Effect of an Intraoral Retrusion Plate on Maxillary Arch Dimensions in Complete Bilateral Cleft Lip and Palate Patients

2005 ◽  
Vol 42 (3) ◽  
pp. 239-244 ◽  
Author(s):  
Barbara C. M. Oosterkamp ◽  
Robert P. van Oort ◽  
Pieter U. Dijkstra ◽  
Kees Stellingsma ◽  
Michiel W. J. Bierman ◽  
...  
Keyword(s):  
Active Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Average Increase ◽  
Dependent Observations ◽  
Bilateral Cleft Lip ◽  
Left And Right ◽  
Student’S T ◽  
Maxillary Arch ◽  
Student’S T Test

Objective The aim of this study was to analyze maxillary arch dimensions in patients with complete bilateral cleft lip and palate treated with an intraoral retrusion plate prior to lip closure. Patients The effects of the intraoral retrusion plate were evaluated on serially obtained maxillary casts of 14 patients with complete bilateral cleft lip and palate. Results The Student's t test for dependent observations showed a significant decrease in distance between the premaxilla and the cleft lateral segments during active treatment. This decrease correlated with an increase in deviation of the premaxilla in relation to the vomer. For each millimeter decrease in distance between the premaxilla and the cleft lateral segments, an average increase in deviation of 4.0 degrees was found. Left and right cleft widths decreased significantly, premaxillary width increased significantly, and transverse dimensions did not change significantly. Conclusion From this study it can be concluded that active presurgical treatment with an intraoral retrusion plate induces a significant decrease in distance between the premaxilla and the lateral segments. This decrease is frequently accompanied by an increase in deviation of the premaxilla relative to the vomer.

A Pristine Approach for the Prominent Premaxilla in Bilateral Cleft Lip and Palate (BCLP) Cases

2019 ◽  
Vol 56 (8) ◽  
pp. 1115-1119
Author(s):  
Nitika Monga ◽  
Om P. Kharbanda
Keyword(s):  
Active Treatment ◽  
Room Temperature ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Retention Period ◽  
Tension Free ◽  
Noticeable Change ◽  
Intraoral Scanning ◽  
Angular Change ◽  
Bilateral Cleft Lip

Objective: The neonate premaxilla in bilateral cleft lip and palate is often protruding and displaced laterally. Surgeons prefer the premaxilla to be repositioned and centralized to allow a tension-free primary lip repair. This report describes the fabrication of a premaxillary bonnet appliance with silicone material and its successful use in 2 cases of bilateral cleft lip and palate (BCLP). Patients, Participants: Two male BCLP patients of ages 34 days and 10 days, respectively. Interventions: Nonsurgical repositioning of the premaxillary segment using silicone cup–bonnet appliance. Results: The duration of active treatment by silicone appliance was 36 days in case 1 and 75 days in case 2. The retention period was 2 months and 3 months, respectively. The appliance made of room temperature vulcanizing (RTV) silicone is flexible and softer in comparison to the rigid conventional acrylic appliance and is therefore almost atraumatic. A gentler appliance resulted in enhanced compliance and acceptance by the neonates. There was a noticeable change in the position of the discernible asymmetric premaxilla. Analysis of frontal facial photographs revealed an angular change in the position of the premaxilla (C) by 12° in case 1 and 6° in case 2 in reference to the midfacial plane. Conclusion: This silicone appliance provides enhanced compliance and improved retention compared to acrylic appliance since it is a more gentle, flexible, and less traumatic alternative to a rigid acrylic appliance. Further, the RTV silicone appliance can be 3-dimensionally printed for better accuracy following intraoral scanning and thus eliminating the need for impression making in cleft newborns.

scholarly journals Presurgical nasoalveolar moulding in unilateral cleft lip and palate

2016 ◽  
Vol 49 (01) ◽  
pp. 42-52 ◽  
Author(s):  
Mohammed Zuhaib ◽  
Krishnamurthy Bonanthaya ◽  
Renu Parmar ◽  
Pritham N. Shetty ◽  
Pradeep Sharma
Keyword(s):  
Prospective Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Valuable Adjunct ◽  
Alar Base ◽  
Student’S T ◽  
A Prospective Study ◽  
Post Therapy ◽  
Student’S T Test

ABSTRACT Context: Presurgical nasoalveolar moulding (PNAM) is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the effi cacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1) To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM). (2) To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM). (3) To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, signifi cant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle closure in unilateral clefts.

Surgical and orthodontic approach for a patient with a severely constricted maxillary arch caused by bilateral cleft lip and palate

2020 ◽  
Vol 79 (2-3) ◽  
pp. 127-134
Author(s):  
Ayaka Oka ◽  
Hiroshi Kurosaka ◽  
Kohei Nakatsugawa ◽  
Takashi Yamashiro
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Bilateral Cleft Lip ◽  
Maxillary Arch

Blepharo-Cheilo-Dontic (BCD) Syndrome: Case Report

2006 ◽  
Vol 43 (2) ◽  
pp. 237-243 ◽  
Author(s):  
Akihiko Iida ◽  
Shota Narai ◽  
Ritsuo Takagi ◽  
Kazuhiro Ono ◽  
Nobuyuki Ikeda
Keyword(s):  
Case Report ◽  
Active Treatment ◽  
Growth And Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Scalp Hair ◽  
Treatment Plan ◽  
Fatal Complication ◽  
Left Hand ◽  
Bilateral Cleft Lip

Objective To report a case of blepharo-cheilo-dontic (BCD) syndrome, to compare with the previous cases, and to discuss the possible treatment. Patient The patient was a 14-day-old boy born uneventfully on August 7, 2002. His scalp hair was sparse and curly. A tumor on the top of his head, which was thought to be a dermoid cyst, and a nevus on the back of his left hand were observed. All typical symptoms of blepharo-cheilo-dontic syndrome, such as euryblepharon with ectropion of the lower eyelids, distichiasis, bilateral cleft lip and palate, severe oligodontia, and conical teeth, were observed. Because there was no fatal complication, and growth and development were about normal, it was recommended that a long and active treatment plan be considered for this patient.

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.

Craniofacial Comparisons in 22-Month-Old Lip-Operated Children with Unilateral Complete Cleft Lip and Palate and Unilateral Incomplete Cleft Lip

2000 ◽  
Vol 37 (3) ◽  
pp. 303-317 ◽  
Author(s):  
N.V. Hermann ◽  
B.L. Jensen ◽  
E. Dahl ◽  
S. Bolund ◽  
S. Kreiborg
Keyword(s):  
Statistical Analysis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Anterior Part ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Facial Morphology ◽  
Surgical Methods ◽  
Student’S T ◽  
Student’S T Test

Objective The objective of the study was to analyze the craniofacial morphology in infants with unilateral complete cleft lip and palate (UCCLP) in which the lip and the anterior part of the palate had been surgically closed at 2 months of age and to compare the morphology with that of a control group with unilateral incomplete cleft lip (UICL) in which the lip had also been surgically closed at 2 months of age. Design The sample consisted of a total of 108 cleft children all fulfilling the entry criteria, besides diagnosis, as follows: The child was of Danish origin; the age of the child was between 650 and 750 days (approximately 22 months) at the time of examination; the child was healthy except for its single cleft malformation; the surgical procedure in each group had been performed at about 2 months of age by the same surgeon. The surgical methods used were a Tennison procedure (UICL group) and a Tennison procedure supplemented by palatovomer plasty (UCCLP group). Methods The method of investigation was infant cephalometry in the lateral, frontal, and axial projections. Linear, angular, and area variables describing the craniofacial morphology were calculated and supplemented by mean plots from the cephalometric projections in the two groups. Results and Conclusions Statistical analysis based on Student's t test showed that the facial morphology in the 22-month-old UCCLP group differed significantly from that of the UICL group. The most pronounced differences were found in the maxillary complex and the mandible. The deviations observed in the UCCLP group at 22 months of age were similar to those previously observed at 2 months of age. However, several of the dysmorphic traits had become less pronounced; some had remained the same; and a few had become worse with time.

scholarly journals Evaluation of dehiscence and fenestration in adolescent patients affected by unilateral cleft lip and palate: A retrospective cone beam computed tomography study

2016 ◽  
Vol 86 (3) ◽  
pp. 431-436 ◽  
Author(s):  
Suleyman Kutalmis Buyuk ◽  
Esra Ercan ◽  
Mevlut Celikoglu ◽  
Ahmet Ercan Sekerci ◽  
Mukerrem Hatipoglu
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cone Beam ◽  
Control Group ◽  
Anterior Teeth ◽  
The Difference ◽  
Student’S T ◽  
Student’S T Test

ABSTRACT Objective:  To evaluate the presence of dehiscence and fenestration defects around anterior teeth in the cleft region and to compare these findings with the noncleft side in the same patients using cone beam computed tomography (CBCT). Materials and Methods:  CBCT scans of 44 patients (26 males, 18 females; mean age, 14.04 ± 3.81 years) with unilateral cleft lip and palate (UCLP) were assessed to define dehiscences and fenestrations of the anterior teeth in both cleft and noncleft sides of the UCLP patients and a control group of noncleft patients (51 patients; 21 males, 30 females; mean age, 14.52 ± 1.16 years). Data were analyzed using Pearson’s χ2 and Student’s t-test. Results:  The prevalence of dehiscences at the maxillary central incisors, lateral incisors, and canines teeth were 43.2%, 70.6%, and 34.1% on the cleft side and 22.7%, 53.1%, and 27.3% on the noncleft side of UCLP patients, and 13.7%, 7.8%, and 13.7% in controls, respectively (statistically no difference between the sides of cleft patients). The cleft patients had a statistically significantly higher prevalence of dehiscences than did the controls on both the cleft and noncleft sides (P < .05), except for the maxillary central incisors. Fenestrations for these teeth were significantly more common on the cleft side in UCLP patients compared with controls (P < .05), whereas the difference for maxillary lateral incisors was not statistically significant. Conclusions:  Patients with UCLP showed a higher prevalence of dehiscence and fenestration defects around the maxillary anterior teeth.

Maxillary Arch Dimensions in Bilateral Cleft Lip and Palate from Birth until Four Years of Age in Boys

1998 ◽  
Vol 35 (3) ◽  
pp. 233-239 ◽  
Author(s):  
Kiki L.W.M. Heidbuchel ◽  
Anne M. Kuijpers-Jagtman ◽  
Gem J.C. Kramer ◽  
Birte Prahl-Andersen
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Hospital ◽  
Control Group ◽  
Posterior Arch ◽  
Anterior Arch ◽  
Arch Width ◽  
Bilateral Cleft Lip ◽  
The University ◽  
Maxillary Arch

Objective To describe the development of maxillary arch dimensions in children with bilateral cleft lip and palate (BCLP) during the first 4 years of life and to compare it with that in noncleft children. Design This was a retrospective, mixed-longitudinal study. Setting The study was conducted at the Cleft Palate Center of the University Hospital of Nijmegen. Subjects The sample consisted of 26 boys with BCLP who were born between 1976 and 1990 and treated at the University Hospital of Nijmegen. Data for a control group of 34 noncleft boys were collected at the University Hospital of Amsterdam. Method Palatal arch dimensions were digitized on dental casts. A comparison between BCLP and noncleft dimensions was made at fixed time intervals. Results At birth, anterior and posterior arch widths as well as arch depths were significantly larger in children with BCLP. After 7 months (lip closure), anterior arch width and arch depth diminished considerably in the cleft group. After 12 months (palatoplasty), a slight decrease in posterior arch width was observed, and arch depths showed slight catch-up growth. At 4 years of age, anterior arch width was significantly narrower and anterior arch depth was shorter in children with BCLP than in control subjects. Posterior arch width was significantly wider. Conclusions During the first 4 years of life, maxillary arch dimensions in children with BCLP show a unique development that is significantly different from that in noncleft children.

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