The Need for Orthognathic Surgery in Patients with Repaired Complete Unilateral and Complete Bilateral Cleft Lip and Palate

2009 ◽  
Vol 46 (5) ◽  
pp. 498-502 ◽  
Author(s):  
John Daskalogiannakis ◽  
Manisha Mehta
Keyword(s):  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Associated Anomalies ◽  
Canadian Health Care System ◽  
Bilateral Cleft Lip ◽  
Canadian Health ◽  
Canadian Health Care ◽  
History Of ◽  
Presurgical Orthopedics

Objective: To determine the percentage of patients with complete unilateral cleft lip and palate and complete bilateral cleft lip and palate treated at SickKids since birth who would benefit from orthognathic surgery. Design: Retrospective cohort study. Subjects: The review comprised records of 258 patients with complete unilateral cleft lip and palate and 149 patients with complete bilateral cleft lip and palate born from 1960 to 1989. Of these, 211 and 129 patients, respectively, had been treated at SickKids since birth. Patients with syndromes or associated anomalies were excluded. Methods: Patients who had undergone orthognathic surgery were recorded. For the remaining patients, arbitrarily set cephalometric criteria were used in order to identify the “objective” need for surgery. Lateral cephalometric radiographs taken beyond the age of 15 years were digitized using Dentofacial Planner cephalometric software. Results: Of the 211 patients with complete unilateral cleft lip and palate, 102 (48.3%) were deemed to benefit from orthognathic surgery. For the complete bilateral cleft lip and palate sample, the percentage was 65.1% (84 of 129). Definitive information on presurgical orthopedics was available for a small subsample (101 patients) of the complete unilateral cleft lip and palate cohort. The need for orthognathic surgery for this group was slightly higher (59.4%, or 60 of 101). Conclusion: These results suggest that a considerable percentage of patients with a history of complete cleft lip and palate at our institution require orthognathic surgery. Factors that need to be considered in the interpretation of these results include the quest for improvement in the profile aesthetics; the fact that the Canadian health care system covers the costs of surgery, making it more accessible to the patients; and the inclusion in the above figures of patients who had orthognathic surgery solely for reasons of closure of previously ungrafted alveolar clefts and associated fistulae.

scholarly journals Presurgical Alignment of Bilateral Cleft Segments With 3D Simulation Under Special Consideration of the Vomer: A Technical Note

2020 ◽  
pp. 105566562096543
Author(s):  
Gül Schmidt ◽  
Max Heiland ◽  
Carsten Matuschek
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Technical Note ◽  
3D Simulation ◽  
Special Consideration ◽  
Bilateral Cleft Lip ◽  
Orthodontic Device ◽  
Presurgical Orthopedics

Background: The main goal of presurgical orthopedics (PSO) for patients with bilateral cleft lip and palate is to correct the protruded and/or twisted premaxilla. However, PSO is associated with the risk of uncontrolled development of the vomer, which has received little attention to date. Solution: We present a removable orthodontic device that can be used to keep or align the vomer and the premaxilla in the midline during preoperative molding of cleft segments independently and 3 dimensionally.

Cleft lip and palate

2020 ◽  
pp. 315-350
Keyword(s):  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Speech Development ◽  
Clinical Psychologist ◽  
Bilateral Cleft Lip ◽  
Facial Anomaly ◽  
Surgical Options ◽  
The Uk

Cleft lip and palate is the most common facial anomaly in the UK. This chapter describes the cleft lip and palate, alongside their aetiology and diagnosis. It then describes the management of the cleft lip, including principles, surgical options, the unilateral and bilateral cleft lip and palate, and then the management of the palate and alveolus. Revision procedures are outlined. The management of the nose and orthognathic surgery for different cleft types are all outlined. Speech development, hearing, and orthodontics are all covered. Finally, there is a section on psychology, and the importance of a clinical psychologist to monitor important transitional points in the child.

scholarly journals Orthognathic surgery or overlay prosthesis: Quality of life in bilateral cleft lip and palate patients

2017 ◽  
Vol 7 (2) ◽  
pp. 176 ◽  
Author(s):  
Simone Soares ◽  
MichellyLima Moro Alves ◽  
JoséFernando Scarelli Lopes ◽  
Ana LúciaPompéia Fraga de Almeida ◽  
KarinHermana Neppelenbroek ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Bilateral Cleft Lip

A Rapid Solution to Align the Severely Malpositioned Premaxilla in Bilateral Cleft Lip and Palate Patients

2008 ◽  
Vol 45 (3) ◽  
pp. 229-231 ◽  
Author(s):  
Amornpong T. Vachiramon ◽  
John N. Groper ◽  
Simon Gamer
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Time ◽  
Bilateral Cleft Lip ◽  
Nasoalveolar Molding ◽  
Presurgical Orthopedics ◽  
Palate Patient

Objective: To describe a laboratory modification of the maxillary cast to make an improved nasoalveolar molding plate used in presurgical orthopedics for infants with bilateral cleft lip and palate. Conclusions: Modifying the nasoalveolar molding plate may reduce the presurgical treatment time for the bilateral cleft lip and palate patient.

Dermatoglyphic Analysis in Parents with Nonfamilial Bilateral Cleft Lip and Palate Children

2010 ◽  
Vol 47 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Arezoo Jahanbin ◽  
Naser Mahdavishahri ◽  
Mohammad Mahdi Naseri ◽  
Yasaman Sardari ◽  
Sareh Rezaian
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Normal Population ◽  
Control Group ◽  
Ridge Count ◽  
Chi Square ◽  
Bilateral Cleft Lip ◽  
History Of ◽  
The Asymmetry ◽  
The Difference

Objectives To test the hypothesis that unaffected parents with nonsyndromic bilateral cleft lip and palate children possess greater levels of dermatoglyphic asymmetry than the normal population and to test for the difference in the distribution of pattern types. Design Case-control study. Setting Mashhad University of Medical Sciences, Mashhad, Iran. Participants Forty-five unaffected parents (45 men and 45 women) of children with nonfamilial bilateral cleft lip and palate anomaly were enlisted. A control group of 45 unaffected parents with at least two unaffected children and no prior family history of clefting were also simultaneously selected. Main Outcome Measures Palm prints and fingerprints were taken from each participant, and total ridge counts, atd angles, and pattern types were determined. For each of the three dermatoglyphic measures, asymmetry scores between right and left hands were defined, and then asymmetry scores of unaffected parents and pattern types were compared statistically with the controls, using Mann-Whitney and chi-square tests. Results In contrast to total ridge count asymmetry, the asymmetry of atd angles in unaffected parents and the asymmetry of patterns (in unaffected mothers) were significantly higher in comparison with the controls. Furthermore, unaffected fathers had significantly more arches than the controls, but there were no significant differences in dermatoglyphic patterns of unaffected mothers and the controls. Conclusion The findings suggest that an increase in the asymmetry of atd angles and pattern types in parents of sporadically affected children may reflect more the genetic base of this congenital malformation.

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