Orthodontic treatment and management of adult patient with cleft lip and palate

성인 구순구개열환자의 교정치료 및 관리

  • Kim, Seong Sik (Department of Orthodontics, School of Dentistry, Pusan National University)
  • 김성식 (부산대학교 치의학전문대학원 치과교정학교실)
  • Received : 2015.06.19
  • Accepted : 2015.06.25
  • Published : 2015.07.01

Abstract

Patients with cleft lip and palate require interdisciplinary treatment to achieve successful rehabilitation. However, there are special difficulties in orthodontic treatment of adult cleft lip and palate patients: 1. Lack of Tissue, Bone, and Soft tissue; 2. Heavy Scar Tissue, Vestibule, and Palate; 3. Severe Anteroposterior discrepancy and Impaired Maxilla; 4. Distortion of Alveolar Ridge; 5. Abnormal Eruption Path and Malalignment of Tooth. Solving these problems, orthodontist should have differential diagnosis on extent of cleft site and residual deformities of adult cleft lip and palate patient. The tooth missing area in cleft site was commonly treated with a removable or fixed prosthesis, but this method is not stable to retain maxillary arch shape. To establish the more stable arch shape in cleft lip and palate, endosseous implants in the alveolar clefts with bone graft is helpful for management of adult cleft lip and palate patient.

Keywords

Acknowledgement

Supported by : Pusan National University Dental Hospital

References

  1. Cooper HK, Long RE Sr., Long RE Jr. and Pepek JH. Orthodontics and Oral orthopedics. In Cooper HK et al, ed. : Cleft palate and cleft lip-A team approach to clinical management and rehabilitation of the patient, Philadephia, WB Saunders Co., 358-429, 1979.
  2. Jacobson BN, Rosenstein SW. Cleft lip and palate : The orthodontist's youngest patients. Am J Orthod Dentofac Orthop 1986;90:63-66. https://doi.org/10.1016/0889-5406(86)90028-4
  3. 양원식, 손우성, 백승학. 알기 쉬운 순, 구개열 이야기. 서울: 지성출판사, 2001.
  4. 손우성. 구개 파열자의 상악치궁 회복에 관한 임상적 고찰. 대한치과의사협회지 1993;31:911-919.
  5. Evans CA. Orthodontic treatment for patients with clefts. Clin Plastic Surg 2004;31:271-290. https://doi.org/10.1016/S0094-1298(03)00125-1
  6. Collins M, James DR, Mars M. Alveolar bone grafting: a review of 115 patients. Eur J Orthod 1998;20:115-20. https://doi.org/10.1093/ejo/20.2.115
  7. Bergland O, Semb G, Abyholm RE. Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment. Cleft Palate J 1986;23:175-205.
  8. Kalaaji A, Lilja J, Friede H. Bone grafting at the stage of mixed and permanent dentition in patients with clefts of the lip and primary palate. Plast Reconstr Surg 1994;93:690-696. https://doi.org/10.1097/00006534-199404000-00005
  9. Mackay D, Mazahari M, Graham WP, Jeffords K, Leber D, Gorman P, Lieser JD, Wrye S, Kutz R, Saggers G. Incidence of operative procedures on cleft lip and palate patients. Ann Plast Surg 1999;42:445-448. https://doi.org/10.1097/00000637-199904000-00017
  10. Cohen SR, Corrigan M, Wilmot J, Trotman CA. Cumulative operative procedures in patients aged 14 years and older with unilateral or bilateral cleft lip and palate. Plast Rec Surg 1995;96:267-271. https://doi.org/10.1097/00006534-199508000-00003
  11. Bardach J, Morris HL, Olin WH, McDermott-Murray J, Mooney M, Bardach E. Late results of multidisciplinary management of unilateral cleft lip and palate. Ann Plast Surg 1984;12:235-242. https://doi.org/10.1097/00000637-198403000-00004
  12. Bardach J, Morris HL, Olin WH, Gray SD, Jones DL, Kelly KM, Shaw WC, Semb G. Results of multidisciplinary management of bilateral cleft lip and palate at the Iowa Cleft Palate Center. Plast Rec Surg 1992;89:419-435. https://doi.org/10.1097/00006534-199203000-00004
  13. Cohen M. Residual deformities after repair of clefts of the lip and palate. Clin Plastic Surg 2004;31:331-345. https://doi.org/10.1016/S0094-1298(03)00133-0
  14. Daw JL, Patel PK. Management of alveolar clefts. Clin Plastic Surg 2004;31:303-313. https://doi.org/10.1016/S0094-1298(03)00129-9
  15. Dempf R, Teltzrow T, Kramer FJ, Hausamen JE. Alveolar bone grafting in patients with complete clefts: a comparative study between secondary and tertiary bone grafting. Cleft Palate Craniofac J 2002;39:18-25. https://doi.org/10.1597/1545-1569(2002)039<0018:ABGIPW>2.0.CO;2
  16. Korayem M, Flores-Mir C, Nassar U, Olfert K. Implant site development by orthodontic extrusion: a systematic review. Angle Orthod 2008;78:752-760. https://doi.org/10.2319/0003-3219(2008)078[0752:ISDBOE]2.0.CO;2
  17. Pena WA, Vargeryik K, Sharma A, Oberoi S. The Role of Endosseous Implants in the Management of Alveolar Clefts. Pediatr Dent 2009;31:329-333.
  18. Kramer FJ, Baethge C, Swennen G, Bremer B, Schwestka-Polly R, Dempf R. Dental implants in patients with orofacial clefts: a long-term follow-up study. Int J Oral Maxillofac Surg 2005;34:715-721. https://doi.org/10.1016/j.ijom.2005.04.014
  19. Wang F, Wu Y, Zou D, Wang G, Kaigler D. Clinical outcomes of dental implant therapy in alveolar cleft patients: a systematic review. Int J Oral Maxillofac Implants 2014;29:1098-1105. https://doi.org/10.11607/jomi.3585