Dental care for cleft lip and palate Flashcards
What is the UK incidence of cleft lip +/- palate?
1:700 livebriths
1000 new cases per year
What are the classifications of cleft lip+/- palate?
soft palate soft and hard palate cleft lip cleft lip and alveolus cleft lip and palate
Is cleft lip +/- palate more common in girls or boys?
Boys
Is cleft palate more common in girls or boys?
girls
T/F. Cleft palate is associated with a wide range of chromosomal abnormalities? what is the percentage and wha are the syndromes?
True 15% are associated with other syndromes sticklers van der woudes pierre robin di george 22q and VCFS more than 400 syndromes
In which race is cleft lip +/- palate most common?
Indian and oriental subpopulations
Are right or left sided clefts more common?
Left
What are the two phases of palatogenesis?
- Primary palate - lip and alveolus
2. Secondary palate - hard and soft palate
At what stage in utero does palatogenesis take place?
5-12 weeks in utero
What occurs in the formation of the primary palate?
fusion of the maxillary and median nasal processes
What occurs in the formation of the secondary palate?
shelf formation
shelf elevation
shelf fusion
How do the palatal shelves fuse?
MEDIAL EDGE EPITHELIUM DEGENERATION
there is programmed cell death, cell migration and epithelial mesenchymal transformation
What are the causes of cleft lip+/- palate?
- Genetic predisposition
- associated with chromosomal abnormalities
- Teratogens
- increased paternal age
- maternal smoking/rubella
What surgical procedures are there to reduce clefts?
- Lip repair (3months): correct muscle layer, aesthtics, functionals appliance eg milliard, delaire
- Palate repair (6/9-12 months): close the palate to achieve velopharyngeal competance where ONF closed for speech
- Alveolar bone graft (8-9 years)
- Pharyngoplasty
- orthognathic surgery
- Lip adhesions
- Lip revision
- Nasal surgery
Additional problems for patients with clefts?
speech and hearing defects
up to 20% have additional abnormalities such as skeletal/cardiac/renal/CNS