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ortho year 4 > Cleft lip and palate > Flashcards

Cleft lip and palate Flashcards

1
Q

Prevalence?

A

Most common craniofacial abnormality – 1 in 700 births (approx)
*Approx 30 cases born per year in N.I.

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2
Q

Different presentations of cleft lip palate?

A

Lip only
*Palate only
*Complete unilateral
*Complete bilateral
*Submucous cleft (bifid uvula + nasal speech

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3
Q

Cleft Lip & Palate: Anatomical Aspects-
what problems does the patient have due to CLP

A

Presentation related to abnormal embryology

*Dental problems (alveolus)

*Orthodontic problems

*Speech problems (soft palate)

*Appearance (lip, facial growth)

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4
Q

Presentation related to abnormal embryology

what structures does cleft lip palate affect?
surgery can?…

A

Can affect lip, alveolar process, hard palate, soft palate
*Surgery can (partially) correct disrupted anatomy

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5
Q

Dental problems (alveolus)

A

Missing teeth and supernumerary (extra) teeth- due to disruption of the dental lamina

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6
Q

Orthodontic problems

A

(alveolus, hard palate)
Problems with facial growth

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7
Q

dont need to know the weeks skip past all this section Development of the face key stages occur between weeks

A

7 and 10

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8
Q

Lateral nasal prominence in week 7 turns into what by week 10

A

Nasolacrimal groove

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9
Q

Medial nasal prominence in week 7 turns to what by week 10

A

Philtrum

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10
Q

What is the intermaxillary segment and what components are there

A

Deep part of medial nasal prominences
Labial component
Upper jaw component
Palatal component

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11
Q

Key embryological features week 6 and week 7

A

Nasal septum
Nasal chamber
Primary palate
Palatine shelf
Tongue

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12
Q

Week 10 what has developed

A

Nasal conchae
Fused palatine shelves
Incisive foramen
Uvula

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13
Q

Cleft palate diagnostic aid

A

Pre natal ultrasonic scanning

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14
Q

Problems for CLP patients immediate?

A

Feeding
*Speech development
*Effects of surgery (growth/hearing)
*Dental

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15
Q

Problems for CLP patients long term?

A

Acceptance by peers
*Multiple hospital visits
*20 alveolar cleft
*May need jaw surgery
*Will need orthodontic treatment

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16
Q

CLP: Early problems (after birth)

A

Feeding
Modified teats to bottles
Feeding plate
Nasogastric tube

*Repair of lip
Rule of 10s - 10/52, Hb 10g, 10lbs

17
Q

Intermediate Problems (until age 10)

A

Palate closure (12-18 months)
*To allow speech development

*Speech therapy & hearing testing – ENT

*Dental supervision & treatment

*Family support & counselling
*Alveolar cleft grafting – age 9-10

18
Q

In order to treat CLP…what must be carried out?

A

Repair of Levator Veli Palatini muscle

19
Q

What are the Dental Problems?

A

Growth restriction in upper jaw
*Bone defect in alveolar process in cleft
*Disruption of the dental lamina
*Distorted (narrow) upper dental arch form

20
Q

Disruption of dental lamina causes?…

A

Missing teeth (“Hypodontia”) – upper lateral incisors
*Extra teeth (“Supernumerary Teeth”)
*Malformed/hypoplastic teeth
*Delayed dental development

21
Q

Other problems?

A

Orthodontic problems

22
Q

Maxillary Growth
Describe the issue

A

*Maxillary Retrognathia (Class III skeletal) aka maxillary growth restriction
*maxilla is underdeveloped

23
Q

Maxillary growth in terms of surgical?

A

Surgical scarring and/or congenital aetiology
*Growth restriction highly correlated with surgical technique: scarring, incisions and denuded bone.
*Can be corrected by surgical maxillary advancement

24
Q

Alveolar Cleft Grafting (approx age 10)
Describe how

A

fill the bony defect
*Allow eruption of the canine tooth
*close any oronasal fistulas
*provide support for the alar base of the nose

25
Q

What age alveolar cleft grafting

A

10

26
Q

What age pre graft orthodontics

A

8/9

27
Q

Pre graft orthodontics (age 8/9) is the

A

Restoration of the normal shape of the upper jaw

28
Q

Usually involves

A

transverse expansion of the upper jaw

*Correction of upper incisors which are behind the bite (class III incisor correction)

29
Q

Overview of pre graft orthodontics

A

On average 6-8 months of treatment with orthodontic appliances (braces)

30
Q

Class III incisor correction is done by

A

Double cantilever Z spring
0.5mm stainlsteel wire

31
Q

After pre graft ortho ?

A

Alveolar bone graft
Followed by
Final phase of orthodontics

32
Q

Final phase of orthodontics done at age

A

12/14 years

33
Q

Final phase of orthodontics (age 12/14) entails

A

Fixed orthodontic appliances 18-24 months
*Extractions may be required
*May need orthognathic surgery if severe maxillary growth restriction
*Replacement of missing teeth
*Bridges
*Dental implants

ortho year 4 (11 decks)

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