Orthodontic Treatment of Malocclusion Associated with Repaired Complete Clefts of the Lip and Palate

1979 ◽  
Vol 6 (2) ◽  
pp. 73-83 ◽  
Author(s):  
W. C. Shaw
Keyword(s):  
Soft Tissue ◽  
Treatment Planning ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Deciduous Dentition ◽  
Arch Form ◽  
Progressive Development ◽  
General Care

The literature concerning orthodontic treatment of malocclusion associated with cleft lip and palate has been reviewed. The aims of treatment and a number of skeletal, soft tissue, dento-alveolar and general care factors which influence treatment planning are discussed. The effect of early orthopaedic treatment, examined solely on the grounds of eventual arch form in the deciduous dentition, reveals a prophylactic benefit in some, but not all reports. There would appear to be little benefit in carrying out orthodontic treatment in the deciduous dentition but it is suggested that the progressive development of severe overclosure during the mixed dentition phase should be intercepted using simple appliances. The most important phase of treatment follows eruption of the permanent dentition and appliances are described which are capable of substantial radial and vertical corrections in preparation for a permanent prosthesis.

The Impacts and Outcomes of Presurgical Nasoalveolar Molding (PNAM) in Newborn Sequential Therapeutic Implementation

2021 ◽  
Author(s):  
Vonda Trivosa
Keyword(s):  
Incidence Rate ◽  
Rural Areas ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Deciduous Dentition ◽  
Parents And Children ◽  
Nasoalveolar Molding

Cleft lip and palate is a common congenital malformation in the oral and maxillofacial regions. According to epidemiological investigation, the incidence rate is about 1.625%, and the incidence rate is high in poor areas and rural areas. Cleft lip and palate mainly involve the upper lip, hard palate, soft palate and nose, which can damage the appearance of children, affect pronunciation, swallowing and chewing, and also bring different degrees of psychological damage to children in the growth stage. Therefore, we should actively carry out sequential treatment and participate in the treatment work through multi-disciplines. Based on restoring the oral and maxillofacial function and health of children, we should also pay attention to their aesthetic needs, enhance the treatment confidence of parents and children, and lay the foundation for the follow-up repair treatment. Most patients with cleft lip and palate are complicated with malocclusion. Orthodontic treatment is an important part of the treatment of cleft lip and palate. The orthodontic treatment of cleft lip and palate can be divided into five periods: newborn period, deciduous dentition period, mixed dentition period, permanent dentition period and combined orthodontic and orthognathic treatment period. Presurgicalnasoalveolar molding (PNAM) was used to reduce the severity of facial deformity in children with cleft lip and palate. This article discusses the therapeutic effect of newborn PNAM according to clinical cases. Objective to study the opportunity and current situation of PNAM in the treatment of children with cleft lip and palate, and to provide a favorable reference for clinical orthodontists, emphasizing the close communication between various disciplines.

Orthopedic Protraction of the Upper Jaw in Cleft Lip and Palate Patients during the Deciduous and Mixed Dentition Periods in Comparison with Normal Growth and Development

1993 ◽  
Vol 30 (2) ◽  
pp. 182-194 ◽  
Author(s):  
Rolf S. Tindlund ◽  
Per Rygh ◽  
Olav E. Bøe
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Normal Growth ◽  
Mixed Dentition ◽  
Deciduous Dentition ◽  
Lower Jaw ◽  
Lateral Cephalograms ◽  
Anterior Position ◽  
Upper Jaw ◽  
Posterior Position

Cleft lip and palate (CLP) patients often develop maxillary retrusion after cleft repair. Since 1977, a group of 98 cases with negative overjet (anterior crossbite) during the period of deciduous dentition has been treated by the Bergen CLP team. The purpose of treatment has been to achieve favorable occlusion with positive overjet and overbite by means of anterior orthopedic traction (protraction). The average age at start of treatment was 6 years 11 months, and mean treatment duration was 13 months. The protraction force was 700 g. The serial lateral cephalograms of the treated CLP group were compared with those of a noncleft group with normal growth. Normalization of the sagittal maxillomandibular relationship (ANB angle) was achieved. Significant changes were a more anterior position of the upper jaw, and a more posterior position of the lower jaw, due to mandibular clockwise rotation. The variation was considerable. This paper reports the overall changes in the whole CLP group (ALL-C group).

scholarly journals Surgical Outcomes of Secondary Alveolar Bone Grafting and Extensive Gingivoperiosteoplasty Performed at Mixed Dentition Stage in Unilateral Complete Cleft Lip and Palate

2020 ◽  
Vol 9 (2) ◽  
pp. 576
Author(s):  
Yu-Ying Chu ◽  
Frank Chun-Shin Chang ◽  
Ting-Chen Lu ◽  
Che-Hsiung Lee ◽  
Philip Kuo-Ting Chen
Keyword(s):  
Bone Grafting ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Prospective Trial ◽  
Mixed Dentition ◽  
Alveolar Bone Grafting ◽  
Significant Difference ◽  
Secondary Alveolar Bone Grafting

Secondary alveolar bone grafting (SABG) is associated with donor site morbidities. We aimed to compare the outcomes of SABG and extensive gingivoperiosteoplasty (EGPP) at the mixed dentition stage. This single-blinded, randomized, prospective trial enrolled 50 consecutive patients with unilateral complete cleft lip and palate who had residual alveolar bone cleft, of which 44 (19 SABG, 25 EGPP) completed the study. Bone volumes before surgery, 6 months postoperatively, and 1-year postoperatively were compared using computed tomography. The Bergland scale score was recorded at 6 months postoperatively. Both groups had the same preoperative alveolar cleft volume. On the Bergland scale, 21, 3, and 1 patient in the EGPP group and 16, 2, and 1 patient in the SABG group were classified as types I, II, and IV, respectively, which did not show significant difference. With perioperative orthodontic treatment, the 1-year residual bone defect volume in both groups did not show significant difference (SABG 0.12 cm3 vs. EGPP at 0.14 cm3, p > 0.05). The study was not able to reveal much difference between SABG and EGPP combined with perioperative orthodontic treatment.

scholarly journals Association of the profile of individuals with cleft lip/palate with the beginning of orthopedic/ orthodontic treatment

RSBO ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 86-93
Author(s):  
Madiana Magalhães Moreira ◽  
Pedro Diniz Rebouças ◽  
Maria Lúcia Bonfim Chagas ◽  
Luan Cartaxo Félix ◽  
Paulo Goberlânio de Barros Silva ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Geographic Origin ◽  
Panoramic Radiograph ◽  
Mixed Dentition ◽  
Chi Square ◽  
Reference Hospital ◽  
Cleft Lip Palate ◽  
Chi Square Test

Cleft lip and palate (CLP) is the most frequent congenital malformation among the anomalies of the head and neck. The orthopedic/orthodontic treatment is included in the rehabilitation of these individuals, however there is no consensus in the literature regarding the ideal time for its beginning. Objective: To verify and characterize the profile of individuals with CLP treated at a reference hospital of the northeast of Brazil from 1998 to 2013 and its association with the beginning of the orthopedic/ orthodontic treatment. Material and methods: Through direct observation of medical records, panoramic radiograph, and study casts of 323 individuals, data regarding sex, cleft type, origin and age of beginning of the orthopedic/orthodontic treatment were surveyed and analyzed using the chi-square test, considering a 5% level of significance. Results: Most of the individuals had transforamen and the unilateral cleft was the most prevalent (p<0.05). Females were statistically more affected by post-foramen cleft and males by trans-foramen cleft (p><0.05). Most individuals with trans-foramen cleft and post-foramen cleft started the orthopedic/ orthodontic treatment between 8 and 12 years old (p><0.05). No statistically significant differences occurred relating the beginning><0.05). Females were statistically more affected by post-foramen cleft and males by trans-foramen cleft (p<0.05). Most individuals with trans-foramen cleft and post-foramen cleft started the orthopedic/ orthodontic treatment between 8 and 12 years old (p<0.05). No statistically significant differences occurred relating the beginning> <0.05). No statistically significant differences occurred relating the beginning of the orthopedic/orthodontic treatment with geographic origin and sex of, although most of them have started treatment at late mixed dentition. Conclusion: Regardless of gender, origin, or cleft type, most patients started orthopedic treatment up to 12 years-old, an age considered ideal by most protocols. Unilateral and trans-foramen cleft were the most prevalent cleft types. post-foramen cleft affected more females, while trans-foramen cleft affected more males.

scholarly journals Cephalometric Soft Tissue Characteristics of Unilateral Cleft Lip and Palate Patients in Relation to Missing Teeth

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Khalid A. Almoammar ◽  
Hala A. Almarhoon ◽  
Waeil Batwa ◽  
Nasser Alqahtani ◽  
Thikriat Al-Jewair ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Management ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Patient Records ◽  
Missing Teeth ◽  
Lower Lip ◽  
Tissue Characteristics ◽  
Retrospective Investigation

Objective. This study aimed to evaluate cephalometric soft tissue characteristics in individuals with unilateral complete cleft lip and palate (UCCLP) both with and without missing teeth. Design. A retrospective investigation of patient records, who are being treated at the cleft lip and palate (CLP) clinics at the College of Dentistry. Ninety-six consecutive records of nonsyndromic UCCLP subjects were recruited (33 subjects without missing teeth and 63 subjects with missing teeth). Linear and angular soft tissue measurements obtained from lateral cephalometric radiographs were evaluated and compared among the studied samples. Results. Lower lip was significantly retruded and shorter (p=0.037), p=0.015, respectively; in addition to the fact that shallower mentolabial sulcus (p=0.05) was found in the subjects with missing teeth, the rest of the soft tissue was not significantly different between the two groups. Conclusion. In subjects with a UCCLP anomaly, missing teeth have an effect on lower lip position and length, which influenced the mentolabial sulcus. Lower lip position and length differ between cleft patients who present with either multiple missing teeth or with no missing teeth, and this needs to be considered during orthodontic treatment planning and surgical management for the cleft defect.

Protração maxilar ancorada em miniplacas na fissura labiopalatina – do diagnóstico à maturidade esquelética

2021 ◽  
Vol 14 (54) ◽  
pp. 80-88
Author(s):  
Renata Mayumi Kato ◽  
Renato André de Souza Faco ◽  
Hilde Timmerman ◽  
Hugo De Clerck ◽  
Daniela Garib
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Full Time ◽  
Class Iii ◽  
Facial Growth ◽  
Maxillary Expansion ◽  
Alveolar Bone Grafting

The purpose of this study was to report a case with complete unilateral cleft lip and palate (CLP) treated with bone anchored maxillary protraction (BAMP) in miniplates followed up until the end of facial growth. A 7-year-old girl with complete left side CLP started the orthodontic treatment in a rehabilitation center. She presented a Class III skeletal pattern due to maxillary deficiency, a GOSLON 4 sagittal interarch relationship, a negative overjet of 1.5mm and agenesis of left upper lateral incisor. In the mixed dentition, the patient was submitted to rapid maxillary expansion followed by the secondary alveolar bone grafting procedure. At 12y 3m two miniplates were installed in the maxilla and two in the mandible with BAMP therapy. The patient was instructed to use full time Class III elastics with force of 250g/side together with a bite lifting plate in the upper arch. BAMP therapy duration was 19 months leading to a positive overjet and GOSLON 1 sagittal interarch relationship. The cephalometric analysis demonstrated a mild maxilla advancement. Class III elastics started to be used only at night as an active retention concomitantly with Phase II orthodontic treatment. Compensatory corrective orthodontic treatment established adequate occlusion between the dental arches with significant improvement of facial aesthetics after the intervention. Le Fort 1 surgery with maxillary advancement was not necessary.

Soft-Tissue Characteristics of Operated Unilateral Complete Cleft Lip and Palate Patients in Mixed Dentition

2011 ◽  
Vol 22 (4) ◽  
pp. 1275-1279 ◽  
Author(s):  
Ren-kai Liu ◽  
Peter Wamalwa ◽  
Da-wei Lu ◽  
Cheng-hao Li ◽  
Hai-kun Hu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Tissue Characteristics

Prevalence and Severity of Malocclusion in Children with Cleft Lip and/or Palate in Hong Kong

1992 ◽  
Vol 29 (3) ◽  
pp. 287-291 ◽  
Author(s):  
Endarra L.K. Tang ◽  
Lisa L.Y. So
Keyword(s):  
Hong Kong ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Dental Development ◽  
Posterior Crossbite ◽  
Early Stages ◽  
Preliminary Study ◽  
Female Subjects

The prevalence and severity of malocclusion among children with cleft lip and palate in Hong Kong has never been assessed or documented. A group of 20 children in the primary or early mixed dentition stages, with clefts of the lip and/or palate were assessed using the Occlusal Index. Results of this preliminary study showed that 92.3 percent of the male and 71.5 percent of the female subjects had severe malocclusion, which Implied that comprehensive orthodontic treatment at a later stage would be needed. More than half (69.2% of the male, and 57.1% of the female subjects) had syndrome F, defined as mesial molar relationship, overjet, overbite, posterior crossbite, midline diastema, and midline deviation (Summers, 1966). Therefore malocclusion problems were shown to manifest early in patients with cleft lip and/or palate, and further that it is possible to assess malocclusion prevalence and severity in early stages of dental development.

scholarly journals Modern aspects of interdisciplinary treatment in children with bilateral cleft lip and palate

2020 ◽  
Vol 15 (4) ◽  
pp. 75-80
Author(s):  
О.V. Dudnik ◽  
◽  
Ad.A. Mamedov ◽  
A.A. Skakodub ◽  
A.B. Maklennan ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Interdisciplinary Treatment ◽  
World Health ◽  
Treatment Methods ◽  
Reconstructive Operations ◽  
Bilateral Cleft Lip

According to the World Health Organization incidence of cleft lip and palate ranges from 0.6-1.6 cases per 1000 newborns per year. Thus, bilateral full cleft lip and palate occurs less frequently around 15–25%. Purpose: to analyze treatment methods for children with bilateral cleft lip and palate during the period of a removable bite. A review of 51 literature sources from 1951 to 2019 was carried out. Occlusion development features in bilateral cleft lip and palate patients during mixed dentition period were analysed. Main anatomical features of the maxillofacial region in children with bilateral cleft lip and palate during mixed dentition period is narrowing of the upper and lower dental arches as well as presence soft tissues scars of the upper lip. The main methods of treatment for such children is surgical reconstructive operations, including the elimination of the anatomical defect of the hard palate using mucoperiosteal flaps from the lateral parts of the hard palate combined with orthodontic treatment methods. Thus, an integral method of treating children with bilateral cleft lip and palate during mixed dentition period is a comprehensive approach, including surgical reconstructive operations, as well as orthodontic treatment, the main purpose of which is to expand and extend dental arch, which results in normal occlusion therefore eliminating myofunctional disorders. Key words: cleft lip, cleft palate, mixed dentition, occlusion features, orthodontic treatment

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