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xD3 Ortho Exam 1 > Cleft Lip and Palate (Redford) > Flashcards

Cleft Lip and Palate (Redford) Flashcards

1
Q

What is the most common craniofacial anomaly requiring complex orthodontic intervention(?

A

Cleft lip and palate

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2
Q

Cleft lip and palate is most common in what racial demographic?

A

Native Americans

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3
Q

What is the order of prevelance racially for cleft lip and palate (CLP) occurrence?

A
  1. Native Americans (most)
  2. Asians (2nd)
  3. Caucasians (3rd)
  4. African-Americans (4th)
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4
Q

What is the rate of occurrence of CLP in Native Americans?

A

1:280

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5
Q

What is the rate of occurrence of CLP in Asians?

A

1:425

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6
Q

What is the rate of occurrence of CLP in Caucasians?

A

1:700

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7
Q

What is the rate of occurrence of CLP in African-Americans?

A

1:1700

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8
Q

What gender is more prone to CLP?

A

Males

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9
Q

If CLP is unilateral, it more commonly occurs on which sid?

A

Left

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10
Q

If CLP is bilateral, on which side is it more severe?

A

Left

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11
Q

What is the most significant etiology for clefts (found in 20-30% of patients with CLP)?

A

Heredity

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12
Q

What are 4 possible teratogens linked to CLP?

A
  1. Steroids
  2. Amphetamines
  3. Anticonvulsants
  4. Alcohol (Fetal Alcohold Syndrome)
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13
Q

What are 2 environmental factors linked to CLP?

A
  1. Radiation

2. Hypoxia

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14
Q

If a parent has a child with a cleft, what is the percent risk subsequent children will also have a cleft?

A

2-4%

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15
Q

If more than one child in a family has a cleft, what is the risk that those siblings, when they have children, will have children with clefts?

A

5-6%

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16
Q

What gender child increases their siblings’ risk for having children with clefts?

A

If the sibling with a cleft is female

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17
Q

Increased age of which: (maternal or paternal?) age is associated with increased frisk for cleft?

A

Increased paternal age

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18
Q

What is risk of child having children with cleft if their parent and sibling had clefts?

A

17%

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19
Q

What results from the failure of fusion of the medial nasal process with the maxillary process?

A

Cleft lip

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20
Q

When does the medial nasal process fuse with the maxillary process during gestation?

A

6 weeks

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21
Q

What results from the failure of the palatine shelves to fuse with each other, with the nasal septum or with the primary palate?

A

Cleft palate

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22
Q

When does fusion on the palatine shelves with each other, with the nasal septum and with the primary palate occur during gestation?

A

7-10 wks

23
Q

What is the most common presentation of Clefting: cleft lip, cleft palate, or combined cleft lip and palate?

A

Combined cleft lip and palate

24
Q

After CLP, which is the next most common cleft?

A

Isolated cleft palate (30%)

25
Q

Which cleft is more associated with syndromes: combined cleft lip and palate or isolated cleft palate?

A

isolated cleft palate (has 50% association with syndrome)

26
Q

What is the total number of syndromes that have associated cleft lip and palate presentation?

A

64

27
Q

What are the 4 most common syndromes associated with CLP?

A
  1. Pierre Robin Syndrome
  2. Sticklet Syndrome
  3. Van der Woude syndrome
  4. Velofacial Syndrome (DiGeorge Syndrome)
28
Q

What syndrome is not hereditary, has no gene defects, and presents with mandibular micrognathia, glossoptosis, and cleft palate?

A

Pierre Robin syndrome

29
Q

What syndrome presents with cleft palate, small jaw, flat face, cataracts, blindness, and can be easy to miss?

A

Stickler syndrome

30
Q

What syndrome characterized by pits of Lower Lip and Cleft lip/and or cleft palate. Due to Chromosome 1 gene mutation?

A

Van der Woude syndrome

31
Q

What syndrome is characterized by cleft palate, heart defects, abnormal facial features, abnormal thymus and underactive parathyroid gland?

A

Velocardiaofacial syndrome (DiGeorge Syndrome)

32
Q

What is the main concern at birth for baby with CLP?

A

The baby is unable to suckle and therefore will fail to thrive

33
Q

How soon does the craniofacial team meet after the birth of a baby with CLP?

A

5 weeks after birth

34
Q

How often does the craniofacial team visit the patient with CLP to check progress and make recommendations?

A

Approximately once a year

35
Q

How old is a baby with CLP when the primary lip repair is done?

A

10 weeks

36
Q

How old is a baby with CLP when cleft palate repair is done?

A

10-18

37
Q

When is an alveolar bone graft done for a pt with CLP and why?

A

At 9-11 yrs old

Before maxillary canine eruption to prevent canine erupting into cleft

38
Q

What is the rule of 10s for primary cleft lip surgery?

A

10 weeks
10 lbs
At least 10 hemoglobin count

39
Q

Is primary cleft lip surgery the final cleft lip surgery?

A

No, passive surgery so growth not compromised due to scarring. Final lip repair completed once growth completed

40
Q

Which muscle is affected in Cleft palate?

A

Medial levator palatine muscle

41
Q

What is the goal of cleft palate repair?

A

To close the oronasal communication from the incisive foramen to uvula
To create dynamic soft palate musculature to aide normal speech

42
Q

What is done to narrow the area air passes between oral and nasal cavity by joining parts of the soft palate with the posterior pharyngeal wall. Goal is to reduce the hypernasal voice during production of pressure sounds?

A

Pharyngeal Flap

43
Q

Why is there only a 75% success rate for pharyngeal flap surgery?

A

Patients have already learned to speak a certain way

44
Q

Is an alveolar bone graft done prior to or after expansion(Phase I orthodontics)?

A

Graft after expansion

45
Q

What is the healing time for alveolar bone graft?

A

6 months

46
Q

What percentage of CLP pts that will have a midfacial deficiency that can be corrected by orthognathic surgery?

A

20-30% of patients

47
Q

What are the most common teeth affected in CLP?

A

Lateral incisors

48
Q

Is bone grafting indicated prior to canine eruption?

A

Yes, it improves canine bony support

49
Q

How often is the lateral incisor either missing or dysmorphic in CLP?

A

Two-thirds of the time

50
Q

What can be done for missing lateral incisors in CLP?

A

Canine substitution

51
Q

What is the phase I orthodontics for CLP?

A

Expansion prior to alveolar grafting

52
Q

Patients with CLP are usually what Angle class and why?

A

Class III

Deficient maxilla growth

53
Q

What is the phase II orthodontics option for CLP?

A

Definitive orthodontic treatment, possible orthognathic surgery

54
Q

Why does a CLP palate need expansion?

A

It is V-shaped. Any V-shaped palate needs expansion.

xD3 Ortho Exam 1 (5 decks)

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