Effect of the Periosteal Flap Technique on Cleft Width and the Formation of Alveolar Ridge in Relation to the Bite Level in Surgery for Cleft Lip and Palate

1974 ◽  
Vol 8 (1-2) ◽  
pp. 62-66 ◽  
Author(s):  
Reijo Ranta ◽  
Tuija Oikari ◽  
Aarne Rintala ◽  
Johannes Haataja
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Ridge ◽  
Periosteal Flap ◽  
Flap Technique

Three-Dimensional Comparison between the Palatal Forms in Complete Unilateral Cleft Lip and Palate with and without Hotz Plate from Cheiloplasty to Palatoplasty

1996 ◽  
Vol 33 (4) ◽  
pp. 312-317 ◽  
Author(s):  
Katsuaki Mishima ◽  
Toshio Sugahara ◽  
Yoshihide Mori ◽  
Masayoshi Sakuda
Keyword(s):  
Nasal Cavity ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Alveolar Ridge ◽  
Maxillary Arch ◽  
Alveolar Arch

The palatal forms in 20 infants with a complete unilateral cleft lip, and palate (12 with a Hotz plate and 8 without, selected at random) were studied from birth until 18 months of age. Using techniques developed previously, the degree of curvature In the palate and the magnitude of migration of the maxillary segments were measured three-dimensionally. Furthermore, using a newly developed method to approximate a set of the points on the alveolar ridge to a circle in a plane, the form of the alveolar arch was evaluated. Results from the group with a Hotz plate revealed that the plate possesses four effects not seen in the group without a Hotz plate. The size of the palate was larger, and the sagittal gap between the two segments of the maxilla was smaller. These results suggest that the appliance could stimulate the growth of the segments and could prevent collapse of the maxillary arch from the force of lip closure. Third, the steepness of the segments toward the nasal cavity was smaller, possibly occurring because the appliance prevents tongue intrusion into the cleft. Fourth, the magnitude of migration of the lesser segment toward the cleft edge of the major segment was larger. This result suggests that the appliance could guide the growth of the maxillary segments to narrow the cleft width until 18 months of age.

scholarly journals Radiological evaluation of secondar y bone grafting results in patients with cleft lip and palate

2021 ◽  
Vol 3 (59) ◽  
pp. 51-55
Author(s):  
Silvia Railean ◽  
◽  
Egor Porosencov ◽  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Type I ◽  
Alveolar Ridge ◽  
Radiological Evaluation ◽  
Equal Distribution ◽  
Care Protocol

Introduction. Bone grafts are a necessary component of the care protocol for patients with cleft lip and palate (CLP). Radiological evaluation is an essential tool in evaluating the integration of the bone graft at the cleft area. Aim: Evaluation of the interdental height of the alveolar ridge in patients with CLP at the pre- and postoperative stages in order to assess the integration of bone graft in the cleft area. Material and methods: Cross-sectional clinical study, which included 34 patients with CLP; with equal distribution by gender, with an average age of 17.6±0.43 years. The study group underwent surgical treatment with bone grafting in the cleft region. The radiological evaluation was performed pre- and postoperatively (over 6 months), according to the scale of assessment proposed by Abyholm et al. Statistical evaluation of the data was performed by the Pearson correlation coefficient. Results: Overall, favorable postoperative results were observed. Initially, according to the radiological evaluation, the patients presented at the preoperative stage type III 29.4% (n = 10) and type IV - 70.6% (n = 24) of the interdental height of the alveolar ridge. Following bone grafting, it was recorded at 52.9% (n = 18) - type I, mainly in female patients (n = 11) and 47.1% (n = 16) - type II of the interdental height of the alveolar ridge , being predominantly registered in male patients (n = 10). Statistically significant differences between the sexes were not recorded (p = 0.132). The successful results obtained by secondary bone grafting in the cleft region allowed to continue the rehabilitation treatment of patients with CLP. Conclusion: Radiological evaluation of secondary bone grafting in the cleft area in terms of assessing the height of the alveolar ridge according to the scale of Abyholm et al. is a valuable diagnostic tool, readily available for assessing the condition of the grafted bone.

Position of Upper Permanent Central Incisors prior to Eruption in Unilateral Cleft Lip and Palate

1996 ◽  
Vol 33 (3) ◽  
pp. 219-224 ◽  
Author(s):  
Zbyněk Šmahel ◽  
Michaela Tomanová ◽  
Živa Müllerová
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Repair ◽  
Alveolar Process ◽  
Flap Surgery ◽  
Periosteal Flap ◽  
Normal Individuals ◽  
Primary Bone ◽  
Males And Females

The position and degree of eruption of permanent central incisors within the premaxilla were measured on x-ray films obtained in 102 patients with unilateral cleft lip and palate and in 52 normal individuals aged 5 years. The patients were subdivided according to sex and to the method of surgical repair (bone grafting or periosteal flap surgery). Individuals with rotated incisors were assessed separately. The results showed that maxillary depth was not significantly reduced prior to palate surgery while the alveolar process was markedly retroclined. An unerupted central upper incisor on the side of the cleft was situated more anteriorly than in controls. Because of the distortion of the alveolar process, it was retroclined and produced a deformation of the subspinal concavity. Both this deformation and the distortion of the alveolar process interfered with the measurements of maxillary depth and rendered it inadequate. The incisor on the normal side was situated more posteriorly than in controls and was less retroclined than the incisor on the affected side. The degree of eruption of Incisors on both the normal and affected sides did not differ from controls. The type of surgical repair influenced only the retroclination of the alveolar process and of the Incisors within this process. The retroclination was more marked after primary bone grafting than after periosteal flap surgery. The position and degree of eruption of rotated Incisors did not differ from nonrotated incisors, and the presence of rotated incisors was not related to the degree of the shortening of maxillary depth. There were no significant differences between males and females.

Palatal and Alveolar Tissue Deficiency in Infants With Complete Unilateral Cleft Lip and Palate

2017 ◽  
Vol 55 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Katy A. Bednar ◽  
David S. Briss ◽  
Mohamed S. Bamashmous ◽  
Barry H. Grayson ◽  
Pradip R. Shetye
Keyword(s):  
Surface Area ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Plan ◽  
Specific Treatment ◽  
Patient Specific ◽  
Alveolar Ridge ◽  
Surface Areas ◽  
Significant Difference ◽  
Alveolar Tissue

Objective: To investigate intrinsic palatal and alveolar tissue deficiency in patients with unilateral cleft lip and palate (UCLP) as compared to age-matched individuals without UCLP using surface area measurements on 3D scans of plaster casts. Methods: 22 maxillary casts of infants with UCLP from the Wyss Department of Plastic Surgery of NYU Langone Medical Center and 37 maxillary casts from infants without clefts from Sillman’s longitudinal study were scanned by Ortho Insight 3D by Motion View Software, LLC (Chattanooga, TN) and measured using Checkpoint software (Stratovan, Davis, CA). The palatal and alveolar surface areas of each cast were measured. The most superior point of the alveolar ridge in front of the incisive papilla and the most superior point of each maxillary tuberosity were connected by a line that ran along the highest part of the alveolar ridge. This line was used to set boundaries for the palatal surface area measurements. The surface areas of greater and lesser segments were measured independently on UCLP casts. A total palatal surface area for the UCLP sample including width of the cleft gap was also measured. Results: There was a statistically significant difference in surface area ( P > .001) when we compared the UCLP area of the cleft segments alone with the non-cleft sample. There was a positive correlation (determine the statistical significance) between the surface area of the cleft segments and cleft gap. In addition, there was a statistically significant difference between UCLP plus cleft area and the non-cleft samples in surface area ( P < .0001). Conclusion: An intrinsic palatal and alveolar tissue deficiency exists in patients born with UCLP. The amount of tissue deficiency for a patient with UCLP should be considered when developing and executing a patient-specific treatment plan.

On the Bone-Forming Capacity of Periosteal Flap in Surgery for Cleft Lip and Palate

1974 ◽  
Vol 8 (1-2) ◽  
pp. 58-61 ◽  
Author(s):  
Aarne Rintala ◽  
Atso Soivio ◽  
Reijo Ranta ◽  
Tuija Oikari ◽  
Johannes Haataja
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Periosteal Flap

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

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