Anterior Segmental Distraction for a Class III Maxillary Prosthetic Defect in a Cleft Palate Patient

2011 ◽  
Vol 37 (4) ◽  
pp. 457-461 ◽  
Author(s):  
Joseph E Van Sickels ◽  
Behruz Abadi ◽  
Reed Attisha

Abstract Reconstruction of a partially dentate skeletal Class III patient who has had repair of a bilateral cleft lip and palate can be challenging. In this article we present our results with a segmental maxillary distraction to esthetically restore the support of the upper lip and functionally reconstruct the anterior maxillary dentition with implants. Prosthetic considerations were critical to determine the vector of distraction to achieve ideal results.

2013 ◽  
Vol 4 (1) ◽  
pp. 123
Author(s):  
Jasmeet Singh ◽  
Deepak Kumar ◽  
Kamlesh Singh ◽  
Kriti Singh

2018 ◽  
Vol 56 (3) ◽  
pp. 314-320 ◽  
Author(s):  
Marilia Sayako Yatabe-Ioshida ◽  
Letícia Dominguez Campos ◽  
Renato Yassukata Yaedu ◽  
Ivy Kiemle Trindade-Suedam

Objectives: The purpose of this study was to 3-dimensionally assess the airway characteristics of patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) who underwent orthognathic surgery. Design: This was a retrospective study. Setting: The study took place at a national referral center for cleft lip and palate rehabilitation. Patients and Participants: The sample comprised cone-beam computed tomography (CBCT) scans obtained before and after orthognathic surgery of 15 individuals (30 CBCT scans), divided into 2 groups: UCLP group (n = 9 patients/18 CBCT scans) and BCLP group (n = 6/12 CBCT scans). All patients had a nonsyndromic UCLP or BCLP and a skeletal class III malocclusion at the preoperative period. Interventions: Airway volume, pharyngeal minimal cross-sectional area (mCSA), location of mCSA, sella-nasion-A point (SNA) and sella-nasion-B point (SNB) angles, and condylion-A point and condyloid-gnathion linear measurements were assessed in open-source software (ITK-SNAP and SlicerCMF). Main Outcome Measure: Airway dimensions of patients with UCLP and BCLP increase after orthognathic surgery. Results: After orthognathic surgery, UCLP group showed a significant 20% increase in nasopharynx volume. Although not significant, BCLP group also showed an increase of 18% in the same region. Minimal cross-sectional area remained dimensionally stable after surgery and was all located in the oropharynx region, on both groups. Additionally, a positive correlation was observed between volume and mCSA on both groups. Conclusion: Overall, individuals with UCLP and BCLP showed an increase in the upper airway after orthognathic surgery and this might explain the breathing and sleep improvements reported by the patients after the surgery.


2021 ◽  
pp. 105566562110434
Author(s):  
Bernardo Olsson ◽  
Isabela Polesi Bergamaschi ◽  
Erika Calvano Küchler ◽  
Aline Monise Sebastiani ◽  
Guilherme dos Santos Trento ◽  
...  

Objective The aim of the study was to assess the quality of life (QOL), oral health-related QOL (OHRQOL), temporomandibular disorders (TMDs), and psychological factors in patients with skeletal Class III malocclusion with cleft lip and palate (CLP) and without CLP. Design Case–control. Setting Primary care, institutional practice. Patients One hundred thirty-six patients with skeletal Class III malocclusion with CLP (n = 68) and without CLP (n = 68). Main outcome measures QOL and OHRQOL were assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire and the Oral Health Impact Profile-14 questionnaire, respectively. TMDs and psychological factors were assessed using the Research Diagnostic Criteria for TMD (RDC/TMD). Results No differences in QOL were found between the groups ( P >  0.05). Patients with CLP reported a better OHRQOL ( P = 0.025) in the physical pain, physical disability, and psychological disability domains ( P <  0.05). Patients with CLP presented with less myofascial pain (OR, 0.28; 95% CI, 0.11-0.71] and other articular conditions (OR 0.24; 95% CI 0.06-0.90]. More patients with CLP reported no chronic pain ( P = 0.012). The QOL of patients with CLP with no depression or with no nonspecific physical symptoms including pain (NSPSIP) was better than that of patients without CLP. The OHRQOL of patients with CLP without TMDs or no psychological factors was better than that of patients without CLP. Conclusions Patients with skeletal Class III malocclusion who require orthognathic surgery with CLP have better OHRQOL and present with fewer TMDs than those patients without CLP.


2010 ◽  
Vol 35 (2) ◽  
pp. 225-231 ◽  
Author(s):  
Kiyoshi Tai ◽  
Jae Hyun Park ◽  
Masahiro Tanino ◽  
Yasumori Sato

Treatment of patients with a cleft lip and palate can be challenging. A boy, 15 years 11 months old, with a bilateral cleft lip and palate and a convex profile, transposed teeth and congenitally missing teeth was treated by orthodontic treatment. 3 year posttreatment records showed excellent results with good occlusion,facial balance and harmony, and long-term stability.


2009 ◽  
Vol 46 (5) ◽  
pp. 512-520 ◽  
Author(s):  
Alexandra I. Holst ◽  
Stefan Holst ◽  
Emeka Nkenke ◽  
Matthias Fenner ◽  
Ursula Hirschfelder

Objective: To investigate whether the craniofacial vertical and sagittal jaw relationship in patients with cleft lip and palate (CLP) differed from that of age-matched noncleft controls, before and after the pubertal growth spurt. Design: Retrospective observational study. Patients: The study group comprised 126 patients with CLP, subdivided according to gender and cleft type, and the control group comprised 53 age-matched skeletal class I patients. Methods: Angular and linear measurements were taken from prepubertal and postpubertal lateral cephalograms of all patients. Results: In patients with cleft lip and palate, the maxillary retrognathism became more remarkable with increasing age; whereas, the retrognathic position of the mandible became less pronounced as compared with controls. Reduced posterior midfacial height, a common prepubertal finding in patients with cleft lip and palate, was significant in postpubertal girls and young women with unilateral cleft lip and palate (p  =  .002). The total anterior facial height in male patients with bilateral cleft lip and palate was larger than in control patients (p  =  .002) after the pubertal growth spurt due to an increased anterior midfacial height. In male patients with unilateral cleft lip and palate, this finding was due to an increased anterior lower facial height (p < .001). Conclusions: Patients with cleft lip and palate treated according to a standardized treatment concept had adequate craniofacial jaw relationships after puberty. Despite a measured skeletal class I in both male and female patients with cleft lip and palate regardless of cleft type, there was a slight tendency toward a skeletal class III. Findings were similar for all groups of cleft lip and palate patients irrespective of the type of orthodontic treatment performed.


2014 ◽  
Vol 51 (6) ◽  
pp. 711-721 ◽  
Author(s):  
Tomohiro Fukunaga ◽  
Tadashi Honjo ◽  
Yuichi Sakai ◽  
Kiyo Sasaki ◽  
Teruko Takano-Yamamoto ◽  
...  

This is a case report about the successful orthodontic treatment of a bilateral cleft lip and palate patient by using a combination of bone grafting and subsequent prosthodontic rehabilitation. An adult patient with a bilateral cleft lip and palate presented with a concave profile, anterior and lateral crossbite, a markedly deep overbite, and residual bilateral alveolar clefts. His jaw movement patterns were unstable and irregular due to his collapsed bite. Orthodontic treatment with bilateral bone grafting improved his concave profile by downward and backward rotation of the mandible within the freeway space, and optimum occlusion and functionally stable and smooth jaw movements were obtained. After a 6-year retention period, no skeletal relapse could be detected, and his occlusal stability was satisfactory.


Author(s):  
Vikrant V. Jadhav ◽  
Pallavi Daigavane ◽  
Ranjit Kamble ◽  
Sunita Shrivastav ◽  
Meenakshi Tiwari

Introduction: The three dimensionally affected growth and development of craniofacial structures in CLCP leads to problems dealing with facial appearance, skeletal and dental malocclusion, feeding, airway, hearing, and speech. Objectives: Evaluation and utilisation of fs morphology as a forecast of future growth for growth pattern and skeletal malocclusion in CLCP cases. Methodology: A 30 Cases from Skeletal Class I, III and CLCP will be selected from Department of Orthodontics. Dimensions and area of frontal sinus is evaluated using 3DVT. Parameters are evaluated in sagittal and coronal section. The measurement's dependability will be determined using a reliability test (Cronbach alpha test). Chisquare Test, One Way ANOVA, and Multiple Comparison will be used to do descriptive and analytical statistics. The Tukey Test is a statistical test that is used. Expected Results: Frontal sinus dimensions when observed for Class III will be found greater. Average dimensions will be observed for skeletal Class I cases. Based on the dimensions of frontal sinus observed in cleft lip and palate, we can predict the skeletal malocclusion and growth pattern. Conclusion: The morphology of the fs is evaluated in cleft cases for the upcoming growth pattern and skeletal malocclusion if is known during formulating a treatment plan for the three dimensionally affected jaw bases and craniofacial structure the requirement for later surgical intervention can be prevented.


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