Cleft Lip and Palate Patients: Diagnosis and Treatment

Abstract

Cleft lip or palate is one of the most common types of craniomaxillofacial birth anomalies. Midface deficiency is a common feature of cleft lip and palate patients due to scar tissue of the lip and palate closure. Cleft lip and palate patients should be carefully evaluated by the craniofacial team in order to detect potentially serious deformities. Craniofacial team is involved with diagnosis of facial morphology, feeding problems, guidance of the growth and development of the face, occlusion, dentition, hearing and speech problems, and psychosocial issues and jaw discrepancy of the patients with cleft lip and palate or craniofacial syndromes. Treatment for cleft children requires a multidisciplinary approach including facial surgery in the first months of life, preventive and interceptive treatment in primary dentition, speech therapy, orthodontics in the mixed dentition phase, oromaxillofacial surgery, and implant and prosthetics in adults. Treatment plan from orthodontic perspective can be divided into the following stages based on the dentition stages: (1) presurgical orthopedics, (2) primary dentition, (3) mixed dentition, and (4) permanent dentition. The aim of this chapter is to assess a rational team work approach in the management of the patient with cleft lip and/or palate from birth to adulthood.

Optimal timing for plastic surgical procedures for common congenital anomalies: A review

“…Apart from obvious problems of feeding and aesthetics at the time of birth, a CLP has significant effect on the child’s hearing and speech with psychosocial difficulties at school due to bullying and teasing by peers because of appearance of their face and consequently attaining lower educational standards. Frequent visits to doctors and operative interventions are stressful in themselves[ 8 ]. The objectives of cleft lip and palate surgery are to achieve symmetry of lip, nose, maxillary arches and their normal growth upto adulthood when the facial growth stops and no further alterations are expected.…”

Congenital Cleft Lip and Palate in Children: Prevalence Rate in Russia and Worldwide, Risk Factors

“…В России показатель заболеваемости колеблется от 3,5 до 5 тыс. [14,15], в Великобритании -до 1200 случаев в год [16,17]; в Бразилии распространенность патологии составляет 1 случай на каждые 673, а в Соединенных Штатах -1 на 500-700 живорожденных; в Италии и Иране 65% всех деформаций челюстно-лицевой области приходится на врожденную расщелину губы и нёба. Причем различия в распространенности патологии могут наблюдаться даже в одной стране в зависимости от территории: так, в США, в штате Нью-Йорк, этот показатель составляет 0,78, на Гавайях -до 1,82, в Алабаме -до 1,94, Нью-Мехико -до 2,5 на 1000 живорожденных; в Германии -1:1200 в Мюнстере и 1:1000 в Лейпциге.…”

“…Обмен опытом онах [7]. Многочисленные исследования подтверждают значимость группы генетических факторов риска, таких, например, как наличие врожденных пороков развития у родственников, возраст родителей к моменту зачатия, порядковый номер беременности, родов, количество детей в семье, сезон зачатия [21,28], и группы «образ жизни», а именно профессиональные вредности (например, работа в контакте с детергентами и пестицидами, контакт с химикатами), вредные привычки родителей (алкоголизм, курение, наркомания, прием некоторых лекарств, например противосудорожных препаратов или наркотиков), избыток или недостаток витамина A и фолиевой кислоты (как в составе мультивитаминов, так и в диете) [16,28].…”

Caries Experience and Oral Hygiene Status in a Group of Cleft Lip and/or Palate in Alexandria, Egypt

“…Cleft lip and/or palate children suffer numerous problems during their life as feeding problems due to inadequate lip seal and escape of fluids into the nose, hearing impairment due to recurrent ear infections, speech problems with nasality of voice and dental abnormalities (8)(9)(10)(11). The management of such a deformity requires a multidisciplinary team approach including dental specialists, medical specialists and allied health care specialists (12).…”