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ORTHO > Cleft lip and palate > Flashcards

Cleft lip and palate Flashcards

1
Q

what is the primary palate made up of?

A

lip
alveoulus
palate- anterior to incisive foramen

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2
Q

what is the secondary palate made up of?

A

soft and hard palate up to the incisive foramen

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3
Q

how can clefts of the primary palate be classified?

A

1- unilateral complete or incomplete

2- bilateral complete or incomplete

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4
Q

how can clefts of the secondary palate be classified?

A

1- complete
2-incomplete
3- submucous

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5
Q

how can clefts of the primary and secondary palate be classified?

A

unilateral or bilateral - complete or incomplete

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6
Q

what is the incidence of both cleft lip and palate?

A

1 in 750

2:1 male:famale

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7
Q

what is the incidence of just cleft lip?

A

1 in 2000

1:2 male: female

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8
Q

what is the most common form of cleft?

A

isolated cleft lip

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9
Q

what is the least coming for of cleft?

A

bilateral cleft lip and palate

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10
Q

what syndromes may be associated with cleft lip and palate?

A

pierre robin
aperts
crouzons

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11
Q

what are genetic causes of clefts?

A

shortened palatal shelves

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12
Q

what environmental factors can contribute to clefts?

A 
maternal alcohol
smoking
anticonvulsant drugs
folic acids deficiency
steroid therapy
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13
Q

what is the risk for offspring if a parent is affected with cleft lip and palate?

A

40% incidence in offspring

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14
Q

what is the risk for subsequent offspring if first child of unaffected partents has cleft?

A

1 in 20

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15
Q

how does the genetic component differ between cleft lip and cleft lip and palate?

A

lesser genetic component in just cleft lip

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16
Q

When does the development of the face and upper lip begin?

A

5-9 week IU

17
Q

how does the lip normally form?

A

maxillary processes fuse together

18
Q

how does the palate form?

A

palatal processes of the maxillary processes fuse 6-11th week IU

19
Q

when do tooth germs develop?

A

7th week IU

20
Q

what defects may appear in teeth where clefts are present?

A 
duplication of tooth types
malformed roots/crowns
enamel hypoplasia
hypodontia
ectopic teeth
21
Q

what other problems may sufferers of clefts experience?

A 
feeding problems
hearing difficulties
speech difficulties
emotional problems
dental anomolies
22
Q

Why may issues occur with feeding?

A

child may be unable to create adequate negative intra oral pressure
results in extended feeding times and reduced nutritional intake

23
Q

what device can help feeding in children with clefts?

A

haberman feeders

24
Q

Why are problems with hearing often associated?

A

problems can occur with middle ear ventilation or Eustachian tubes

25
Q

palatal surgery can also help what function?

A

Eustachian tube function

26
Q

How can speech be adversely affected?

A

fistulae or soft palate may not make contact with pharynx

poor speech often comes secondary to poor hearing

27
Q

what can aid speech?

A

SALT

Electropalatography EPG

28
Q

what order does specialist treatment come in?

A

birth- parental councilling and feeding advice
3 months- lip repair
6-12 months- palate repair
SALT and ENT
mixed dentition- preventative advice and ortho Ax
8.5-10 year- expansion and alveolar bone grafting
permanent dentition- definitive ortho, orthognatic surgery and plastics

29
Q

what pre surgery orthopaedics can be carried out?

A

URA
prevent tongue sitting in cleft
encourages lateral palatal shelf growth
aids feeding in infants

30
Q

describe lip repair surgery

A

carried out at 3 months

dissect and re oppose muscles of lip and alar base

31
Q

why is minimal dissection important in lip repair surgery?

A

so scarring is limited and growth not further limited

32
Q

describe palatal surgery

A

carried out 6-12 months

aims to separate nasal and oral cavity

33
Q

what issues may be seen in the mixed dentition?

A 
delayed eruption
hypodontia
general smaller tooth size
abnormalities in tooth size and shape
enamel defects
34
Q

what role does orthodontics take re. clefts?

A

provision of pre surgery orthopaedics
from 6 years- alignment of maxillary dentition and correction of cross bites
provision of obturators

35
Q

what preparation should be taken prior to alveolar bone grafting

A

removal of any supernumeraries or decisuous teeth prior to surgery
pre surgery expansion in maxillary segments
allignement of upper anteriors with FA during expansion

36
Q

where is bone sourced for bone grafting?

A

cancellous bone is used
iliac crest
tibia
cranial cancellous bone

37
Q

what definitive ortho should be carried out in permanent dentition?

A

FA if no skeletal discrepancies

if Skeletal discrepancy- orthagnatic surgery when growth has ceased

38
Q

what ortho surgery is commonly required?

A

maxilla is often required to be expanded due to inhibited growth

ORTHO (9 decks)

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