1/12. The reconstruction of bilateral clefts using endosseous implants after bone grafting.This article presents the orthodontic reconstruction of an adult bilateral cleft patient with a severe Class III malocclusion in which endosseous implants were inserted after secondary alveolar bone grafting. The patient was a 21-year-old Japanese male whose lateral incisors were congenitally missing and whose premaxilla was inclined lingually. The occlusion was classified as Angle Class III with an overjet of -8 mm. Orthodontic alignment was initiated to correct the position of the maxillary incisors before bone grafting. After the anterior occlusal relationship was corrected, bilateral alveolar clefts were reconstructed by bone grafting with autogenous particulate marrow and cancellous bone harvested from the iliac crest. ITI-SLA fixtures (Institute Straumann, Waldenburg, switzerland) (length, 10 mm; diameter, 4.1 mm) were placed into the grafted bone for prosthetic restoration of the missing lateral incisors. The results illustrate that this protocol can be expected to provide an acceptable occlusion and good dentoalveolar stability in adult cleft patients.- - - - - - - - - - ranking = 1keywords = cleft (Clic here for more details about this article) |
2/12. Maxillary expansion and protraction in correction of midface retrusion in a complete unilateral cleft lip and palate patient.A 7-year-old girl with a cleft lip and palate had a midface retrusion due to growth inhibition of the maxillary complex. She presented for correction of a severe total crossbite with a Class III skeletal pattern. Initially, maxillary expansion was provided to widen the maxilla and then maxillary protraction headgear was worn to improve the sagittal skeletal relation. Fixed orthodontic appliances were placed to align the dentition and Class III elastics were used to establish intercuspation and stability. The maxillary expansion and protraction usually provide effective improvement in skeletal Class III patients with repaired cleft lip and palate patients. The success of the orthopedic procedure essentially depends on the individual growth of the maxilla and the mandible. This case report shows the significant growth of the mandible after maxillary expansion and protraction in late adolescence.- - - - - - - - - - ranking = 1.9358189014977keywords = palate, cleft (Clic here for more details about this article) |
3/12. New oral-acral syndrome with partial agenesis of the maxillary bones.We report on a woman with congenital defect of the anterior part of the maxillary bone (including absence of incisors and canines) without cleft lip or palate, and ectrodactyly of the feet. This syndrome appears to represent a new entity of unknown cause.- - - - - - - - - - ranking = 0.32263648358295keywords = palate, cleft (Clic here for more details about this article) |
4/12. Surgical orthodontic treatment of a severe open bite malocclusion with cleft palate and neuropathy.AIM: This case demonstrates an orthodontic and surgical approach to a severe open bite malocclusion with cleft palate and neuropathy. methods: Pre- and postsurgical orthodontic treatment involved a multi-bracket appliance, Le Fort I osteotomy, and sagittal split mandibular ramus osteotomy. The diagnostic background and the treatment procedures are sequentially presented. CONCLUSION: The combined orthognathic surgery and orthodontic treatment resulted in a significant correction of the occlusion.- - - - - - - - - - ranking = 5.6724970511062keywords = cleft palate, palate, cleft (Clic here for more details about this article) |
5/12. cleft palate and beckwith-wiedemann syndrome.OBJECTIVE: patients with beckwith-wiedemann syndrome suffer numerous anomalies, which vary somewhat from case to case. cleft palate in combination with this syndrome has rarely been reported in the literature. Through two cases, this report examines the staging of the surgical repairs and the role of macroglossia in cleft palate and the consequences of the scarred palate on mandibular development. RESULTS: Of four patients with beckwith-wiedemann syndrome, only two had a cleft palate. The timing of the repair in these two children was different. speech development was satisfactory in the first case but mediocre in the second. This result seemed to be related to a poor social environment. Mandibular prognathism persisted in both cases. CONCLUSION: The treatment of patients with cleft palate and beckwith-wiedemann syndrome remains complex. It is preferable not to operate on a cleft palate before performing a tongue reduction plasty, but rather to combine these two surgical interventions. This would reduce the risks of anesthesia and enable the palate to heal more efficiently. Surgical treatment should be performed after the age of 6 months and before problems in speech development occur. An orthognathic surgery at adolescence could be performed if prognathism persists. While the origin of the cleft palate is still being discussed, we cannot claim that macroglossia is related to the development of cleft palate, nor that the scarred palate has an impact on the mandibular development.- - - - - - - - - - ranking = 8.2452311871338keywords = cleft palate, palate, cleft (Clic here for more details about this article) |
6/12. Internal midface distraction in correction of severe maxillary hypoplasia secondary to cleft lip and palate.BACKGROUND: Maxillary hypoplasia is a familiar deformity in patients with cleft lip and palate. A large amount of maxilla advancement is often needed to correct the severe deformity, but local soft-tissue scars around the maxilla restrict maxilla advancement and increase the relapse rate. By gradually lengthening both the bones and the soft tissues, midface distraction can greatly increase postoperative stability and lower the relapse rate. methods: Ten patients with severe maxillary hypoplasia secondary to cleft lip and palate were treated with midface distraction using three kinds of internal distraction devices. Among them, six patients received an alveolar bone graft from the iliac crest during their Le Fort I osteotomy, and a bilateral sagittal split ramus osteotomy was performed simultaneously to push back the mandible in five patients with prognathia, to obtain a normal soft-tissue profile and occlusal relationship. RESULTS: Successful maxillary advancements ranging from 5 to 15 mm were measured from preoperative and postoperative cephalograms. patients' sella-nasion-point A angles increased from an average of 71.25 degrees preoperatively to 79.05 degrees postoperatively. Orthodontic therapies were adopted before and/or after midface distraction. After the consolidation period, dense new bone was found to have formed in the distraction gap. During the follow-up period, the position of the maxilla and the final occlusal relationship were stable and acceptable, and no obvious relapses were seen. CONCLUSION: Midface distraction is an ideal choice for the correction of severe maxillary hypoplasia secondary to cleft lip and/or palate.- - - - - - - - - - ranking = 2.2584553850806keywords = palate, cleft (Clic here for more details about this article) |
7/12. Dental management of a child with trisomy 9 mosaicism: a case report.This case report presents the dental management of a 13-year-old girl with mosaic trisomy 9. She had: (1) severe psychomotor retardation; (2) short stature; (3) progressive microcephaly; (4) flat feet; (5) genu valgum; and (6) severe kyphoscoliosis. Dysmorphic facial features included: (1) maxillary prognathism; (2) narrow high-arched palate; (3) short philtrum; (4) small low posterior dysplastic ears; and (5) down slanting palpebral fissures with right eye ptosis. The case report describes initial treatment under general anesthesia and further treatments using conscious sedation. Emphasis was placed on the need to adjust the treatment to patient's skeletal malformations and respiratory problems by adjusting her ability to sit in the dental chair in an upright position. Supernumerary premolars and opalescent changes of the maxillary incisors might be part of the clinical features related to trisomy 9 mosaic syndrome.- - - - - - - - - - ranking = 0.1797793407258keywords = palate (Clic here for more details about this article) |
8/12. Cephalometric findings in two cases with unrepaired bilateral cleft lip and palate.Two cases with unoperated bilateral cleft lip and palate were examined clinically and cephalometrically and compared to matched normals. The findings indicate a severe premaxillary skeletal protrusion which results in a maxillary-mandibular discrepancy. The maxillary incisor inclination was acceptable, while the mandibular incisors were relatively more lingually inclined in the cleft group. Surgical management of one case necessitated premaxillary resection.- - - - - - - - - - ranking = 1.7560395607719keywords = palate, cleft (Clic here for more details about this article) |
9/12. Terminal transverse defects with orofacial malformations (TTV-OFM): case report with mandibular prognathism and submucous cleft palate.Terminal transverse defects of varying severity, ranging from aplasia of phalanges and digits to hemimelia, have been reported in association with various orofacial malformation. Temtamy and McKusick (1978) introduced the term "terminal transverse defects with orofacial malformations (TTV-OFM)" as a formal genesis syndrome (etiologically undefined) to include the following clinical entities: (1) aglossia-adactylia syndrome; (2) ankyloglossum (superius) syndrome; (3) Hanhart syndrome; (4) ectrodactyly with OFM; and (5) mobius syndrome with digital malformations (including the Charlie "M" syndrome). This report describes a patient whose phenotypic characteristics qualify for inclusion under this heading, but with facial features somewhat different from those previously reported in the literature including the presence of an eccentric submucous cleft of the hard palate and zona pellucida of the soft palate.- - - - - - - - - - ranking = 5.0404134651937keywords = cleft palate, palate, cleft (Clic here for more details about this article) |
10/12. A second case of microcephaly, microphthalmia, ectrodactyly (split-foot) and prognathism (MMEP).In 1993, Viljoen and Smart described a woman with ectrodactyly of the feet, midline facial cleft, microphthalmia, and mental retardation in association with a de novo chromosome 6;13 translocation. We present a man with similar features who had a normal karyotype.- - - - - - - - - - ranking = 0.14285714285714keywords = cleft (Clic here for more details about this article) |
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