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A Stepwise Procedure for the Fabrication of the NAM Appliance Using Grayson’s Technique
Rohit Raghavan,
Biswas PP,
Shaju George,
Shiji M. Kunjappan
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
1-6
Received:
23 December 2015
Accepted:
23 February 2016
Published:
23 March 2016
DOI:
10.11648/j.sjcm.s.2016050401.11
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Abstract: Rehabilitation of cleft lip and palate (CLP) patients is a challenge for all the concerned members of the cleft team, and various treatment modalities have obtained aesthetic results. Nasoalveolar molding (NAM) has gained wide acceptance and evidence in cleft therapy. Nasal moulding seems to be more beneficial and effective in unilateral cleft lip and palate patients. The principle objective of presurgical nasoalveolar molding (NAM) is to reduce the severity of the initial cleft deformity. This enables the surgeon and the patient to enjoy the benefits associated with repair of cleft deformity that is of minimal severity. For the fabrication of such appliances, an impression of the defect is necessary. Impression making in infants with cleft lip and palate is a challenging task.
Abstract: Rehabilitation of cleft lip and palate (CLP) patients is a challenge for all the concerned members of the cleft team, and various treatment modalities have obtained aesthetic results. Nasoalveolar molding (NAM) has gained wide acceptance and evidence in cleft therapy. Nasal moulding seems to be more beneficial and effective in unilateral cleft lip ...
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Forging a New Path in Cleft Rehabilitation by Tissue Engineering – A Review
Rohit Raghavan,
Sumitra S.,
Nadeem Abdul Rahman,
Justin Baby
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
7-13
Received:
23 December 2015
Accepted:
23 February 2016
Published:
16 April 2016
DOI:
10.11648/j.sjcm.s.2016050401.12
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Abstract: Of all the birth defects, Cleft palate is among the most common and affects about one in 1,500 births resulting in medical, physical, developmental, social and emotional problems in affected children in addition to the high health care costs. Current treatment is based on surgical closure of the cleft followed by orthodontic dental care, speech therapy, bone grafting, and requires multiple surgeries spanning over 18 years. Thus, there is a pressing need to develop more effective methods of treatment to provide young patients with a safer option that will result in a complete closure of the palatal cleft shortly after birth. In this review, the application of the field of tissue engineering, involving the use of adult stem cells, such as mesenchymal stem cells from bone marrow and Adipose-derived Stem Cells (ASCs) seeded on currently available biomaterials is presented in the context of healing craniofacial defects like the cleft palate. This article presents the concise technique to generate new bone in cleft deformities, using stem cells. It also throws light on the work done by various researchers to regenerate bone in large defects.
Abstract: Of all the birth defects, Cleft palate is among the most common and affects about one in 1,500 births resulting in medical, physical, developmental, social and emotional problems in affected children in addition to the high health care costs. Current treatment is based on surgical closure of the cleft followed by orthodontic dental care, speech the...
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Cleft Lip and Cleft Palate: A Comprehensive Understanding of Etiology, Pathogenesis and an Oral Physician’s Role in Comprehensive Care
Anjana Ramanathan,
Deepak T. A.,
Sowmya Krishna,
Sindhu Ravindra,
Himanshu Lakhani
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
14-19
Received:
2 January 2016
Accepted:
7 January 2016
Published:
16 April 2016
DOI:
10.11648/j.sjcm.s.2016050401.13
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Abstract: Cleft lip with or without cleft palate (CL/CP) is one of the most common structural birth defects, with treatment in multiple surgeries, speech therapy, and orthodontic treatments over first 18 years of life. Of special interest is etiology, incidence, risk factors and prevention. Better understanding of the embryology and genetics of orofacial clefting is crucial for development of a biologically relevant orofacial cleft classification system. The recent identification of specific genes involved in syndromic and non-syndromic orofacial clefting shows a correlation between both conditions with an overlapping genetic basis. However, it has limited application with screening of specific candidates, association studies and genome-wide scans in revealing the molecular basis of human clefting. With a heavy bearing of this condition on the patient and the family alike, providing care for these patients and families can be challenging. Surgically repaired clefts have residual deformity due to scarring and abnormal facial development affecting the social integration of the patient. It is of paramount importance, as the first contact professional, the oral physician must be patient, understanding and empathetic and must record a complete prenatal and natal history; urge the parents to seek immediate care and stress the importance of genetic counselling and prenatal diagnosis in the event of a future pregnancy.
Abstract: Cleft lip with or without cleft palate (CL/CP) is one of the most common structural birth defects, with treatment in multiple surgeries, speech therapy, and orthodontic treatments over first 18 years of life. Of special interest is etiology, incidence, risk factors and prevention. Better understanding of the embryology and genetics of orofacial cle...
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Cleft Lip Rhinoplasty - A Review
Ashok Jonnalagadda,
Sreeja Jami,
Kusuma latha Pydi
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
20-26
Received:
13 January 2016
Accepted:
16 February 2016
Published:
16 April 2016
DOI:
10.11648/j.sjcm.s.2016050401.14
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Abstract: Cleft lip nasal deformity presents an extreme challenge to the facial plastic surgeon. The deformity is complex and involves all tissue layers, including skeletal platform, inner lining, osseocartilaginous structure, and overlying skin. Ever since Blair and Brown first described the intricacies of the cleft pathology in 1931, the appropriate approach has been extensively debated in the literature with respect to timing, technique, and extent of surgical intervention. Secondary repair of the cleft lip nasal defect requires an understanding of the pathological nasal anatomy associated with congenital clefting. The basic cleft nasal deformity is characteristic and defendant upon the original extent of clefting of the lip. However, the secondary nasal defect varies greatly and is a result of: 1) the original malformation, 2) any interim surgery performed, and 3) growth of the nose and face. The cleft surgeon must therefore have a treatment philosophy and technique flexible enough to reconstruct a variable range of associated nasal problems. By reviewing the literature, this article described and summerised the various modalities for achieving a successful rhinoplasty in the patient with a cleft nasal deformity.
Abstract: Cleft lip nasal deformity presents an extreme challenge to the facial plastic surgeon. The deformity is complex and involves all tissue layers, including skeletal platform, inner lining, osseocartilaginous structure, and overlying skin. Ever since Blair and Brown first described the intricacies of the cleft pathology in 1931, the appropriate approa...
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Prosthetic Consideration in Management of Cleft Lip and Palate Patients
Ranjith Kumar P.,
Rohit Raghavan,
Jishnu S.,
Monisha V. S.,
Jency S. Raj,
Shreshta Sathish
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
27-30
Received:
23 December 2015
Accepted:
8 March 2016
Published:
19 May 2016
DOI:
10.11648/j.sjcm.s.2016050401.15
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Abstract: Although patient with cleft lip and palate are not seen regularly in dental practice, this has been a frequent congenital anomaly. The cause of cleft lips and palate is unknown; but possible causes are irradiations and mutations during pregnancy, teratogenic and infectious agents, psychological stress, and other factors like inheritance. Most clefts are likely caused by multiple genetic and non-genetic factors. Prosthetic therapy aids the patients in developing normal speech, promoting deglutition and mastication and in separating the oral and nasal cavities. The results not only enhance the esthetics, but can also be instrumental in the psychological and social acceptance of the cleft palate patients. This article throws light on various methods of prosthetic management and rehabilitation modalities in cleft lip and palate patients
Abstract: Although patient with cleft lip and palate are not seen regularly in dental practice, this has been a frequent congenital anomaly. The cause of cleft lips and palate is unknown; but possible causes are irradiations and mutations during pregnancy, teratogenic and infectious agents, psychological stress, and other factors like inheritance. Most cleft...
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Prosthodontics Approach for the Fabrication of Feeding Plates in Cleft Palate Patients
Shajahan P. A.,
Rohit Raghavan,
Ritha Bos,
Geethprasad T. S
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
31-36
Received:
23 December 2015
Accepted:
8 March 2016
Published:
19 May 2016
DOI:
10.11648/j.sjcm.s.2016050401.16
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Abstract: Cleft lip and palate is most common congenital anomalies of the craniofacial region. Cleft lip and palate is an anomaly that affects several systems and functions which includes the facial growth, dentition, speech, hearing and genetic aspects because of the complex mode of inheritance. Cleft lip and palate forms a part of many syndromicand non-syndromic disorders like the Pierre-Robin sequence, etc. Early intervention provides a positive impact on the development of the infants with clefts. Adequate knowledge of the appliances which are available and the impression procedures which should be followed, leads to a better understanding and coordination of the efforts of the various specialties which are involved in cleft lip and palate care.
Abstract: Cleft lip and palate is most common congenital anomalies of the craniofacial region. Cleft lip and palate is an anomaly that affects several systems and functions which includes the facial growth, dentition, speech, hearing and genetic aspects because of the complex mode of inheritance. Cleft lip and palate forms a part of many syndromicand non-syn...
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Cleft Lip and Palate- A Psychology Insight
Nitin Khargekar,
Naveen Khargekar,
Vandana Khargekar,
Surabhi Rajan
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
37-40
Received:
27 February 2016
Accepted:
4 April 2016
Published:
19 May 2016
DOI:
10.11648/j.sjcm.s.2016050401.17
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Abstract: Cleft lip and cleft palate are considered to be the most common birth defects involving craniofacial structure. Clefts affects not only aesthetically but also affects different functions. Complete clefts have an effect on feeding, hearing, nasal breathing, and phonation. All these aspects are addressed as part of an integral treatment. Though the physical rehabilitation of the patient is done, psychological issues are always neglected. For the positive outcome of the treatment along with proper treatment the patient should be psychologically strong with high self esteem to term the treatment as success. As a cleft child grows to adult through adolescence he comes across many people and situations which can make him psychologically weak or strong. Hence the current study was undertaken to evaluate the psychological factors associated with cleft lip and palate patients.
Abstract: Cleft lip and cleft palate are considered to be the most common birth defects involving craniofacial structure. Clefts affects not only aesthetically but also affects different functions. Complete clefts have an effect on feeding, hearing, nasal breathing, and phonation. All these aspects are addressed as part of an integral treatment. Though the p...
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Alveolar Bone Defect and Secondary Bone Grafting Outcome in Cleft Lip/Palate Patients
Alice Kurian,
Ravi V.,
Sherry Peter,
Ushass P.,
Latha P. Rao
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
41-48
Received:
26 March 2016
Accepted:
4 April 2016
Published:
19 May 2016
DOI:
10.11648/j.sjcm.s.2016050401.18
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Abstract: Background: Current evidence on factors influencing the outcome of Secondary Alveolar Bone Grafting (SABG) in cleft lip/palate patients is ambiguous and further deliberations are required to provide solid proof on prognostic criteria. Objectives: The objectives of this study were to determine the changes brought about by SABG in cleft depth and alveolar bone support of teeth in the vicinity of the cleft and to elucidate their prognostic value in surgical outcomes. Materials & methods: A prospective study was designed for 17 consecutive cleft lip and palate patients who underwent secondary alveolar bone grafting with anterior iliac crest graft at the AIMS Cleft Lip and Palate Clinic, Amrita Institute of Medical Sciences, Kochi. Maxillary occlusal radiographs taken at two time periods (T1- preoperative within 1month, T2-post-operative, after 6 months) were assessed for medial and lateral bone support of the teeth adjacent to cleft as well as for reduction in alveolar notching. The changes between the two were statistically analyzed using paired t-test and correlation computed with Pearson correlation coefficient. Results: Statistically and clinically significant improvements were achieved by the SABG procedure in terms of bone support and cleft depth. Pre surgical medial alveolar bone support and medial alveolar crest defect were found to have a positive impact on post surgical values. Conclusion: Significant increase in bone support achieved for cleft adjacent teeth and elimination/reduction of alveolar notching proves the beneficial role of SABG in cleft management protocol.
Abstract: Background: Current evidence on factors influencing the outcome of Secondary Alveolar Bone Grafting (SABG) in cleft lip/palate patients is ambiguous and further deliberations are required to provide solid proof on prognostic criteria. Objectives: The objectives of this study were to determine the changes brought about by SABG in cleft depth and alv...
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A Century of Cleft Treatment- An Orthodontic Perspective
Anurag Mahale,
Vishnu Ben Latif,
Varun Menon P.,
Heena Shaikh,
Ancy Koshy,
Bhavik Patel,
Abdul Shahariyar
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
49-58
Received:
27 March 2016
Accepted:
28 March 2016
Published:
19 May 2016
DOI:
10.11648/j.sjcm.s.2016050401.19
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Abstract: Orofacial clefting is the most common congenital deformity. Its treatment is a long drawn process with various challenges. However, successful completion of treatment is highly satisfying not just to the patient but also the team of specialists involved with it. The following article provides an overview of the evolution of cleft treatment over the past century. It briefly describes the changing views of the orthodontic specialty towards the diagnosis and treatment of this deformity over the past century. Its gradual process from the rudimentary treatment protocols of the early 20th century to the holistic approach followed currently.
Abstract: Orofacial clefting is the most common congenital deformity. Its treatment is a long drawn process with various challenges. However, successful completion of treatment is highly satisfying not just to the patient but also the team of specialists involved with it. The following article provides an overview of the evolution of cleft treatment over the...
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Techniques for the Treatment of Maxillary Hypoplasia in Cleft Patients: An Overview
Midhuna Prathap,
Varun Menon P.
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
59-63
Received:
5 February 2016
Accepted:
9 February 2016
Published:
16 June 2016
DOI:
10.11648/j.sjcm.s.2016050401.20
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Abstract: Purpose of review Maxillary hypoplasia is often unavoidable sequelae in cleft lip and palate patients who had undergone timely surgical and orthodontic intervention. Since 1970s these deformities have been traditionally corrected by means of orthognathic surgery. Numerous published studies have tried different techniques to combat the same. The advantages and disadvantages of the various techniques are overviewed. Recent Findings Distraction osteogenesis is one of the recent major developments in the field of oral and maxillofacial surgery and provides promising outcome. Tooth borne device hyrax proved good skeletal stability of distracted anterior maxillary segment. Distraction forces when directly transferred to the bone resulted in significant dentoalveolar compensation. This modern technique has also been used to evaluate its immediate and long term impact on nasal index as well which showed significant increase. This technique overcomes significant disadvantages of relapse and velopharyngeal insufficiency and also helps to produce better normal facial esthetics and profiles and masticatory function. Summary The oral and maxillofacial surgeons have widely accepted the use of maxillary distraction osteogenesis as an attractive alternative to treat malocclusion in CLP patients and this has broadened the reconstructive spectrum. Recent advancements have led to a wider clinical application and improved acceptance.
Abstract: Purpose of review Maxillary hypoplasia is often unavoidable sequelae in cleft lip and palate patients who had undergone timely surgical and orthodontic intervention. Since 1970s these deformities have been traditionally corrected by means of orthognathic surgery. Numerous published studies have tried different techniques to combat the same. The adv...
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Chromosomal Abnormalities Associated With Cleft Lip and Cleft Palate
Ajay Ajit Pala,
Neha Rajkumar Sonvanshi
Issue:
Volume 5, Issue 4-1, July 2016
Pages:
64-69
Received:
17 March 2016
Accepted:
6 June 2016
Published:
21 June 2016
DOI:
10.11648/j.sjcm.s.2016050401.21
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Abstract: Aim and Objective: To enumerate the various chromosomal abnormalities which may lead to cleft lip and cleft palate and to know about their prevention which can prove better than cure and to know the cure as well in cases where the stage of prevention has surpassed. Materials: Various reference articles regarding the chromosomal abnormalities are referred to know about the various categories of chromosomal abnormalities, their etiologies, early diagnosis, prevention and treatment plans for the same. Results: the article enumerates the theoretical part of the topic in detail but has not been conducted practically because of which it doesn’t give the idea of prevalence amongst any particular type of regional population. Theoretical part of the article explains all the anomalies, risk factors, preventive measures which can further be used as a base to conduct a practical study. Conclusion: The article is an attempt to understand the abnormalities associated with cleft lip and cleft palate at genetic level. This gives a scenario of what are the conditions causing cleft lip and cleft palate and how important it is to diagnose this at an early age to provide further problems.
Abstract: Aim and Objective: To enumerate the various chromosomal abnormalities which may lead to cleft lip and cleft palate and to know about their prevention which can prove better than cure and to know the cure as well in cases where the stage of prevention has surpassed. Materials: Various reference articles regarding the chromosomal abnormalities are re...
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