Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study

Abstract This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.

3D comparison of dental arch stability in patients with and without cleft lip and palate after orthodontic/rehabilitative treatment

Abstract This study aimed to compare the linear dimensions of the dental arches of adult patients with complete unilateral cleft lip and palate (UCLP) after orthodontic and prosthetic treatment with fixed partial dentures (FPD) to patients without clefts, using 3D technology. This retrospective longitudinal study sample consisted of 35 subjects divided into two groups. Included in this sample were 15 complete UCLP individuals who had received orthodontic treatment before rehabilitation with a fixed partial denture (FG), as well as 20 patients without cleft as control group (CG). All patients were aged between 18 and 30 years. Digital dental casts were obtained in two stages: (T1) end of orthodontic treatment and (T2) one year after prosthetic rehabilitation (FG); and (T1) end of orthodontic treatment and (T2) one year after removal of the orthodontic appliance (CG). Intercanine, interfirst premolar and intermolar distances, and incisor-molar length were obtained. A precalibrated and trained examiner performed the assessments. Intergroup differences between T2 and T1 were compared between the groups using the t test or Mann-Whitney test with a significance level of 5% (p<0.05). The intercanine distance variation (T2-T1) showed statistical difference (p=0.005) increasing in the FG group and decreasing in the CG group. In the interfirst premolar distance variation, FG decreased, while CG increased with statistically significant difference (p=0.008). The intercanine distance of individuals with cleft showed stability, while that of the CG had no stability. The CG showed stability in the interfirst premolar distance, while FG had no stability. These findings showed that the FPD is capable of restricting orthodontic results, leading to a stabilization of the dental arches.

Removable partial denture with attachment as a treatment option in patients with cleft lip and palate / Prótese parcial removível com encaixe como opção de tratamento em paciente com fissura labiopalatina

ABSTRACT The rehabilitation treatment of patients with cleft lip and palate is lengthy and is carried out by various professionals from different areas of healthcare.To this end, planning and specialist knowledge are critical to the success of the treatment, in this way envisioning the aesthetic and functional rehabilitation of the individual in order to integrate them into society. This study consists of a literature review along with the report of a clinical case, demonstrating the treatment performed with the use of a removable partial denture using the abutment teeth treated with milled metal-ceramic crowns and the use of attachments, with a view to promoting the retention and stability of the prosthetic device. With the use of this system as a whole, aimed at improving the facial proportions due to the restoration of vertical dimension of occlusion and adequate lip support, features that are often not present in individuals with cleft lip and palate. In this work, we are seeking to underline the importance of scientific and technical knowledge, combined with a well-executed planning, in order to achieve successful treatment that restores function and aesthetics to the patient, thereby enabling their reintegration into society.

RESUMO O tratamento reabilitador de um paciente com fissura labiopalatina envolve um longo período e efetuado por diversos profissionais de diferentes áreas da saúde. Para tal, o planejamento e o conhecimento específico são de suma importância para o sucesso do tratamento, vislumbrando, dessa forma, a reabilitação estética e funcional do indivíduo de forma a integrá-lo na sociedade. O presente trabalho consiste em relato de um caso clínico, demonstrando o tratamento efetuado com a utilização de prótese parcial removível utilizando os dentes pilares tratados com coroas metalo-cerâmicas fresadas e a utilização de encaixes, com intuito de favorecer a retenção e estabilidade do aparelho protético. Com o uso de todo esse sistema objetivando a melhoria nas proporções faciais devido à devolução da dimensão vertical de oclusão e suporte labial adequado, características que muitas vezes não estão presentes nos indivíduos com fissuras labiopalatinas. Este trabalho tem o intuito de ressaltar a importância do conhecimento científico e técnico, somados a planejamento bem realizado a fim de se conseguir o sucesso do tratamento, devolvendo função e estética do paciente, reintegrando-o a sociedade.