Dental Arch Relationship Outcomes in One- and Two-Stage Palatoplasty for Japanese Patients with Complete Unilateral Cleft Lip and Palate

Abstract

These results suggest that the anteroposterior relationship was not significantly different between the groups, but the transversal relationship was better in the two-stage group than in the one-stage group.

Three-dimensional evaluation of surgical techniques in neonates with orofacial cleft

“…We found a significant increase in the anterior-posterior distance of neonates submitted to one-stage palatoplasty compared to those submitted to two-stage palatoplasty. This result differs from that of the study of Mikoya et al ., 2015,[6] who did not find anterior-posterior differences between one- and two-stage palatoplasty, but they found differences in the transversal relation which was better in the group submitted to two-stage palatoplasty. Xu et al ., 2015,[21] concluded that the maxillary sagittal length may be impaired by palate repair performed at one or two stages.…”

“…[5678] The postsurgical healing tissue impairs the tissue distension negatively influencing on the face's skeletal growth, mainly in individuals with large cleft lip and palate because in these cases, a greater mucoperiosteal displacement occurs and creates thicker fibrous tissue. [27] Notwithstanding, the literature lacks consensus on the type of primary plastic surgery, suitable technique, and surgical time that would cause the most restrictive effects in these individuals.…”

“…[27] Notwithstanding, the literature lacks consensus on the type of primary plastic surgery, suitable technique, and surgical time that would cause the most restrictive effects in these individuals. [69]…”

“…[4567101112] The virtual analysis of the dental arch morphology from birth to skeletal maturity is easy, favors the diagnosis, and enables to tailor the therapeutic planning during the anatomic-functional rehabilitation. [13] Thus, this study aimed to evaluate the dimensional alterations of the dental arches of neonates with unilateral complete cleft lip and palate before and after two different primary surgery techniques.…”

Achados videofluoroscópicos das estruturas velofaríngeas após a cirurgia primária do palato

“…Com a finalidade de tentar resolver a controvérsia em relação ao tempo cirúrgico para otimizar a relação desenvolvimento de fala vs. crescimento facial, alguns autores preconizaram a realização da palatoplastia primária em dois estágios, porém a descrição da idade de realização de cada estágio também é controversa, variando de 8 a 18 meses no primeiro estágio, com o fechamento apenas do palato mole deixando o palato duro recoberto com uma placa obturadora, até a sua correção final entre 6 e 14 anos de idade, quando o crescimento da maxila está praticamente concluído (HOTZ et al, 1978;SCHWECKENDIEK;DOZ, 1978;GNOINSKI, 1979;ROHRICH et al 1996;ENEMARK, 2001;LIAO et al, 2010;RANDAG;DREISE;RUETTERMANN, 2014 MIKOYA et al, 2014). Outros encontraram efeitos benéficos da palatoplastia primária realizada em um tempo apenas, tanto em relação à fala quanto ao crescimento facial, com a vantagem de os pacientes terem apresentado menor tempo cirúrgico e de permanência hospitalar ( VAN LIERDE et al, 2004;KATZEL et al, 2009;PRADEL et al, 2009;RANDAG;DREISE;RUETTERMANN, 2014;LOSEE, 2014 os distúrbios de crescimento e deformidades dento-alveolares e criar um mecanismo velofaríngeo adequado para o desenvolvimento da fala normal (ANDRADES et al, 2008;AGRAWAL, 2009;PRADEL et al, 2009;MAHONEY;SWAN;FISHER, 2013;MENDONCA et al, 2014;HOPPER et al, 2014).…”