Interdisciplinary collaboration in cleft problems: surgeon-stomatologist.

During treatment of patients with clefts, reliable interdisciplinary collaboration of plastic surgeons and stomatologists-orthodontists is essential. The authors describe the principles and procedures of these disciplines that are linked and mutually interconnected. These have been elaborated on the basis of many years experience and have proven very satisfactory in the long-term care of patients.

Dental care in patients with facial clefts.

The dental care in patients with facial clefts is discussed. In addition to the routine dental care these patients should be submitted to a long-term complex orthodontic therapy and in some of them is required a prosthesis or dental surgery.

The occurrence of hypodontia in patients with cleft lip and/or palate.

The frequency of hypodontia (but for the third molar) was studied in a series of 600 patients with cleft lip and/or palate. The series was subdivided into three groups according to the type of facial cleft. As compared to the general normal population the occurrence of hypodontia was markedly increased in patients with clefts. The highest percentage of hypodontia was recorded in patients with cleft lip and palate, the lowest frequency was present in cleft lip only. In cleft lip and in cleft lip and palate girls were affected significantly more frequently than boys. The occurrence of hypodontia in the lower and in the upper jaw differed according to the type of cleft. The upper jaw was affected more often in cleft lip and in cleft lip and palate, the mandible was involved more frequently in isolated cleft palate. The dental bud of the upper lateral incisor was affected most commonly in cleft lip and in cleft lip and palate, while the second lower premolar was most frequently absent in isolated cleft palate.

The use of bone grafts in orofacial clefts.

In the repair of orofacial clefts can be used various techniques of bone transplantations. The authors describe the long term experience with untoward effects of primary bone grafts on the growth of the maxilla. They discuss the effects of a secondary bone graft consisting of a compact bone. This bone graft, however, does not eliminate the defect of the alveolar process. They prefer the technique of an autotransplantation of spongious bone grafts applied after the onset of puberty. This graft reconstructs he threshold of the nostril and the alveolar process. It exerted favorable effects on the development of the alveolar process and of the anterior segment of the maxilla.

Hypodontia in patients with isolated cleft palate, its relationship to etiopathogenesis.

The authors studied the incidence of hypodontia in 200 patients with isolated cleft palate. These patients were divided into 3 groups according to the degree of malformation (complete cleft palate, incomplete cleft palate, soft palate cleft). In the 3 groups, hypodontia was studied on permanent teeth, with the exception of the 3rd molars. Compared with the healthy population, hypodontia in patients with cleft palate appeared at a significantly higher rate (25.5%). No difference was found between boys and girls. Hypodontia in the mandible appeared in 18%, in the maxilla in 10%. The upper jaw showed maximum incidence in complete cleft palate (21%), while in the mandible hypodontia was observed most frequently in soft palate clefts (37% patients). In most cases the dental germs of the 2nd lower premolar failed to develop. Our results correlate with hypotheses based on experimental studies on the etiopathogenesis of facial clefts.