Early Orthopaedic Treatment of Unilateral Cleft Lip and Palate

1978 ◽  
Vol 5 (3) ◽  
pp. 119-132 ◽  
Author(s):  
W. C. Shaw
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Cleft ◽  
Orthopaedic Treatment ◽  
Partial Data ◽  
Alveolar Tissue ◽  
Maxillary Arch

Serial frontal and lateral cephalometric radiographs with implants and study models of 31 infants' who received orthopaedic treatment for unilateral cleft lip and palate, were analysed with an electronic XY reader. Partial data for 50 normal infants and 10 isolated palatal cleft patients were included to allow certain comparisons. The records at birth indicate that the size of the alveolar cleft in unilateral cleft cases is governed mainly by the degree of transverse segmental separation which is present and only to a lesser extent by deficiency of alveolar tissue, except in a minority of cases. It is clear that in the early months of life, the divided maxillary arch can be made to assume near normal dimensions by inward rotation of the anterior ends of the segments, at the alveolar and basal level, around axes in the tuberosity regions. Appositional growth of the cleft margins makes little contribution to the reduction in cleft size. The significance of the findings is discussed.

Presurgical Nasoalveolar Molding Therapy for the Treatment of Unilateral Cleft Lip and Palate: A Preliminary Study

2007 ◽  
Vol 44 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Christopher F. Ezzat ◽  
Carmen Chavarria ◽  
John F. Teichgraeber ◽  
Jung-Wei Chen ◽  
Robin G. Stratmann ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Significant Positive Correlation ◽  
Cleft Lip And Palate ◽  
Average Length ◽  
Alveolar Cleft ◽  
Arch Width ◽  
Preliminary Study ◽  
A Prospective Study ◽  
Nasoalveolar Molding ◽  
Maxillary Arch

Objective: To evaluate the outcome of presurgical nasoalveolar molding (PNAM) therapy in the treatment of patients with nonsyndromic unilateral cleft and palate (UCLP). Design: A prospective study with blinded measurements. Patients: Twelve patients with UCLP treated from 1997 to 2003. Interventions: The starting age for PNAM therapy was 26 days and the average length of the therapy was 110 days. Main Outcome Measures: Measurements of intraoral and extraoral casts were made, and statistical analyses were used to compare the differences between pre- and posttherapy measurements. Results: After PNAM therapy, there was a statistically significant decrease in both intersegment alveolar cleft distance and columellar deviation (p < .05). There was also a statistically significant increase in cleft nostril height, maxillary width, and columellar width (p < .05). Moreover, although there was no statistically significant reduction of the affected nostril width, it demonstrated on average 1.7-mm reduction after PNAM therapy. The length of the time the patient utilized the appliance and postmolding nostril height were found to have a statistically significant positive correlation (p < .05). Conclusions: PNAM therapy decreases intersegment alveolar cleft distance while permitting an increase in posterior maxillary arch width. It also increases nasal symmetry by decreasing columellar deviation, increasing nostril height on the affected side, maintaining bialar width of nose, increasing columellar width, and creating more symmetrical nostril heights and widths. The improvement of the height of the cleft nostril was correlated with the time the appliance was applied.

scholarly journals Alveolar cleft and maximum cleft width as predictors for difficult laryngoscopy and intubation in patients with unilateral complete cleft lip and palate

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Gamal A. Abdelhameed ◽  
Wael A. Ghanem ◽  
Simon H. Armanios ◽  
Tamer Nabil Abdelrahman
Keyword(s):  
Body Weight ◽  
Odds Ratio ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Difficult Laryngoscopy ◽  
Secondary Outcome ◽  
Pediatric Airway ◽  
Alveolar Cleft ◽  
Cleft Lip Palate ◽  
Width Measurements

Abstract Background Cleft lip and palate is one of the commonest congenital anomalies, which have an impact on feeding, speech, and dental development away from the significant psychosocial sequel. Early surgical repair aims to restore appearance and function, and the modern techniques can leave many defects undetectable. Therefore, the anesthetic challenge facing the pediatric airway with such abnormalities is still of a great impact. The aim of our study among 189 patients enrolled is to correlate alveolar gap and maximum cleft width measurements as predictors of difficult laryngoscopy and intubation in infants with unilateral complete cleft lip/palate aging from 1 to 6 months. As a secondary outcome, their weight is to be correlated too as another parameter. Results The alveolar gap and maximum cleft width are both of equal high predictive power (p value ≤ 0.001) with 100% sensitivity for both and specificity of 76.10% and 82.39% respectively, with a cut off value of ≤ 10 mm and 11 mm for these dimensions respectively, and odds ratio of incidence of difficult intubation is 4.18 and 5.68 respectively, while body weight ≤ 5.75 kg has an odds ratio of 2.32. Conclusion Alveolar cleft and maximum cleft width can be used as predictors for anticipation of difficult laryngoscopy and intubation infant patients with unilateral complete cleft lip and palate, while body weight ≤ 5.75 kg increases the risk more than twice.

Rehabilitation of a Patient with Cleft Lip and Palate with an Extremely Edentulous Atrophied Posterior Maxilla Using Zygomatic Implants: Case Report

2004 ◽  
Vol 41 (5) ◽  
pp. 571-574 ◽  
Author(s):  
Anh Viet Pham ◽  
Marcelo Abarca ◽  
Albert De Mey ◽  
Chantal Malevez
Keyword(s):  
Case Report ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Oral Implants ◽  
Alveolar Cleft ◽  
Dental Prostheses ◽  
Posterior Maxilla ◽  
Zygomatic Implants ◽  
Dental Rehabilitation

Objective This case report describes the clinical and surgical management of a patient with a unilateral alveolar cleft and associated extremely atrophied totally edentulous maxilla. Method Two zygomatic implants and four endosseous oral implants were placed under general anesthesia in a compromised maxilla to rehabilitate a 33-year-old patient with cleft lip and palate. The two specially designed zygomatic implants were utilized to avoid the need for bone grafting in the patient. The final prosthetic rehabilitation was an esthetic and functional maxillary overdenture prosthesis supported by implants. Results Preliminary results have shown how dental prostheses supported by endosseous implants in grafted alveolar cleft are a reliable possibility in the dental rehabilitation of this malformation. Conclusion The use of zygomatic implants may be considered a reliable alternative to more resource-demanding techniques such as bone grafting in patients with cleft palate.

An Investigation of 3D Maxillary Arch Morphometry of Children With Unilateral Cleft Lip and Palate

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sanjida Haque ◽  
Mohd Fadhli Khamis ◽  
Mohammad Khursheed Alam ◽  
Wan Muhamad Amir Wan Ahmad
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillary Arch

Maxillary Lateral Incisors of Subjects with Cleft Lip and/or Palate: Part 2

1992 ◽  
Vol 29 (4) ◽  
pp. 380-384 ◽  
Author(s):  
Akira Suzuki ◽  
Mieko Watanabe ◽  
Masayuki Nakano ◽  
Yasuhide Takahama
Keyword(s):  
Cleft Lip ◽  
Primary Teeth ◽  
Cleft Lip And Palate ◽  
Permanent Teeth ◽  
Intermediate Type ◽  
Alveolar Cleft ◽  
Distal Side ◽  
Bilateral Cleft Lip ◽  
Dental Hospital ◽  
Primary Lateral

Maxillary lateral incisors on the alveolar cleft were investigated in 431 cleft children registered in the Department of Orthodontics, Kyushu University Dental Hospital. The majority of primary maxillary lateral incisors were located on the distal side of the alveolar cleft in both unilateral cleft lip and alveolus (UCLA) and unilateral cleft lip and palate (UCLP) subjects. Permanent teeth in UCLA tend to be located distally, but in UCLP they tend to be congenially absent (p < .01). The majority of primary teeth had normal shapes; the majority of permanent teeth were of intermediate type or were missing congenially. One third of the UCLA and one half of the UCLP subjects who had primary maxillary lateral incisors were not followed by permanent replacements. The location of the majority of permanent maxillary lateral incisors tallied with that of the primary ones except in four UCLA, ten UCLP, and two bilateral cleft lip and palate (BCLP) subjects. Four UCLA and ten UCLP subjects who had primary lateral incisors on the distal side were followed by their permanent successors on the mesial side. Three UCLP and one BCLP subjects had permanent maxillary lateral incisors even though they had no temporary predecessors.

Quantitative 3D Maxillary Arch Evaluation of Two Different Infant Managements for Unilateral Cleft Lip and Palate

2000 ◽  
Vol 37 (6) ◽  
pp. 562-570 ◽  
Author(s):  
Chandra N. Prasad ◽  
Jeffrey L. Marsh ◽  
Ross E. Long, Jr. ◽  
Miroslav Galic ◽  
Donald V. Huebener ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillary Arch

Longitudinal Study on the Changes of Maxillary Arch Dimensions in Japanese Children with Cleft Lip and/or Palate: Infancy to 4 Years of Age

1995 ◽  
Vol 32 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Yasuo Honda ◽  
Akira Suzuki ◽  
Masamichi Ohishi ◽  
Hideo Tashiro
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Lateral Displacement ◽  
Growth Patterns ◽  
Posterior Displacement ◽  
Arch Width ◽  
Dental Hospital ◽  
Growth Changes ◽  
Isolated Cleft Palate ◽  
Maxillary Arch

The focus of this study was an analysis of maxillary arch growth changes prior to the time of cheiloplasty up to 4 years of age. Serial dental casts were obtained and measured in 95 children with cleft lip and palate, or both: 7 unilateral cleft lip and alveolus (CLA), 52 unilateral cleft lip and palate (UCLP), 24 bilateral cleft lip and palate (BCLP), and 12 isolated cleft palate (CP). The children were treated at the Kyushu University Dental Hospital. The results are as follows: (1) Prior to cheiloplasty, the maxillary buccal segments in the subjects with cleft lip and palate showed lateral displacement. The premaxilla in BCLP subjects was protruded. (2) Cheiloplasty influenced maxillary anterior arch width, but not posterior width. The operation caused posterior displacement of the premaxilla in BCLP subjects. (3) Palatoplasty affected the growth of the maxillary arch in the transverse and anteroposterior dimensions. (4) A variety of growth patterns observed in the patients (e.g., increasing or decreasing of the maxillary arch dimensions) suggests that maxillary arch dimensions were affected not only by surgery, but also by other individual factors such as genetic facial pattern and severity of the cleft.

Three-Dimensional Comparison between the Palatal Forms in Complete Unilateral Cleft Lip and Palate with and without Hotz Plate from Cheiloplasty to Palatoplasty

1996 ◽  
Vol 33 (4) ◽  
pp. 312-317 ◽  
Author(s):  
Katsuaki Mishima ◽  
Toshio Sugahara ◽  
Yoshihide Mori ◽  
Masayoshi Sakuda
Keyword(s):  
Nasal Cavity ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Alveolar Ridge ◽  
Maxillary Arch ◽  
Alveolar Arch

The palatal forms in 20 infants with a complete unilateral cleft lip, and palate (12 with a Hotz plate and 8 without, selected at random) were studied from birth until 18 months of age. Using techniques developed previously, the degree of curvature In the palate and the magnitude of migration of the maxillary segments were measured three-dimensionally. Furthermore, using a newly developed method to approximate a set of the points on the alveolar ridge to a circle in a plane, the form of the alveolar arch was evaluated. Results from the group with a Hotz plate revealed that the plate possesses four effects not seen in the group without a Hotz plate. The size of the palate was larger, and the sagittal gap between the two segments of the maxilla was smaller. These results suggest that the appliance could stimulate the growth of the segments and could prevent collapse of the maxillary arch from the force of lip closure. Third, the steepness of the segments toward the nasal cavity was smaller, possibly occurring because the appliance prevents tongue intrusion into the cleft. Fourth, the magnitude of migration of the lesser segment toward the cleft edge of the major segment was larger. This result suggests that the appliance could guide the growth of the maxillary segments to narrow the cleft width until 18 months of age.

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