scholarly journals Alternative Craniofacial Orthodontics Treatment Approaches for Differential Severity in Patients with Unilateral Cleft Lip with/without Palate

2021 ◽  
Author(s):  
David F. Gómez-Gil
Keyword(s):  
Growth And Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Protocol ◽  
Current Treatment ◽  
Interdisciplinary Treatment ◽  
Dental Development ◽  
Multidisciplinary Teams ◽  
Key Aspects ◽  
Treatment Alternatives

The treatment of patients with cleft lip with/without cleft palate is still a challenge for its correct team management. The fact that not all clefts are alike, based on anatomical findings and ortho/surgical alternatives used in their correction, requires that clinicians -working in interdisciplinary or multidisciplinary teams- direct efforts not only to repair the facial and oral characteristics of the cleft, but also to work in the context of the patient’s craniofacial growth and development, tri-dimensionally affected by this type of craniofacial difference. The first part of this chapter is focused on the diagnostic approach for patients with unilateral cleft lip and palate (UCLP), using a modified version of the GOSLON yardstick (GOSLON+) that considers not only dental components but also 3D facial aspects of a complex malocclusion originated from this congenital malformation. Second, current treatment alternatives based on patient’s stages of dental development and cleft width, using either straight-wire or passive self-ligation appliances are presented, directed to avoid dental prosthetic replacements if possible. Finally, our treatment algorithms summarized in a step-by-step fashion the treatment of such differences with approaches that will focus on these two key aspects, essential for a successful, patient-based, interdisciplinary treatment protocol.

scholarly journals Feeding interventions for growth and development in infants with cleft lip, cleft palate or cleft lip and palate

2001 ◽  
Author(s):  
AM Glenny ◽  
L Hooper ◽  
WC Shaw ◽  
S Reilly ◽  
J Reid
Keyword(s):  
Cleft Palate ◽  
Growth And Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Feeding Interventions

Dental development in cleft lip and palate patients: A systematic review

2019 ◽  
Vol 300 ◽  
pp. 63-74 ◽  
Author(s):  
Julie Van Dyck ◽  
Maria Cadenas de Llano-Pérula ◽  
Guy Willems ◽  
Anna Verdonck
Keyword(s):  
Systematic Review ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Development

Timing of Hard Palate Closure and Dental Arch Relationships in Unilateral Cleft Lip and Palate Patients: A Mixed-Longitudinal Study

1993 ◽  
Vol 30 (4) ◽  
pp. 391-396 ◽  
Author(s):  
Alexis E.M. Noverraz ◽  
Anne Marie Kuijpers-Jagtman ◽  
Michael Mars ◽  
Martin A. Van't Hof
Keyword(s):  
Longitudinal Study ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Dental Development ◽  
Dental Arch ◽  
Group A ◽  
Group B ◽  
Group D

In a mixed longitudinal study, dental arch relationships of 88 consecutive UCLP patients treated at the Nijmegen Cleft Palate Centre were evaluated using the Goslon Yardstick. On the basis of timing of hard palate closure, the patients were divided into four groups. Mean age of hard palate closure in group A (n = 18) was 1.5 years, in group B (n = 26) 4.6 years and in group C (n = 18) 9.4 years. In group D (n = 26, no patient older than 10 years) the hard palate was still open. Four stages of dental development were distinguished; deciduous dentition, early mixed dentition, late mixed dentition and permanent dentition. Reproducibility of scoring with the Goslon Yardstick was good for all stages of dental development. No differences in dental arch relationships were found between the four groups. In 86% of the cases, the dental arch relationships of UCLP patients treated in Nijmegen were acceptable. Pharyngeal flap surgery had minor unfavorable effects on dental arch relationships.

Importance of Stem Cell Transplantation in Cleft Lip and Palate Surgical Treatment Protocol

2018 ◽  
Vol 29 (6) ◽  
pp. 1445-1451 ◽  
Author(s):  
Marcelo Paulo Vaccari Mazzetti ◽  
Nivaldo Alonso ◽  
Ryane Schmidt Brock ◽  
Alexandre Ayoub ◽  
Sally Mizukami Massumoto ◽  
...  
Keyword(s):  
Stem Cell ◽  
Surgical Treatment ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Protocol

Presurgical orthopaedics/nasoalveolar moulding in cleft children: could you, should you, would you?

2013 ◽  
Vol 4 (3) ◽  
pp. 132-137
Author(s):  
Alexander C Cash
Keyword(s):  
Best Practice ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Plate Osteosynthesis ◽  
Scientific Evidence ◽  
Treatment Protocol ◽  
Evidence Base ◽  
Big Brother ◽  
Research Protocols ◽  
Mini Plate

‘Amalgam versus composite’, ‘wisdom tooth coronectomy versus extraction in toto’, ‘wet versus dry bonding’, ‘smooth versus rough implants’, ‘cortical screws versus Mini-plate osteosynthesis’ – there are controversies, myths and mystery in all areas of modern dentistry, even today, in this age of scientific evidence, best practice and big brother. In the cleft world, controversies also abound. In fact, fundamental questions remain unanswered: we still do not know what the best overall treatment protocol is for the child born with a complete unilateral bony cleft lip and palate.1 Little by little, however, the evidence base is enlarging. Centralised UK regional cleft services, knowledge of national and international outcomes, and research protocols all aid the plugging of these gaps in our knowledge, and help us to find the missing pieces of the cleft jigsaw.

Prevalence of Abnormalities in Dental Structure, Position, and Eruption Pattern in a Population of Unilateral and Bilateral Cleft Lip and Palate Patients

2008 ◽  
Vol 45 (2) ◽  
pp. 154-162 ◽  
Author(s):  
Chiara Tortora ◽  
Maria C. Meazzini ◽  
Giovanna Garattini ◽  
Roberto Brusati
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Permanent Dentition ◽  
Dental Development ◽  
Surgical Trauma ◽  
Dental Anomalies ◽  
Supernumerary Teeth ◽  
Bilateral Cleft Lip ◽  
Maxillary Premolars ◽  
Maxilla And Mandible

Objective: To evaluate the dental characteristics of patients subjected to a protocol that included early secondary gingivoalveoloplasty (ESGAP). Design: Panoramic radiographs of 87 patients with unilateral cleft lip and palate (UCLP) and 29 with bilateral cleft lip and palate (BCLP) were evaluated. Missing and supernumerary teeth were also quantified on the cleft and noncleft side and in the maxilla and mandible. Crown and root malformations and tooth rotations were quantified. A subsample in permanent dentition was extrapolated to analyze canine eruption patterns. Results: A total of 48.8% of the UCLP patients presented with missing permanent lateral incisors in the cleft area and 6.1% contralaterally. A total of 4.9% presented with missing second maxillary premolars on the cleft site and 1.2% contralaterally. A total of 7.3% presented with supernumerary lateral incisors, and 45% of the BCLP cleft sites presented with missing lateral incisors, while 25% of the cleft sites presented second maxillary premolars agenesis. Five percent of the cleft sites presented with supernumerary lateral incisors. Evaluation of the subsample in permanent dentition showed that 15.5% had a canine retention and 4.4% of the canines had to be surgically exposed. A significant association was observed between canine inclination and retention but not with absence of the lateral incisor. Conclusions: The frequency of dental anomalies in this sample was similar to other cleft populations. As surgical trauma has been suggested to damage forming teeth, the results of this study indicated that ESGAP has no detrimental influence on subsequent dental development.

Early Two-Stage Palatoplasty Using Modified Furlow's Veloplasty

2010 ◽  
Vol 47 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Nishio Juntaro ◽  
Yamanishi Tadashi ◽  
Hiroshi Kohara ◽  
Yoshiko Hirano ◽  
Michiyo Sako ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Protocol ◽  
Dental Occlusion ◽  
Central Incisor ◽  
Two Stage ◽  
Treatment Protocols ◽  
Normal Occlusion ◽  
New Treatment ◽  
Velopharyngeal Function

Objective To achieve sufficient velopharyngeal function and maxillary growth for patients with unilateral cleft lip and palate (UCLP), the authors have designed a new treatment protocol for palate closure involving early two-stage palatoplasty with modified Furlow veloplasty. Details of the surgical protocol and the outcomes of the dental occlusion of patients at 4 years of age are presented. Design and Setting This was an institutional retrospective study. Patients Seventy-two UCLP patients were divided into two groups based on their treatment protocols: patients treated using the early two-stage palatoplasty protocol (ETS group; n = 30) and patients treated using Wardill-Kilner push-back palatoplasty performed at 1 year of age (PB group; n = 42). Interventions The features of the ETS protocol are as follows: The soft palate is repaired at 12 months of age using a modified Furlow technique. The residual cleft in the hard palate is closed at 18 months of age. Lip repair is carried out at 3 months of age with a modified Millard technique for all subjects. Results The ETS group showed a significantly better occlusal condition than the PB group. The incidence of normal occlusion at the noncleft side central incisor was 7.1% in the PB group; whereas, it was 66.7% in the ETS group. Conclusion The results indicate that the early two-stage protocol is advantageous for UCLP children in attaining better dental occlusion at 4 years of age.

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