Ortho - Lecture 17: Cleft Lip and Palate

Question 1

Most common facial/oral congenital anomalies

Answer 1

Cleft lip and palate

Question 2

Cleft lip and palate ratios

Answer 2

Cleft lip -> male to female 3:2

Cleft palate -> female to male 2:1

Question 3

T/F: Older women have a higher incidence of giving birth to a cleft lip/palate child

Answer 3

True

(over age 35 doubles the risk, over age 39 triples the risk)

Question 4

Cleft lip only

Answer 4

Class I

Question 5

Cleft of secondary palate only

Answer 5

Class II

Question 6

Cleft of lip, alveolus, and palate

(complete cleft lip and palate)

Answer 6

Class III

Question 7

Cleft of lip and alveolus

(primary cleft palate and lip)

Answer 7

Class IV

Question 8

Miscellaneous group; includes clefts which do not fit into class I-IV

Answer 8

Class V

Question 9

Failure of the maxillary process and medial
nasal process to fuse

Answer 9

Cleft lip

Question 10

When does the maxillary process and medial nasal process normally fuse? (ON EXAM)

Answer 10

Week 6

Question 11

Failure of the palatal shelves to meet and
fuse

Answer 11

Cleft palate

Question 12

When do the palatal shelves normally fuse?

Answer 12

Begins at week 7/8
Completes by week 10

Question 13

What are the 3 main causes of cleft lip/palate?

Answer 13

Syndromic
Familial
Isolated or non-familial

Question 14

What are the complications associated with cleft lip/palate?

Answer 14

Bonding issues
Feeding difficulties
Ear infection + hearing loss
Speech/language delay
Dental issues
Psychosocial issues

Question 15

T/F: Tx occurs in surgical/non-surgical stages from birth to young adulthood

Answer 15

True

Question 16

What is the first surgical intervention?

Answer 16

Primary lip closure

Question 17

What rule is applied during the first surgical intervention?

Answer 17

Rule of 10

Question 18

What is the rule of 10?

Answer 18

10 weeks
10 lbs
10 mg hemoglobin

Question 19

What is the second surgical intervention?

Answer 19

Surgery to close hard and soft palate

Question 20

When is the second surgical intervention completed?

Answer 20

12-18 months

Question 21

What is the major concern for the second surgical intervention?

Answer 21

Speech development

Question 22

What can be used to proximate the primary palate prior to the first surgical intervention?

Answer 22

Orthopedic force

(an ortho device)

Question 23

Surgery to control airflow to improve speech, generally done at age 4

Answer 23

Pharyngeal flap surgery

Question 24

Ortho intervention is done to prepare the cleft site to receive a ________ ________

Answer 24

bone graft

Question 25

What are the donor sites for bone grafting?

Answer 25

Alveolar Iliac crest Cranial

Question 26

Timing for ortho intervention is associated with what?

Answer 26

Eruption of permanent canine (ideal = 1/3 of canine root is formed)

Question 27

What is the goal of ortho intervention?

Answer 27

Permanent canine erupt through bone graft

Question 28

Which tooth is generally missing?

Answer 28

Lateral incisor adjacent to cleft

Question 29

What jaw pattern do cleft lip/palate patients typically have?

Answer 29

Class III