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.

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.

scholarly journals Comprehensive Orthodontic Treatment of Adult Patient with Cleft Lip and Palate

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Noemí Leiva Villagra ◽  
Miguel Muñoz Domon ◽  
Sebastian Véliz Méndez
Keyword(s):  
Adult Patient ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Multidisciplinary Approach ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Excellent Result ◽  
Maxillary Expansion ◽  
Optimal Function ◽  
Therapy Treatment

The aim of the paper is to present full orthodontic treatment of an operated cleft lip adult patient.Case Report. An 18-year-old patient consulted for severe crowded teeth. He comes from a poor family. At that time he already had four operations (velum, palate, lip, and myringotomy). Treatment included maxillary expansion, tooth extraction, and fixed orthodontic, as well as kinesiology and speech therapy treatment. A multidisciplinary approach allowed us to achieve successfully an excellent result for this patient and gave him a harmonic smile and an optimal function without orthognathic surgery. Two years after treatment, occlusion remains stable.

Protração maxilar ancorada em miniplacas na fissura labiopalatina – do diagnóstico à maturidade esquelética

2021 ◽  
Vol 14 (54) ◽  
pp. 80-88
Author(s):  
Renata Mayumi Kato ◽  
Renato André de Souza Faco ◽  
Hilde Timmerman ◽  
Hugo De Clerck ◽  
Daniela Garib
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Full Time ◽  
Class Iii ◽  
Facial Growth ◽  
Maxillary Expansion ◽  
Alveolar Bone Grafting

The purpose of this study was to report a case with complete unilateral cleft lip and palate (CLP) treated with bone anchored maxillary protraction (BAMP) in miniplates followed up until the end of facial growth. A 7-year-old girl with complete left side CLP started the orthodontic treatment in a rehabilitation center. She presented a Class III skeletal pattern due to maxillary deficiency, a GOSLON 4 sagittal interarch relationship, a negative overjet of 1.5mm and agenesis of left upper lateral incisor. In the mixed dentition, the patient was submitted to rapid maxillary expansion followed by the secondary alveolar bone grafting procedure. At 12y 3m two miniplates were installed in the maxilla and two in the mandible with BAMP therapy. The patient was instructed to use full time Class III elastics with force of 250g/side together with a bite lifting plate in the upper arch. BAMP therapy duration was 19 months leading to a positive overjet and GOSLON 1 sagittal interarch relationship. The cephalometric analysis demonstrated a mild maxilla advancement. Class III elastics started to be used only at night as an active retention concomitantly with Phase II orthodontic treatment. Compensatory corrective orthodontic treatment established adequate occlusion between the dental arches with significant improvement of facial aesthetics after the intervention. Le Fort 1 surgery with maxillary advancement was not necessary.

scholarly journals Evaluation of Nasal Airway Volume of Operated Unilateral Cleft Lip and Palate Patients Compared With Skeletal Class III Individuals

2018 ◽  
Vol 56 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Ümit Ertaş ◽  
Mert Ataol
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Nasal Passage ◽  
Study Group ◽  
Nasal Airway ◽  
Class Iii ◽  
Skeletal Class ◽  
Alar Base ◽  
Nasal Function

Cleft lip and palate (CLP) patients have various problems with nasal anatomy beyond just oronasal separation. The alar base, concha, and septum are over impressed in these individuals. Additionally, skeletal class III deformity is seen. These conditions may limit nasal function. In our study, 15 unilateral patients with CLP older than 15 years (10 females, 5 males; mean age: 19.13) who had received surgery were included as the study group, and 15 participants with noncleft skeletal class III deformities were included as the control group (10 females, 5 males; mean age: 19.20). The individuals’ nasal airway volumes (total/cleft side/noncleft side/control/ nasal passages) were examined and compared statistically. The results showed that the study group had significantly higher values in terms of total airway volume ( P < .05). Additionally, there were significant differences between the cleft side and noncleft side volumes, between the cleft side volumes and the volumes of the control group participants, and between the noncleft side volumes and the volumes of the control group participants ( P < .05). There was no difference between the groups in terms of nasopharyngeal ( P = .39) and nasal passage volumes ( P = .73). The results show there are some problems regarding nasal airway volume in patients with CLP, even when lip, palate, and alveolar cleft operations have been performed. The aim of this study was to evaluate differentiation of nasal airway volumes between unilateral patients with CLP and individuals with noncleft skeletal class III serving as the control group.

Maxillary Anterior Tooth Size and Arch Dimensions in Unilateral Cleft Lip and Palate

2008 ◽  
Vol 45 (6) ◽  
pp. 639-646 ◽  
Author(s):  
Benjamin R. K. Lewis ◽  
Melanie R. Stern ◽  
Derrick R. Willmot
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Univariate Analysis ◽  
Chord Length ◽  
Control Group ◽  
Study Group ◽  
Image Analysis System ◽  
Anterior Teeth ◽  
Maxillary Incisors ◽  
Maxillary Cleft

Objective: To investigate differences in size of the maxillary permanent anterior teeth and arch dimensions between individuals with repaired unilateral cleft lip and palate (UCLP) and a matched control group representing the general population. Design: Retrospective study cast review. Participants: Study casts of 30 subjects due to commence orthodontic treatment following an alveolar bone graft (ABG) were collected from the Cleft Lip and Palate Units in South Yorkshire. Thirty control subjects were collected from a previously validated control group of white individuals in South Yorkshire. Main Outcome Measures: Casts were analyzed with an image analysis system to measure the dimensions of the maxillary permanent anterior teeth, incisor chord lengths, and the intercanine and intermolar widths. The results were analyzed statistically using paired t-tests and two-way univariate analysis of variance (ANOVA). Results: The mesiodistal widths of maxillary anterior teeth in the study group were smaller than the noncleft control group (p < .01). The dimensions of the cleft side maxillary incisors and incisor chord length were smaller (p < .05 and p < .01 respectively) compared with the noncleft side. The study group maxillary cleft side incisor chord length and maxillary intercanine width were narrower than the control group (p < .0001). Conclusions: (1) Anterior teeth are smaller mesiodistally in individuals with UCLP. (2) Maxillary incisors are smaller on the cleft side than the noncleft side. (3) UCLP subjects had smaller maxillary cleft side incisor chord lengths and intercanine widths than the control group despite pre-ABG expansion.

Masticatory Function Assessment of Adult Patients With Cleft Lip and Palate After Orthodontic Treatment

2021 ◽  
pp. 105566562199173
Author(s):  
Sayumi Miura ◽  
Hiroshi Ueda ◽  
Koji Iwai ◽  
Cynthia Concepcion Medina ◽  
Eri Ishida ◽  
...  
Keyword(s):  
Contact Area ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Adult Patients ◽  
Occlusal Force ◽  
Occlusal Contact ◽  
Masticatory Function ◽  
Masticatory Efficiency ◽  
Normal Occlusion

Objective: To determine whether orthodontically treated patients with cleft lip and palate (CLP) possess a different masticatory function than those of untreated patients with normal occlusion. Design: Occlusal contact area, occlusal force, as well as masseter and anterior temporal muscular activity were measured during maximum voluntary clenching (MVC) tests. Mandibular left and right lateral movements during mastication were also assessed. To further elucidate the nature of masticatory function, especially to determine the rate of abnormal jaw movement patterns, a parametric error index (EI) was set. Finally, masticatory efficiency was evaluated with a glucose sensitive measuring device. Participants: Fifteen patients with CLP who had previously completed the orthodontic treatments required to achieve an acceptable and more harmonious occlusion accepted to volunteer in this study along with 21 untreated patients who already possessed a normal occlusion. Results: Patients with CLP showed a significantly lower occlusal force, reduced occlusal contact area, and decreased masticatory efficiency as well as significantly higher EI value when compared with controls. However, there was no significant difference when analyzing muscle activity, although masticatory efficiency was significantly different between the 2 groups. Despite this result, the scores obtained by the patients with CLP in the masticatory efficiency tests were still in the normal range. Conclusions: Orthodontic treatment for adult patients with CLP provides a satisfactory result for the patients’ masticatory ability albeit significantly less ideal compared with untreated patients with normal occlusion.

Dermatoglyphics and Cheiloscopy as Key Tools in Resolving the Genetic Correlation of Inheritance Patterns in Cleft Lip and Palate Patients: An Assessment of 160 Patients

2017 ◽  
Vol 54 (5) ◽  
pp. 588-594 ◽  
Author(s):  
Priyankar Singh ◽  
Dipesh B. Nathani
Keyword(s):  
Cleft Palate ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Study Group ◽  
Healthy Children ◽  
Type Ii ◽  
Type Iii ◽  
Group B

Objective The objective of this study was to correlate dermatoglyphics and cheiloscopy with genetic inheritance in cleft lip and cleft palate patients. Design and Setting This was a case-control study to look for asymmetry in finger and lip print patterns. All of the participants were divided into two equal groups (40 mothers and 40 fathers in each group). The data were analyzed by three evaluators who were blind to the study to avoid any chances of error. Patients/Participants A sample of 160 sporadic participants were identified and evaluated. Group A was composed of 80 healthy parents not affected by cleft lip and cleft palate but had at least one child born with nonsyndromic cleft. Group B consisted of 80 healthy parents not affected by cleft lip and cleft palate and had healthy children without cleft lip and cleft palate. Main Outcome Measures Main outcome measures were marked dermatoglyphic asymmetry and specific lip print pattern in the study group. Results We found marked asymmetry in various fingerprints and specific type II and type III lip print in the study group when compared with the control group. It was observed that groove count on the lip was significantly more frequent in study group parents. Conclusion Our study determined that there is a significant correlation between increased dermatoglyphic asymmetry and specific type II and type III lip print pattern in parents of children born with cleft. This could act as an important screening marker for the prediction of cleft lip and cleft palate inheritance.

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