Ortho - Lecture 17: Cleft Lip and Palate Flashcards
Most common facial/oral congenital anomalies
Cleft lip and palate
Cleft lip and palate ratios
Cleft lip -> male to female 3:2
Cleft palate -> female to male 2:1
T/F: Older women have a higher incidence of giving birth to a cleft lip/palate child
True
(over age 35 doubles the risk, over age 39 triples the risk)
Cleft lip only
Class I
Cleft of secondary palate only
Class II
Cleft of lip, alveolus, and palate
(complete cleft lip and palate)
Class III
Cleft of lip and alveolus
(primary cleft palate and lip)
Class IV
Miscellaneous group; includes clefts which do not fit into class I-IV
Class V
Failure of the maxillary process and medial
nasal process to fuse
Cleft lip
When does the maxillary process and medial nasal process normally fuse? (ON EXAM)
Week 6
Failure of the palatal shelves to meet and
fuse
Cleft palate
When do the palatal shelves normally fuse?
Begins at week 7/8
Completes by week 10
What are the 3 main causes of cleft lip/palate?
Syndromic
Familial
Isolated or non-familial
What are the complications associated with cleft lip/palate?
Bonding issues
Feeding difficulties
Ear infection + hearing loss
Speech/language delay
Dental issues
Psychosocial issues
T/F: Tx occurs in surgical/non-surgical stages from birth to young adulthood
True
What is the first surgical intervention?
Primary lip closure
What rule is applied during the first surgical intervention?
Rule of 10
What is the rule of 10?
10 weeks
10 lbs
10 mg hemoglobin
What is the second surgical intervention?
Surgery to close hard and soft palate
When is the second surgical intervention completed?
12-18 months
What is the major concern for the second surgical intervention?
Speech development
What can be used to proximate the primary palate prior to the first surgical intervention?
Orthopedic force
(an ortho device)
Surgery to control airflow to improve speech, generally done at age 4
Pharyngeal flap surgery
Ortho intervention is done to prepare the cleft site to receive a ________ ________
bone graft
What are the donor sites for bone grafting?
Alveolar
Iliac crest
Cranial
Timing for ortho intervention is associated with what?
Eruption of permanent canine
(ideal = 1/3 of canine root is formed)
What is the goal of ortho intervention?
Permanent canine erupt through bone graft
Which tooth is generally missing?
Lateral incisor adjacent to cleft
What jaw pattern do cleft lip/palate patients typically have?
Class III
