A Simple and Precise Classification for Cleft Lip and Palate: A Five-Digit Numerical Recording System

2007 ◽  
Vol 44 (5) ◽  
pp. 465-468 ◽  
Author(s):  
Qiang Liu ◽  
Ming-Liang Yang ◽  
Zeng-Jian Li ◽  
Xiao-Feng Bai ◽  
Xu-Kai Wang ◽  
...  
Keyword(s):  
Data Analysis ◽  
Classification System ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillofacial Surgery ◽  
Recording System ◽  
New Classification ◽  
Secondary Palate ◽  
Primary Palate ◽  
Medical University

Objective: Numerous methods have been developed for recording cleft lip and palate deformities, but none has been universally accepted due to limitations, inadequate description of the cleft deformities, and varying complexity. Design: The classification system introduced in this article is designed to describe detailed information of the cleft deformities with five-digit codes. The anatomic description of the cleft components is denoted with five Arabic numerals in order of right lip, right alveolus and primary palate, secondary palate, left alveolus and primary palate, and left lip. The extent of the cleft deformities is recorded using the numerals 0 to 4 (i.e., from intact to complete). Setting: Department of Oral-Maxillofacial Surgery, The Affiliated Hospital of Stomatology, China Medical University. Results: This new classification system allows a numerical description of any kind of complete cleft, incomplete cleft, asymmetry, and complex clefts with an intervening intact segment (all simulated cases). Conclusions: The simplicity and precision of this five-digit classification system make it easy to understand, and it can be used for computerized data analysis.

A New Classification System for Unilateral Cleft Lip and Palate Infants to assist Presurgical Infant Orthopedics

2015 ◽  
Vol 39 (3) ◽  
pp. 231-234 ◽  
Author(s):  
PS Daigavane ◽  
PV Hazarey ◽  
P Niranjane ◽  
SD Vasudevan ◽  
BR Thombare ◽  
...  
Keyword(s):  
Classification System ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Anatomical Variations ◽  
Scar Formation ◽  
Alar Cartilage ◽  
New Classification ◽  
Aesthetic Results ◽  
The Aesthetic ◽  
Infant Orthopedics

The proposed advantages of pre-surgical naso-alveolar moulding (PNAM) are easy primary lip repair which heals under minimum tension reducing the scar formation and improving the aesthetic results in addition to reshaping of alar cartilage and improvement of nasal symmetry.However, the anatomy and alveolar morphology varies for each cleft child; the procedure for PNAM differs accordingly. In an attempt to categorize unilateral cleft lip and palate cases as per anatomical variations, a new classification system has been proposed. This classification aims to give an insight in unilateral cleft morphology based on which modification in PNAM procedure could be done.

Alveolar Bone Grafting in Patients with Complete Clefts: A Comparative Study between Secondary and Tertiary Bone Grafting

2002 ◽  
Vol 39 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Rupert Dempf ◽  
Thomas Teltzrow ◽  
Franz-Josef Kramer ◽  
Jarg-Erich Hausamen
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Comprehensive Treatment ◽  
Alveolar Bone Grafting ◽  
Medical University ◽  
Mixed Stage

Objective This investigation evaluated the results of alveolar bone grafting in patients with complete clefts, comparing secondary alveolar bone grafting (during the mixed stage of dentition) versus tertiary bone grafting (after completion of the second stage of dentition). Design This was a retrospective study. Of 140 osteoplasties, which all were operated according to the same standardized surgical technique, a clinical and roentgenological follow-up investigation was carried out in a collective of 85 osteoplasties. Clinically we searched for oronasal fistulae, assessed the periodontal status, determined the extent of the gingival attachment in the area of the osteoplasty, and searched for vertical growth disturbances in the area of the osteoplasty. Roentgenologically the height of the alveolar bone in the former clefted area was ascertained. Setting Records were obtained from a clinical and radiological study of the Department of Oral and Maxillofacial Surgery of the Medical University of Hannover (Germany). Interventions All patients were operated with the same standardized surgical method. The osteoplastic bridging of the alveolar cleft was performed via a vestibular gingival marginal incision and exclusively by grafting of cancellous bone from the iliac crest. Results The best results of alveolar bone grafting in cases of secondary osteoplasty were obtained when the lateral incisor or canine had grown into the transplant and had led to a functional stress of the transplanted bone. Approximately good results were to be found in tertiary osteoplasty when the transplanted bone had been stressed functionally through a dental implant. Comparing the secondary with the tertiary osteoplasty, there was a trend of lower resorption in secondary osteoplasty. Conclusions Secondary osteoplasty should represent an integral component of any concept for the comprehensive treatment of patients with cleft lip and palate.

A New Approach to Classify Cleft Lip and Palate

2001 ◽  
Vol 38 (6) ◽  
pp. 545-550 ◽  
Author(s):  
M. R. Ortiz-Posadas ◽  
L. Vega-Alvarado ◽  
J. Maya-Behar
Keyword(s):  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mathematical Expression ◽  
New Method ◽  
New Approach ◽  
Secondary Palate ◽  
Primary Palate ◽  
Incisive Foramen ◽  
Horizontal Portion

Objective: To propose a new method, which allows for a complete description of primary and secondary cleft palates, incorporating elements that are related to the palate, lip, and nose that will also reflect the complexity of this problem. Method: To describe the type of cleft, two embryonic structures were considered: (1) the primary palate, formed by the prolabium, premaxilla, and columella and (2) the secondary palate, which begins at the incisive foramen and is formed by a horizontal portion of the maxilla, the horizontal portion of the palatine bones, and the soft palate. Anatomical characteristics to be considered were defined, and a new method is proposed to more fully describe any cleft. Results: A description of five cases was made using the method proposed in this work and compared with other published methods for the classification and description of clefts. Conclusions: A mathematical expression was developed to characterize clefts of the primary palate, including the magnitude of palatal segment separation and the added complexity of bilateral clefts, yielding a numerical score that reflects overall complexity of the cleft. Clefts of the secondary palate are also considered in a separate score. Using this method, it is possible to incorporate elements that are not considered in other approaches and to describe all possible clefts that may exist.

Unilateral Cleft Lip with or without Cleft Palate and Handedness: Is There an Association?

1998 ◽  
Vol 35 (1) ◽  
pp. 46-51 ◽  
Author(s):  
John Daskalogiannakis ◽  
Kari L. Kuntz ◽  
Albert E. Chudley ◽  
R. Bruce Ross
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Chi Square ◽  
Children's Hospital ◽  
Secondary Palate ◽  
Children’S Hospital ◽  
Primary Palate ◽  
The Difference ◽  
Sick Children ◽  
The Right

Objective The purpose of this study was to investigate the possibility of a relationship between the side of occurrence of unilateral clefting of the lip and/or palate and handedness, also taking into account the type of the initial cleft condition, a factor that has not been adequately assessed in previous studies. Design This was a retrospective study. Setting Division of Orthodontics, The Hospital for Sick Children, Toronto, Canada, and Cleft Lip and Palate Program, Children's Hospital, Winnipeg, Canada. Participants Subjects were 289 patients (176 males and 113 females) 9 years of age or older presenting with a history of unilateral clefts of the lip with or without the palate. Of these patients, 217 were recruited from the patient pool of the Orthodontic Clinic at the Hospital for Sick Children in Toronto. The remaining 72 were selected from the registry of the Cleft Lip and Palate Program of the Children's Hospital in Winnipeg. Any syndromic cases were excluded from the sample. Main outcome Measures Assessment of handedness was performed by asking the patients to fill out a multi-item questionnaire in which patients were asked to identify which hand they would use for different tasks. The side and type of the initial cleft condition were identified by reviewing each patient's hospital chart and by cross-referencing with clinical examination. Statistical evaluation of the results was performed by using the chi-square test. Results There was a significantly larger number of left-sided clefts (198) in the sample than right-sided clefts (91), (p < .001). The proportion of left-sided clefts among left-handers (84.6%) was higher than that among right-handers (66.8%). However, the relationship between side of cleft and handedness was not statistically significant (p = .185). Clefts of the primary palate only seemed to occur on the left side 3.5 times more often than on the right, whereas the corresponding ratio of left:right manifestation for clefts of the primary and secondary palate was 1.8:1. The difference was statistically significant (p < .05). Conclusion The findings of this study confirm the affinity of unilateral clefts for the left side but suggest that there are differences between clefts of the primary palate only and clefts of the primary and secondary palate. Also, non-right-handed patients show a greater predilection for having a cleft on the left side than do right-handed patients.

The Incidence of Cleft Lip and Palate in Northern Ireland from 1980–1990

1994 ◽  
Vol 21 (4) ◽  
pp. 387-392 ◽  
Author(s):  
Terry Gregg ◽  
Dorothy Boyd ◽  
Andrew Richardson
Keyword(s):  
Sex Differences ◽  
Northern Ireland ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Live Births ◽  
Secondary Palate ◽  
Primary Palate

This study reports the incidence of the various types of cleft lip and/or palate drawn from a regional database of all affected children born in Northern Ireland during the period 1980–1990. The incidence of these anomalies was 1·28 per 1000 live births (1:781). Fifty-three per cent of clefts involved the secondary palate only, 16 per cent the primary palate only, 26 per cent involved both primary and secondary palate, and 5 per cent were unconnected. Overall, more males than females were affected and there were more males than females in the group having complete clefts. Separate clefts of lip and palate occurred exclusively in males with only one exception. Unilateral clefts were more common on the left side. Within the group showing complete unilateral cleft of the primary and secondary palate, left-sided clefts were more commonly male, right-sided clefts were more commonly female. There were no statistically significant sex differences between sides in the unilateral primary palate cleft group.

scholarly journals Incidence of lip and palate clefts in children in Nis from 1990 to 2007

2011 ◽  
Vol 139 (5-6) ◽  
pp. 298-303 ◽  
Author(s):  
Vladimir Mitic ◽  
Marina Jonovic ◽  
Nadica Mitic ◽  
Aleksandar Mitic ◽  
Dejan Mitic ◽  
...  
Keyword(s):  
Congenital Anomaly ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Epidemiological Investigation ◽  
Number Of Children ◽  
Significant Difference ◽  
Secondary Palate ◽  
Clinical Centre ◽  
Primary Palate ◽  
Investigation Period

Introduction. Cleft lip and palate is a complex congenital anomaly of the orofacial system in children. Objective. The aim of this study was to determine the incidence of live-born children with cleft lip and/or palate compared to the total number of children born in the period from January 1, 1990 to December 31, 2007. Methods. Epidemiological investigation was based on the records of live-born children at the Hospital of Gynaecology and Obstetrics of the Clinical Centre Nis. The study included 61,116 live-born children, i.e. 56,905 full-term babies. Results. The total number of registered clefts during the investigation period was 43 (22 boys and 21 girls). The most frequent were the secondary palate clefts (44.2%); combined clefts were present in 34.9%, while primary palate clefts were reported in 20.9%. In respect to the season and order of birth, there was no statistically significant difference in the frequency of the primary, secondary and complete palate clefts. The age of mothers was not identified as a risk factor for the occurrence of cleft lip and palate. Conclusion. In the studied period, 43 children were born with the cleft lip and/or palate, equally in boys as in girls. The secondary palate clefts were most frequent. The season and order of birth had no statistical influence on the occurrence of this anomaly.

scholarly journals Five-Fold Variation Among Surgeons and Hospitals in the Use of Secondary Palate Surgery

2018 ◽  
Vol 56 (5) ◽  
pp. 586-594 ◽  
Author(s):  
Thomas J. Sitzman ◽  
Adam C. Carle ◽  
Pamela C. Heaton ◽  
Michael A. Helmrath ◽  
Maria T. Britto
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Primary Repair ◽  
Multivariable Analysis ◽  
Secondary Surgery ◽  
Secondary Palate ◽  
Primary Palate ◽  
Cleft Palate Repair ◽  
Palate Repair

Objective: To identify child-, surgeon- and hospital-specific factors at the time of primary cleft palate repair that are associated with the use of secondary palate surgery. Design: Retrospective cohort study. Setting: Forty-nine pediatric hospitals. Participants: Children who underwent cleft palate repair between 1998 and 2015. Main Outcome Measure: Time from primary cleft palate repair to secondary palate surgery. Results: By 5 years after the primary palate repair, 27.5% of children had undergone secondary palate surgery. In multivariable analysis, cleft type and age at primary palate repair were both associated with secondary surgery ( P < .01). Children with unilateral cleft lip and palate had a 1.69-fold increased hazard of secondary surgery (95% confidence interval [CI]: 1.54-1.85) compared to children with cleft palate alone. Primary palate repair before 9 months had a 3.99-fold increased hazard of secondary surgery (95% CI: 3.39-4.07) compared to repair at 16 to 24 months of age. After adjusting for cleft type, age at repair, and procedure volume, there remained substantial variation in secondary surgery use among surgeons and hospitals ( P < .01). For children with isolated cleft palate, the predicted proportion of children undergoing secondary surgery within 5 years of primary repair ranged from 8.5% to 46.0% across surgeons and 9.1% to 49.4% across hospitals. Conclusions: There are substantial differences among surgeons and hospitals in the rates of secondary palate surgery. Further work is needed to identify causes for this variation among providers and develop interventions to reduce the need for secondary surgery.

Prevalence of a Simonart's Band in Patients with Complete Cleft Lip and Alveolus and Complete Cleft Lip and Palate

2006 ◽  
Vol 43 (4) ◽  
pp. 442-445 ◽  
Author(s):  
Omar Gabriel da Silva Filho ◽  
Milton Santamaria ◽  
Gisele da Silva Dalben ◽  
Gunvor Semb
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sao Paulo ◽  
São Paulo ◽  
Cross Sectional ◽  
Secondary Palate ◽  
Bilateral Cleft Lip ◽  
Primary Palate ◽  
Year 2000

Objective To investigate the prevalence of the presence of a soft tissue bridge (Simonart's band) in patients with complete cleft lip and alveolus and complete cleft lip and palate. Design Cross-sectional. Sample We assessed 407 consecutive unoperated patients first attending the Hospital for Rehabilitation of Craniofacial Anomalies of University of São Paulo, in Bauru, São Paulo, Brazil, in the year 2000. The patients were classified as presenting complete cleft of the primary palate or of the primary and secondary palate, unilateral or bilateral, as follows: unilateral cleft lip, bilateral cleft lip, unilateral cleft lip and palate, and bilateral cleft lip and palate. Method Clinical examination. The band was considered as present whenever there was a soft tissue bridge between the separated alveolar ridges, regardless of volume and position. Results were analyzed by descriptive statistics and were expressed as percentages, according to the type of cleft. Conclusion 31.2% of patients presented with Simonart's band. The band was observed more frequently in patients with unilateral clefts than in patients with bilateral clefts, and in patients with complete cleft lip and alveolus than in patients with complete cleft lip and palate.

Sri Lankan Cleft Lip and Palate Study Model Analysis: Clefts of the Secondary Palate

1993 ◽  
Vol 30 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Andrew Mccance ◽  
David Roberts-Harry ◽  
Martyn Sherriff ◽  
Michael Mars ◽  
William J.B. Houston
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Model Analysis ◽  
Control Group ◽  
Tooth Size ◽  
Sri Lankan ◽  
Control Groups ◽  
Secondary Palate ◽  
Comparable Control ◽  
And Control

The study models of a group of adult Sri Lankan patients with clefts of the secondary palate were investigated. Tooth-size and arch-dimension comparisons were made with a comparable control group. Significant differences were found between the cleft and control groups in tooth sizes, chord lengths, and arch widths. The cleft group dimensions were generally smaller than those of the control group. Overjets were larger in the cleft group.

Comparison of Dental Caries Prevalence in Patients with Cleft Lip and/or Palate and Their Sibling Controls

2009 ◽  
Vol 46 (5) ◽  
pp. 529-531 ◽  
Author(s):  
Mahmoud Al-Dajani
Keyword(s):  
Dental Caries ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillofacial Surgery ◽  
Permanent Teeth ◽  
Control Group ◽  
Oral And Maxillofacial Surgery ◽  
Caries Prevalence ◽  
Dmft Index ◽  
And Control

Objective: To evaluate the prevalence of dental caries in patients with cleft lip and/or palate and their cleft-free sibling controls. Methods: The two subject groups (patient and control) comprised 106 participants. The former group consisted of 53 patients with cleft lip and/or palate, aged 12 to 29 years, who visited the Oral and Maxillofacial Surgery Hospital at Damascus University of Syria. The control group consisted of the patients’ siblings who had no clefts, and they were sex matched to the patient group. Dental caries were examined clinically and were reported using the decayed, missing, and filled permanent teeth (DMFT) index. The DMFT scores were compared between the two groups. Results: The author found an overall association of dental caries with the presence of cleft lip and/or palate (odds ratio  =  2.52; 95% confidence interval  =  1.389–4.574; p < .05). The DMFT index scores were proportionally higher in patients with cleft lip and/or palate compared with the control group (p < .001). Conclusion: Subjects with cleft lip and palate are susceptible to dental caries independently of socioeconomic status.

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