Secondary alveolar bone graft in patients with bilateral cleft lip and palate submitted to premaxilla repositioning: retrospective study (original) (raw)
Related papers
Cleft lip and palate: a review for dentists
Journal (Canadian Dental Association), 2001
The goals of primary closure of cleft lip and palate include not only re-establishing normal insertions for all of the nasolabial muscles but also restoring the normal position of all the other soft tissues, including the mucocutaneous elements. Conventional surgical wisdom, which recommends waiting until growth is complete before undertaking surgical correction of the postoperative sequelae of primary cheiloplasty, carries with it many disadvantages. If, after primary surgery of the lip, orolabial dysfunctions remain, they will exert their nefarious influences during growth and will themselves lead to long term dentofacial imbalances. These imbalances can significantly influence facial harmony. Unless accurate, symmetric and functional reconstruction of the nasolabial muscles is achieved during the primary surgery, not only will the existing dentoskeletal imbalances be exaggerated, but other deformities will be caused during subsequent growth, among which the most important are nas...
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.
American Journal of Orthodontics and Dentofacial Orthopedics, 2014
Introduction: In this study, we compared patterns of morphologic variations of the craniofacial skeleton between patients affected by clefts who were operated on and unaffected subjects, aiming to discuss possible morphofunctional consequences of treatment in craniofacial development. Methods: The lateral cephalograms of 76 subjects, comprising patients with operated unilateral cleft lip and palate (OpC) and a group matched for sex and age without cleft, were used. Thirteen landmarks were used as variables in geometric morphometric tests quantifying and describing overall shape variation, differences between group means, allometry, and upperlower face covariation. Results: The OpC group showed broader shape variations including noncleft group characteristics, but mainly a retrognathic maxilla, a vertically elongated face, a more open mandibular angle, and a more closed basicranial angle. Group means differed mainly in the maxillomandibular relationships. Allometry differed between groups, with the smallest OpC patients showing the most altered morphology. Upper and lower face covariation was stronger in the OpC group, showing mainly vertical changes in the anterior face. Conclusions: Operated patients affected by clefts achieve a broad range of morphologies; the most altered were found in those with skeletal Class III and small size. Furthermore, their strongest upper and lower face shape covariation suggests that a harmonic dental occlusion could be a key factor in achieving "normal" craniofacial morphology. (Am J Orthod Dentofacial Orthop 2014;146:346-54) C lefts of the lip and palate (CLP) are common congenital anomalies. The incidence is highly variable among populations. The highest incidence is found in Asians and Native Americans, with 1 in 500 live births, and the lowest in Africans, with 1 in 2500 births; white, Hispanic, and Latin populations (among these, Chileans) have intermediate incidence of 1 in 1000 live births. 1-4 Cleft etiology is multifactorial, comprising both genetic and environmental factors acting during intrauterine development. 5-7 Unilateral CLP (UCLP) is the most common cleft type. 5,8 Morphologic alterations of operated patients with UCLP have been widely reported in the literature, of which changes in maxillomandibular relationship are the most prevalent, as described below. Since unoperated subjects have the potential to develop a "normal" (ie, skeletal Class I) maxillomandibular relationship, 9,10 it has been proposed that altered maxillomandibular relationships are caused by the effect of surgery, particularly lip closure, on the developing bone and sutures. 11-13 This has led to the proposal of different protocols for the surgical management of CLP that concur in the importance of reconstructing the muscular anatomy of the lip and the soft palate after the third month of age. 12,14-16 Despite the differences in surgical approaches and treatment protocols, the morphologic features in operated patients with UCLP tend to be uniform. In general,
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 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.
Journal of Cranio-Maxillofacial Surgery, 2003
Introduction: The purpose of this study was to assess differences of the long-term results following surgical treatment in patients with cleft palate treated by two different surgical concepts. Patients: Fifty-nine adult patients operated on for cleft palate were examined. Thirty palates were closed by a two stage (Widmaier and Veau) and 29 by a single-stage procedure (Veau's pedicled flap). Methods: Lateral cephalometric and model analysis was performed. In the cephalometric analysis, the vertical and horizontal parameters of the position of maxilla and midface and transverse and sagittal dimensions of the models were compared between the two groups. Results: Model analysis: According to the Bolton analysis the maxillary dental arch was too large in 22 patients in each group. The other patients had mandibular arches that were too large. In 18 patients with two-stage closure and in 9 patients with one-stage closure, a space deficit in the lateral part of the maxilla was observed. Persisting transverse deficits were seen in all patients with two-stage repairs and in 11 patients with one-stage repairs. The deficit was more severe in the molar area in the first group and almost equally severe in the premolar and the molar regions of the second group. A sagittal deficiency was found more often in patients with two-stage repairs while Angle's class I occlusion was seen more often in patients with one-stage surgery. Lateral cephalometry: Similar SNA-angles were seen in both groups whereas the ANB-angle was greater following twostage repair. In both patient groups a low inclination of the midface was seen. The vertical dimension of the midface in comparison with the lower face was normal in the one-stage group; in the other group a deficiency of the anterior midface height was registered. Conclusion: There was a more severe growth impairment of the midface in patients with this type of two-stage palatal repair. The horizontal deficiency was similar in both groups. The long-term occlusal result revealed smaller sagittal and transverse deficiencies in patients with this type of single-stage closure.