Combined Bone Grafting and Delayed Closure of the Hard Palate in Patients with Unilateral Cleft Lip and Palate: Facilitation of Lateral Incisor Eruption and Evaluation of Indicators for Timing of the Procedure

2000 ◽  
Vol 37 (1) ◽  
pp. 98-105 ◽  
Author(s):  
Jan Lilja ◽  
Amin Kalaaji ◽  
Hans Friede ◽  
Anna Elander
Keyword(s):  
Bone Grafting ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Lateral Incisor ◽  
Delayed Closure

Predictive factors for canine position in patients with unilateral cleft lip and palate

2020 ◽  
Author(s):  
Sara Rizell ◽  
Zahra Alhakim ◽  
Hans Mark ◽  
Julia Naoumova
Keyword(s):  
Regression Analysis ◽  
Predictive Factors ◽  
Bone Grafting ◽  
Medical Records ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Exact Test ◽  
Multiple Stepwise Regression Analysis ◽  
Surgical Exposure

Summary Objectives The aims were to compare cleft and non-cleft canine position, to find predictive factors for canine position and to assess surgically exposed canines. Materials/Methods One hundred forty-eight individuals, born 1978–2005, with total unilateral cleft lip and palate (including Simonart’s band <5 mm) treated in Gothenburg, were included. Canine angulation as well as vertical and horizontal position were assessed on panoramic radiographs (PAN) taken at the age of 10. Plausible predictive factors were registered from PAN, cast models and medical records. Data on spontaneous eruption or surgical exposure were available for 88 patients. Cleft- and non-cleft side was compared using paired t-test and Fisher’s exact test. Multiple stepwise regression analysis and logistic regression analysis were used to detect possible predictors for cleft canine position. Results The cleft canine angulation was 29.3 ± 13.1 degrees (mean ± standard deviation) versus 7.6 ± 8.2 degrees on the non-cleft side (p < 0.001). Cleft canines were higher positioned and located closer to the midline compared to non-cleft canines (p < 0.001). Age for both hard palate closure and bone grafting, cleft lateral agenesis as well as transposition were associated with canine position. Cleft canines that required surgical exposure (28%) had an increased angulation and were higher positioned than spontaneously erupted canines (p < 0.001). Limitations The shortcomings were the retrospective design and incomplete assessment of the buccal–palatal canine position on 2D images. Conclusions/Implications With increased age for bone grafting, decreased age for hard palate closure and transposition, an association with abnormal canine position was found. A rigorous monitoring of cleft canine eruption is, therefore, advocated.

Influence of Early Hard Palate Closure in Unilateral and Bilateral Cleft Lip and Palate on Maxillary Transverse Growth during the First Four Years of Age

2003 ◽  
Vol 40 (2) ◽  
pp. 126-130 ◽  
Author(s):  
Bernhard Lehner ◽  
Joerg Wiltfang ◽  
Karin Strobel-Schwarthoff ◽  
Michaela Benz ◽  
Ursula Hirschfelder ◽  
...  
Keyword(s):  
Hard Palate ◽  
Primary Closure ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Arch Width ◽  
Significant Difference ◽  
Early Primary ◽  
Delayed Closure ◽  
The University

Objective To evaluate and compare the effects of early primary closure of the hard palate on the anterior and posterior width of the maxillary arch in children with bilateral (BCLP) and unilateral (UCLP) cleft lip and palate during the first 4 years of life. Design A retrospective, mixed-longitudinal study. Setting Cleft Palate Center of the University of Erlangen-Nuremberg. Subjects and Methods The present investigation analyzes longitudinally 42 children with UCLP and 8 children with BCLP between 1996 and 2000 with early simultaneous primary closure of lip and hard palate (4 to 5 months). Palatal arch width was measured on dental casts with a computer-controlled three-dimensional digitizing system, and their growth velocities were calculated from consecutive periods (mean follow-up 39 months). Differences in growth velocities were compared with those of 25 children with UCLP and 15 children with BCLP with delayed closure of hard palate (12 to 14 months). Results and Conclusions There was no significant difference in terms of anterior and posterior maxillary width between early and delayed closure of hard palate within the first 4 years of life.

Factors Influencing Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients: Prospective Analysis Using CT Image Analyzer

2007 ◽  
Vol 44 (3) ◽  
pp. 286-291 ◽  
Author(s):  
Tomomichi Ozawa ◽  
Susumu Omura ◽  
Eiji Fukuyama ◽  
Yoshiro Matsui ◽  
Katuyuki Torikai ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Significant Negative Correlation ◽  
Lateral Incisor ◽  
Image Analyzer ◽  
Ct Image ◽  
Bone Bridge ◽  
Alveolar Bone Grafting

Objective: To examine the effect of migration of the germ of the lateral incisor into the bone for eruption factors on bone bridge resorption. Methods: Twenty-five subjects who underwent secondary alveolar bone graft were enrolled. The volume of the alveolar bone grafts immediately after the operation (V1), bone bridge formation 6 months postoperatively (V2), and tooth (teeth) migration into the bone bridge (Vt) were measured using a computed tomography (CT) image analyzer. Based upon these measurements, the following points were examined: (1) the correlation between the tooth-occupied ratio (Rt = Vt/V2 × 100) and the ratio of bone bridge resorption (Rv = (V1 − V2)/ V1 × 100); and (2) comparison of the tooth-occupied ratio (Rt) and the ratio of bone bridge resorption (Rv) between the groups with and without the germ of the lateral incisor. Results: A significant negative correlation was found between Rv and Rt (p < .001). Comparison of Rv and Rt between the groups with and without a germ of the lateral incisor revealed that both indices were significantly higher in the former group than the latter one (p < .05). Conclusion: In cleft lip and palate patients with a germ of the lateral incisor, it is beneficial to carry out secondary bone grafting to the alveolar cleft at the age of 5 to 7 years, preceding eruption of the canine, in order to form a good bone bridge that will facilitate eruption of the lateral incisor and subsequent normal dentition and occlusion.

Supernumerary Lateral Incisor Teeth

1974 ◽  
Vol 1 (4) ◽  
pp. 149-157 ◽  
Author(s):  
D. B. Johnson
Keyword(s):  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Significant Proportion ◽  
Great Majority ◽  
Lateral Incisor ◽  
Supernumerary Teeth ◽  
Unaffected Side ◽  
Nasal Floor ◽  
A Minor

A sample of 62 cases of supernumerary teeth found in the lateral incisor area was selected and analysed. The great majority of these teeth were supplemental teeth, with deciduous precedents. Both teeth (the normal incisor and supernumerary) showed reduction in size as compared to the unaffected side. Differences were found between the mesial unit and the distal—the mesial being larger and having an incisor shape and the distal smaller and resembling a canine. Many of the pairs were similar to supernumerary teeth found in cleft lip and palate and there were also effects upon the other teeth particularly central incisors. Stigmata of cleft were observed in the alveolus, nasal floor and hard palate in a significant proportion of cases. It is concluded that supernumerary laterals arise by gemination or failure of development of normal odontogenic material. The anomaly fulfils the hypothetical criteria for a microform of cleft and may be the result of a minor error in embryonic fusion.

A Comparative Study of Prespeech Vocalizations in Two Groups of Toddlers with Cleft Palate and a Noncleft Group

2000 ◽  
Vol 37 (2) ◽  
pp. 172-178 ◽  
Author(s):  
Elisabeth Willadsen ◽  
Hans Enemark
Keyword(s):  
Mental Retardation ◽  
Retrospective Study ◽  
Cleft Palate ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Comparison Group ◽  
Place Of Articulation ◽  
Delayed Closure ◽  
Palatal Surgery

Objective This study examined the prelinguistic contoid (consonant-like) inventories of 14 children with unilateral cleft lip and palate (C-UCLP) at 13 months of age. The children had received primary veloplasty at 7 months of age and closure of the hard palate was performed at 3–5 years. The results of this investigation were compared to results previously reported for 19 children with cleft palate and 19 noncleft children at the age of 13 months. The children with clefts in that study received a two-stage palatal surgery. This surgical procedure was formerly used at our center and included closure of the lip and hard palate at 3 months of age and soft palate closure at 22 months of age. Design Retrospective study. Setting The participants were videorecorded in their homes during play with their mothers. The videotapes were transcribed independently by three trained speech pathologists. Patients Fourteen consecutive patients born with C-UCLP and no known mental retardation or associated syndromes served as subjects. Results The children who received delayed closure of the hard palate demonstrated a significantly richer variety of contoids in their prespeech vocalizations than the cleft children in the comparison group. Both groups of subjects with clefts had significantly fewer plosives in their contoid inventory than the noncleft group, and there was no difference regarding place of articulation between the group that received delayed closure of the hard palate and the noncleft group.

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