Multi Disciplinary Approach To Cleft Lip and Palate / Orthodontic Courses by Indian Dental Academy

Multi disciplinary
approach to cleft lip and

palate

INDIAN DENTAL ACADEMY

Leader in continuing dental education
www.indiandentalacademy.com

CONTENTS

1. Introduction
2. Embryological aspect
3. Classification of cleft lip and palate
4. Anatomy of cleft lip and palate
5. Role of various specialities
a. Pediatrician
b. speech therapist
c. orthodontist
d. oral and maxillofacial surgery
6. Feeding difficulties
7. Presurgical orthopaedics

8. Surgical aspect
9. Alveolar bone grafting
10. Orthognathic surgery
11. Distraction osteogenesis
12. Conclusion
13. References
INTRODUCTION

EMBRYOLOGY
The first pharyngeal arch (mandibular arch),
develops two prominences:
The maxillary prominence
The mandibular prominence
As the medial nasal prominences merge with the maxillary
prominence, they form an intermaxillary segment.
The intermaxillary segment gives rise to :-
1. philtrum of the upper lip.
2. The premaxillary part of the maxilla
3. The primary palate.

PALATE EMBRYOLOGY

DAVIS AND RITCHIE CLASSIFICATION
(1922):
They classified congenital clefts based on the position of the
cleft in relation to the alveolar process.

Group I-Pre alveolar clefts Lip
clefts only with subdivisions for
unilateral, median, bilateral.

Group II-Post alveolar clefts
degrees of involvement of soft and
hard palate to be specified till the
alveolar ridge, submucous clefts
included.

Group III-Alveolar clefts is
complete clefts of palate, alveolus
ridge and lip with subdivisions for
unilateral, median, bilateral.

VEAUS CLASSIFICATION
(1931):

Group I - Cleft of soft
palate only

Group II - Cleft of hard and
soft palate, extending no
further than the incisive
foramen thus involving the
secondary palate alone.

Group III - Complete
unilateral cleft of soft and
hard palate, lip and
alveolar ridge

Group IV - Complete
bilateral cleft of soft and
hard palate, lip and
alveolar ridge on both
sides.


FOGH ANDERSON CLASSIFICATION (1942)

A) Hare lip includes alveolus
& as for back as
incisive foramen

B) Hare lip & cleft palate

C) Isolated cleft of the palate as
forward as the incisive foramen
KERNAHAN & STARKS CASSIFICATION
OF CLEFTS

A. Clefts of primary palate
1. Unilateral (r/ l)
complete
incomplete

2. Median
complete (premaxilla absent)
incomplete (premaxilla rudimentary)

3. Bilateral
complete
incomplete

B) Clefts of secondary palate only
complete
incomplete
submucous

C) Clefts of primary and secondary palate
1. unilateral ( r / l )
complete
incomplete

2. median
complete
incomplete

3. bilateral

complete
incomplete
KERNAHANS STRIPED Y
CLASSIFICATION (1971):

In this classification the incisive
foramen is taken as the reference
point
Y logo are each divided into three
sections, representing the lip, the
alveolus and the hard palate as far
back as the incisive foramen. The
stem of the Y is also divided into
three parts, representing varying
degrees of clefting of the hard and
soft palates.
MILLARDS CLASSIFICATION
(1977):

A modification of
Kernahans striped Y
classification.
. The inverted triangles
represent the nasal arch the
upright triangles represent
the nasal floor.

CLEFT ANATOMY
Unilateral cleft lip

Bilateral cleft lip

Role of various
specialities
NEONATES TO 2 YEARS
PEDIATRICIANS ROLE
ORTHODONTISTS ROLE
SPEECH THERAPIST ROLE
SURGEONS ROLE
FEEDING DIFFICULTIES
PRESURGICAL ORTHOPEDICS
PRIMARY DENTITION PERIOD

MIXED DENTITION PERIOD

PERMANENT DENTITION PERIOD

SURGICAL TECHNIQUES
Cleft lip
Timing of surgery

History

Techniques

Unilateral cleft lip
Millards rotationadvancement
technique

Bilateral cleft lip

Cleft palate
Timing of surgery
History

Primary and secondary palate

Von Langenbeck procedure
Secondary palate

ALVEOLAR BONE GRAFTING(ABG)
ORTHOGNATHIC SURGERY/
DISTRACTION OSTEOGENESIS

SECONDARY SURGERIES

CONCLUSION

Refernces
PLASTIC SURGERY. Vol.4. Cleft lip & palate and Craniofacial
Anomalies edited by Joseph C. McCarthy. W. B. Saunders 1990
Grabb and Smiths PLASTIC SURGERY. edited by Aston, Beasly and
Thoma. Lippincott-Raven 1997.
Textbook of Plastic, Maxillofacial and Reconstructive Surgery.
Volume I. Part III. Head and Neck. G. S. Georgiade, N. G.
Georgiade, R. Riefkohl, W. T. Barwick (eds). 1992.
Complete management of cleft lip and palate. edited by Dr. N. S.
Gopalakrishnan
Human Embryology. Inderbir Singh 6
th
edition 1996.
Surgery of Mouth and Jaws. edited by J. R. Moore 1985
Textbook of Oral and Maxillofacial Surgery. Gustav O. Kruger; 6
th

edition; 1984.
Starks PLASTIC SURGERY. 1974.


Thank you

For more details please visit


Multi Disciplinary Approach To Cleft Lip and Palate / Orthodontic Courses by Indian Dental Academy

Încărcat de

Informații document

Titlu original

Drepturi de autor

Formate disponibile

Partajați acest document

Partajați sau inserați document

Opțiuni de partajare

Vi se pare util acest document?

Este necorespunzător acest conținut?

Drepturi de autor:

Formate disponibile

Multi Disciplinary Approach To Cleft Lip and Palate / Orthodontic Courses by Indian Dental Academy

Încărcat de

Drepturi de autor:

Formate disponibile

Multi disciplinary

approach to cleft lip and

S-ar putea să vă placă și