Orthodontic Treatment Of Cleft Lip And Palate
Write short note on orthodontic management of cleft lip and palate.
Answer.
Orthodontic Management of Cleft Lip and Cleft Palate
The orthodontic management of clef lip and clef palate consist of following stages, i.e.:
“Understanding orthodontic care for cleft lip and palate”
Stage 1: Infancy Stage
- Predental treatment/pre-surgical orthopedics:
- Pre-surgical orthopedic appliances:
- The aim of pre-surgical orthopedic is to align the displaced clef segments.
- Lip repair is carried out at about 3 months and clef palate is carried out at 9-18 months.
- A passive feeding appliance incorporated with acrylic or wire wings.
- Duyzing plate is used for patients with cleft of hard and soft palates. Hard palate is blocked and a soft acrylic extension is used to cover the sof palate defects.
- Extraoral strapping: The main objective of the extraoral strapping is to reposition the premaxillary portion of jaw by means of pressure from extraoral strapping when an appliance is worn in the mouth.
- Feeding plates are used which assist in feeding by closing oronasal fitula. These are removable appliances.
“Importance of early orthodontic intervention for cleft cases”
Stage 2: During Deciduous Dentition
- Orthodontic treatment should not be undertaken because of its limited advantage at this stage.
- Permanent incisors erupts rotated and are in crossbite. This is corrected by using removable appliances.
Stage 3: During Mixed Dentition
- Treatment of cleft lip and cleft palate during early mixed dentition: Permanent incisors may erupt into linguo-occlusion. This should be corrected if feasible but may be delayed until the next phase of development.
- Treatment of cleft lip and cleft palate during mid-mixed dentition: If an alveolar clef is evident, secondary alveolar bone graft is routinely performed at age of 9–10 years.
“Role of orthognathic surgery in cleft lip and palate treatment”
Stage 4: During Permanent Dentition
- Fixed orthodontic treatment is started at this era.
- In the missing tooth areas space closing is done by bone grafting.
“Treatment options for cleft lip and palate orthodontics”
After Growth Completion
- Preadjusted edgewise appliances should be used for positioning of teeth.
- Impacted teeth should be brought in the arch.
- For redirecting mandibular regrowth chin cup is employed.
Maxillary protraction is done by orthognathic surgery.
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