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BDS4 Ortho > Cleft Lip and Palate > Flashcards

Cleft Lip and Palate Flashcards

1
Q

What does OFC stand for?

A
  • Orofacial clefting
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2
Q

What is the classification used for Cleft lip and palate cases? How is it used? exam

A
  • LAHSHAL
  • Lips
  • Alveolar bone
  • Hard palate
  • Soft palate

If on the right hand side use LAHS
If on the left hand side use SHAL
If it has both sides use LAHSHAL

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3
Q

Using the LAHSHAL classification what would the classification of this image be? Why?

A
  • LAHS
  • Includes lips , alveolar bone, hard and soft palate and it is on the right side
  • Use capital letter for full cleft
  • Use little letters for partial cleft
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4
Q

Using the LAHSHAL classification what would the classification of this image be? Why?

A
  • LAHSHAL
  • Extends from lips, alveolar bone, hard and soft palate on both sides
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5
Q

Using the LAHSHAL classification what would the classification of this image be? Why?

A
  • hs
  • Hard palate and soft palate
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6
Q

Is cleft palate more common in males or females?

A
  • More common females
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7
Q

Is cleft lip and palate more common in males or females?

A
  • Males
  • 2:1
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8
Q

What are the different types of cleft lip and palates?

A
  • Unilateral cleft lip
  • Bilateral cleft lip
  • Unilateral cleft lip and palate
  • Bilateral cleft lip and palate
  • Cleft palate
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9
Q

In the UK what is the ratio of UCLP and CP ?

A

UCLP 1:1000
CP 1:2500

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10
Q

What is the aetiology of UCLP?

A

Genetic predisposition
- Syndromes (5% have another syndrome , most common cardiac)
- FH (1 child with it gives 5% of another child with it)
- Sex ratio
- Laterality
- Ethnic dist.

Environment
- Social deprivation
- Smoking (smoking ban reduced CP by 10%)
- Alcohol
- Anti-epileptics
- Multivitamins

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11
Q

What are the 5 implications of UCLP?

A
  • Aesthetics
  • Speech
  • Dental
  • Other anomalies
  • Hearing / Airways
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12
Q

Why is aesthetics an implication of UCLP?

A
  • No health issue with having a cleft lip , pressure it purely put on society to have the surgery
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13
Q

Why is speech an implication of UCLP?

A
  • Soft palate does not close properly therefore does not block the oropharynx
  • Air leaves through the nose making pt hypernasal
  • Makes it hard to make fh and p sounds
  • Pt can also become hyponasal
  • Pt needs to see speech therapist every 6 months to ensure speech developing normally
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14
Q

What other anomalies can be implications for UCLP?

A
  • Cardiac problems are most common
  • Common for external auditory meatus to not form properly due to brachial arch improper neural crest migration
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15
Q

What are the dental implications of UCLP?

A
  • Missing teeth
  • Impacted teeth
  • Supernumerary teeth
  • Hyperplastic teeth
  • Crowded upper arch due to constricted upper arch
  • Rotated teeth
  • High caries rate
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16
Q

What is the most common tooth to be missing in UCLP?

A
  • Lateral incisors
  • Missing premolars also common
17
Q

Why are you likely to get rotated teeth around the cleft palate?

A
  • Not enough bone present to come in straight
  • Comes in at an angle
18
Q

Why are UCLP pt high caries risk?

A
  • Low socioeconomic status
  • Crowding can make it hard to clean
  • Hypoplastic teeth
  • Lower clearance rate and buffering ability
19
Q

What are stages in Patient journey of UCLP?

A
  • 3-6 months lip surgery (compulsory)
  • 9-12 months Cleft palate surgery (compulsory)
  • 8-10yrs alveolar bone graft surgery (compulsory)
  • 12-15yrs Definitive orthodntics
  • 18-20yrs Surgery
20
Q

Why is lip surgery done?

A
  • Aesthetic reasons only
  • Repairs the orbicularis oris so things move properly , can pout
21
Q

What is the IOTN of cleft lip or palate?

A

5p

22
Q

Why is cleft palate surgery done at 9-12 months?

A
  • Babies are obligate nasal breathers before 6 months
  • If do surgery on palate befoe this then blocks breathing
  • 12 months they begin to babble so want to get palate as norm as poss before this
23
Q

What is involved in alveolar bone grafting?

A
  • based on development of teeth into cleft site
  • remove or move teeth in cleft site
  • Bone comes from the hip with 95-99% success rate
  • Place bone graft
  • Canine moves into the bone graft area (need to move tooth in graft area within 3 yrs otherwise it will fail)
24
Q

Who is involved in the MDT for cleft lip and palate pts?

A
  • GDP
  • Paediatric dentist
  • Dental therapist
  • Orthodontist
  • Orthodontic therapist
  • Restorative dentist
  • Oral surgeon
25
Q

What is the role of GDP in cleft lip and palate pts?

A
  • Prevention prevention prevention
  • Txt as normal pt
  • Refer to cleft clinics anytime in their life
26
Q
A

BDS4 Ortho (9 decks)

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