Orofacial Clefts Flashcards
What is orofacial cleft?
- Failure of lip and palate tissues to close during embryonic development
- Present at birth
- Malformation, deformation, or disruption in one or more parts of the body
- Has a serious, adverse effect on health, development, or functional ability
- Most common: in American indians, Whites, Asains
- Least Common: African Americans
- Males: Lip and palate (mostly)
- Females: Cleft palate only
What are the causes of nonsyndromic (isolated) cleft ?
- inherited (Genetics)
- Environmental (Teratogens): Gestational diabetes
- Protective: maternal education level of bachelors degress and prenatal care
What are the causes of syndromic clefts?
- Associated with other congenital disorders or syndromes
What are the causes of pierre robin sequence?
- Cleft palate
- Micrognathia (small mandible)
- Glossopotosis (airway obstruction caused by
tongue displacement).
What is the embryology ?
Upper lip forms 5th week
Palate forms 5-12 week
Lip Cleft: Chelioschisis
Palate Cleft: Palatoschisis
Fusion failure: late movement of lateral palatine process
What orofacial clefts ais most severe?
Bilateral complete CLP
What are the medical management ?
Primary Surgery / Repair
* Chelioplasty between 3-12 months
* Palatoplasty between 9-18 months
* Nasoalveolar molding appliance
Oral Appliances
* Obturators, palatal lift, speech bulb
Secondary
* Cosmetic, reconstructive, orthognathic
What are the dental management ?
Collaboration with interprofessional team
Educate and understand complications
What are the oral manifestations?
Malocclusion Class III
Open palate
Maxillary growthrestriction
Congenitally missing and supernumerary teeth
Teeth morphologically deformed, hypoplastic,
hypomineralized
Increase caries risk in primary dentition
(maxillary incisors, teeth adjacent to cleft, molars)
Oral prostheses effects: gingival
inflammation, recession
