Interdisciplinary Evaluation of Consecutive Patients With Unilateral Cleft Lip and Palate at Age 6, 15, and 25 Years

Tindlund, Rolf S.; Holmefjord, Anders; Eriksson, Jens-Christian; Johnson, Gunnar Espolin; Vindenes, Hallvard

doi:10.1097/scs.0b013e3181b3edb5

Cited by 22 publications

(7 citation statements)

References 14 publications

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“…Previous reports have used 10 consecutive patients to avoid selection bias [54][55][56][57] ; however, Power and Matic argue that more subjects are needed. 58 As such, we used the middle 20 consecutive cases as representative examples.…”

Section: Discussionmentioning

confidence: 95%

Unilateral Cleft Lip Repair Using the Anatomical Subunit Approximation

Tse

Lien

2015

Plastic and Reconstructive Surgery

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Section: Discussionmentioning

confidence: 95%

Unilateral Cleft Lip Repair Using the Anatomical Subunit Approximation

Tse

Lien

2015

Plastic and Reconstructive Surgery

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“…Clearly; the earlier secondary revisional procedures are carried out; the less will be the adverse effect on growth, development, and psychological concerns. [89101112131415161718192021] However, even when growth has ceased, every opportunity to improve dysfunction should be taken. Moreover as Ralph Millard said: “If the secondary surgeon could be guided by such simple, sound dicta as: Never make the same mistake twice; two wrongs do not make a right; when in doubt, don’t!…”

Section: Discussionmentioning

confidence: 99%

“…[123] Once the primary surgery takes place, clinical features shows an abnormal growth of basal and alveolar maxillary bone combined with a horizontal incongruence of dentoalveolar arches which result in a complete malocclusion not limited to cleft area. Therefore, even if a good primary surgery has been performed, job is probably not over as secondary treatment has to deal with following specific issues: Dentoskeletal deformities, lip deformities, nose deformities, and hard and soft palate deformities[2345678910] [Figures 1–3]. …”

Section: Introductionmentioning

confidence: 99%

Simultaneous options for cleft secondary deformities

Scopelliti

Fatone

Cipriani

et al. 2013

Ann Maxillofac Surg

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Introduction:So much has been written by so many about secondary procedures in cleft surgery that testify not only the complexity and variable expression of cleft deformity itself but also the need to find methods of primary surgery that will reduce, if not avoid, adverse effects on all the structures and functions involved and affected. It must be the principal aim of cleft surgeon to restore the deformed and displaced regional anatomy to as close to normality as possible, whether or not true hypoplasia exists. The pathogenesis of secondary deformities is related to specific features as: the presence of scar tissues into the cleft basal bone area, that inhibits alveolar growth; scarring of palatal soft tissue, that inhibits growth and causes palatal orientation of dentoalveolar elements; and the exceeding lip tension, that may inhibits maxillary growth along dentoalveolar structures.Materials and Methods:From 2008 to 2011 at the Department of Cranio-Maxillo-Facial Surgery, Santo Spirito Hospital, Rome 25 patients (21 males and 4 females) who had undergone previous surgery for unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) were enrolled in our study. Diagnosis of deformity was made by means of a cephalometric and photographic analysis (Arnett), gipsometry and a radiological assessment (orthopantomography, lateral and frontal cephalometric X-rays). Moreover, every patient was studied with a temporomandibular joint (TMJ) tomography, TMJ magnetic resonance imaging (MRI) and a computerized gnatography to better evaluate potential TMJ dysfunctions. The surgical procedures adopted simultaneously were: Total or segmental maxillomandibular osteotomies, genioplasty, rhinoplasty, labioplasty, and application of facial prosthesis. Every patient received a postoperative questionnaire to evaluate his/her satisfaction with the surgery performed.Results:The surgical procedures adopted were Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO) in 16 patients (65%) and only Le Fort I osteotomy in 9 patients (35%). A relapse of malformation occurred in 4.5% of cases. Concerning the patient questionnaire, 96% of patients were satisfied with the jaw surgery and favorable for combined surgery, 88% were satisfied with lip-nose surgery, and finally 76% would advise to a friend.Conclusions:Simultaneous correction of the deformities is indicated as to avoid several surgical distresses for the patient, to improve facial aesthetic and function in one surgical step, and to reduce risk of psychological consequences.

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“…All individuals born with a cleft are included in the national interdisciplinary team of medical specialists in Oslo, or in Bergen. Most of the treatment by the Bergen CLP team is undertaken in early adolescence, allowing evaluation of the treatment outcome at the age of 16 years [20].…”

Section: Introductionmentioning

confidence: 99%

Orthodontic Status and Association with Oral-Health-Related Quality of Life—A Study of 16-Year-Old Norwegians with a Cleft Lip and Palate

Saele,

Mustafa,

Åstrøm

2024

IJERPH

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Objective: To assess the association between clinical orthodontic indicators and oral-health-related quality of life, adjusted for socio-demographic factors, focusing on 16-year-old patients with cleft lip and/or palate (CL/P). Participants: One hundred and twenty-two patients with CL/P, representing cleft-lip (CL), cleft-palate (CP), unilateral/bilateral cleft-lip-palate (UCLP/BCLP), enrolled in the national CLP-Team, Bergen, Norway. Method: A cross-sectional study by two orthodontists assessing the number of teeth, intermaxillary sagittal relation (ANB-angle), dental arch and occlusion of 16-year-old patients with CL/P. All completed a digital questionnaire including self-reported socio-demographic variables, OHIP-14 questionnaire and dental aesthetics. Cross-tabulations with Pearson’s Chi-square test were used to identify associations between self-reported OHRQoL and socio-demographic and clinical indicators. Multiple variable analyses were conducted with binary logistic regression analysis using the odds ratio (OR) and 95% confidence interval (CI) to assess associations between OHRQoL and clinical indicators adjusted for socio-demographic variables. Ethical approval was granted by the regional ethics committee. Results: Patients with UCLP and BCLP had poorer clinical indicators compared to patients with CL and CP (p < 0.05). A total of 80% of the patients had OHIP-14 > 0. The highest oral impact was reported for psychological domains and articulation and the least for functional domains. Respondents with BCLP and those with poor intermaxillary relationships (ANB < 0°) reported a high impact on OHRQoL (p < 0.05). No statistically significant associations between other clinical indicators and socio-demographic variables such as gender, educational aspiration, and place of residence were reported. Conclusions: The study revealed an association between severe cleft diagnosis, missing teeth, misaligned teeth, negative overjet, and poor OHRQoL, but a statistically significant association was found only between OHRQoL and poor intermaxillary sagittal relations (unfavorable profile). To improve OHRQoL among patients with clefts, there is a need for an individual follow-up and prioritization of oral healthcare.

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Interdisciplinary Evaluation of Consecutive Patients With Unilateral Cleft Lip and Palate at Age 6, 15, and 25 Years

Abstract: : This longitudinal study shows how a multidisciplinary evaluation adequate for intercenter comparison can be performed when standardized procedures, registrations, and documentations are available.

Cited by 22 publications

References 14 publications

Unilateral Cleft Lip Repair Using the Anatomical Subunit Approximation

Unilateral Cleft Lip Repair Using the Anatomical Subunit Approximation

Simultaneous options for cleft secondary deformities

Orthodontic Status and Association with Oral-Health-Related Quality of Life—A Study of 16-Year-Old Norwegians with a Cleft Lip and Palate

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