Maxillary Lateral Incisors of Subjects with Cleft Lip and/or Palate: Part 2

1992 ◽  
Vol 29 (4) ◽  
pp. 380-384 ◽  
Author(s):  
Akira Suzuki ◽  
Mieko Watanabe ◽  
Masayuki Nakano ◽  
Yasuhide Takahama
Keyword(s):  
Cleft Lip ◽  
Primary Teeth ◽  
Cleft Lip And Palate ◽  
Permanent Teeth ◽  
Intermediate Type ◽  
Alveolar Cleft ◽  
Distal Side ◽  
Bilateral Cleft Lip ◽  
Dental Hospital ◽  
Primary Lateral

Maxillary lateral incisors on the alveolar cleft were investigated in 431 cleft children registered in the Department of Orthodontics, Kyushu University Dental Hospital. The majority of primary maxillary lateral incisors were located on the distal side of the alveolar cleft in both unilateral cleft lip and alveolus (UCLA) and unilateral cleft lip and palate (UCLP) subjects. Permanent teeth in UCLA tend to be located distally, but in UCLP they tend to be congenially absent (p < .01). The majority of primary teeth had normal shapes; the majority of permanent teeth were of intermediate type or were missing congenially. One third of the UCLA and one half of the UCLP subjects who had primary maxillary lateral incisors were not followed by permanent replacements. The location of the majority of permanent maxillary lateral incisors tallied with that of the primary ones except in four UCLA, ten UCLP, and two bilateral cleft lip and palate (BCLP) subjects. Four UCLA and ten UCLP subjects who had primary lateral incisors on the distal side were followed by their permanent successors on the mesial side. Three UCLP and one BCLP subjects had permanent maxillary lateral incisors even though they had no temporary predecessors.

Abnormal Maxillary Trapezoid Pattern in Human Fetal Cleft Lip and Palate

2008 ◽  
Vol 45 (2) ◽  
pp. 131-140 ◽  
Author(s):  
Soung Min Kim ◽  
Young Joon Lee ◽  
Sang Shin Lee ◽  
Yeon Sook Kim ◽  
Suk Keun Lee ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Nasal Septum ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Growth Patterns ◽  
Radiographic Images ◽  
Alveolar Cleft ◽  
Abnormal Growth ◽  
Bilateral Cleft Lip ◽  
Different Types

Objective: To elucidate abnormal growth patterns of human fetal maxillae with cleft lip and palate (CLP). Subject: A total of 71 fetal maxillae with CLP were obtained from aborted human fetuses. Method: Dimensions of the maxillary trapezoid (MT), formed by the maxillary primary growth centers (MxPGC), were taken from radiographic images. The CLP dimensions were compared with maxillary trapezoid dimensions of normal fetuses from a previous study (Lee et al., 1992). Main Outcome Measures: Cleft lip subjects without a cleft palate, unilateral cleft lip-alveolar cleft or cleft palate (UCL+A/UCLP), and bilateral cleft lip-alveolar cleft or cleft palate (BCL+A/BCLP) displayed abnormal MT patterns. MT abnormalities were most marked in the BCL+A/BCLP cohort. Results: The MT growth of prenatal CLP maxillae was severely arrested, resulting in abnormal MT shape on palatal radiograms. BCL+A/BCLP subjects had a more protruded nasal septum than subjects with other types of CLPs, while UCL+A/UCLP subjects showed severe deviation of the protruded nasal septum toward the noncleft side. Cleft lip-only subjects also exhibited abnormal MT growth. Conclusion: MT is primarily involved in CLPs, so that the MT shape could be utilized as a sensitive indicator for the analysis of maxillary malformation in different types of CLPs.

scholarly journals Enamel defects in permanent teeth of patients with cleft lip and palate: a cross-sectional study

2019 ◽  
Vol 47 (5) ◽  
pp. 2084-2096 ◽  
Author(s):  
Chia-An Shen ◽  
Runzhi Guo ◽  
Weiran Li
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Permanent Teeth ◽  
Cross Sectional ◽  
Developmental Defects ◽  
Enamel Defects ◽  
Enamel Defect ◽  
Bilateral Cleft Lip ◽  
Developmental Defects Of Enamel

Objective This study investigated the prevalence, type, and location of enamel defects in the permanent teeth of patients with complete unilateral or bilateral cleft lip and palate (CLP), and compared the prevalence and characteristics of defects between CLP patients and non-CLP individuals. Methods We examined completely erupted permanent dentition, except for third molars, of CLP patients and non-CLP individuals of both sexes, 9–36 years of age, and analyzed corresponding panoramic radiographs. Two independent examiners performed clinical examinations in accordance with the Modified Developmental Defects of Enamel index. Results A total of 210 (87.9%) CLP patients and 194 (41.4%) non-CLP individuals had at least one enamel defect; these were more prevalent in the CLP group than in the non-CLP group. Upper teeth were primarily affected by enamel defects associated with the cleft; defects were most prevalent on the cleft side in CLP patients, followed by the non-cleft side in CLP patients, and then by non-CLP individuals. Conclusion Enamel defects were more common in CLP patients than in non-CLP individuals. Among CLP patients, enamel defects were more prevalent in the cleft side of the maxilla; the central incisor was the most commonly affected tooth in this quadrant.

scholarly journals Orthognathic Surgery Combined with Orthodontic Treatment in a Patient with Bilateral Cleft Lip, Palate and Alveolus, Without Alveolar Bone Graft: A Case Report

2021 ◽  
Vol 3 (1) ◽  
pp. 1
Author(s):  
Yudi Siswanto ◽  
Magda Rosalina Hutagalung ◽  
Indri Lakhsmi Putri ◽  
Jusuf Sjamsudin
Keyword(s):  
Bone Graft ◽  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Maxillary Hypoplasia ◽  
Le Fort ◽  
Alveolar Cleft ◽  
Bilateral Cleft Lip ◽  
Cleft Lip Palate

Background: The incidence of cleft lip and palate is 8 in every 10,000 live births. A patient with this condition experiences a deficiency in maxillary growth. Maxillary hypoplasia leads to malocclusion and skeletal disharmony. Orthognathic surgery at skeletal maturity is the standard procedure at the end of the protocol to correct maxillary hypoplasia resulting in malocclusion not correctable with orthodontics alone.Case Presentation and Operation Technique: We report the result of orthognathic surgery performed on a 23 year old male with complete bilateral cleft lip, palate, and alveolus. We proceeded with bimaxillary surgery despite the alveolar cleft. We also recorded a neglected alveolar cleft in which he should have had undergone alveolar bone graft prior to the current procedure. The pre-maxillary segment was stabilized with miniplate followed by Le Fort 1 advancement and mandibular setback guided by an occlusal wafer. Malar augmentation was done by onlay bone grafts. Mandibulo-maxillary fixation was maintained. Postoperatively, a good occlusion and better facial harmony were achieved. He was planned to undergo a septorhinoplasty in the near future.Discussion: Despite adequate treatments following the protocol recommended by many centres, some patients developed some degree of maxillary hypoplasia. A quarter of this population need osteotomies and Le Fort I maxillary osteotomy is the most common procedure to correct retrognathic maxilla.Conclusion: Orthognathic surgery combined with orthodontic treatment in a patient with bilateral cleft lip and palate provided good functional and aesthetic result. However, this procedure cannot replace the standard protocol of having an alveolar bone graft performed before permanent canine eruption to achieve optimal outcomes

Preliminary Report of Two-Stage Secondary Alveolar Bone Grafting for Patients with Bilateral Cleft Lip and Palate

2003 ◽  
Vol 40 (5) ◽  
pp. 449-452 ◽  
Author(s):  
S. Kamakura ◽  
T. Yamaguchi ◽  
S. Kochi ◽  
A. Sato ◽  
K. Motegi
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Contralateral Side ◽  
Two Stage ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Bilateral Cleft Lip ◽  
Secondary Alveolar Bone Grafting

Objective To overcome the difficulties of one-stage secondary alveolar bone grafting for patients with bilateral cleft lip and palate (BCLP) who have a broad alveolar cleft, the value of two-stage alveolar bone grafting was examined. Patients Three patients (2 girls and 1 boy) with BCLP were treated by two-stage alveolar bone grafting. The procedure consisted of a first-stage surgery (mean age 8 year 6 months ± 7.8 months), which consisted of alveolar bone grafting for one side of the BCLP, and second-stage surgery for the contralateral side several months later. For the postoperative assessment, radiographs of the operated site were examined. Results The average amount of implanted bone per operation and per patient was 6.8 ± 1.1 g and 13.7 ± 1.0 g, respectively. Postoperative clinical and radiographic examinations revealed that an appreciable alveolar bone ridge had formed, and there were no major complications. Conclusions Two-stage alveolar bone grafting, which makes it possible to reduce the amount of implanted bone, could be an optional surgical procedure for patients with BCLP and a broad alveolar cleft.

Distribution Patterns of Primary and Permanent Dentition in Children with Unilateral Complete Cleft Lip and Palate

1998 ◽  
Vol 35 (2) ◽  
pp. 154-160 ◽  
Author(s):  
Tzong-Ping Tsai ◽  
Chiung-Shing Huang ◽  
Chuan-Chuan Huang ◽  
Lai-Chu See
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Distribution Patterns ◽  
Permanent Dentition ◽  
Primary Dentition ◽  
Lateral Incisor ◽  
Permanent Teeth ◽  
Alveolar Cleft ◽  
Maxillary Lateral Incisor ◽  
Numerical Variation

Objective To investigate the distribution patterns of primary and permanent teeth in the cleft area and the numerical variation in teeth in unilateral complete cleft lip and palate (UCLP) patients. Design A survey of the dentition in UCLP patients. Setting Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan. Patients 137 UCLP patients who met the following criteria: (1) have had at least one panoramic film taken, (2) the first panoramic film illustrates either primary or early mixed dentition. Evaluation of both permanent and primary dentition was available in 91 cases. Main Outcome Measures Two evaluators performed independent evaluations of number and distribution of teeth in UCLP patients. The hypothesis that there are two odontogenic origins for maxillary lateral incisors was proposed to explain the occurrence of distribution patterns of dentition in the cleft area and to explain differences between primary and permanent dentition in UCLP patients. Results Four distribution patterns in the cleft area were identified in both the primary and the permanent dentition. In the primary dentition, placement of the lateral incisor distal to the alveolar cleft was the predominant pattern (pattern y, 82.4%), followed by absence of the cleft side maxillary lateral incisor (pattern ab, 9.9%), presence of one tooth on each side of the alveolar cleft (pattern xy, 5.5%), and placement of the lateral incisor mesial to the alveolar cleft (pattern x, 2.2%). In the permanent dentition, the most common pattern was the absence of the maxillary lateral incisor on the cleft side (pattern AB, 51.8%), followed by lateral incisor placement distal to the alveolar cleft (pattern Y, 46%), lateral incisor placement mesial to the alveolar cleft (pattern X, 1.5%) and the presence of one tooth on each side of the alveolar cleft (pattern XY, 0.7%). The discrepancy between the distribution patterns of primary dentition and permanent dentition successors is 57.1%. Variations in tooth number in both primary and permanent dentition of UCLP patients occurred most often in the cleft area. Abnormalities in the number of teeth (hypodontia or hyper-dontia) outside the cleft area were more common in the permanent dentition than in the primary dentition (24.1% versus 4.4%). Conclusions Four distribution patterns in the cleft area were identified in both sets of dentition. Our findings of distribution patterns in UCLP patients support the hypothesis that there may be two odontogenic origins for maxillary lateral incisors. Clinicians involved in managing the dentition of UCLP patients should consider the high frequency of numerical variation both in and outside the cleft area before starting dental treatment.

scholarly journals Alveolar cleft and maximum cleft width as predictors for difficult laryngoscopy and intubation in patients with unilateral complete cleft lip and palate

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Gamal A. Abdelhameed ◽  
Wael A. Ghanem ◽  
Simon H. Armanios ◽  
Tamer Nabil Abdelrahman
Keyword(s):  
Body Weight ◽  
Odds Ratio ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Difficult Laryngoscopy ◽  
Secondary Outcome ◽  
Pediatric Airway ◽  
Alveolar Cleft ◽  
Cleft Lip Palate ◽  
Width Measurements

Abstract Background Cleft lip and palate is one of the commonest congenital anomalies, which have an impact on feeding, speech, and dental development away from the significant psychosocial sequel. Early surgical repair aims to restore appearance and function, and the modern techniques can leave many defects undetectable. Therefore, the anesthetic challenge facing the pediatric airway with such abnormalities is still of a great impact. The aim of our study among 189 patients enrolled is to correlate alveolar gap and maximum cleft width measurements as predictors of difficult laryngoscopy and intubation in infants with unilateral complete cleft lip/palate aging from 1 to 6 months. As a secondary outcome, their weight is to be correlated too as another parameter. Results The alveolar gap and maximum cleft width are both of equal high predictive power (p value ≤ 0.001) with 100% sensitivity for both and specificity of 76.10% and 82.39% respectively, with a cut off value of ≤ 10 mm and 11 mm for these dimensions respectively, and odds ratio of incidence of difficult intubation is 4.18 and 5.68 respectively, while body weight ≤ 5.75 kg has an odds ratio of 2.32. Conclusion Alveolar cleft and maximum cleft width can be used as predictors for anticipation of difficult laryngoscopy and intubation infant patients with unilateral complete cleft lip and palate, while body weight ≤ 5.75 kg increases the risk more than twice.

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