Classification of Cleft Lip and Palate

Aim. To determine the structure of functional disorders and their dynamic changes in children with congenital cleft lip and palate from the position of International Classification of Functioning. Materials and methods. The indices, included into International Classification of Functioning, were assessed in 77 children (age range 1 to 6 years) with congenital cleft lip and palate, who received a complex five-stage therapy. Results. Direct correlation between the type of cleft and the value of disorders in classification constituents “function” and “structure” was revealed. Thus, in patients with bilateral cleft lip and palate, disorders of functions reached 82 %, in children with one-sided cleft lip and palate - 45 %. In children of group I, more marked structural disorders were observed, forming from 24 to 96 %, in children of groups 2 and 3 - from 5 to 49 %. In children with bilateral cleft lip and palate, there were observed more marked abnormalities in the category “activity and participation” (25-95 %) compared to children of groups 2 and 3 (0-24 %). Conclusions. Application of International Classification of Functioning for children with congenital cleft lip and palate shows a wide range of the assessed functional disorders and the possibility of using it for dynamic analysis of efficiency and treatment.

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New Neonatal Classification of Unilateral Cleft Lip and Palate—Part 1: To Predict Primary Lateral Incisor Agenesis and Inherent Tissue Hypoplasia

The Cleft Palate-Craniofacial Journal ◽

10.1597/12-113 ◽

2014 ◽

Vol 51 (4) ◽

pp. 392-399 ◽

Cited By ~ 6

Author(s):

Christian Delestan ◽

Pedro Montoya ◽

Jean-Charles Doucet ◽

Michèle Bigorre ◽

Caroline Baümler ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Lateral Incisor ◽

Lateral Incisor Agenesis ◽

Primary Lateral

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Cleft lip and palate in general dental practice: filling in the gaps

Dental Update ◽

10.12968/denu.2021.48.7.547 ◽

2021 ◽

Vol 48 (7) ◽

pp. 547-554

Author(s):

Sharan Reddy ◽

Catherine Liu ◽

Mina Vaidyanathan ◽

Nabina Bhujel

Keyword(s):

Oral Health ◽

Dental Caries ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Dental Practice ◽

Craniofacial Anomalies ◽

Dental Anomalies ◽

Increased Risk

Cleft lip and palate (CLP) is the most common of craniofacial anomalies in humans. CLP results from disruption of embryonic processes during orofacial development; while syndromic clefts may have clearer aetiology, non-syndromic clefts are heterogeneous in aetiology. It is important for GDPs to understand the classification of CLP and the structure of centralized cleft centres in order to communicate with cleft teams. This article aims to clarify the role of GDPs within cleft management and discusses challenges in maintaining oral health in this group of patients, including increased risk of dental caries and periodontal disease, dental anomalies and psychosocial considerations. CPD/Clinical Relevance: The GDP should be responsible for maintaining good oral health for the patient with cleft lip and palate, focusing on prevention from a young age and restorative work if needed.

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Clinical Outcomes Utilizing a “Modified Latham” Appliance for Presurgical Infant Orthopedics in Patients With Unilateral Complete Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665618816892 ◽

2018 ◽

Vol 56 (7) ◽

pp. 929-935 ◽

Cited By ~ 1

Author(s):

Diana S. Jodeh ◽

Stephen Ruso ◽

Randy Feldman ◽

Ernesto Ruas ◽

S. Alex Rottgers

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Retrospective Chart Review ◽

International Classification Of Diseases ◽

Average Hospital ◽

Classification Of Diseases ◽

Cleft Lip Palate ◽

Direct Approximation ◽

Infant Orthopedics

Presurgical infant orthopedic manipulation is utilized prior to cleft lip/nasal repair to facilitate a gingivoperiosteoplasty (GPP) and primary nasolabial repairs. The Latham dentomaxillary advancement appliance uses a screw that must be tightened daily to approximate the cleft segments in unilateral complete clefts. Our cleft center has been utilizing a “modified Latham” appliance since 1987, including an orthodontic elastic power chain to close the gap in a shorter amount of time. We performed a retrospective chart review of all patients undergoing treatment at Johns Hopkins All Children's Hospital (JHACH) with a unilateral complete cleft lip and palate between 1987 and 2017. Patients were identified by the International Classification of Diseases, Ninth Revision code (749.21). The majority of the patients represent the experience of the senior authors (E.R. and R.F.). Two hundred and eighty-one patients with unilateral complete cleft lip/palate were identified. Seventy-five patients were treated with a “modified Latham” appliance prior to their lip repair. The “modified Latham” appliance remained in place on average 20.6 days (range: 4-82), and average hospital stay after placement was 1.18 days. Nearly 96% of patients underwent a successful GPP at the time of nasolabial repair. Modification of the Latham appliance by utilizing an elastic power chain and eliminating the screw allows rapid closure of the alveolar cleft with limited need for adjustments and outpatient visits. Direct approximation of the palatal segments allows successful completion of a GPP in 95.9% of patients with limited dissection.

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Speech Intelligibility of Patients with Cleft Lip and Palate after Placement of Speech Prosthesis

The Cleft Palate-Craniofacial Journal ◽

10.1597/06-061.1 ◽

2007 ◽

Vol 44 (6) ◽

pp. 635-641 ◽

Cited By ~ 29

Author(s):

João Henrique Nogueira Pinto ◽

Giseleda Silva Dalben ◽

Maria Inês Pegoraro-Krook

Keyword(s):

Cleft Palate ◽

Speech Intelligibility ◽

Cleft Lip ◽

Speech Therapy ◽

Cleft Lip And Palate ◽

Velopharyngeal Insufficiency ◽

Cross Sectional ◽

Before And After ◽

Dental Needs

Objective: To evaluate the speech intelligibility of patients with clefts before and after placement of a speech prosthesis. Design: Cross-sectional. Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, Brazil. Patients: Twenty-seven patients with unoperated cleft palate or operated cleft palate presenting with velopharyngeal insufficiency (VPI) after primary palatoplasty, treated with speech prosthesis, aged 8 to 63 years. Interventions: Patients were fitted with palatopharyngeal obturators or pharyngeal bulbs, suitable to their dental needs. Five speech-language pathologists blindly evaluated speech samples of the patients with and without the prosthesis. Main Outcome Measures: Classification of speech samples according to a scoring system developed for speech intelligibility problems: 1 (normal), 2 (mild), 3 (mild to moderate), 4 (moderate), 5 (moderate to severe), and 6 (severe). Results were evaluated by the calculation of means of all judges for each patient in both situations. Results: The judges presented significant agreement (W = .789, p < .01). Speech intelligibility was significantly better after placement of the prosthesis for both unoperated patients (Z = 1.93, p = .02) and operated patients with VPI after primary palatoplasty (Z = 1.78, p = .03). Conclusions: Speech intelligibility may be improved by rehabilitation of patients with cleft palate using a speech prosthesis. Speech therapy is needed to eliminate any compensatory articulation productions developed prior to prosthetic management.

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