Evaluation of Facial Soft Tissue in Patients With Cleft Lip and Palate Corrected Using Maxillary Protraction Appliances

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sayuri Uehara ◽  
Aya Honda ◽  
Yoko Kawase-Koga ◽  
Daichi Chikazu
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Facial Soft Tissue ◽  
Maxillary Protraction

Soft-Tissue Profile Changes during Widening and Protraction of the Maxilla in Patients with Cleft Lip and Palate Compared with Normal Growth and Development

1993 ◽  
Vol 30 (5) ◽  
pp. 454-468 ◽  
Author(s):  
Rolf S. Tindlund ◽  
Per Rygh
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Lower Lip ◽  
Maxillary Protraction ◽  
Transverse Expansion ◽  
Short Period ◽  
Soft Tissue Profile ◽  
Lateral Cephalograms ◽  
Maxillary Deficiency

During the last 15 years, cleft lip and palate (CLP) patients with maxillary deficiency in the care of the Bergen CLP team have undergone an interceptive orthopedic treatment phase during the deciduous and mixed dentition period. The present study includes 68 patients who received maxillary transverse expansion by use of a modified quad-helix appliance and 98 cases given maxillary protraction by a facial mask. All cases were treated until an acceptable normal occlusion was attained. Lateral cephalograms were taken immediately before and after the active treatment periods. Sagittal changes of the soft-tissue profile during transverse expansion and protraction were analyzed separately for unilateral complete cleft lip and palate (UCLP) patients and bilateral complete cleft lip and palate (BCLP) patients. The soft-tissue profiles of the groups were compared to growth changes of noncleft age-matched children (NORM group). During the short period of maxillary transverse expansion (mean period, 3.5 months) no significant change of the soft-tissue profile was found, except in the protrusion of the lower lip in the BCLP group. During the period of maxillary protraction (mean periods, 12 months in the UCLP group and 15 months in the BCLP group) the soft-tissue profile improved significantly by reducing the characteristic tendency towards a concave profile in CLP patients with maxillary deficiency. Significant Increases of the sagittal maxillomandlbular lip relation (angle SS-N-SM: mean Increase, 2.5 degrees) and the Holdaway-angle (H-angle: mean increase, 3.0 degrees) were found to be similar in the UCLP and BCLP groups. However, the use of different reference lines for evaluation of treatment effects upon the soft-tissue profile resulted in conflicting findings suggesting that anteriorly situated reference lines are more suitable for the evaluation of CLP patients. Thus, the esthetic line (E.line) indicated a favorable position of the lips after treatment; the subspinale-pogonlon line (ss.pg) revealed an Improved soft-tissue profile; the soft-tissue-facial line (N.PG) showed a retruded nose and upper lip; whereas basal references such as the nasion-sella line (NSL) and the occlusal-line perpendicular (OLP) mainly showed major differences between the CLP groups and the NORM groups.

Facial Soft-Tissue Morphology of Adolescent Patients With Nonsyndromic Bilateral Cleft Lip and Palate

2014 ◽  
Vol 25 (1) ◽  
pp. 314-317 ◽  
Author(s):  
Nadia Hasanzadeh ◽  
Mohammad Reza Majidi ◽  
Hamidreza Kianifar ◽  
Neda Eslami
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Facial Soft Tissue ◽  
Tissue Morphology ◽  
Bilateral Cleft Lip ◽  
Adolescent Patients

Evaluation of the Facial Soft-Tissue Thickness in Patients With Cleft Lip and Palate

2019 ◽  
Vol 30 (6) ◽  
pp. 1706-1709 ◽  
Author(s):  
Emire Aybuke Erdur ◽  
Zeliha Muge Baka ◽  
Merve Fidanboy ◽  
Omer Erdur
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Tissue Thickness ◽  
Facial Soft Tissue ◽  
Soft Tissue Thickness

Orthodontic Pre Grafting Closure of Large Alveolar Bony and Soft Tissue Gaps: A Novel Nonsurgical Protraction of the Lesser Segments in Growing Patients With Cleft Lip and Palate

2021 ◽  
pp. 105566562110076
Author(s):  
Maria Costanza Meazzini ◽  
Noah Cohen ◽  
Valeria Marinella Augusta Battista ◽  
Cristina Incorvati ◽  
Federico Biglioli ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Procedures ◽  
Efficient Method ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Cleft Lip And Palate ◽  
Face Mask ◽  
Younger Patients ◽  
Good Healing

Background: Closure of wide alveolar clefts with large soft tissue gaps and reconstruction of the dentoalveolar defect are challenging for the surgeon. Some authors successfully used interdental segmental distraction, which requires an additional surgical procedure. Objective: This study evaluates the effectiveness of tooth borne devices utilized to orthopedically advance the lesser segments, with a complete approximation of the soft tissue of the alveolar stumps, allowing traditional simultaneous soft tissue closure and bone grafting, and avoiding the need for supplementary surgery. Methods: Eight growing patients, 2 with unilateral complete cleft lip and palate (UCLP) and 6 with bilateral complete cleft lip and palate (BCLP), with large soft tissue and bony alveolar defects prior to bone grafting were prospectively selected. A banded rapid palatal expander (RPE) in BCLP and a modified RPE in UCLP combined with protraction face mask in younger patients or a modified Alt-Ramec in patients older than 12 years were applied. Radiographic and photographic records were available at T0, at the end of protraction (T1) and at least 1 year after bone grafting (T2). Results: Patients with large gaps showed a significant reduction in the bony cleft area and approximation of the soft tissues at T1. All patients received bone grafting with good healing and ossification at T2. Conclusion: In growing patients with UCLP and BCLP with large gaps, presurgical orthodontic protraction seems to be an efficient method to reduce the cleft defect, minimizing the risk of post grafting fistulas, reducing the need for supplementary surgical procedures.

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