Cleft Lip/Palate Flashcards
Cleft lip is more common in what gender?
Boys
Isolated cleft palate is more common in what gender?
Girls
What side is it more common to see a cleft?
Left
What fraction of clefts are unilateral?
3/4
Embryologically, this moves down so that the palatine shelves can come together horizontally.
Tongue
Failure of the tongue to descend can cause this.
Cleft palate.
A second child with a cleft parent has what % chance of having a cleft?
15
Familial role of cleft palate in what percent of cases?
20-30%
Most common environmental cause of cleft palate.
Alcohol use while pregnant.
Most clefts are secondary to what?
Environmental exposure, and NOT because of genetics.
An environmental exposure at or before this period causes clefts.
6 weeks
Environmental causes of clefts.
- Drugs (corticosteroids and alcohol)
- Nutritional deficiencies
- Radiation
- Hypoxia
- Viral infection
Cleft babies often grow to have scarring on the maxilla, which causes this Angle malocclusion.
Type 3
Dental problems associated with clefts.
- Congenitally missing lateral or cuspid.
- Supernumerary teeth.
- Morphogenic dental problems.
Ear problems develop in cleft patients bc of this.
- Levator and tensor veli palatini muscles don’t form properly.
Problems associated with clefts.
- Nasal deformity.
- Feeding difficulties.
- Ear problems
- Speech problems.
Cleft babies have trouble eating bc they can’t form this pressure in their mouth.
Negative pressure
Used to help cleft patients eat.
Haberman feeder
Velopharyngeal insufficiency causes this kind of speech in cleft patients.
Hypernasal
These sounds are improper in cleft patients.
Consonant
When are cleft lips repaired?
“Rule of 10”
- 10 weeks old
- 10 lbs
- 10 g Hb/ deciliter of blood
At what age is the palate fixed?
18-24 months
At what age is primary bone grafting done?
8-12 months old
Source of bone graft in primary bone grafting?
Rib
What does primary bone grafting prevent?
Maxillary arch collapse
A boneless bone graft.
Periosteoplasty
This may be done at the time of lip closure.
Periosteoplasty.
Secondary bone grafting is done at what age?
6-15 years old
Secondary bone grafting provides bone for what?
The dentition
This bone grafting PREVENTS maxillary arch collapse.
Priamry
This bone grafting DOES NOT prevent maxillary arch collapse.
Secondary
This bone grafting provides continuity of the alveolar ridge.
Secondary
Want to place the secondary bone graft before what?
Permanent adjacent teeth erupt.
How much root formation do you want the permanent adjacent teeth to have when you do the seconadry bone graft?
1.3-1/2 root formation
Donor site of secondary bone graft.
- Iliac crest
- Cranial bone
- Mandibular symphysis
- Allogeneic bone
- Fresh autogenous bone
This bone graft material is the most successful at the recipient site.
Fresh autogenous particulate cancellous
When is correction surgery performed?
Skeletal maturity
Skeletal maturity for females
14-16 years old
Skeletal maturity for males.
16-18 years old
