Alveolar Cleft

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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Rehabilitation of a Patient with Cleft Lip and Palate with an Extremely Edentulous Atrophied Posterior Maxilla Using Zygomatic Implants: Case Report

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-105.1 ◽

2004 ◽

Vol 41 (5) ◽

pp. 571-574 ◽

Cited By ~ 28

Author(s):

Anh Viet Pham ◽

Marcelo Abarca ◽

Albert De Mey ◽

Chantal Malevez

Keyword(s):

Case Report ◽

Bone Grafting ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Oral Implants ◽

Alveolar Cleft ◽

Dental Prostheses ◽

Posterior Maxilla ◽

Zygomatic Implants ◽

Dental Rehabilitation

Objective This case report describes the clinical and surgical management of a patient with a unilateral alveolar cleft and associated extremely atrophied totally edentulous maxilla. Method Two zygomatic implants and four endosseous oral implants were placed under general anesthesia in a compromised maxilla to rehabilitate a 33-year-old patient with cleft lip and palate. The two specially designed zygomatic implants were utilized to avoid the need for bone grafting in the patient. The final prosthetic rehabilitation was an esthetic and functional maxillary overdenture prosthesis supported by implants. Results Preliminary results have shown how dental prostheses supported by endosseous implants in grafted alveolar cleft are a reliable possibility in the dental rehabilitation of this malformation. Conclusion The use of zygomatic implants may be considered a reliable alternative to more resource-demanding techniques such as bone grafting in patients with cleft palate.

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Prospective evaluation of morbidity associated with iliac crest harvest for alveolar cleft grafting

Journal of Oral and Maxillofacial Surgery ◽

10.1016/s0278-2391(97)90528-0 ◽

1997 ◽

Vol 55 (3) ◽

pp. 219-223 ◽

Cited By ~ 42

Author(s):

Robert A Rudman

Keyword(s):

Iliac Crest ◽

Prospective Evaluation ◽

Alveolar Cleft

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Regeneration in Experimental Alveolar Bone Defect Using Human Umbilical Cord Mesenchymal Stem Cells

Cell Transplantation ◽

10.1177/0963689720975391 ◽

2021 ◽

Vol 30 ◽

pp. 096368972097539

Author(s):

Akiko Toyota ◽

Rei Shinagawa ◽

Mikiko Mano ◽

Kazuyuki Tokioka ◽

Naoto Suda

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Bone Formation ◽

Cleft Lip ◽

Human Umbilical Cord ◽

Bone Surface ◽

Bone Bridge ◽

Bridge Formation ◽

Alveolar Cleft ◽

Umbilical Cords

Cleft lip and palate is a congenital disorder including cleft lip, and/or cleft palate, and/or alveolar cleft, with high incidence.The alveolar cleft causes morphological and functional abnormalities. To obtain bone bridge formation and continuous structure between alveolar clefts, surgical interventions are performed from infancy to childhood. However, desirable bone bridge formation is not obtained in many cases. Regenerative medicine using mesenchymal stem cells (MSCs) is expected to be a useful strategy to obtain sufficient bone bridge formation between alveolar clefts. In this study, we examined the effect of human umbilical cord-derived MSCs by transplantation into a rat experimental alveolar cleft model. Human umbilical cords were digested enzymatically and the isolated cells were collected (UC-EZ cells). Next, CD146-positive cells were enriched from UC-EZ cells by magnetic-activated cell sorting (UC-MACS cells). UC-EZ and UC-MACS cells showed MSC gene/protein expression, in vitro. Both cells had multipotency and could differentiate to osteogenic, chondrogenic, and adipogenic lineages under the differentiation-inducing media. However, UC-EZ cells lacked Sox2 expression and showed the lower ratio of MSCs than UC-MACS cells. Thus, UC-MACS cells were transplanted with hydroxyapatite and collagen (HA + Col) into alveolar cleft model to evaluate bone formation in vivo. The results of micro computed tomography and histological staining showed that UC-MACS cells with HA + Col induced more abundant bone formation between the experimental alveolar clefts than HA + Col implantation only. Cells immunopositive for osteopontin were accumulated along the bone surface and some of them were embedded in the bone. Cells immunopositive for human-specific mitochondria were aligned along the newly formed bone surface and in the new bone, suggesting that UC-MACS cells contributed to the bone bridge formation between alveolar clefts. These findings indicate that human umbilical cords are reliable bioresource and UC-MACS cells are useful for the alveolar cleft regeneration.

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