ABSTRACT
After secondary osteoplasty radiographic assessment was carried out on 101 patients with cleft lip, jaw and palate (CLP) with 129 uni- and bilateral clefts. The bone formation in the grafted area was assessed on dental radiographs taken 2.9 years on average after secondary osteoplasty. Patients were assigned to 4 groups (Types I to IV) with Types I and II being rated as a success. The purpose of the study was to compare the results in terms of the patients' age at time of surgery, presence or absence of the lateral incisors and prosthetic or orthodontic space closure. The best results in grafted bone height were observed among 6- to 9-year-olds and when the space in the dental arch had been closed orthodontically. If even hypoplastic lateral incisors were preserved, growth into the grafted area could be observed, resulting in successful bone formation of Types I and II. Space due to missing lateral incisors could best be orthodontically closed in the youngest age group and resulted in favorable septal height. The results obtained for the over 14-year-olds were least satisfactory. A reduced septal height was observed and space closure had to be obtained most frequently by prosthetic means.
Subject(s)
Alveolar Process/abnormalities , Alveolar Process/diagnostic imaging , Bone Transplantation/diagnostic imaging , Cleft Lip/diagnostic imaging , Cleft Palate/diagnostic imaging , Adolescent , Alveolar Process/surgery , Bone Transplantation/statistics & numerical data , Child , Cleft Lip/surgery , Cleft Palate/surgery , Follow-Up Studies , Humans , Postoperative Complications/diagnostic imaging , Postoperative Complications/epidemiology , Radiography, Panoramic , Treatment OutcomeABSTRACT
The diagnosis of median facial dysplasia is made in cases of a typical deficiency of the median facial structures without concomitant abnormalities of the brain, and presence of unilateral or bilateral cleft lip and palate. The identification and description of this type of cleft lip and palate are important because such patients have severe growth disturbances and tissue deficiencies. These make surgical reconstruction and orthodontic treatment difficult. This is demonstrated in two examples. The clinical and roentgenological findings in the mother of one of the demonstrated patients point to a discrete form of the same anomaly.
Subject(s)
Cleft Lip/surgery , Cleft Palate/surgery , Orthodontics, Corrective , Patient Care Team , Surgery, Oral , Adolescent , Cephalometry , Child , Cleft Lip/diagnosis , Cleft Palate/diagnosis , Female , Humans , Magnetic Resonance ImagingABSTRACT
The relationship between orthodontic and logopedic findings was evaluated with statistical contingency analysis. The investigation was focused on selected dentomorphologic parameters and oral function/malfunction of 100 patients between 3 and 7 years of age with unilateral cleft lip and palate. For further classification into contingency tables "normal" and "abnormal" attributes were defined. Interdependencies between observed findings and their probable frequencies were calculated and represented in diagrams by means of statistical parameters such as the contingency coefficient. Scatterplots of the calculated coefficients showed a characteristic pattern corresponding to clinical experience. While overjet and transversal occlusion are strongly associated with oral functions, overbite tends not to be associated with oral functions. The contingency coefficient calculated from sagittal and transversal orthodontically relevant conditions of occlusion and incorrect tongue position as well as incorrect swallowing tends to be stronger than that of "abnormal" morphologic parameters and an incorrect tongue position during speech. The longitudinal study of lip position and the 3 investigated morphologic parameters revealed strongly associated contingency coefficients.
Subject(s)
Cleft Lip/pathology , Cleft Palate/pathology , Dentition, Mixed , Tongue/physiopathology , Tooth, Deciduous , Child , Child, Preschool , Cleft Lip/physiopathology , Cleft Lip/therapy , Cleft Palate/physiopathology , Cleft Palate/therapy , Combined Modality Therapy , Humans , Jaw Relation Record , Longitudinal Studies , Malocclusion/physiopathology , Models, Dental , Time FactorsABSTRACT
The symptoms of Silver-Russel syndrome are described using two cases. Special attention was paid to the development of the teeth and the jaws. The typical microretrognathism is accompanied by a frontal crowding especially in the lower jaw. It is possible to adjust it to a regular occlusion using functional orthopedic appliances. Noticeable is the high degree of caries in the first dentition. Paramorphiae are not ascertainable. Etiologically, the submucosal cleft palate, which was diagnosed for the first time, would suggest an intrauterine disturbance in the eighth to the tenth week of pregnancy.
