scholarly journals Evaluation of upper arch changes in patients with unilateral cleft lip and palate after maxillary expansion using digital dental casts

2020 ◽  
Vol 7 (3) ◽  
pp. 184-190
Author(s):  
Fabrizia d’Apuzzo ◽  
◽  
Ludovica Nucci ◽  
Abdolreza Jamilian ◽  
Rosario Rullo ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Time ◽  
Young Patients ◽  
Maxillary Expansion ◽  
Significance Level ◽  
Total Treatment Time ◽  
Expansion Time ◽  
Before And After ◽  
Dental Casts

Objective To compare the upper arch dimensions of young patients with unilateral cleft lip and palate (UCLP) before and after treatment with bonded maxillary expander and hybrid activation protocol using digital dental casts. Methods Sixteen subjects with UCLP, aged between 7 and 14 years (mean age 10.9 ± 2.7 years) consecutively treated with bonded maxillary expander and hybrid activation were included. The dental casts before and after treatment were digitalized using a 3Shape scanner. Intercanine, interpremolar and intermolar widths (at cusp and gingival levels) and arch perimeters were measured. The significance level for statistical analyses was set as p < 0.05. Results The total treatment time using the hybrid expansion protocol lasted 12 ± 1.9 months while the active expansion time lasted 4 ± 0.2 months. Patients with UCLP showed significant differences in all transverse upper arch dimensions both at cusp and gingival level. Conclusion The use of a bonded maxillary expander with a hybrid activation protocol during growth may be efficient to improve all transverse upper arch widths in patients affected by UCLP

Morphologic Effect of Preoperative Maxillofacial Orthopedics (T-Traction) on the Maxilla in Unilateral Cleft Lip and Palate Patients

1993 ◽  
Vol 30 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Margareta Larson ◽  
Kjell-Ove Sällström ◽  
Ola Larson ◽  
John Mcwilliam ◽  
Margareta Ideberg
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
External Device ◽  
Normal Anatomy ◽  
Before And After ◽  
Dental Casts

Sixty-eight children born with complete unilateral cleft lip and palate were studied using dental casts taken at ages 0-0,1; 0,2-0,4; and 0,5-0,6 years of age. They were all treated with preoperative maxillofacial orthopedics using an external device (T-traction). The treatment was started after the first model was taken. Dental casts were analyzed regarding the morphology of the cleft region and the maxillary segments before and after treatment. The measurements were compared with measurements on dental casts of nontreated cleft children of similar age. The results suggest that a more normal anatomy of the cleft region occurs during the first 6 months of life whether preoperative maxillofacial orthopedics (T-traction) is used or not. However, this normalized growth seems to occur faster with the T-traction.

Rapid Maxillary Expansion after Secondary Alveolar Bone Graft in a Patient with Bilateral Cleft Lip and Palate

2004 ◽  
Vol 41 (3) ◽  
pp. 332-339 ◽  
Author(s):  
Arlete de Oliveira Cavassan ◽  
Marcelo D'Albuquerque de Albuquerque ◽  
Leopoldino Capelozza Filho
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Bilateral Cleft Lip ◽  
Maxillary Constriction ◽  
Intercanine Distance ◽  
Dental Casts

Objective To verify the effects of rapid maxillary expansion performed after secondary alveolar bone graft in one patient. Setting Department of Orthodontics of the Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo. Patient(s) The patient had bilateral cleft lip and palate, had already had a bone graft, and showed a relapsing maxillary constriction in need of correction. Intervention A fixed dental-mucous-bone-supported expander corrected the maxillary constriction. Main Outcome Measure(s) Measurements were obtained from dental casts, including transverse dimensions (intercanine distance [IC], interfirst premolar distance [IP], and interfirst molar distance [IM]) and measurements of the grafted area (interfirst premolar/central incisors [IPI] and interfirst premolar/canine [IPC]) to observe the changes. Clinical and radiographic analyses were done through direct view. Results The occlusal radiograph of the maxilla after expansion showed opening of the intermaxillary suture in the premaxillary area, which was clinically confirmed by the diastema between the maxillary central incisors. No radiographic alteration was observed in the grafted area. The transverse measurements of the dental casts (IC, IP, and IM) showed a significant increase. The measurements of the teeth adjacent to the grafted area, IPI and IPC, increased. Conclusions The orthopedic effect of rapid maxillary expansion after bone graft was verified. Nevertheless, additional studies are necessary to define any side effects in patients submitted to bone graft.

Efficacy of Rapid Maxillary Expansion Associated With Maxillary Protraction in Patients With Unilateral Complete Cleft Lip and Palate

2020 ◽  
Vol 57 (7) ◽  
pp. 872-876
Author(s):  
Okada Terumi Ozawa ◽  
Costa Daniela Salzedas ◽  
de Lima Beatriz Oliveira ◽  
Renata Sathler ◽  
Gleisieli Baessa ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Sample ◽  
Face Mask ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Maxillary Protraction ◽  
The Stability ◽  
In The Beginning ◽  
Dental Casts

Objective: To evaluate the efficacy of rapid maxillary expansion (RME) and maxillary protraction (MP) in patients with unilateral complete cleft lip and palate (UCLP) using the Goslon yardstick index. Design: Retrospective study. Patients: Dental casts of 34 Goslon 3 (G3) and Goslon 4 (G4) patients treated with RME and MP were evaluated which composed the treated sample (S1). The dental cast were taken before the RME (T1) and immediately after the use of face mask for MP was suspended (T2). In order to verify the stability of the treatment, dental casts of 17 of these patients were evaluated 1 year after the treatment was finished (T3). For the control sample (S2), dental casts of 20 untreated G3 and G4 patients were evaluated. Results: At T2, 85.7% of study sample patients initially G3 and 70% of patients initially G4 obtained improvement in occlusal index. At T3, the majority of patients initially classified as G3 and G4 returned to the same classification as in the beginning of the treatment. The evaluation of the control sample showed that patients initially classified as G3, 55.6% continued at this initial index, and 44.4% had it worsened. Those initially G4, 100%, continued at this initial index. Conclusion: The immediate result of RME and MP was satisfactory, and despite the instability of these results, the outcome of this treatment option was better than the untreated sample.

scholarly journals Two-phase orthodontic treatment in a unilateral cleft lip and palate patient with 1-year follow-up results

2017 ◽  
Vol 7 ◽  
pp. 101-107
Author(s):  
Prashant M. Dhole ◽  
Divya O. Maheshwari
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Time ◽  
Two Phase ◽  
Total Treatment Time ◽  
Total Treatment ◽  
Growth Modification ◽  
Palate Patient

Treatment of a patient with cleft lip and palate can be challenging. A 10-year and 10-month-old girl presented with uneven and crowded teeth. She had unilateral cleft lip and palate on left side for which she had undergone primary lip repair and palatoplasty when she was younger. On examination, she had concave facial appearance, crossbite of upper arch with reverse overjet of 2 mm, wits appraisal of 6 mm and impacted 23. She was treated with two-phase orthodontic treatment; growth modification appliances followed by fixed mechanotherapy. Total treatment time was 5 years. 1-year follow-up shows that results have been stable with good facial aesthetics and functional occlusion.

Multidisciplinary Rehabilitation of an Adult with a Cleft Lip and Palate: An Illustration of a Dental Substitution Approach for the Management of Unilateral Agenesis of Central and Lateral Incisors

FACE ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 30-38
Author(s):  
Rany M. Bous ◽  
Anand Kumar ◽  
Manish Valiathan
Keyword(s):  
Case Report ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Time ◽  
3 Dimensional ◽  
Mandibular Asymmetry ◽  
Total Treatment Time ◽  
Patient Reported ◽  
Total Treatment ◽  
Congenitally Missing

Cleft lip and Palate (CLP) is the most common craniofacial condition. Management of patients with clefts often requires multi-disciplinary rehabilitation of the orofacial structures. This case report demonstrates the multi-disciplinary management of an adult with a cleft lip and palate, highlighting the benefits of 3-Dimensional (3D) diagnosis, treatment planning and clinical execution of the plan. The patient presented with a severe maxillary deficiency, mandibular asymmetry, and congenitally missing maxillary right central and lateral incisors. This case report demonstrates an alternative approach for the management of cases with ipsilateral missing central and lateral incisors. The maxillary right canine substituted the congenitally missing maxillary right central incisor, while the maxillary right first premolar substituted the congenitally missing right lateral incisor, eliminating the need for prosthetic replacements. Total treatment time was 19 months, and the burden of care for the patient was minimized. An acceptable occlusion was achieved, and the patient’s esthetics improved significantly at the end of treatment. More importantly, the patient reported a marked improvement in his quality of life.

Treating Velopharyngeal Inadequacy Using Bilateral Buccal Flap Revision Palatoplasty

2019 ◽  
Vol 4 (5) ◽  
pp. 878-892
Author(s):  
Joseph A. Napoli ◽  
Linda D. Vallino
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
A Priori ◽  
Sufficient Evidence ◽  
Obstructive Sleep ◽  
Before And After ◽  
Buccal Flap

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

A Possible Otological Complication Due to Maxillary Expansion in a Cleft Lip and Palate Patient

2000 ◽  
Vol 37 (4) ◽  
pp. 416-420 ◽  
Author(s):  
Dror Aizenbud ◽  
Tsila Hefer ◽  
Adi Rachmiel ◽  
Alvaro A. Figueroa ◽  
Henry Z. Joachims ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillary Expansion ◽  
Palate Patient

scholarly journals Maxillary expansion in grafted alveolar arches in patients with cleft lip and palate: A literature review

2021 ◽  
pp. 100034
Author(s):  
Adriana Parra Barillas ◽  
Dimitrios Michelogiannakis ◽  
P. Emile Rossouw ◽  
Fawad Javed
Keyword(s):  
Literature Review ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillary Expansion

Treatment of Unilateral Cleft Lip and Palate Patient With Intraoral Tooth Tissue Borne Distractor and Facemask Therapy: A Case Report

2021 ◽  
pp. 105566562199336
Author(s):  
Akansha Bansal Agrawal ◽  
Harshavardhan Kidiyoor ◽  
Anand K. Patil Morth
Keyword(s):  
Case Report ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Face Mask ◽  
Rapid Maxillary Expansion ◽  
Growth Potential ◽  
Maxillary Expansion ◽  
Long Term Stability ◽  
Tooth Tissue

This case report demonstrates the successful use of intraoral distractor/hygenic rapid expander (HYRAX) for rapid maxillary expansion in anteroposterior direction with an adjunctive use of face mask therapy for anterior orthopedic traction of maxillary complex in a cleft patient with concave profile. The patient was a 13-year-old girl who reported with a chief complaint of backwardly positioned upper jaw and a severely forward positioned lower jaw. Therefore, a treatment was chosen in which acrylic bonded rapid maxillary expansion was done with tooth tissue borne intraoral distractor/HYRAX having a different activation schedule along with Dr Henri Petit facemask to treat maxillary retrognathism. As a result, crossbite got corrected and attained a positive jet with no bone loss in cleft area over a period of 5 months which was followed by fixed mechanotherapy achieving a well settled occlusion in 1 year. After completion of expansion and fixed mechanotherapy, ANB became +1 post-treatment which was −4 pretreatment. The prognathic profile was markedly improved by expansion and taking advantage of the remaining growth potential, thus minimizing the chances of surgery later in life. This provided a viable alternative to orthognathic surgery with good long-term stability.

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