scholarly journals Management of severe maxillary discrepancy in unilateral cleft lip and palate: six year follow up in a patient with tongue graft

2021 ◽  
Author(s):  
Amrit Thapa ◽  
Nanda Kishore Sahoo ◽  
Balakrishnan Jayan ◽  
Sukhbir Singh Chopra ◽  
Andrews Navin Kumar
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Initial Alignment ◽  
Skeletal Class ◽  
Soft Tissue Profile ◽  
Original Case ◽  
Dental Crowding ◽  
Skeletal Stability ◽  
Palatal Defect

<p class="abstract">The purpose of this original case study was to present the efficiency of combined orthodontic and distraction osteogenesis (DO) in severe maxillary hypoplasia along with importance of tongue graft for closure of large residual palatal defect. DO has been successfully chosen in lengthening and widening the maxilla transversely to relieve anterior dental crowding and transverse discrepancies between the dental arches. A UCLP (unilateral cleft lip and palate), 15 year old male with the chief complaint of esthetic and functional problems because of skeletal class III malocclusion with anterior crossbite and severe midline shift was taken up for this modality of treatment. Considering the severity of malocclusion, combined orthodontic and DO treatment was considered adequate which was likely less invasive and equally stable procedure. RED (rigid external distractor) was used for distraction after initial alignment followed by closure of residual large palatal defect with tongue graft. Result obtained was esthetically good with acceptable occlusion considering the severity with pleasing soft tissue profile. The review was done after six year which showed remarkable skeletal stability with no dehiscence of tongue graft in palate area. The combined use of DO and orthodontic correction in ULCP case had substantial skeletal stability, improving patient esthetic and self-esteem.</p>

Upper Airway 3D Changes of Patients With Cleft Lip and Palate After Orthognathic Surgery

2018 ◽  
Vol 56 (3) ◽  
pp. 314-320 ◽  
Author(s):  
Marilia Sayako Yatabe-Ioshida ◽  
Letícia Dominguez Campos ◽  
Renato Yassukata Yaedu ◽  
Ivy Kiemle Trindade-Suedam
Keyword(s):  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Upper Airway ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Class Iii ◽  
Linear Measurements ◽  
Cross Sectional ◽  
Skeletal Class

Objectives: The purpose of this study was to 3-dimensionally assess the airway characteristics of patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) who underwent orthognathic surgery. Design: This was a retrospective study. Setting: The study took place at a national referral center for cleft lip and palate rehabilitation. Patients and Participants: The sample comprised cone-beam computed tomography (CBCT) scans obtained before and after orthognathic surgery of 15 individuals (30 CBCT scans), divided into 2 groups: UCLP group (n = 9 patients/18 CBCT scans) and BCLP group (n = 6/12 CBCT scans). All patients had a nonsyndromic UCLP or BCLP and a skeletal class III malocclusion at the preoperative period. Interventions: Airway volume, pharyngeal minimal cross-sectional area (mCSA), location of mCSA, sella-nasion-A point (SNA) and sella-nasion-B point (SNB) angles, and condylion-A point and condyloid-gnathion linear measurements were assessed in open-source software (ITK-SNAP and SlicerCMF). Main Outcome Measure: Airway dimensions of patients with UCLP and BCLP increase after orthognathic surgery. Results: After orthognathic surgery, UCLP group showed a significant 20% increase in nasopharynx volume. Although not significant, BCLP group also showed an increase of 18% in the same region. Minimal cross-sectional area remained dimensionally stable after surgery and was all located in the oropharynx region, on both groups. Additionally, a positive correlation was observed between volume and mCSA on both groups. Conclusion: Overall, individuals with UCLP and BCLP showed an increase in the upper airway after orthognathic surgery and this might explain the breathing and sleep improvements reported by the patients after the surgery.

Quality of Life and Temporomandibular Disorders in Patients With Skeletal Class III Malocclusion With Cleft Lip and Palate

2021 ◽  
pp. 105566562110434
Author(s):  
Bernardo Olsson ◽  
Isabela Polesi Bergamaschi ◽  
Erika Calvano Küchler ◽  
Aline Monise Sebastiani ◽  
Guilherme dos Santos Trento ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Temporomandibular Disorders ◽  
Psychological Factors ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Skeletal Class ◽  
Better Than

Objective The aim of the study was to assess the quality of life (QOL), oral health-related QOL (OHRQOL), temporomandibular disorders (TMDs), and psychological factors in patients with skeletal Class III malocclusion with cleft lip and palate (CLP) and without CLP. Design Case–control. Setting Primary care, institutional practice. Patients One hundred thirty-six patients with skeletal Class III malocclusion with CLP (n = 68) and without CLP (n = 68). Main outcome measures QOL and OHRQOL were assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire and the Oral Health Impact Profile-14 questionnaire, respectively. TMDs and psychological factors were assessed using the Research Diagnostic Criteria for TMD (RDC/TMD). Results No differences in QOL were found between the groups ( P >  0.05). Patients with CLP reported a better OHRQOL ( P = 0.025) in the physical pain, physical disability, and psychological disability domains ( P <  0.05). Patients with CLP presented with less myofascial pain (OR, 0.28; 95% CI, 0.11-0.71] and other articular conditions (OR 0.24; 95% CI 0.06-0.90]. More patients with CLP reported no chronic pain ( P = 0.012). The QOL of patients with CLP with no depression or with no nonspecific physical symptoms including pain (NSPSIP) was better than that of patients without CLP. The OHRQOL of patients with CLP without TMDs or no psychological factors was better than that of patients without CLP. Conclusions Patients with skeletal Class III malocclusion who require orthognathic surgery with CLP have better OHRQOL and present with fewer TMDs than those patients without CLP.

scholarly journals Broadening the Scope and Utility of Frontal Sinus Morphology for Predicting the Growth Pattern and Skeletal Malocclusion in Cleft Lip and Palate Cases

2021 ◽  
pp. 173-179
Author(s):  
Vikrant V. Jadhav ◽  
Pallavi Daigavane ◽  
Ranjit Kamble ◽  
Sunita Shrivastav ◽  
Meenakshi Tiwari
Keyword(s):  
Growth Pattern ◽  
Frontal Sinus ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Plan ◽  
Class I ◽  
Class Iii ◽  
Skeletal Class ◽  
Skeletal Malocclusion ◽  
Chisquare Test

Introduction: The three dimensionally affected growth and development of craniofacial structures in CLCP leads to problems dealing with facial appearance, skeletal and dental malocclusion, feeding, airway, hearing, and speech. Objectives: Evaluation and utilisation of fs morphology as a forecast of future growth for growth pattern and skeletal malocclusion in CLCP cases. Methodology: A 30 Cases from Skeletal Class I, III and CLCP will be selected from Department of Orthodontics. Dimensions and area of frontal sinus is evaluated using 3DVT. Parameters are evaluated in sagittal and coronal section. The measurement's dependability will be determined using a reliability test (Cronbach alpha test). Chisquare Test, One Way ANOVA, and Multiple Comparison will be used to do descriptive and analytical statistics. The Tukey Test is a statistical test that is used. Expected Results: Frontal sinus dimensions when observed for Class III will be found greater. Average dimensions will be observed for skeletal Class I cases. Based on the dimensions of frontal sinus observed in cleft lip and palate, we can predict the skeletal malocclusion and growth pattern. Conclusion: The morphology of the fs is evaluated in cleft cases for the upcoming growth pattern and skeletal malocclusion if is known during formulating a treatment plan for the three dimensionally affected jaw bases and craniofacial structure the requirement for later surgical intervention can be prevented.

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.

Factors Responsible for Unfavorable Dental Arch Relationship in non Syndromic Unilateral Cleft Lip and Palate Children

2017 ◽  
Vol 41 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Sanjida Haque ◽  
Mohammad Khursheed Alam ◽  
Mohd Fadhli Khamis
Keyword(s):  
Regression Analysis ◽  
Family History ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Arch ◽  
Class Iii ◽  
Skeletal Class ◽  
History Of ◽  
Relationship Of ◽  
Dental Arch Relationship

Objectives: Multiple factors are whispered to be crucial cause of unfavourable dental arch relationship in cleft lip and palate (CLP).This study aims to evaluate the dental arch relationship of Bangladeshi children with non syndromic unilateral cleft lip and palate (UCLP) following cheiloplasty and palatoplasty. Also to explore the various congenital (UCLP type, UCLP side, family history of cleft, family history of class III) and environmental (cheiloplasty, palatoplasty) factors that affects dental arch relationship of UCLP patients. Study design: This was a retrospective study where 84 dental models were taken before orthodontic treatment and alveolar bone grafting. The mean age was 7.69± 2.46 (mean± SD). The dental arch relationship was assessed by GOSLON (Great Ormond Street, London and Oslo) Yardstick. According to GOSLON Yardstick, five categories are rated; named- 1: excellent; 2: good; 3: fair; 4: poor; 5: very poor. Also the groups have been dichotomized into favorable (category ratings 1–3) and unfavorable (category ratings 4 and 5) groups. Kappa statistics was used to evaluate the intra- and inter-examiner agreements and logistic regression analysis was used to explore the responsible factors that affect dental arch relationship. Results: Total 37 subjects (44% of all subjects) were categorized into unfavourable group (category rating 4 and 5) using GOSLON yardstick. Intra- and inter-examiner agreements were very good. The mean GOSLON score was 3.238. Using crude and stepwise backward regression analysis, significant association was found between family history of skeletal class III malocclusion (p = 0.015 and p = 0.014 respectively) and unfavourable dental arch relationship. Complete UCLP (p = 0.054) and left sided UCLP (p = 0.053) also seemed to be correlated but not significant with unfavourable dental arch relationship using crude and stepwise backward regression analysis respectively. Conclusion: This analysis suggested that family history of skeletal class III was significantly correlated with unfavourable dental arch relationship of Bangladeshi UCLP children.

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