Treatment of a Patient with Cleft Lip and Palate Using an Internal Distraction Device

2008 ◽  
Vol 45 (5) ◽  
pp. 552-560 ◽  
Author(s):  
Emel Sari ◽  
Cihan Ucar ◽  
Oytun Türk ◽  
Huseyin Kurtulmus ◽  
H. Ayberk Altug ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Latency Period ◽  
Open Bite ◽  
Maxillary Expansion ◽  
Anterior Open Bite ◽  
Automatic Speech Recognition System ◽  
Rapid Palatal Expansion ◽  
Maxillary Osteotomy ◽  
Maxillary Distraction

A 24-year-old man with a bilateral cleft lip and palate was treated by a multidisciplinary team composed of an orthodontist, plastic surgeon, and prosthodontist with assistance from an engineer. Before treatment, clinical photographs, dental casts, lateral and posteroanterior cephalograms, periapical and panoramic radiographs, and three-dimensional computed tomography (3D CT) images were obtained. He presented with a narrow and retrognathic maxilla with a 23-mm anterior open bite. Following maxillary expansion with rapid palatal expansion, a Le Fort I maxillary osteotomy was performed, and an internal distractor was placed. After a 5-day latency period, internal maxillary distraction was performed at a rate of 1 mm/day achieved by two activations per day. Cephalometric analysis showed a 7-mm maxillary advancement. Mandibular bilateral sagittal split osteotomy was also performed to close the open bite following maxillary distraction and a 3-month stabilization period. Finally, the treatment was completed with prosthetic rehabilitation. The changes in speech production were evaluated using an automatic speech recognition system.

Evaluation of Transverse Maxillary Expansion after a Segmental Posterior Subapical Maxillary Osteotomy in Cleft Lip and Palate Patients with Severe Collapse of the Lateral Maxillary Segments

2014 ◽  
Vol 51 (6) ◽  
pp. 651-657 ◽  
Author(s):  
S. Carpentier ◽  
J. Van Gastel ◽  
J. Schoenaers ◽  
C. Carels ◽  
V. Vander Poorten ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Adult Patients ◽  
Control Group ◽  
Study Group ◽  
Maxillary Expansion ◽  
University Hospitals ◽  
Rapid Palatal Expansion ◽  
Maxillary Osteotomy

Objective The purpose of this longitudinal retrospective study was to evaluate transverse maxillary expansion after a Schuchardt or segmental posterior subapical maxillary osteotomy (SPSMO) in patients with cleft lip and palate (CLP). A second aim was to compare these data with data for adult patients without CLP who were receiving a surgical assisted rapid palatal expansion (SARPE). Method The study group comprised 19 patients with CLP and a severe transversally collapsed maxilla who were treated with SPSMO followed by hyrax expansion at the University Hospitals Leuven. Dental casts of the 19 patients were analyzed before treatment, at maximum expansion, during orthodontic treatment, at the completion of orthodontic treatment. and 2 years after orthodontic treatment and were measured at the canine, premolar, and molar levels. Adult patients without CLP who were enrolled in a prospective study served as the control group. Results Maxillary expansion within the study group was significantly greater ( P < .05) at all measured levels compared with the maxillary arch before treatment. No significant relapse was measured in the study group 2 years after orthodontic treatment. When comparing the study and control groups, the only statistical difference was that canine expansion was significantly greater in the study group. Conclusion SPSMO followed by maxillary expansion and orthodontic treatment is an appropriate treatment option to correct a severe transversally collapsed maxilla in patients with CLP. The overall treatment effect of SPSMO expansion is comparable with the effects of SARPE, although canine expansion was greater in the SPSMO group.

Orthodontic-Surgical Approach for Treating Skeletal Class III Malocclusion With Severe Maxillary Deficiency in Isolated Cleft Palate

2018 ◽  
Vol 56 (3) ◽  
pp. 400-407 ◽  
Author(s):  
Kohei Nakatsugawa ◽  
Hiroshi Kurosaka ◽  
Kiyomi Mihara ◽  
Susumu Tanaka ◽  
Tomonao Aikawa ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Surgical Approach ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Maxillary Expansion ◽  
Rapid Palatal Expansion ◽  
Isolated Cleft Palate ◽  
Maxillary Deficiency

Orthodontic treatment in patients with orofacial cleft such as cleft lip and palate or isolated cleft palate is challenging, especially when the patients exhibit severe maxillary growth retardation. To correct this deficiency, maxillary expansion and protraction can be performed in the first phase of orthodontic treatment. However, in some cases, the malocclusion cannot be corrected by these procedures, and thus, skeletal discrepancy remains when the patients are adolescents. These remaining problems occasionally require various orthognathic treatments according to the degree of the discrepancy. Here, we describe one case of a female with isolated cleft palate and hand malformation who exhibited severe maxillary deficiency until her adolescence and was treated with multiple orthognathic surgeries, including surgically assisted maxillary expansion (surgically assisted rapid palatal expansion), LeFort I osteotomy, and bilateral sagittal split osteotomy in order to correct severe skeletal discrepancy and malocclusion. The treatment resulted in balanced facial appearance and mutually protected occlusion with good stability. The purpose of this case report is to show the orthodontic treatment outcome of 1 patient who exhibited isolated cleft palate and subsequent severe skeletal deformities and malocclusion which was treated by an orthodontic-surgical approach.

Proportions of anxiety and depression symptoms in adult cleft patients and non-cleft patients with skeletal malocclusions

2017 ◽  
Vol 41 (S1) ◽  
pp. s497-s497
Author(s):  
V. Medvedev ◽  
Y. Fofanova ◽  
V. Frolova ◽  
A. Drobyshev
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Anxiety Symptoms ◽  
Open Bite ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Class Iii ◽  
Anterior Open Bite ◽  
Skeletal Class Ii ◽  
Reactive Anxiety

IntroductionDiagnosis and treatment of patients with craniofacial anomalies such as cleft lip and palate and skeletal malocclusions present a challenge to public health. Dentofacial abnormalities may be associated with depressive and anxiety disorders and poor quality of life.The aim of this screening study was to evaluate and to compare the rates of anxiety and depression in cleft patients and non-cleft patients with skeletal malocclusions.MethodsThe study used psychometric method-HADS and State Trait Anxiety Inventory were used. The first group consisted of cleft patients, the second group consisted of non-cleft patients with skeletal Class II, Class III and anterior open bite malocclusions; the third group was control.ResultsStudy sample consists of 42 patients (33 females; 24 ± 7.2 years). In the 1st group, anxiety symptoms were detected in 34.7%; depression symptoms - in 17.2% of patients, high rates of reactive anxiety were registered in 35.8%. In the 2nd group, anxiety symptoms were detected in 29.6% of patients; depression symptoms - in 13,1% of patients, high rates of reactive anxiety were registered in 34.2%. In the 3rd group anxiety (18.7%) and depression (8.3%) symptoms and high rates of reactive anxiety (17.7%) were registered significantly less often than in 1st and 2nd groups (P < 0.005, P < 0.001 and P < 0.001 respectively).ConclusionsOur data suggest that cleft-patients and non-cleft patients with skeletal malocclusions have statistically significant higher rates of anxiety and depression than controls and require orthodontic-surgical treatment that should be organized with the assistance of psychiatrist.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Maxillary distraction osteogenesis for correction of maxillary retrognathia in cleft lip and palate patients: a case series

2019 ◽  
Vol 5 (6) ◽  
pp. 154
Author(s):  
Burçak Kaya ◽  
Secil Cubuk ◽  
Sıdıka Akdeniz ◽  
Burak Bayram
Keyword(s):  
Distraction Osteogenesis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Protocol ◽  
Case Series ◽  
Dental Arch ◽  
Maxillary Expansion ◽  
Oronasal Fistula ◽  
Alveolar Bone Grafting ◽  
Maxillary Distraction

<p class="abstract">The treatment protocol of patients having maxillary retrognatia is presented in this case series. Maxillary expansion, secondary alveolar bone grafting and/or oronasal fistula closure were performed in 6 cleft lip and palate patients. Preoperative simulation of Le Fort I osteotomy and adaptation of maxillary distractors were realized with stereolytographic cranium models. Intraoral maxillary distraction was applied under general anesthesia. A single unit acrylic occlusal splint was ligated to maxillary dental arch and worked as a guide during entire activation and consolidation period of distraction osteogenesis. Rigid internal fixation plates were placed in the osteotomy sites at the end of consolidation period. The amount of maxillary advancement was between 5-14 mm.  Satisfying occlusal and skeletal relationships were obtained in all patients. Advancement of maxilla by distraction osteogenesis resulted in gradual formation of bone at the osteotomy line and enhanced treatment outcome in patients with cleft lip and palate.</p>

scholarly journals Pattern of Distribution of Malocclusions in Patients Seeking Orthodontic Treatment at BPKIHS from Sunsari District of Nepal

1970 ◽  
Vol 8 (2) ◽  
pp. 93-96 ◽  
Author(s):  
JN Sharma
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Open Bite ◽  
Class I ◽  
Kappa Statistics ◽  
Class Iii ◽  
Anterior Open Bite ◽  
Dental Surgery ◽  
Standard Format

Setting: College of Dental Surgery, B P Koirala Institute of Health Sciences, Sunsari, Nepal. Aims: To evaluate the pattern and distribution of malocclusions in patients seeking for orthodontic treatment from Sunsari district of Nepal. Material and Methods: Total of 350 patients who were permanent inhabitants of Sunsari district of age range 8-36 years were included in the study. A standard format was prepared to record the data. Descriptive statistics for mean, standard deviation and frequencies were calculated. Ages and Class I, II and III malocclusions were cross tabulated to check for any relationship using ANOVA. Intra investigator error was calculated using kappa statistics. Results: The prevalence of Class I, II and III malocclusions were 62.28 %, 29.4%.and 8.2% respectively. Out of 350 cases studied for various occlusal traits the nature of distribution of various occlusal findings were: absent teeth-12.6%, supernumerary teeth-2.9% ectopic eruption-7.1%, midline diastema-16%, incisor crowding-52.9%, spacing-30%, malformations-3.1%, increased overjet (>4mm)- 42.3%, anterior open bite . 5.1% and deep bite (>4mm )- 40 % and cleft lip and palate was 0.28%. Most prevalent age group seeking orthodontic treatment was 12-24 years with females to male ratio of 2.3:1 Comparison of mean ages with different malocclusion groups using ANOVA was statistically not significant. Conclusion: Class I malocclusion was the most prevalent followed by Class II malocclusion and the Class III malocclusion showed least prevalence. There were diverse occlusal traits. Keywords: Malocclusion; Angle’s Classification; Sunsari; BPKIHS

scholarly journals Correction of transverse maxillary deficiency and anterior open bite in an adult Class III skeletal patient

2016 ◽  
Vol 6 ◽  
pp. 166-170
Author(s):  
Prerna Hoogan Teja ◽  
Samarjit Singh Teja ◽  
Rabindra S. Nayak ◽  
Abhijit Bagade ◽  
Manu Rashmi Sharma
Keyword(s):  
Transverse Dimension ◽  
Open Bite ◽  
Class Iii ◽  
Maxillary Expansion ◽  
Anterior Open Bite ◽  
Palatal Expansion ◽  
Posterior Crossbite ◽  
Rapid Palatal Expansion ◽  
Dental Crowding ◽  
Maxillary Deficiency

Transverse maxillary deficiency may be associated with sagittal or vertical problems of the maxilla or mandible. It may contribute to unilateral or bilateral posterior crossbite, anterior dental crowding, and unesthetic black buccal corridors on smiling. An adequate transverse dimension is important for stable and proper functional occlusion. Surgically, assisted rapid palatal expansion has been the treatment of choice to resolve posterior crossbite in skeletally mature patients. The following case report presents an adult Class III skeletal patient with an anterior open bite and bilateral posterior crossbite which was treated by surgically assisted rapid maxillary expansion with satisfactory outcomes.

Orthodontics

2014 ◽  
pp. 119-170
Author(s):  
David A. Mitchell ◽  
Laura Mitchell ◽  
Lorna McCaul
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Poor Quality ◽  
Open Bite ◽  
Functional Appliance ◽  
Anterior Open Bite ◽  
Temporary Anchorage Devices ◽  
Functional Appliances ◽  
Permanent Molars ◽  
Removable Appliances

Contents. What is orthodontics?. Definitions. Orthodontic assessment. The Index of Orthodontic Treatment Need. Cephalometrics. More cephalometrics. Treatment planning. Management of the developing dentition. Extractions. Extraction of poor quality first permanent molars. Spacing. Distal movement of the upper buccal segments. Buccally displaced maxillary canines. Palatally displaced maxillary canines. Increased overjet. Increased overbite. Management of increased overbite. Anterior open bite (AOB). Reverse overjet. Crossbites. Anchorage. Temporary anchorage devices (TAD). Removable appliances. Fixed appliances. Functional appliances—rationale and mode of action. Types of functional appliance and practical tips. Orthodontics and orthognathic surgery. Cleft lip and palate.

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