Cleft lip – a comprehensive review (original) (raw)
Related papers
Cleft lip: our experience in repair
Journal of Maxillofacial and Oral Surgery, 2010
The ideally repaired cleft lip should provide a symmetrical cupid's bow, philtrum and a minimal scar. The lip length, pout and symmetry of the alar base should be maintained to achieve the best result. The most popular method for cleft lip repair is rotation advancement technique introduced by Millard which improves the relationship of alar base of cleft side, produces harmonious symmetry of the nostril, the surgical scar is masked in the philtral crest and nostril floor. In addition, it uses and preserves the lip anatomy, returns lip tissue into its normal position, minimizes amount of tissue discard and reconstructs orbicularis oris muscle. Methodology We have assessed the incidence of cleft lip deformities, discussed the feasibility of repair by Millard, its modifications and evaluated the results of cleft lip repairs at our center. The study included 158 patients of cleft lip and palate, of which 60 cleft lip patients underwent surgical repair. Result The outcome of our surgical result was good and suggested quantitative changes with progressive diminution of asymmetry of the cleft and non cleft sides.
Siriraj Medical Journal, 2022
Cleft lip and/or cleft palate (CL±P) in addition to the cleft palate (CP) are a category of anomalies known as orofacial clefts (OC). These anomalies are accompanied by several aesthetic and functional problems. Information on the prevalence of OC showed different values between studies worldwide. In addition, the presence of cleft lip and/or cleft palate is determined by several changes during the embryonic stage. Besides, cleft repair may lead to a significant impact on the overall aesthetic and function and could negatively affect maxillary growth on certain occasions. Therefore, having the background and knowledge on this phenomenon is essential in designing the overall treatment and obtaining outcomes that are as close to normal as possible. This article reviews the maxillary development, occurrence of cleft lip and/or palate and their prevalence, facial growth in the presence of clefts, effect of cleft repair, an overview of alveolar cleft treatment, as well as the essential information related the prevention of cleft lip and palate.
Cleft Lip and Palate Management from Birth to Adulthood: An Overview
Insights into Various Aspects of Oral Health, 2017
Cleft lip and palate (CLP) is the most common congenital deformity of the orofacial. Clefts are thought to be of multifactorial etiology due to genetic and environmental factors. Different dental abnormalities are usually seen in cleft patients, including midface deficiency, collapsed dental arches, malformation of teeth, hypodontia, and supernumerary teeth. Moreover, feeding and speech are major functional dilemmas for those patients. The goal of treatment is to restore esthetics and functional impairments associated with clefts. The nature and the extent of medical and dental problems among CLP patients dictate the need toward multidisciplinary approach where different medical and dental specialists are involved in the treatment. The purpose of this section is to codify and synthesize a literature about management of cleft lip and palate deformity from birth until adulthood so that general concepts, principles, and axioms can be formulated. In this regard, feeding plates, nasoalveolar molding (NAM), lip and palate repair, palatal expansion, alveolar bone grafting, rhinoplasty, orthodontic treatment, and orthognathic surgery will be discussed. Furthermore, the question of proper timing for each therapeutic procedure is scrutinized in this chapter. Suggested clinical tips and changes of treatment modalities are summarized and illustrated as well.
Cleft Lip and Palate Patients: Diagnosis and Treatment
Designing Strategies for Cleft Lip and Palate Care, 2017
Cleft lip or palate is one of the most common types of craniomaxillofacial birth anomalies. Midface deficiency is a common feature of cleft lip and palate patients due to scar tissue of the lip and palate closure. Cleft lip and palate patients should be carefully evaluated by the craniofacial team in order to detect potentially serious deformities. Craniofacial team is involved with diagnosis of facial morphology, feeding problems, guidance of the growth and development of the face, occlusion, dentition, hearing and speech problems, and psychosocial issues and jaw discrepancy of the patients with cleft lip and palate or craniofacial syndromes. Treatment for cleft children requires a multidisciplinary approach including facial surgery in the first months of life, preventive and interceptive treatment in primary dentition, speech therapy, orthodontics in the mixed dentition phase, oromaxillofacial surgery, and implant and prosthetics in adults. Treatment plan from orthodontic perspective can be divided into the following stages based on the dentition stages: (1) presurgical orthopedics, (2) primary dentition, (3) mixed dentition, and (4) permanent dentition. The aim of this chapter is to assess a rational team work approach in the management of the patient with cleft lip and/or palate from birth to adulthood.
An Introduction to Cleft Lip and Palate Senior Capstone Experience
The purpose of this review is to provide a summary of the cleft lip or palate procedure with a focus on human anatomy. Cleft lip and palate are the most common facial malformations and occur in 1 newborn in 2500 live births.1 Through a thorough analysis of journal articles and viable source-s one will be able to grasp a. introductory understanding of cleft palate including the history, anatomy, causes, procedure, and post-operation lifestyle with cleft palate. Although the problem is genetic and embryological in nature, anatomy is very relevant as the complications stem from oropharyngeal muscles inserting on structural bones, impacting neurovascular areas of the mouth, leading to a complex deformity. The topic was subdivided to cover all areas relevant to the review. The sources used were primarily from journal articles such as PubMed, books, and other online published data. Overall the topic is closely related to medicine and dentistry while incorporating the basic anatomical concepts learned in BIOL-N261 to satisfy the honors paper requirement.
Cleft Lip and Palate Surgery: An Update of Clinical Outcomes for Primary Repair
Oral and Maxillofacial Surgery Clinics of North America, 2010
The comprehensive management of cleft lip and palate has received significant attention in the surgical literature over the last half century. It is the most common congenital facial malformation in the United States and has a significant developmental, physical, and psychological impact on those with the deformity and their families. In the United States, current estimates place the prevalence of cleft lip and palate or isolated cleft lip at 16.86 per 10,000 live births (approximately 1 in 600). 1 There is significant phenotypic variation in the specific presentation of facial clefts. Care of children and adolescents with orofacial clefts needs an organized team approach to provide optimal results. 2-4 Specialists from multiple areas are needed for successful management from infancy through adolescence. These include oral and maxillofacial surgery, otolaryngology, plastic surgery, genetics and dysmorphology, speechlanguage pathology, social work, psychology, orthodontics, pediatric dentistry, prosthodontics, audiology, and nursing. 4 The specific goals of surgical care for children born with cleft lip and palate include: Normalized esthetic appearance of the lip and nose Intact primary and secondary palate Normalized speech, language, and hearing Nasal airway patency Class I occlusion with normal masticatory function Good dental and periodontal health Normal psychosocial development These goals are best achieved when surgeons with extensive training and experience in all phases of care are actively involved in the planning and treatment. 5-7 Surgical treatment must be based on the best available clinical research to avoid unfruitful, biased treatment schemes and optimize outcomes. Ideally, randomized prospective controlled trials with comparative data and appropriate outcome measures would guide one's decisions. Outcome studies pertaining to the multiple outcome measures, such as facial appearance, facial growth, occlusion, patient satisfaction, and psychosocial development, are essential. Unfortunately, this level of published
Principles of Cleft Lip Repair: Conventions, Commonalities, and Controversies
Plastic and reconstructive surgery, 2017
After reading this article, the participant should be able to: 1. Understand the principles of contemporary methods for repair of unilateral and bilateral cleft lip. 2. Understand the design elements of a poor repair that predispose to a suboptimal outcome. The authors describe the evaluation and management of unilateral and bilateral cleft lip (with or without cleft alveolus and with or without cleft palate). Each deformity is presented in a "principles-based" manner. For unilateral cleft lip, the authors discuss common modifications of rotation-advancement and Fisher's anatomical subunit approach. In expert hands, both techniques can give excellent results. For bilateral cleft lip, Mulliken's method is presented. Methods for synchronous correction of the cleft lip nasal deformity are also discussed.
Orofacial clefts: treatment based on a multidisciplinary approach
ARCHIVES OF HEALTH INVESTIGATION, 2020
Objective: The present study aims to expose through a literature review the cleft lip and/or cleft palate (CL/CP) and its treatment in a multidisciplinary approach. Methodology: This literature review was conducted by the leading health databases: Pubmed (https://www.ncbi.nlm.nih.gov/pubmed). The keywords for the textual search were: Cleft Lip; Cleft Palate; Dental Staff; Classification; Embryology. The inclusion criteria were: literature on the subject under study, literature of the last years, english language, laboratory and clinical studies and systematic review. Literature Review: Fissures can be defined by a space at the junction between two bones, usually where there would be a suture. Orofacial clefts are part of the congenital facial anomalies resulted from the non-junction of the embryonic facial processes. These changes occur due to an alteration in the migratory velocity of the neural crest cells, in charge of the phenomenon of fusion of the facial prominences between th...