scholarly journals Facial profile esthetics in operated children with bilateral cleft lip and palate

2017 ◽  
Vol 22 (4) ◽  
pp. 41-46 ◽  
Author(s):  
Rita de Cássia Moura Carvalho Lauris ◽  
Leopoldino Capelozza Filho ◽  
Louise Resti Calil ◽  
José Roberto Pereira Lauris ◽  
Guilherme Janson ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Spearman Correlation ◽  
Friedman Test ◽  
Upper Lip ◽  
Oral Clefts ◽  
Facial Profile ◽  
Facial Esthetics ◽  
Bilateral Cleft Lip

ABSTRACT Objective: The aim of this study was to evaluate the facial profile esthetics of rehabilitated children with complete bilateral cleft lip and palate (BCLP), comparing the judgment of professionals related and not related to cleft rehabilitation and laypersons. Methods: Thirty children in the mixed dentition (24 male; 6 female) with a mean age of 7.8 years were evaluated using facial profile photographs by 25 examiners: 5 orthodontists and 5 plastic surgeons with experience in cleft care, 5 orthodontists and 5 plastic surgeons without experience in oral cleft rehabilitation and 5 graduated laymen. Their facial profiles were classified into esthetically unpleasant (grade 1 to 3), esthetically acceptable (grade 4 to 6), and esthetically pleasant (grade 7 to 9). Intraexaminer and interexaminer errors were evaluated using Spearman correlation coefficient and Kendall’s test, respectively. Inter-rater differences were analyzed using Friedman test and Student-Newman-Keuls test for multiple comparisons. Results: Orthodontists dealing with oral clefts rehabilitation considered the majority of the sample as esthetically pleasant. Plastic surgeons of the cleft team and laypersons classified most of the sample as esthetically acceptable. Most of the orthodontists and plastic surgeons not related to cleft care evaluated the facial profile as esthetically unpleasant. The structures associated to unpleasant profiles were the nose, the midface and the upper lip. Conclusions: The facial profile of children with BCLP was classified as esthetically acceptable by laypersons. Professionals related to cleft rehabilitation were more lenient and those not related to cleft care were stricter to facial esthetics than laypersons.

Facial and Nasolabial Aesthetics of Complete UCLP Submitted to 2-Stage Palate Repair With Vomer Flap

2018 ◽  
Vol 55 (9) ◽  
pp. 1211-1217
Author(s):  
Terumi Okada Ozawa ◽  
Luciana Lais Savero Reis ◽  
Renata Mayumi Kato ◽  
Diógenes Laercio Rocha ◽  
Renata Sathler ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Single Center ◽  
Facial Profile ◽  
Main Outcome Measure ◽  
Kappa Test ◽  
Palate Repair ◽  
Vomer Flap

Objective: To evaluate the aesthetics of nasolabial appearance and facial profile of children with unilateral cleft lip and palate (UCLP) submitted to 2-stage palate repair with vomerine flap. Design: Retrospective. Setting: Single center. Patients: Forty patients with UCLP, mean age of 7.81 years of both sexes, rehabilitated at a single center by 1 plastic surgeon. Interventions: Lip and anterior palate repair with nasal alar repositioning was performed at 3 to 6 months of age by Millard technique and vomer flap, respectively. Posterior palate was repaired at 18 months by Von Langenbeck technique. Main Outcome Measure(s): Four cropped digital facial photographs of each patient were evaluated by 3 orthodontists to score the nasolabial aesthetics and profile. Frequencies of each score as well means and medians were calculated. Kappa test was used for evaluating inter- and intrarater reproducibility. Results: The nasal form and deviation was scored as good/very good in 70%, fair in 22.5%, and poor in 7.5% of the sample. The nasal–subnasal aesthetic was considered good/very good in 55%, fair in 30%, and poor in 15% of the sample. The lip vermilion border and the white part of surgical scar aesthetics were good/very good in 77.5% and 80%, fair in 17.5% for both categories, and poor in 5% and 2.5% of the cases, respectively. In all, 67.5% showed convex facial profile, 20% was straight, and 12.5% was concave profile. Conclusions: Two-stage palatoplasty presented an adequate aesthetical results for the majority of patients with UCLP in the mixed dentition.

Esthetic Evaluation of the Facial Profile in Rehabilitated Adults With Complete Bilateral Cleft Lip and Palate

2015 ◽  
Vol 73 (1) ◽  
pp. 169.e1-169.e6 ◽  
Author(s):  
Flávio Mauro Ferrari Júnior ◽  
Priscila Vaz Ayub ◽  
Leopoldino Capelozza Filho ◽  
José Roberto Pereira Lauris ◽  
Daniela Gamba Garib
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Facial Profile ◽  
Bilateral Cleft Lip

Sagittal Position of the Left and Right Maxillary Segment in Children with Cleft Lip and Palate

1997 ◽  
Vol 34 (5) ◽  
pp. 438-442 ◽  
Author(s):  
Frank Ras ◽  
Laura van Aalten ◽  
Arina Janse ◽  
Shell Mobers ◽  
Birte Prahl-Andersen
Keyword(s):  
Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Multivariate Analyses ◽  
Cranial Base ◽  
Oral Clefts ◽  
Bilateral Cleft Lip ◽  
Different Types ◽  
Left And Right ◽  
The Right

Objective: The purpose of the present study was to investigate left-right differences in the sagittal position of the maxillary segments in children with cleft lip and palate. Method: The sample consisted of children with operated cleft lip or cleft lip and alveolus [CL/CLA (n=16) mean age, 9.3 yr], operated unilateral cleft lip and palate [UCLP (n=27) mean age, 9.1 yr], and operated bilateral cleft lip and palate [ [BCLP(n = 17) mean age, 9.5 yr]. Computed tomography (CT) horizontal slices of the maxilla were obtained and used to determine the sagittal position of the left and right segment of the maxilla in relation to the mandibular rami and the cranial base. Significant effects were analyzed with multivariate analyses of variance (MANOVA). Results and Conclusions: It was concluded that, in contrast to children having CL/CLA or UCLP, children with BCLP showed left-right differences in the sagittal position of the maxillary segments. The segment on the left side was more posteriorly positioned compared to the right side. Because the same results were obtained in relation to the mandibular rami as well as in relation to the cranial base, it can be assumed that the position of these rami are not affected by the different types of oral clefts.

scholarly journals A Case of Cleft Hypoplastic Maxilla corrected by Single-stage Lefort 1 Osteotomy to improve Esthetics and Function

2015 ◽  
Vol 6 (1) ◽  
pp. 25-27
Author(s):  
Pradeep Christopher ◽  
Bala Gughan ◽  
Poorna Devadoss ◽  
Naveen H Krishnamurthy
Keyword(s):  
Cleft Lip ◽  
Total Population ◽  
Cleft Lip And Palate ◽  
Healing Process ◽  
Single Stage ◽  
Palatal Fistula ◽  
Facial Esthetics ◽  
Bilateral Cleft Lip ◽  
And Function ◽  
Palatal Mucosa

ABSTRACT Among the congenital anomalies, cleft lip and palate take about 14% of the total population; among them, unilateral cleft lip and palate is predominant than bilateral. Cleft lip correction preceding the cleft palate is usually done within a gap of 3 years. Due to the wide median palatal cleft, a perfectly performed Langenbeck pushback closures can leave behind persistent oronasal fistulas during the healing process, due to which severe scarring of palatal mucosa takes place. Secondary alveolar grafting is a procedure performed irrespective of the age for persistent oronasal fistulas. Further closure of nasal and palatal fistula with intervening bone graft is always successful but can compromise the growth of maxilla resulting in hypoplasia. In one such case of a failed secondary alveolar grafting, a Lefort 1 advancement alone was done not only to improve the facial esthetics but also function. This paper discusses in detail the comprehensive surgical procedure performed. How to cite this article Christopher P, Gughan B, Devadoss P, Krishnamurthy NH. A Case of Cleft Hypoplastic Maxilla corrected by Single-stage Lefort 1 Osteotomy to improve Esthetics and Function. J Health Sci Res 2015;6(1):25-27.

scholarly journals Modern aspects of interdisciplinary treatment in children with bilateral cleft lip and palate

2020 ◽  
Vol 15 (4) ◽  
pp. 75-80
Author(s):  
О.V. Dudnik ◽  
◽  
Ad.A. Mamedov ◽  
A.A. Skakodub ◽  
A.B. Maklennan ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Interdisciplinary Treatment ◽  
World Health ◽  
Treatment Methods ◽  
Reconstructive Operations ◽  
Bilateral Cleft Lip

According to the World Health Organization incidence of cleft lip and palate ranges from 0.6-1.6 cases per 1000 newborns per year. Thus, bilateral full cleft lip and palate occurs less frequently around 15–25%. Purpose: to analyze treatment methods for children with bilateral cleft lip and palate during the period of a removable bite. A review of 51 literature sources from 1951 to 2019 was carried out. Occlusion development features in bilateral cleft lip and palate patients during mixed dentition period were analysed. Main anatomical features of the maxillofacial region in children with bilateral cleft lip and palate during mixed dentition period is narrowing of the upper and lower dental arches as well as presence soft tissues scars of the upper lip. The main methods of treatment for such children is surgical reconstructive operations, including the elimination of the anatomical defect of the hard palate using mucoperiosteal flaps from the lateral parts of the hard palate combined with orthodontic treatment methods. Thus, an integral method of treating children with bilateral cleft lip and palate during mixed dentition period is a comprehensive approach, including surgical reconstructive operations, as well as orthodontic treatment, the main purpose of which is to expand and extend dental arch, which results in normal occlusion therefore eliminating myofunctional disorders. Key words: cleft lip, cleft palate, mixed dentition, occlusion features, orthodontic treatment

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
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Upper Lip ◽  
Skeletal Class ◽  
Bilateral Cleft Lip ◽  
Maxillary Dentition ◽  
Partially Dentate ◽  
Palate Patient ◽  
Maxillary Distraction

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.

Alveolar Bone Morphology in Patients with Bilateral Complete Cleft Lip and Palate in the Mixed Dentition: Cone Beam Computed Tomography Evaluation

2012 ◽  
Vol 49 (2) ◽  
pp. 208-214 ◽  
Author(s):  
Daniela Gamba Garib ◽  
Marília Sayako Yatabe ◽  
Terumi Okada Ozawa ◽  
Omar Gabriel da Silva Filho
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Bone Plate ◽  
Cone Beam ◽  
Axial Section ◽  
Bilateral Cleft Lip

Objectives To verify the thickness and level of alveolar bone around the teeth adjacent to the cleft by means of cone beam computed tomography (CBCT) in patients with complete bilateral cleft lip and palate prior to bone graft surgery and orthodontic intervention. Method The sample comprised 10 patients with complete bilateral cleft lip and palate (five boys and five girls) in the mixed dentition. The mean age was 9.5 years, and all subjects showed a G3 interarch relationship according to the Bauru index. The thickness of alveolar bone surrounding the maxillary incisors and the maxillary canines was measured in CBCT axial section using the software iCAT Xoran System. The distance between the alveolar bone crest and the cement-enamel junction (CEJ) was measured in cross sections. Results The tomography images showed a thin alveolar bone plate around teeth adjacent to clefts. No bone dehiscence was observed in teeth adjacent to clefts during the mixed dentition. A slight increase in the distance between the alveolar bone crest and the CEJ was observed in the mesial and lingual aspects of canines adjacent to cleft. Conclusion In patients with BCLP in the mixed dentition, teeth adjacent to the alveolar cleft are covered by a thin alveolar bone plate. However, the level of alveolar bone crest around these teeth seems to be normal, and no bone dehiscence was identified at this age.

scholarly journals Facial profile and maxillary arch dimensions in unilateral cleft lip and palate children in the mixed dentition stage

2017 ◽  
Vol 11 (01) ◽  
pp. 076-082 ◽  
Author(s):  
Vellore Kannan Gopinath ◽  
Ab Rani Samsudin ◽  
Siti Noor Fazliah Mohd Noor ◽  
Hady Youssef Mohamed Sharab
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Mixed Dentition ◽  
Dental Arch ◽  
Base Length ◽  
Facial Profile ◽  
Arch Width ◽  
Significant Difference ◽  
Maxillary Arch

ABSTRACT Objectives: The aim of this study was to evaluate the vertical and sagittal facial profile and maxillary arch width, depth, and length of patients with unilateral cleft lip and palate (UCLP) and to compare them with healthy noncleft children in the mixed dentition stage (7–13 years). Materials and Methods: This study is conducted at Hospital Universiti Sains Malaysia. UCLP group comprised 48 patients with nonsyndromic UCLP who have had the lip and palate repaired, whereas the control group comprised 48 healthy noncleft cases. The lateral cephalometrics measurements were used to determine the vertical height, sagittal depth of the face, and cranial base length and angle. Maxillary arch dimensions were measured on the study cast including arch width, depth, and length. Results: Vertical facial height and sagittal depth measurements showed a significant decrease (P < 0.05) in the mean growth pattern in UCLP group. The anterior cranial base length (S-N) was shorter in UCLP children (P < 0.001), while Ba-N length had no significant difference (P = 0.639). Nasion-Sella Tursica-Basion angle was significantly higher in the UCLP group (P = 0.016). Dental arch width with reference to canine-to-canine and first premolar-to- first premolar distance was significantly larger in control (P = 0.001). Conclusion: Mean vertical and sagittal facial dimensions in the UCLP children who do not undergo orthodontic treatment are significantly lesser in all directions of growth than healthy noncleft children. The maxillary dental arch had a normal depth but constricted in width and arch length.

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