Cleft Lip and Palate, the Initial Phase of Treatment Planning and Interdisciplinary Therapy for Patients in the Neonatal Age
Authors:
J. Borský 1; M. Hubáček 2; J. Kozák 2; M. Kašparová 2; J. Fišer 1; T. Dostálová 2
Authors‘ workplace:
Klinika plastické chirurgie 3. LF UK a FNKV, Praha
1; Dětská stomatologická klinika 2. LF UK a FN Motol, Praha
2
Published in:
Česká stomatologie / Praktické zubní lékařství, ročník 112, 2012, 1, s. 14-20
Category:
Review Article
Overview
Aim of Review:
The purpose of this paper is to present a comprehensive overview of views on the treatment in patients with cleft lip and palate (CLP), primary lip repair, lip reconstruction in the neonatal period, including knowledge of fetal tissue healing.
Background:
Authors try to summarize the principles of stomato-orthodontic follow-up care. Orofacial clefts are the most common congenital developmental defects. Based on the statistical data, the mean incidence of all types of cleft defects in the orofacial area is 1.86 per 1000 live-born children Etiology is multifactorial. With respect to the range of the defect, the cooperation of a number of experts is required, and complicated and long-lasting therapies are necessary, especially for successful jaw growth. It is necessary to postpone a definitive solution to that time when the arches are in the growth phase. The multidisciplinary therapy involves the following disciplines: plastic surgery, orthodontics, speech pathology, psychology, otorhinolaryngology, genetics, pediatrics, and social work. Due to the extent of affliction, interdisciplinary co-operation is necessary and usually complicated and long-term therapy, which is needed especially for gradual growth of the jaw bones. Therefore, the final solution has to be postponed to a time when the arches are not in a growth period. The treatment should be initiated with a surgical lip correction (usually in the 3rd month of age of a child or fetal healing can be used) and later with a correction of the palate (between the 1st – 4th years of age). It should be followed by orthodontic therapy that optimally achieves correction (e.g. in an isolated palate cleft) but a final prosthetic solution is needed more often (especially in complex clefts). A favorable shape and size of the dental arches without anomalies is an important factor for the prosthetic phase. A cleft defect often means that some teeth are missing (lateral incisors, more often premolars) and there may be other orthodontic anomalies which include either crossed occlusion, inverse occlusion in the frontal part or various anomalies of a tooth position (inclination, rotation, etc.). Early prosthetic therapy (usually around 18 years of age) including implant insertion finalized treatment.
Key words:
cleft lip and palate – primary lip repair – operation of the palate – follow up care
Sources
1. Al-Dajani, M.: Comparison of dental caries prevalence in patiens with cleft lip and/or palate and thein sibling controls. Cleft Palate-Craniofac. Journal, roč. 46, 2009, č. 5, s. 529–532.
2. Anil, V. A., Nagesh, L., Hedge, P., Karipabasappa, G. N.: Primary dentition status and tratment needs of children with cleft lip and/or palate. J. Indian. Soc. Pedod. Prev. Dent., roč. 23, 2005, č. 2, s. 80–82.
3. Bardach, J., Morris, H. L.: Multidisciplinatory management of cleft lip and palate. 1st ed. Philadelphia, W. B. Saunders Company, Harcourt Brace Jovanovich, USA, 1990, s. 586–591.
4. Borský, J., Tvrdek, M., Kozák, J., Černý, M., Zach, J.: Our first experience with primary lip repair in newborns with cleft lip and palate. Acta Chir. Plast., roč. 49, 2007, s. 83–87.
5. Chandrakant, P. S., Wong, D.: Managment of children with cleft lip and palate. CMA Journal, roč. 122, 1980, č. 1, s. 19–24.
6. Cheby, L. L., Moor, S. L., Ho, C. T.: Predisposing factors to dental caries in children with cleft lip and palate: a review and strategies for early prevention. Cleft palate Craniofac. J., roč. 44, 2007, č.1, s.67–72.
7. Ciminello, F. S., Morin, R. J., Nguyen, T. J., Wolfe, S. A.: Cleft lip and palate: review. Compr. Ther., roč. 35, 2009, č. 1, s. 37–43.
8. Dang, C., Ting, K., Soo, C., Longaker, M. T., Lorenz, H. P.: Fetal wound healing current perspectives. Clin. Plast. Surg., roč. 30, 2003, č. 1, s. 13–23.
9. Hasslöf, P., Twetman, S.: Caries prevalence in children with cleft lip and palate - a systematic review of case-control studies. Int. J. Pediatr. Dent., roč. 5, 2007, č. 17, s. 313–319.
10. Hunt, D., Burden, D., Hepper, P., Johnston, C.: The psychosocial effects of cleft lip and palate: a systemic review. European Journal of Orthodontics, roč. 27, 2005, s. 274–285.
11. Lorenz, H. P., Longaker, M. T.: In utero surgery for cleft lip/palate: minimizing the „Ripple Effect“ of scarring. J. Craniofac. Surg., roč. 14, 2003, č. 4, s. 504–511.
12. Manna, F., Pensiero, S., Clarich, G., Guarneri, G. F., Parodi, P. C.: Cleft lip and palate: current status from the literature and our experience. J. Craniofac. Surg., roč. 20, 2009, č. 5, s. 1383–1387.
13. Molsted, K.: Treatment outcomes in cleft lip and palate: Issues and perspectives. Crit. Rev. Oral Biol. Med., roč. 10, 1999, č. 2, s. 225–239.
14. Mossey, P. A., Little, J., Munger, R. G., Dixon, M. J., Shaw, W. C.: Cleft lip and palate. Lancet, 2009, s 1773–1785.
15. Pandey, S. C., Pandey, R. K.: The status or oral hygiene in cleft lip, palate patients after surgical correction. J. Indian Soc. Pedod. Prev. Dent., 2005, č. 23, s. 183–184.
16. Papadopulos, N. A., Papadopoulos, M. A., Kovací, L., Zeilhofer, H. F., Henke, J., Boettcher, P., Biemer, E.: Foetal surgery and cleft lip and palate: current status and new perspectives. Br. J. Plast. Surg., roč. 58, 2005, č. 5, s. 593–607.
17. Penkava, J., Peterka, M.: Anatomic changes of the upper jaw and dental arch after Schweckendiek’s surgery for cleft palate. Čes. Stomat., roč. 77, 1977, s. 297–311.
18. Peterka, M.: Upper alveolar arch development in patients with total bilateral cleft lip and palate. Acta Chir. Plast., roč. 26, 1984, s. 30–38.
19. Ramos, G. A., Ylagan, M. V., Romine, L. E., D’Agostini, D. A., Pretorius, D. H.: Diagnostic evaluation of the fetal face using 3-dimensional ultrasound. Ultrasound Q., roč. 24, 2008, č. 4, s. 215–223.
20. Robin, N. H., Baty, H., Franclin, J., Guyton, F. C., Mann, J., Woolley, A. L., Waite, P. D., Grant, J.: The multidisciplinary evaluation and management of cleft lip and palate. South Med. J., roč. 99, 2006, , č. 10, s. 1111–1120.
21. Shaw, B.: Improving services for cleft lip and palate. A work in progress. Community Dent. Health., roč. 27, 2010, č. 1, s. 2–3.
22. Stator, R., Russell, J, Cole, A., Tomlinson, J., Bridges, M., Clark, V., Morton, J., Reading, J.: Understanding cleft lip and palate. 2: The first five years. J. Fam. Health Care, roč. 4, 2009, s. 122–125.
23. Šmahel, Z. Trefný, P., Formánek, P., Mullerová, Z., Peterka, M.: Three-dimensional morphology of the palate in subjects with isolated cleft palate at the stage of permanent dentition. Cleft Palate-Craniofacial Journal, 2003, roč. 40, s. 577–584.
24. Tindlund, R. S., Holmefjord, A., Eriksson, J. C., Johnson, G. E., Vindenes, H.: Interdisciplinary evaluation of consecutive patients with unilateral cleft lip and palate at age 6, 15, and 25 years: a concurrent standardized procedure and documentation by plastic surgeon; speech and language pathologist; ear, nose, and throat specialist; and orthodontist. The Journal of Craniofac. Surg., roč. 20, 2009, 20, Suppl. 2, s. 1687–1698.
25. Weby, G. L., Cassell, C. H.: The impact of orofacial clefts on quality of life and healthcare use and costs. Oral Dis., roč. 16, 2010, č. 1, s. 3–10.
26. Zarate, Y. A., Martin, L. J., Hopkin, R. J., Bender, P. L., Zhang, X., Saal, H. M.: Evaluation of growth in patients with isolated cleft lip and/or cleft palate. Pediatrics, 2010, č. 125, s. 543–549.
Labels
Maxillofacial surgery Orthodontics Dental medicineArticle was published in
Czech Dental Journal
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