Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2021) – 132.50
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI (2021) – 0.5
Average rejection rate (2022) – 79.69%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download original text (EN)

Dental and Medical Problems

2022, vol. 59, nr 4, October-December, p. 509–515

doi: 10.17219/dmp/145065

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Cite as:

Ariawan D, Vitria EE, Sulistyani LD, et al. Prevalence of Simonart’s band in cleft children at a cleft center in Indonesia: A nine-year retrospective study. Dent Med Probl. 2022;59(4):509–515. doi:10.17219/dmp/145065

Prevalence of Simonart’s band in cleft children at a cleft center in Indonesia: A nine-year retrospective study

Dwi Ariawan1,A,B,C,D,E,F, Evy Eida Vitria1,A,C,E,F, Lilies Dwi Sulistyani1,A,C,E,F, Cut Safira Anindya1,B,C,E,F, Nada Suci Rahmadani Adrin1,B,C,E,F, Nur Aini2,B,E,F, Muhammad Syafrudin Hak2,B,C,E,F

1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Indonesia, Jakarta, Indonesia

2 Cleft Lip and Palate Center, Harapan Kita Women and Children Hospital, Jakarta, Indonesia


Background. Simonart’s band is a soft tissue band that connects the cleft gap of the base of the nostril or the margin of the alveolus. While research on the prevalence of Simonart’s band in cleft lip and palate cases has been carried out in various countries, research on Simonart’s band in Indonesia has yet to be conducted.
Objectives. This study aimed to determine the prevalence of different types of Simonart’s band at a cleft center in Indonesia.
Material and methods. The data of cleft patients were reviewed retrospectively over a 9-year period at the Cleft Lip and Palate Center Center, Harapan Kita Women and Children Hospital, Jakarta, Indonesia. The patients were divided based on the type of cleft and the type of Simonart’s band. The results were analyzed by means of descriptive statistics.
Results. Out of 638 cleft patients from the period 2008–2016, 77 patients had Simonart’s band. The liptolip band was most commonly found (52 cases, 67.5%). The lip-to-alveolus band was found in 20 cases (26.0%) and the alveolus-to-alveolus band had the lowest prevalence of 5 cases (6.5%). Associations between the cleft type (unilateral cleft lip and palate (UCLP), unilateral cleft lip and alveolus (UCLA), and bilateral cleft lip and palate (BCLP)) and Simonart’s band type were all significant (p = 0.001, according to Fisher’s exact test), which indicates significant differences in the distribution of the bands with regard to different cleft types. There was a significant difference in the distribution of the bands between the UCLP and UCLA groups (p = 0.000). On the other hand, the distribution of the bands in the UCLP group did not differ much from that in the BCLP group (p = 0.065).
Conclusions. The prevalence of Simonart’s band was significantly higher in the patients with the unilateral complete cleft of the primary and secondary palate than in the subjects with the cleft of the primary palate. In the UCLP group, most patients had the lip-to-lip band type. In the BCLP group, the majority also had the lip-to-lip band type. In contrast, in the UCLA group, the majority showed the lip-to-alveolus band type.

Key words

cleft lip and palate, Simonart’s band, soft-tissue band, cleft lip and alveolus

References (32)

  1. Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: Understanding genetic and environmental influences. Nat Rev Genet. 2011;12(3):167–178. doi:10.1038/nrg2933
  2. Leslie EJ, Marazita ML. Genetics of cleft lip and cleft palate. Am J Med Genet C Semin Med Genet. 2013;163C(4):246–258. doi:10.1002/ajmg.c.31381
  3. Rahimov F, Marazita ML, Visel A, et al. Disruption of an AP-2alpha binding site in an IRF6 enhancer is associated with cleft lip. Nat Genet. 2008;40(11):1341–1347. doi:10.1038/ng.242
  4. De Cuyper E, Dochy F, De Leenheer E, Van Hoecke H. The impact of cleft lip and/or palate on parental quality of life: A pilot study. Int J Pediatr Otorhinolaryngol. 2019;126:109598. doi:10.1016/j.ijporl.2019.109598
  5. De Paepe J, Dochy F, Willems S, Van Hoecke H, De Leenheer E. Ear- and hearing-related impact on quality of life in children with cleft palate: Development and pretest of a health-related quality of life (HRQOL) instrument. Int J Pediatr Otorhinolaryngol. 2019;122:35–39. doi:10.1016/j.ijporl.2019.03.023
  6. Gundlach KK, Maus C. Epidemiological studies on the frequency of clefts in Europe and world-wide. J Craniomaxillofac Surg. 2006;34(Suppl 2):1–2. doi:10.1016/S1010-5182(06)60001-2
  7. Heidsieck DS, Smarius BJ, Oomen KP, Breugem CC. The role of the tensor veli palatini muscle in the development of cleft palate-associated middle ear problems. Clin Oral Investig. 2016;20(7):1389–1401. doi:10.1007/s00784-016-1828-x
  8. Sell D, Southby L, Wren Y, et al. Centre‐level variation in speech outcome and interventions, and factors associated with poor speech outcomes in 5‐year‐old children with non‐syndromic unilateral cleft lip and palate: The Cleft Care UK study. Part 4. Orthod Craniofac Res. 2017;20(Suppl 2):27–39. doi:10.1111/ocr.12186
  9. Wang Y, Sun Y, Huang Y, et al. Association study between Van der Woude Syndrome causative gene GRHL3 and nonsyndromic cleft lip with or without cleft palate in a Chinese cohort. Gene. 2016;588(1):69–73. doi:10.1016/j.gene.2016.04.045
  10. Kondo S, Schutte BC, Richardson RJ, et al. Mutations in IRF6 cause Van der Woude and popliteal pterygium syndromes. Nat Genet. 2002;32(2):285–289. doi:10.1038/ng985
  11. Silva Filho OG, Cristovâo RM, Semb G. Prevalence of a soft tissue bridge in a sample of 2014 patients with complete unilateral clefts of the lip and palate. Cleft Palate Craniofac J. 1994;31(2):122–124. doi:10.1597/1545-1569_1994_031_0122_poastb_2.3.co_2
  12. Naran S, Kirschner RE, Schuster L, et al. Simonart’s band: Its effect on cleft classification and recommendations for standardized nomenclature. Cleft Palate Craniofac J. 2017;54(6):726–733. doi:10.1597/15-319
  13. Mulliken JB, Schmidt AG. Gustav Simon’s band and the evolution of labial adhesion. J Craniofac Surg. 2013;24(1):108–114. doi:10.1097/SCS.0b013e318270fe4d
  14. Gibson T. Gustav Simon (1824–1876): Simonart (s)(z) of the band? Br J Plast Surg. 1977;30(4):255–260. doi:10.1016/0007-1226(77)90111-4
  15. da Silva Filho OG, Santamaria M Jr., da Silva Dalben G, Semb G. Prevalence of a Simonart’s band in patients with complete cleft lip and alveolus and complete cleft lip and palate. Cleft Palate Craniofac J. 2006;43(4):442–445. doi:10.1597/05-0302.1
  16. Kitamura H. Evidence for cleft palate as a postfusion phenomenon. Cleft Palate Craniofac J. 1991;28(2):195–211. doi:10.1597/1545-1569_1991_028_0195_efcpaa_2.3.co_2
  17. Semb G, Shaw WC. Simonart’s band and facial growth in unilateral clefts of the lip and palate. Cleft Palate Craniofac J. 1991;28(1):40–48. doi:10.1597/1545-1569_1991_028_0040_ssbafg_2.3.co_2
  18. Vermeij-Keers C, Rozendaal AM, Luijsterburg AJ, et al. Subphenotyping and classification of cleft lip and alveolus in adult unoperated patients: A new embryological approach. Cleft Palate Craniofac J. 2018;55(9):1267–1276. doi:10.1177/1055665618767106
  19. Hovorakova M, Lesot H, Peterkova R, Peterka M. Origin of the deciduous upper lateral incisor and its clinical aspects. J Dent Res. 2006;85(2):167–171. doi:10.1177/154405910608500210
  20. Yatabe MS, Garib DG, Janson G, Poletto RS, Ozawa TO. Is the presence of Simonart’s band in patients with complete unilateral cleft lip and palate associated with the prevalence of missing maxillary lateral incisors? Am J Orthod Dentofacial Orthop. 2013;144(5):649–653. doi:10.1016/j.ajodo.2013.06.018
  21. Naidoo S, Bütow KW. Oblique lip-alveolar banding in patients with cleft lip and palate. Br J Oral Maxillofac Surg. 2015;53(4):390–392. doi:10.1016/j.bjoms.2015.01.014
  22. Acharya SS, Mohanty P, Sahoo N, Gowd S, Baratam S, Sreedevi G. Simonart’s bands and facial growth in unilateral cleft lip and palate patients: A cephalometric analysis. J Int Oral Health. 2016;8(1):53–57.
  23. Carvalho Carrara CF, Passucci Ambrosio EC, Fernandes Mello BZ, et al. Three-dimensional evaluation of surgical techniques in neonates with orofacial cleft. Ann Maxillofac Surg. 2016;6(2):246–250. doi:10.4103/2231-0746.200350
  24. Elsherbiny A, Mazeed AS. Comprehensive and reliable classification system for primary diagnosis of cleft lip and palate. J Craniomaxillofac Surg. 2017;45(6):1010–1017. doi:10.1016/j.jcms.2017.03.008
  25. Reddy SG, Shah R, Ansari S, Reddy RR, Fanan A. Efficacy of morpho-functional repair in management of different morphological variants of unilateral complete cleft lip. J Craniomaxillofac Surg. 2019;47(10):1569–1576. doi:10.1016/j.jcms.2019.07.028
  26. Nollet PJ, Katsaros C, Van’t Hof MA, Kuijpers-Jagtman AM. Treatment outcome in unilateral cleft lip and palate evaluated with the GOSLON yardstick: A meta-analysis of 1,236 patients. Plast Reconstr Surg. 2005;116(5):1255–1262. doi:10.1097/01.prs.0000181652.84855.a3
  27. Jorge PK, Gnoinski W, Laskos KV, et al. Comparison of two treatment protocols in children with unilateral complete cleft lip and palate: Tridimensional evaluation of the maxillary dental arch. J Craniomaxillofac Surg. 2016;44(9):1117–1122. doi:10.1016/j.jcms.2016.06.032
  28. Akarsu-Guven B, Arisan A, Ozgur F, Aksu M. Influence of nasoalveolar molding on skeletal development in patients with unilateral cleft lip and palate at 5 years of age. Am J Orthod Dentofacial Orthop. 2018;153(4):489–495. doi:10.1016/j.ajodo.2017.08.012
  29. Vandersluis YR, Fisher DM, Stevens K, Tompson BD, Lou W, Suri S. Comparison of dental outcomes in patients with nonsyndromic complete unilateral cleft lip and palate who receive secondary alveolar bone grafting before or after emergence of the permanent maxillary canine. Am J Orthod Dentofacial Orthop. 2020;157(5):668–679. doi:10.1016/j.ajodo.2019.11.012
  30. Nordin KE, Larson O, Nylén B, Eklund G. Early bone grafting in complete cleft lip and palate cases following maxillofacial orthopedics. I. The method and the skeletal development from seven to thirteen years of age. Scand J Plast Reconstr Surg. 1983;17(1):33–50. doi:10.3109/02844318309007177
  31. Luijsterburg AJ, Rozendaal AM, Vermeij-Keers C. Classifying common oral clefts: A new approach after descriptive registration. Cleft Palate Craniofac J. 2014;51(4):381–391. doi:10.1597/1569-51.4.493
  32. McBride WA, McIntyre GT, Carroll K, Mossey PA. Subphenotyping and classification of orofacial clefts: Need for orofacial cleft subphenotyping calls for revised classification. Cleft Palate Craniofac J. 2016;53(5):539–549. doi:10.1597/15-029