Oral Rehabilitation of a Patient with Complete Unilateral Cleft Lip and Palate Using an Implant-Retained Speech-Aid Prosthesis: Clinical Report

2007 ◽  
Vol 44 (6) ◽  
pp. 673-677 ◽  
Author(s):  
Amara Abreu ◽  
Daniel Levy ◽  
Enrique Rodriguez ◽  
Irma Rivera

Objective: To report the oral rehabilitation of velopharyngeal insufficiency due to a congenital anatomic defect using an implant-retained speech-aid prosthesis. Case Report: A 65-year-old man with a diagnosis of complete unilateral cleft lip and palate on the left side with an unrepaired palate was examined. A removable partial denture with a speech bulb had been used for approximately 40 years. After primary care for gross caries and tooth mobility, an implant-retained obturator with a speech bulb was fabricated. Results and Conclusion: Improvement in mastication, speech, and velopharyngeal function was achieved with a satisfactory esthetic result.

2014 ◽  
Vol 24 (3) ◽  
pp. 250-253 ◽  
Author(s):  
Marina Rechden Lobato Palmeiro ◽  
Caroline Scheeren Piffer ◽  
Vivian Martins Brunetto ◽  
Paulo César Maccari ◽  
Rosemary Sadami Arai Shinkai

Author(s):  
Neha Hajira ◽  
Pulkit Khandelwal ◽  
HS Shashidhar ◽  
Harleen Sachdeva ◽  
Sumit Khare

ABSTRACT Reconstruction of large anterior ridge defects is often a prosthodontic challenge. Such defects require closure of the defect along with the replacement of the missing teeth so as to achieve proper speech and esthetics. Classifying these defects in the preoperative examination helps to diagnose and predict the prognosis and technical difficulties to be encountered. The aim and purpose of this case report is to describe the management of one such case with missing anterior teeth and severe anterior ridge defects. We also describe the process of fabrication of Andrew's bridge (a fixed-removable partial denture) to treat this Siebert's class III anterior ridge defect. How to cite this article Hajira N, Khandelwal P, Shashidhar HS, Sachdeva H, Khare S. Andrew's Bridge: Achieving Esthetics with a Prosthetic Alternative-Managing Severe Anterior Ridge Defects in Operated Case of Cleft Lip and Palate. Int J Prosthodont Restor Dent 2016;6(4):93-97.


2020 ◽  
Vol 24 (1) ◽  
pp. 57-61
Author(s):  
Almina Murić ◽  
Demet Cagil Ayvalioglu ◽  
Bilge Gokcen Rohlig

SummaryBackground/Aim: Congenital defects such as cleft palate and lips require a long-lasting and multidisciplinary approach. In cases when surgical and orthodontic treatment is not feasible, prosthodontic management of these patients is advocated. Prosthetic rehabilitation of cleft palate in concerning of achieving aesthetic and function (such as swallowing and speech) outcomes is very demanding.Case report: Material and method: After performing the necessary surgical procedures and orthodontic treatment, 24-years-old male patient was sent to the Department for Maxillofacial Prosthetics of Istanbul University. Followed the clinical examination, the necessary periodontal and conservative therapy was performed. After radiographic evaluation and dental cast analysis prosthetic rehabilitation was performed. The prosthetic rehabilitation of cleft palate was accomplish with conventional fixed partial denture whose number of included abutment were defined by biomechanical principles. Additionally removable partial denture were manufactured for closing oro-nasal defects and lip supporting.Conclusions: The prosthetic rehabilitation resulted with functionally and aesthetically content prosthesis. With achieving proper swallowing Quality of Life of the patient was enormously enhanced.


2019 ◽  
Vol 57 (4) ◽  
pp. 420-429
Author(s):  
Susanna Botticelli ◽  
Annelise Küseler ◽  
Kirsten Mølsted ◽  
Helene Soegaard Andersen ◽  
Maria Boers ◽  
...  

Aim: To examine the association of cleft severity at infancy and velopharyngeal competence in preschool children with unilateral cleft lip and palate operated with early or delayed hard palate repair. Design: Subgroup analysis within a multicenter randomized controlled trial of primary surgery (Scandcleft). Setting: Tertiary health care. One surgical center. Patients and Methods: One hundred twenty-five infants received cheilo-rhinoplasty and soft palate repair at age 3 to 4 months and were randomized to hard palate closure at age 12 or 36 months. Cleft size and cleft morphology were measured 3 dimensionally on digital models, obtained by laser surface scanning of preoperative plaster models (mean age: 1.8 months). Main outcome measurements: Velopharyngeal competence (VPC) and hypernasality assessed from a naming test (VPC-Sum) and connected speech (VPC-Rate). In both scales, higher scores indicated a more severe velopharyngeal insufficiency. Results: No difference between surgical groups was shown. A low positive correlation was found between posterior cleft width and VPC-Rate (Spearman = .23; P = .025). The role of the covariate “cleft size at tuberosity level” was confirmed in an ordinal logistic regression model (odds ratio [OR] = 1.17; 95% confidence interval [CI]:1.01-1.35). A low negative correlation was shown between anteroposterior palatal length and VPC-Sum (Spearman = −.27; P = .004) and confirmed by the pooled scores VPC-Pooled (OR = 0.82; 95% CI: 0.69-0.98) and VPC-Dichotomic (OR = 0.82; 95% CI: 0.68-0.99). Conclusions: Posterior cleft dimensions can be a modest indicator for the prognosis of velopharyngeal function at age 5 years, when the soft palate is closed first, independently on the timing of hard palate repair. Antero-posterior palatal length seems to protect from velopharyngeal insufficiency and hypernasality. However, the association found was significant but low.


Author(s):  
Tiago Rebelo Costa ◽  
Cláudio Akira Yamaguchi ◽  
Alessandra Pucci Mantelli Galhardo ◽  
Roberto Chaib Stegun ◽  
Bruno Costa ◽  
...  

Oral rehabilitation with free-end removable partial denture (RPD) is one of the major challenges in prosthodontic dentistry. The absence of a distal abutment produces undesirable RPD movement during masticatory function due to the high resilience of the residual ridge, which limits the denture efficiency and may damage the abutment teeth and bone over time. The advent of dental implants made possible to substitute the missing teeth with fixed implant-supported dentures as the first choice treatment to overcome such inconveniences. However, this indication may not be suitable for all patients due to financial, anatomical or systemic health conditions. Nevertheless it is possible to improve free extension RPD by using implants in the posterior edentulous ridge to achieve biological, biomechanical, physiological and social benefits. This article aims to present a case report on oral rehabilitation in which a RPD was made combined with an implant for posterior support in a sizeable edentulous ridge. The patient appreciated the retention improvement and the aesthetic result. The combination of a RPD with a posterior implant is an alternative treatment for cases in which implant-supported fixed prosthesis is not indicated, reducing the displacement and minimizing the limitations of the free-end devices.


2020 ◽  
pp. 105566562094656
Author(s):  
Catarina Borges da Fonseca Cumerlato ◽  
Cinthia Studzinski dos Santos ◽  
Mateus Bertolini Fernandes dos Santos ◽  
César Dalmolin Bergoli ◽  
Noéli Boscato

Cleft lip and/or cleft palate defects often result in a functional deficiency in the patient’s chewing, speech ability, and aesthetic appearance, usually demanding multidisciplinary effort for addressing the aesthetic and functional patient’s requirements. This clinical report describes the planned oral rehabilitation of a 46-year-old woman with unilateral cleft lip defect based on the patient’s peculiarities and age. Due to limitations concerning bone grafts and implant procedures, as well as orthodontic treatment, the prosthodontic rehabilitation using the metal-ceramic fixed partial denture was chosen. The treatment adequately reestablished the aesthetic and functional activities, positively impacting the patient’s quality of life.


2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Emrah Ayna ◽  
Emine Göncü Başaran ◽  
Köksal Beydemir

Although patients with cleft lip and palate (CLP) are not seen regularly in general dental practice, this is a frequent congenital anomaly; approximately one in every 800 live births results in a CLP. The cause of CLP is unknown, but possible causes are malnutrition and irradiation during pregnancy, psychological stress, teratogenic agents, infectious agents (viruses), and inheritance. Most clefts are likely caused by multiple genetic and nongenetic factors. Prosthetic reconstruction of the anterior maxilla is important for these patients. This paper describes the prosthetic rehabilitation of two patients with CLP, 19-year-old and 21-year-old women, both with surgically treated CLP. In both, an examination revealed a residual palatal defect of  mm and missing maxillary lateral incisors. The 19-year-old was treated with a fiber-reinforced composite resin-bonded fixed partial denture. The 21-year-old was treated with a removable partial denture with an extracoronal attachment system. The prosthetic rehabilitation of the two patients with CLP was evaluated clinically. In both, well-planned prosthetic, periodontal, and surgical therapy resulted in satisfactory function and esthetics, alleviating their deformities. With education and appropriate recall, the patients should be able to maintain their oral health.


2017 ◽  
Vol 65 (4) ◽  
pp. 380-385
Author(s):  
Marianne Barbosa Salgado de OLIVEIRA ◽  
Maria Giulia Rezende PUCCIARELLI ◽  
José Fernando Scarelli LOPES ◽  
Rafael D’Aquino TAVANO

ABSTRACT The rehabilitation treatment of patients with cleft lip and palate is lengthy and is carried out by various professionals from different areas of healthcare.To this end, planning and specialist knowledge are critical to the success of the treatment, in this way envisioning the aesthetic and functional rehabilitation of the individual in order to integrate them into society. This study consists of a literature review along with the report of a clinical case, demonstrating the treatment performed with the use of a removable partial denture using the abutment teeth treated with milled metal-ceramic crowns and the use of attachments, with a view to promoting the retention and stability of the prosthetic device. With the use of this system as a whole, aimed at improving the facial proportions due to the restoration of vertical dimension of occlusion and adequate lip support, features that are often not present in individuals with cleft lip and palate. In this work, we are seeking to underline the importance of scientific and technical knowledge, combined with a well-executed planning, in order to achieve successful treatment that restores function and aesthetics to the patient, thereby enabling their reintegration into society.


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