Aktuelle Behandlungsprinzipien bei Lippen-, Kiefer-und Gaumenspalten aus Sicht des Kieferorthop�den

Abstract

The aim of this review was to put new clinical research findings into proper perspectives relative to previously accepted knowledge on treatment of patients with cleft lip and palate. The first part of the paper deals with various aspects of infant orthopedic treatment, such as its influence on primary surgery, maxillary arch form and dimensions, feeding, psychological situation of the parents and speech development. Following parts analyze general maxillofacial growth outcome after surgery and also maxillofacial growth in relation to particular surgical procedures (palatal repair, periosteoplasty/gingivoplasty, bone grafting). The last part of the review discuss the effects of certain orthodontic/orthopedic treatment approaches as well as the role of dental implants in treatment of cleft lip and palate patients.

Long-Term Effects of Presurgical Infant Orthopedics in Patients with Cleft Lip and Palate: A Systematic Review

“…There are different kinds of PSIO treatment approaches with different mechanics, all seeking and achieving different objectives (Friede et al, 1998;Kuijpers-Jagtman et al, 2000;Prahl-Andersen, 2000;Ross et al, 2000;Watson et al, 2004;Berkowitz, 2006). Among these, presurgical nasoalveolar molding (PNAM) appliances have generated considerable interest in recent years and have been in use as a new approach to traditional presurgical infant orthopedics (TPSIO) Maull et al, 1999;Grayson et al, 2001;Suri and Tompson, 2004;Singh et al, 2005).…”

Cephalometric evaluation of long-term craniofacial development in unilateral cleft lip and palate patients treated with delayed hard palate closure

“…Traditionally, of all interventions during cleft lip and palate treatment, palatal repair has been considered to have the greatest influence on subsequent craniofacial growth and development 6 . For many years, there has been much controversy about the timing of palatal closure.…”

Studies on the Craniofacial Morphology of Adult Cleft Patients Using Euclidean Distance Matrix Analysis (EDMA)

“…The morphology at the end of the growth period is determined by both hereditary factors and iatrogenic influences resulting from surgical and orthodontic interventions [6]. Surgical cleft lip and palate rehabilitation is believed to have a decisive effect on craniofacial growth [10,16,17,32].…”

“…So findet man am Ende des Wachstums eine Morphologie, die von hereditären wie auch iatrogenen Einflüssen durch chirurgische und kieferorthopädische Interventionen [6] geprägt ist. Entscheidenden Einfluss auf das Wachstum des Gesichtsschädels wird dem Konzept der operativen Versorgung der LKGSpalte [10,16,17,32] zugeschrieben.…”