Maxillary Growth After the Use of Protraction Head Gear in Conjunction With Presurgical Orthopedics and Gingivoperiosteoplasty for Complete Bilateral Cleft Lip and Alveolus Patients

2013 ◽  
Vol 24 (5) ◽  
pp. 1679-1684
Author(s):  
Shinji Kobayashi ◽  
Takashi Hirakawa ◽  
Toshihiko Fukawa ◽  
Jiro Maegawa
Keyword(s):  
Cleft Lip ◽  
Bilateral Cleft Lip ◽  
Maxillary Growth ◽  
Presurgical Orthopedics

scholarly journals Longitudinal Study of Effect of Hotz's Plate and Lip Adhesion on Maxillary Growth in Bilateral Cleft Lip and Palate Patients

2012 ◽  
Vol 49 (2) ◽  
pp. 230-236 ◽  
Author(s):  
Muhammad Syafrudin Hak ◽  
Masaaki Sasaguri ◽  
Farida Kamil Sulaiman ◽  
Enny Tyasandarwati Hardono ◽  
Akira Suzuki ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillofacial Surgery ◽  
University Hospital ◽  
Dental Arch ◽  
Prospective Longitudinal Study ◽  
Bilateral Cleft Lip ◽  
Maxillary Growth ◽  
Prospective Longitudinal

Objective To investigate the effects of infant orthopedic treatment and lip adhesion on maxillary growth of patients with bilateral cleft lip and palate (BCLP). Design Prospective longitudinal study. Setting The present study was conducted at the Cleft Lip and Palate Center, Harapan Kita Children and Maternity Hospital, Indonesia, and the Department of Oral and Maxillofacial Surgery, Kyushu University Hospital, Japan. Subjects The study sample consisted of 53 patients with complete BCLP and 10 noncleft patients with other diseases. Patients with BCLP were divided into three groups: H (-), 11 patients treated without Hotz's plate; H (+), 24 treated with Hotz's plate; and LA-H, 18 treated with lip adhesion and Hotz's plate. Methods Serial dental casts were obtained from each BCLP child at the following four time points: first visit, labioplasty, palatoplasty, and 5 years of age. Each maxillary dental cast was scanned, and the linear and angular dimensions were measured. Results and Conclusion Lip adhesion showed a temporary negative effect. In all patients with BCLP, the surgeries affected the growth of the anterior arch width until the age of 5 years. Collapse of the premaxilla following labioplasty in the H (-) group affected the growth of dental arch length until the age of 5 years. Treatment using Hotz's plate prevented collapse of the premaxilla, and the growth of the arch length was comparable to that observed in the noncleft group.

scholarly journals Presurgical Alignment of Bilateral Cleft Segments With 3D Simulation Under Special Consideration of the Vomer: A Technical Note

2020 ◽  
pp. 105566562096543
Author(s):  
Gül Schmidt ◽  
Max Heiland ◽  
Carsten Matuschek
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Technical Note ◽  
3D Simulation ◽  
Special Consideration ◽  
Bilateral Cleft Lip ◽  
Orthodontic Device ◽  
Presurgical Orthopedics

Background: The main goal of presurgical orthopedics (PSO) for patients with bilateral cleft lip and palate is to correct the protruded and/or twisted premaxilla. However, PSO is associated with the risk of uncontrolled development of the vomer, which has received little attention to date. Solution: We present a removable orthodontic device that can be used to keep or align the vomer and the premaxilla in the midline during preoperative molding of cleft segments independently and 3 dimensionally.

The Need for Orthognathic Surgery in Patients with Repaired Complete Unilateral and Complete Bilateral Cleft Lip and Palate

2009 ◽  
Vol 46 (5) ◽  
pp. 498-502 ◽  
Author(s):  
John Daskalogiannakis ◽  
Manisha Mehta
Keyword(s):  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Associated Anomalies ◽  
Canadian Health Care System ◽  
Bilateral Cleft Lip ◽  
Canadian Health ◽  
Canadian Health Care ◽  
History Of ◽  
Presurgical Orthopedics

Objective: To determine the percentage of patients with complete unilateral cleft lip and palate and complete bilateral cleft lip and palate treated at SickKids since birth who would benefit from orthognathic surgery. Design: Retrospective cohort study. Subjects: The review comprised records of 258 patients with complete unilateral cleft lip and palate and 149 patients with complete bilateral cleft lip and palate born from 1960 to 1989. Of these, 211 and 129 patients, respectively, had been treated at SickKids since birth. Patients with syndromes or associated anomalies were excluded. Methods: Patients who had undergone orthognathic surgery were recorded. For the remaining patients, arbitrarily set cephalometric criteria were used in order to identify the “objective” need for surgery. Lateral cephalometric radiographs taken beyond the age of 15 years were digitized using Dentofacial Planner cephalometric software. Results: Of the 211 patients with complete unilateral cleft lip and palate, 102 (48.3%) were deemed to benefit from orthognathic surgery. For the complete bilateral cleft lip and palate sample, the percentage was 65.1% (84 of 129). Definitive information on presurgical orthopedics was available for a small subsample (101 patients) of the complete unilateral cleft lip and palate cohort. The need for orthognathic surgery for this group was slightly higher (59.4%, or 60 of 101). Conclusion: These results suggest that a considerable percentage of patients with a history of complete cleft lip and palate at our institution require orthognathic surgery. Factors that need to be considered in the interpretation of these results include the quest for improvement in the profile aesthetics; the fact that the Canadian health care system covers the costs of surgery, making it more accessible to the patients; and the inclusion in the above figures of patients who had orthognathic surgery solely for reasons of closure of previously ungrafted alveolar clefts and associated fistulae.

Associations between Severity of Clefting and Maxillary Growth in Patients with Unilateral Cleft Lip and Palate Treated with Infant Orthopedics

2001 ◽  
Vol 38 (6) ◽  
pp. 582-586 ◽  
Author(s):  
Timo Peltomäki ◽  
Bruno L. Vendittelli ◽  
Barry H. Grayson ◽  
Court B. Cutting ◽  
Lawrence E. Brecht
Keyword(s):  
New York ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Medical Center ◽  
New York University ◽  
Maxillary Growth ◽  
Reconstructive Plastic Surgery ◽  
Cephalometric Measurements ◽  
Presurgical Orthopedics

Objective: The purpose of this study was to examine possible associations between severity of clefting in infants and maxillary growth in children with complete unilateral cleft lip and palate. Design: This was a retrospective study of measurements made on infant maxillary study casts and maxillary cephalometric variables obtained at 5 to 6 years of follow-up. Setting: The study was performed at the Institute of Reconstructive Plastic Surgery of New York University Medical Center, New York, New York. Patients: Twenty-four consecutive nonsyndromic unilateral complete cleft lip and palate patients treated during the years 1987 to 1994. Interventions: All the patients received uniform treatment (i.e., presurgical orthopedics followed by gingivoperiosteoplasty to close the alveolar cleft combined with repair of the lip and nose in a single stage at the age of 3 to 4 months). Closure of the palate was performed at the age of 12 to 14 months. Results: Infant maxillary study cast measurements correlated in a statistically significant manner with maxillary cephalometric measurements at age 5 to 6 years. Conclusions: The results demonstrate the large variation in the severity of unilateral cleft lip and palate deformity at birth. Patients with large clefts and small arch circumference, arch length, or both demonstrated less favorable maxillary growth than those with small clefts and large arch circumference or arch length at birth.

Evaluation of Congenital Maxillary Growth Using Computed Tomography in Patients With Bilateral Cleft Lip and Palate

2019 ◽  
Vol 57 (3) ◽  
pp. 282-287
Author(s):  
Shinji Kobayashi ◽  
Kazunori Yasumura ◽  
Takashi Hirakawa ◽  
Toshihiko Fukawa ◽  
Jiro Maegawa
Keyword(s):  
Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Medical Center ◽  
Nasal Bone ◽  
Segment Length ◽  
Control Group ◽  
Bilateral Cleft Lip ◽  
Ct Analysis ◽  
Maxillary Growth

Objective: To analyze congenital lateral maxillary growth for patients with bilateral cleft lip and palate (BCLP). Design: A retrospective study. Setting: Kanagawa Children’s Medical Center. Materials: Images from computed tomography (CT) of patients with BCLP and control patients that were previously used for treatment. Main Outcome Measures: The following landmarks were used: A, the posterior most point of the piriform aperture; B, the superior most point of the acoustic meatus; C, the point at which line A-B intersects the line drawn perpendicular from line A-B to the maxillary tuberosity; and D, the apical most point of the nasal bone. The following distances were then measured using these landmarks: (1) A-B distance; (2) A-C distance; (3) A-C/A-B; (4) the angle between lines A-B and A-D (∠BAD); and (5) B-D distance. Result: Mean A-B and A-C distances and A-C/A-B were significantly smaller in the BCLP group than in the control group ( P < .01 each). Mean ∠BAD was significantly larger in the BCLP group than in the control group ( P < .01). Mean B-D distance did not differ significantly between groups. Conclusions: Our results indicated that the lateral maxillary segments of patients with BCLP were more posterior than those of the control group, and segment length was shorter compared to the control group on 3D-CT analysis. The lateral maxillary segments of patients with BCLP were basically suggested to originally be underdeveloped.

A Rapid Solution to Align the Severely Malpositioned Premaxilla in Bilateral Cleft Lip and Palate Patients

2008 ◽  
Vol 45 (3) ◽  
pp. 229-231 ◽  
Author(s):  
Amornpong T. Vachiramon ◽  
John N. Groper ◽  
Simon Gamer
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Time ◽  
Bilateral Cleft Lip ◽  
Nasoalveolar Molding ◽  
Presurgical Orthopedics ◽  
Palate Patient

Objective: To describe a laboratory modification of the maxillary cast to make an improved nasoalveolar molding plate used in presurgical orthopedics for infants with bilateral cleft lip and palate. Conclusions: Modifying the nasoalveolar molding plate may reduce the presurgical treatment time for the bilateral cleft lip and palate patient.

Effect of Presurgical Infant Orthopedics on Facial Esthetics in Complete Bilateral Cleft Lip and Palate

1994 ◽  
Vol 31 (1) ◽  
pp. 68-73 ◽  
Author(s):  
R. Bruce Ross ◽  
M.C. Macnamera
Keyword(s):  
Surgical Procedures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sex Distribution ◽  
Facial Esthetics ◽  
Bilateral Cleft Lip ◽  
Full Face ◽  
Presurgical Orthopedics ◽  
Infant Orthopedics ◽  
Age And Sex

A sample of 40 teenage individuals with repalred complete bilateral cleft lip and palate, 20 of whom had received presurgical infant orthopedics, was obtained to test the effects of presurgical Infant orthopedics on facial esthetics. All subjects had surgery by the same surgeon. The age and sex distribution was approximately equal between the two groups. A panel of five judges evaluated the lip and nose esthetics from full face and profile slides and a mean panel score for each subject was derived for six individual features and three total scores. No difference in the esthetic scores between the two groups could be detected. No differences were found In the number of revisionary surgical procedures required to the lip or nose. The findings indicate that conservative presurgical orthopedics for infants with complete bilateral cleft lip and palate has no lasting effect on the esthetics of the lip and nose, and does not alter the need for subsequent revisionary surgery.

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