Background/Objectives: Miniscrew-assisted rapid palatal expansion (MARPE) has been increasingly used as a nonsurgical alternative for maxillary expansion in adults. However, reports of complications remain limited. This case describes a rare instance of maxillary bone fracture following MARPE and its clinical implications. Methods: A 32-year-old patient underwent MARPE as part of presurgical orthodontic treatment for maxillary constriction. Five days after activation, severe pain developed, followed by sensory disturbances in the infraorbital region. CT imaging revealed a maxillary fracture extending from the infraorbital foramen to the alveolar process. Symptoms gradually improved over two years, but psychological distress led to the abandonment of orthognathic surgery. Results: This case suggests that MARPE-induced maxillary fractures may be associated with stress concentration at the zygomatico-maxillary suture, particularly in individuals with increased midpalatal suture interdigitation and thin cortical bone. Finite element analysis and stress distribution studies indicate that the zygomatic buttress serves as a major resistance point, which may have contributed to the fracture. Conclusions: These findings highlight the importance of careful patient selection, preoperative CT assessments of bone thickness, and individualized expansion protocols. In high-risk cases, alternative approaches, such as surgically assisted expansion, may be considered. Further research on MARPE’s risk assessment and treatment protocols is needed to improve safety.

Background/Objectives: Temporary decreases in dermal collagen caused by artificial ultraviolet exposure are largely affected by increased epidermis-derived matrix metalloproteinase (MMP)-1 levels. However, the role of epidermal MMP-1 in dermal tissue remodeling induced by chronic sun exposure remains unclear. This study aimed to clarify the involvement of epidermal and dermal MMP-1 in dermal collagen reduction induced by chronic sun exposure. Methods: Immunofluorescent staining of 30 facial skin tissue samples was performed to visualize MMP-1. The fluorescence intensity of epidermal MMP-1 observed on microscopic images was analyzed in relation to the severity of dermal tissue remodeling and the dermal collagen fiber density. A similar correlation analysis of the number of dermal MMP-1-positive cells was also performed. Results: Epidermal MMP-1 was observed in the stratum spinosum of skin without severe tissue remodeling; however, in skin with severe dermal tissue remodeling, MMP-1 was localized throughout the epidermis. The epidermal MMP-1 signal area and dermal collagen fiber density were negatively correlated (ρ = −0.383; p = 0.0002; n = 90). However, the ratio of dermal MMP-1-positive cells to total dermal cells was only negatively correlated with the collagen fiber density in skin that was not severely remodeled (ρ = −0.746; p = 0.001; n = 15). Conclusions: Epidermal MMP-1 is involved in the tissue remodeling of skin that is subjected to chronic sun exposure and short-term ultraviolet radiation exposure. However, dermal-cell-derived MMP-1 may be involved in biological processes that require an immediate collagen degradation response. The results of this study demonstrate the importance of controlling epidermal MMP-1 to inhibit dermal tissue remodeling induced by chronic sun exposure and provide new insights that are beneficial to the development of anti-photoaging skincare cosmetics.

Background/Objectives: In Japan, artificial orbital implants are not approved as medical materials, limiting the number of facilities that perform orbital implant surgery. However, this procedure is crucial for improving the quality of life of ocular prosthesis users by enhancing cosmetic outcomes. This study aimed to evaluate the short-term outcomes of orbital implant surgery using costal cartilage grafts and assess the cosmetic impact by comparing upper eyelid positions between patients who underwent the procedure and those who did not. Methods: Patients were divided into two groups: those who underwent evisceration and orbital implant grafting with costal cartilage (Group 1) and those who used a prosthetic eye without an orbital implant (Group 2). In Group 1 cases, following evisceration, a spherical implant was created using the sixth autologous costal cartilage and covered with four pedicled scleral flaps. The incidence of complications and the necessity for additional surgery were investigated through medical records, and both complications and upper eyelid symmetry were assessed at least 12 months after the final surgical procedure. Results: A total of 23 patients were included: 13 in Group 1 and 10 in Group 2. Group 1 had a significantly lower median age (52 vs. 68 years, p = 0.002) and a higher proportion of females (76.9% vs. 30%, p = 0.024). Upper eyelid asymmetry was significantly greater in Group 2 than in Group 1 (p < 0.05). Orbital fracture was associated with a higher risk of requiring additional surgery (100% vs. 37.5%, p = 0.075), though not statistically significant. Conclusions: Orbital implant surgery with costal cartilage grafts improves eyelid symmetry and cosmetic appearance. Early and accurate orbital volume repair is essential for preventing enophthalmos.

Background/Objectives: Miniscrew-assisted rapid palatal expansion (MARPE) has emerged as a non-surgical alternative for maxillary expansion in adults. However, complications associated with MARPE remain underreported. This case report describes a rare instance of maxillary bone fracture following MARPE and discusses its clinical implications. Case Presentation: A brief description of the main methods or treatments applied. This can include any relevant preregistration or specimen information. Results: Sensory disturbances, likely resulting from infraorbital nerve injury, gradually improved over two years and eventually resolved completely. However, due to psychological distress, the patient abandoned the planned orthognathic surgery and pursued orthodontic treatment alone.Conclusions: This case underscores the risk of maxillary bone fractures associated with MARPE, particularly in adults with ossified sutures and reduced bone elasticity. The fracture appears to have resulted from load distribution around the zygomatico-maxillary suture during expansion. Careful patient selection, comprehensive risk assessment, and vigilant monitoring are crucial in minimizing complications. In high-risk cases, surgical approaches for transverse expansion should be considered rather than presurgical orthodontic expansion.

Background: Reliable early prediction of long-term speech outcomes after primary palatoplasty has not been explored. This study aimed to (1) clarify the relationship between the pattern of initial consonant production and postoperative speech outcome in patients with cleft palate (CP), and (2) investigate whether differences exist in the order pattern of initial consonant production by CP presence. Methods: Consecutive children who underwent primary CP surgery between 2001 and 2016 at our hospital were retrospectively analyzed; 42 and 38 children were assigned to the CP and non-CP groups, respectively. The production order of the main Japanese consonants/k/,/g/,/t/, and/d/ was analyzed, and 3 groups were created: type td, where t/d precedes k/g; type kg, where k/g precedes t/d; and type same, where t/d and k/g occur simultaneously. We compared consonant patterns between groups and assessed the association between these patterns and the incidence of velopharyngeal insufficiency (VPI), abnormal articulations, and the need for additional treatment in the CP group. Results: At both 4 and 7 years, the likelihood of having VPI was significantly higher in type kg children than in type td children. Velar consonants did not precede alveolar consonants in the non-CP group. Significantly more type kg patients received additional treatment than type td (P < 0.001) and type same (P = 0.003) groups. Conclusions: Patients with normal velopharyngeal function acquired alveolar consonants (td) before velar consonants (kd), indicating that those who first produced velar consonants were more likely to present with VPI or require additional treatment.

Introduction: Upper lip deformities, such as a whistle deformity, asymmetry, and a disproportionately narrow and tight upper lip, are common challenges in patients with bilateral cleft lip and palate (BCLP). In cases with a hypoplastic prolabium, the vertical length discrepancy between the lateral white lip segments and the central prolabium results in a triangular red lip shape. These deformities cause significant surgical challenges. Presentation of case: Herein, we present a 22-year-old female patient with incomplete BCLP and an evident whistle deformity. Surgical correction involved spindle-shaped trimming of the lateral white lip and the use of the excised tissue as de-epithelialized pedicled flaps for augmenting the central red lip. The procedure reshaped the triangular vermilion border into a natural contour with adequate red lip height, reduced the whistle deformity, and improved lip closure. Minimal scars and decreased mentalis muscle tension resulted in a natural, balanced lip appearance. Discussion: For BCLP with mild tissue deficiency but without significant lip imbalance, spindle-shaped trimming of the white lip effectively corrected contour deformities. Augmentation with de-epithelialized pedicled flaps improved the whistle deformity and enhanced central red lip projection. This technique minimizes visible scars and provides a reliable, less invasive alternative to the Abbe flap. Conclusion: Horizontal trimming of the white lip and de-epithelialized pedicled flaps is a reliable, minimally invasive solution for addressing upper lip deformities in patients with BCLP. Further research and extended follow-up are required to validate long-term stability and patient satisfaction with this technique. Highlights: