 4. - S. 190-193. [Vasil'ev YUA, Red'ko AN, Gulenko OV, Udina IG. Prenatal ultrasonic detection of congenital clefts of lip and palate in krasnodarskii krai. Rossijskij stomatologicheskij zhumaL 2017; 21(4): 190-193. (In Russ).] doi: 10.18821/1728-2802-2017-21-4-190-193.

Kurbatova O.L., Vasiliev Yu.A., Pobedonostseva E.Yu., et al. Territorial distribution of the frequency of congenital cleft lip and/or palate in the Krasnodar Territory due to environmental pollution// Kuban Scientific Medical Bulletin . - 2013. - No. 6. -P. 111-114.

Namazova-Baranova L.S., Ginter O.V., Polunina T.A., Davydova I.V., Savosfyanov K.V., Pushkov A.A., Zhurkova N.V., Mospan T. .1. algorithm for early diagnosis and treatment of chromosome deletion syndrome 22 (22q 11.2).

Chuikin S.V., Davletshin N.A., Averyanov S.V., Chuikin O.S. Surgical methods of treatment of children with congenital cleft lip and palate. - Ufa: Publishing house of GOU VPO "Bashkir State Medical University of Roszdrav", 2011. - 160 p. [Chuykin SV, Davletshin NA, Aver’yanov SV, Chuykin OS. Khirurgicheskie metody lecheniya detey s vrozhdennoy rasshchelinoy verkhney guby i neba. Ufa: Bashkirskiy gosudarstvennyy meditsinskiy universitet Roszdrava; 2011. 160 rubles. (In Russian).]

Eurocat Data [Internet], Analyze congenital anomalies and compare performance across population groups or geographic areas. Available from: https://eu-rd-platform.jrc.ec.europa.eu /eurocat/eurocat-data en.

Kabanova S.A., Kabanova A.A., Dubovets A.V., Masyuk N.Yu. Awareness of doctors-spccialists in Vitebsk in the issues of complex rehabilitation of patients with cleft lip and palate. Bulletin of VSMU. Dentistry. - 2013. - T. 12. - No. 4. -S. 118-122.

Inoyatov A.Sh., Saidova M.A., Shodmonov K.E. Analysis of factors contributing to the development of congenital malformations of the maxillofacial region // Bulletin of the Council of Young Scientists and Specialists of the Chelyabinsk Region. - 2016. - T. 3. - No. 4. - S. 51-55. [Inoyatov ASh, Saidova MA, Shodmonov KE. The analysis of factors of the congenital defects of maxillofacial area promoting development. Vestnik Soveta molodyh uchenyh i specialistov Chelyabinskoj oblasti. 2016; 3(4): 51-55. (In Russian).]

Tokarev P.V., Shulaev A.V., Plaksina L.V., Marapov D.I. The prevalence of congenital cleft lip and/or palate in the Republic of Tatarstan // Practical Medicine. - 2015. - No. 2-2.- S. 101-103. [Tokarev PV, Shulaev AV, Plaksina LV, Marapov DI. Prevalence of congenital lip and/or palate clefts in Tatarstan Republic. Prakticheskaya Meditsina. 2015; (2-2); 101-103. (In Russian).]

Shakirova R.R., Uskova M.P., Bibik T.V. Dental anomalies in children with congenital cleft lip and/or palate in the Udmurt Republic // Practical Medicine. - 2009. - No. 1. - S. 87-88. [Shakirova RR, Uskova MP Bibik TV. Dentomaxillaris anomalies at children with congenital crevices of a lip and/ or the sky in the Udmurt Republic. Prakticheskaya medicina. 2009; (1): 87-88. (In Russian).]

Shakirova RR The structure of dentoalveolar anomalies in children with congenital cleft lip and palate in the Udmurt Republic // Collection of scientific abstracts and articles ’’Health and education in the XXI century". - 2008. - T. 10. -No. 4. - S. 701-702. [Shakirova RR. Strukturazubochelyustn ykh anomaliy u detey s vrozhdennymi rasshchelinami guby i neba v Udmurtskoy Respublike. Sbomik nauchnyh tezisov i statej “Healthy i obrazovanie v xxi veke”. 2008; 10(4): 701-702. (In Russian).]

Udina LG., Vasilicv Yu.A., Pobcdonostscva E.Yu., ct al. Spatio-temporal frequency dynamics of congenital cleft lip and/or palate in the Krasnodar Territory // Kuban Scientific Medical Bulletin. - 2013. - No. 1.-S. 171-175.

Eshiev A.M., Darbishev E.P., Davydova A.K. Frequency and reasons for the birth rate of children with congenital clefts in the southern region of Kyrgyzstan // Young scientist. - 2014. -No. 21.-S. 39-41.

Starikova, N.V. Orthodontic correction of abnormal tongue position and function in children with unilateral cleft lip and palate: abstracts/ N.V. Starikova, A.G. Nadtochiy, N.V. Udalova// 9-th European Craniofacial Congress. - Salzburg, Austria, 2011.-P. 253.

[ 17] Steele, С. M. Tongue movements during water swallowing in healthy young and older adults/ С. M. Steele, P. Van Lieshout // Journal of Speech, Language, and Hearing Research. - 2009. -Vol. 52, №. 5.-P. 1255-1267.

Younkin, S. G. A genome-wide study of de novo deletions identifies a candidate locus for non-syndromic isolated cleft lip/palate risk/ S.G. Younkin et al. //BMC genetics. - 2014. -Vol. 15, №. l.-P. 24.

Zharkova, N. A normative-speaker validation study of two indices developed to quantify tongue dorsum activity from midsagittal tongue shapes/ N. Zharkova //Clinical linguistics & phonetics. - 2013. - Vol. 27, №. 6-7. - P. 484-496.

Hepagreen - восстановление нормальной работы печени Androgard — препарат для настоящих мужчин Androgard — препарат для настоящих мужчин Byutivit - Натуральный продукт для женщин любого возраста Byutivit - Натуральный продукт для женщин любого возраста Byutivit - Натуральный продукт для женщин любого возраста Maksimus - Натуральный продукт, для бодрости и энергии Lactovita - Номер один в естественном улучшении иммунитета Lactovita - Номер один в естественном улучшении иммунитета Avicenna’s Lab inLibrary — это научная электронная библиотека UACD - Антикоррупционный дайджест Узбекистана inConference - научно-практические конференции inScience - Журнал Общество и инновации Gulyamov - Гулямов Саид Саидахрарович MUVI24 - Смотрите фильмы онлайн, большая коллекция, новинки кинопроката Megatorg - Доска объявлений Megatorg.net: сайт бесплатных частных объявлений Skinormil - Космецевтика активного действия Pils - Интернет-аптека >METAMED - Фармацевтическая компания с полным спектром услуг All.Tube - Смотрите онлайн видео бесплатно в хорошем качестве Dexaflu - от симптомов гриппа и простуды UMAR PROEKT - Комплексное проектирование UZDA - Ассоциации стоматологов Узбекистана