• Title/Summary/Keyword: Cleft Palate

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ORTHODONTIC AND PROSTHODONTIC TREATMENT IN CLEFT LIP AND PALATE PATIENT (순/구개열 환자에서의 교정-보철 치험례)

  • Chang, Weon-Suk;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.3
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    • pp.388-393
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    • 2000
  • Cleft lip and palate is one of the most common congenital defects in oro-maxillo-facial region. Because most patients undergo surgical repair in early life, the sagittal jaw relationships used to be deteriorated gradually from palate surgery up to adulthood. Also, the maxillary lateral incisor may be absent or atypical-shaped in the cleft site and may not erupt or erupt ectopically, so multidisciplinary dental cares are needed for cleft lip and palate patients. The effects of the cleft lip and alveolus seem to be limited to that part of the dentofacial complex that surrounds the cleft area. In the maxillary arch, the anterior part of the non cleft segment has a tendency to be rotated forward. On the other hand, the cleft segment has a tendency to rotated slightly medially ; hence, the tendency for canines to be edge-to-edge and sometimes in crossbite. Lip and alveolus surgery adequetely correct these problems, with little untoward effect on the skeletal maxillary-mandible relationships. In this report, the patient has a repaired lip and cleft alveolus on the left side with congenital missing on '62, '22, oronasal fistula, and skeletal class III malocclusion which is not affected by lip surgery. Dental treatments for this patient including orthodontic(space supervision, functional regulator in mixed dentition, fixed therapy in permanent dentition) and prosthodontic(removable obturator with key and keyway attachment and Konus crown) therapy were performed to improve the patient's functions and esthetics.

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THE EFFECTS OF CLEFT ON MESIODISTAL DIMENSIONS OF PERMANENT TEETH IN UNILATERAL CLEFT LIP AND PALATE PATIENTS (순구개열이 영구치 근원심 폭경에 미치는 영향)

  • Bok, Jae-Kweon;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.25 no.4
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    • pp.447-451
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    • 1995
  • The purpose of this study was to investigate the effects of cleft on mesiodistal dimensions of permanent teeth in unilateral cleft lip and palate patients. Mesiodistal dimensions of permanent teeth were measured to the nearest 0.01mm on plaster models of 50 subjects with unilateral complete cleft lip and palate, 10 siblings and 50 Controls. The results were as follows : 1. Tooth size discrepancy in the cleft group was significant in all regions except maxillary cuspid, mandibular cuspid and mandibular first premolar. 2. Some of the mesiodistal dimensions of the teeth on the cleft side were significantly smaller than those of their antimeres on the non-cleft side in the cleft group. 3. A comparison of mesiodistal dimensions of the teeth for the right and left sides of the control group showed no statisically significant differences excepts maxillary lateral incisor. 4. Asymmetries of mesiodistal dimensions of the teeth in the sibling group was not found except maxillary first molar.

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Treatment including orthognathic surgery of a patient with Hypohidrotic ectodermal dysplasia with cleft palate: A Clinical report (구개열을동반한저한성외배엽형성이상환자의 악교정수술을포함한치료: A Clinical report)

  • Kim, Jwa-Young;Park, In-Young;Song, Yun-Jung
    • The Journal of the Korean dental association
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    • v.57 no.2
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    • pp.93-99
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    • 2019
  • Ectodermal dysplasia is a genetic disorder in which various clinical manifestations involve two or more of the differentiated tissues of the ectoderm. Facial deformity, which is frequently associated with ectodermal dysplasia, appears in the form of cleft lip or cleft palate, especially in the middle facial area.Cleft and tooth defects result in decreased alveolar bone development.This leads to severe skeletal incongruity. Facial features include frontal protrusion, malar bone hypoplasia, flat nose, mandibular prominence and long lower facial height. This clinical report presents treatment including orthognathic surgery of a patient with Hypohidrotic Ectodermal dysplasia with cleft palate.

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Treatment of Otitis Media in Cleft Palate (구개열 환자에 있어 중이염의 치료)

  • Pang, Kang-Mi;Ji, Young-Min;Kim, Seong-Min;Myoung, Hoon;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pil-Hoon;Kim, Myung-Jin;Hwang, Soon-Jung
    • Korean Journal of Cleft Lip And Palate
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    • v.10 no.2
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    • pp.89-96
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    • 2007
  • Otitis media with effusion is known to be very common among children with cleft palate and is the common cause of acquired hearing loss in childhood. The purpose of the present study was to examine the anatomic variances, incidence and treatment of middle ear disease in children with cleft palate. In Korea, before 4-year-old age, the prevalence of otitis media was as high as 91.7%. Common treatments for otitis media were conservative or surgical treatment. The medical treatment options include the use of decongestants, antihistamines, antibiotics and mucolytics. Surgical treatment options include grommet insertion, myringotomy. Unlike the case for children without clefts, cleft patient has a higher incidence of recurrence, so surgical treatment between the age of 3 month and 6 month was recommended. The effect of palatoplasty on middle ear disease has remained controversial. Early and periodic evaluation on the symptomatic infection or significant of hearing loss was recommended.

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Maxillary Advancement using Distraction Osteogenesis Devices in Cleft Palate Patients (악정형 장치를 이용한 구순구개열 환자의 상악골 전방 견인)

  • Jin, Im-Geon;Shin, Jung-Hyun;Park, Seong-Su;Kim, Seong-Min;Myoung, Hoon;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pil-Hoon;Kim, Myung-Jin;Hwang, Soon-Jung
    • Korean Journal of Cleft Lip And Palate
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    • v.10 no.2
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    • pp.75-80
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    • 2007
  • For the treatment of cleft palate patients, orthognathic surgery has been used by standard protocol. Predictable results have been achieved with standard techniques in slight to moderate maxillary hypoplasia. However, limited advancement and high relapse rate was reported in severe cases. The purpose of the present study was to review the clinical results of distraction osteogenesis in the patients with cleft lip and palate. Distraction osteogenesis has improved results in these patients by allowing soft tissue relaxation and gradual bone generation. Therefore, greater movement of the craniofacial skeleton is possible in severe cases of maxillary retrusion with lower relapse rates. In conclusion, distraction osteogenesis for the advancement of hypoplastic maxilla of cleft patients has shown successful treatment method.

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Objective assessment of cleft lip nose deformity by neural network (구순열 비변형의 객관적 평가를 위한 Neural Network의 적용)

  • Park, Joong-Hoon;Kim, Jin-Tae;Hong, Hyun-Ki;Kim, Soo-Chan;Kim, Deok-Won
    • Proceedings of the KIEE Conference
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    • 2006.04a
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    • pp.45-47
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    • 2006
  • Cleft palate is a congenital deformity condition with separation of the two sides of the lip resulting in nose deformity. Evaluation of surgical corrections and outcome assessments for nose deformity due to the cleft lip depends mainly on doctor's subjective judgment. An objective method for evaluation of the condition and surgical outcome of nose deformity due to the cleft palate is needed. This study aimed at objective assessment of a cleft palate nose deformity condition by analyzing the following parameters obtained from photographic images of a cleft palate patients: (1) angle difference between two nostril axes. (2) center of the nostril and distance between two centers. (3) overlapped area of two nostrils, and (4) the overlapped area ratio of the two nostrils. A regression equation of doctor's grades was obtained using the eight parameters. Three plastic surgeons gave us the grades for the each photographic image by 10 increments with maximum grade of 100. The average reproducibility of the grades given by the three plastic surgeons and the three laymen using the developed program was $10.8{\pm}4.6%$ and $7.4{\pm}1.8%$, respectively. Kappa values representing the degree of consensus of the plastic surgeons and the three laymen were 0.43 and 0.83. respectively. Correlation coefficient of the grades evaluated by the surgeons and obtained by the neural network was 0.798. In conclusion. the developed neural network model provided us better reproducibility and much better consensus than doctor's subjective evaluation in addition to objectiveness and easy application.

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Non-surgical orthodontic treatment of malocclusion with cleft lip and palate (구순구개열을 동반한 부정교합의 비외과적 교정치료)

  • Lee Seung-Ho;Jeon Young-Mi;Kim Jong-Ghee
    • Korean Journal of Cleft Lip And Palate
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    • v.2 no.1_2
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    • pp.29-41
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    • 1999
  • Cleft lip and palate is the most frequent congenital facial deformity of the orofacial area. Successful management of patients with cleft lip / palate requires a multidiciplinary approach from birth to adult stage. Coordinated treatment by the cleft palate team is an essential requirement to obtain optimum treatment results. One of the negative effect of the early surgical interventions of lip and palate is a significant incidence of maxillary growth restriction that produces secondary deformities of the jaws and malocclusion that includes congenital missing of lateral incisor, malformed teeth, rotation or ectopic position of upper anterior teeth, and it has been thought due to the resistance of palatal scar tissue. In Orthodontic treatment for cleft lip / palate patients, expansion of upper dental arch or palatal suture is often needed to correct posterior and/or anterior cross bite and align upper teeth. Various appliances such as hyrax, quad-helix, fan-type expansion screw and jointed-fan type expander can be used for palatal expansion. In the orthodontic treatment of the cleft lip / palate patient, we must consider patient age and severity of palatal constriction for proper appliance selection, and must pay special attention to maintain the treatment results.

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Inhibitory Effect of Dimethyl Sulforxide on Phenytoin-induced Fetal Cleft Palate and Maternal Corticosterone Level (Phenytoin의 태아 구개열 유발과 모체 혈청 Corticosterone 증가에 대한 Dimethyl Sulfoxide 억제 작용)

  • Lee, Jae-Kwon;Lee, Chang-Eop;Lee, Mun-Han;Ryu, Pan-Dong;Lee, Young-Jae;Sung, Ha-Jung
    • Toxicological Research
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    • v.8 no.2
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    • pp.273-284
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    • 1992
  • It is well known that phenytoin (PHT), a commonly prescribed anticonvulsant, has teratogenicity in experimental animals and human. The major malformation induced by PHT in mouse is cleft palate. The mechanisms of the embryotoxic effects of PHT are unknown. However, PHT and synthetic glucocorticoids share several features with respect to their teratogenicity, and it was known that PHT increased maternal corticosterone level. Therefore PHT-induced cleft palate may be mediated indirectly by elevated maternal corticosterone. Recently it was reported that secalonic acid Dinduced cleft palate and elevated endogenous corticosterone level, and that such effects were antagonized by DMSO. The purpose of this work was to investigate whether the elevated maternal corticosterone is associated with the teratogenicity of PHT in the ICR mouse fetuses by treatment with PHT or PHT plus DMSO. PHT (74mg/kg, BW) was daily administered intraperitoneally on day 10~12 of gestation with and without DMSO(2ml/kg, BW), and the fetal malformation was observed on day 18. Maternal serum corticosterone and fetal PHT levels were determined by HPLC. The results are summarized as follows. 1)The percentage of cleft palate incidense in fetuses following treatment with PHT on day 10~12 of gestation was 51.7%. 2)There was a significant decrement in the cleft palate incidence in fetuses to 30.8% in the group treated with PHT plus DMSO compared with 51.7% in that with PHT alone. 3) Maternal serum corticosterone levels following treatment with PHT on day 10~12 of gestation increased by 116~343% compared with that of vehicle control. Such effect was antagonized by DMSO. 4)PHT concentration in the fetuses was not affected by DMSO. These results suggest that PHT-induced cleft-palate in fetuses seems to be closely associated with the elevation of maternal corticosterone level.

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