SPINA classification of cleft lip and palate: A suggestion for a complement

Rodrigues, Rita; Fernandes, Maria Helena; Monteiro, A. Bessa; Furfuro, Rowney; Sequeira, Teresa; Silva, Cátia Carvalho; Manso, Maria Conceição

doi:10.1016/j.arcped.2018.08.001

Cited by 19 publications

(15 citation statements)

References 7 publications

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“…As fi ssuras orais podem acometer o lábio, o rebordo alveolar, o palato duro e o palato mole, em vários graus e com número considerável de combinações possíveis, podendo ser unilaterais, bilaterais ou medianas, completas ou incompletas, dependendo da extensão e gravidade da fi ssura (RODRIGUES et al, 2018;WORLEY et al, 2018). No Brasil, Spina et al (1972) classifi caram as fi ssuras utilizando o forame incisivo como referência anatômica, o qual representa o ponto de junção das estruturas que formam o lábio e o palato.…”

Section: Fissuras Labiopalatinasunclassified

“…Após uma revisão da classifi cação de Spina (DA SILVA FILHO et al, 1992), as fi ssuras labiopalatinas foram divididas em: fi ssuras pré-forame incisivo, quando acometem estruturas anteriores ao forame incisivo (palato primário, lábio e/ou rebordo alveolar); fi ssuras transforame incisivo, que envolvem o palato primário e secundário, podendo estender-se do lábio à úvula, atravessando o rebordo alveolar; fi ssuras pós-forame incisivo, quando acometem estruturas posteriores ao forame incisivo, como o palato secundário e úvula e; Fissuras raras da face, quando não há envolvimento do forame incisivo, podendo comprometer bochechas, pálpebras, orelhas, nariz e ossos do crânio e da face. Para internacionalização da classificação, as fissuras labiopalatinas são divididas em: Fissura de lábio (FL), com ou sem envolvimento do rebordo alveolar; Fissuras de lábio e palato (FLP) que envolvem lábio, rebordo alveolar, palato duro e palato mole; Fissuras de palato isoladas (FP) que envolvem palato duro e/ou mole, as quais podem ser completas ou incompletas, unilaterais ou bilaterais (TOLAROVÁ; CERVENKA, 1998;RODRIGUES et al, 2018;WORLEY et al, 2018).…”

Section: Fissuras Labiopalatinasunclassified

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Cárie Dentária em Indivíduos com Fissuras Labiopalatinas: Revisão de Literatura

et al. 2021

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As fissuras labiopalatinas (FLP) são as malformações congênitas mais comuns da região craniofacial e apresentam diferentes fenótipos e características clínicas, que diferem entre si de acordo com as estruturas anatômicas envolvidas: fissura de lábio, fissura de lábio e palato e fissura de palato isolada. A etiologia das FLP é multifatorial e inclui fatores genéticos e ambientais. O objetivo do presente estudo foi investigar o papel das fissuras labiopalatinas na prevalência de cárie dentária por meio de uma revisão na literatura. O defeito anatômico que envolve o rebordo alveolar e/ou o palato pode resultar em agenesias dentárias, dentes supranumerários, anomalias de forma e estrutura, bem como atresia maxilar, mordidas cruzadas posteriores e apinhamentos dentários. Também, a presença da FLP pode resultar aos indivíduos problemas durante alimentação, pronúncia de alguns fonemas, audição e integração social, o que poderia afetar a qualidade de vida do indivíduo e da dinâmica familiar. Quando a saúde bucal de crianças e adolescentes com FLP foi investigada, maior retenção do biofilme microbiano nas superfícies dentárias, de inflamação gengival e maior ocorrência de cárie dentária foram observados. Para um diagnóstico e tratamento adequados, é fundamental uma abordagem multidisciplinar, individualizada, para orientação e planejamento do tratamento dos indivíduos com a malformação, desde o nascimento até a fase adulta. O conhecimento dos efeitos da FLP na saúde bucal e no bem-estar dos indivíduos e das famílias afetadas é fundamental para mudanças nas políticas públicas das práticas de saúde e redução da sobrecarga da presença da malformação congênita. Palavras-chave: Cárie Dentária. Fenda Labial. Fissura Palatina. Saúde Bucal Abstract Cleft lip and palate (CLP) are the most common congenital malformations of the craniofacial region and they present different phenotypes and clinical characteristics, which differ according to the anatomical structures involved: cleft lip, cleft lip and palate and isolated cleft palate. The etiology of CLP is multifactorial and includes genetic and environmental factors. The aim of this study was to investigate the role of cleft lip and palate in the prevalence of dental caries through a literature review. The anatomical defect involving the alveolar ridge and / or the palate can result in dental agenesis, supernumerary teeth, anomalies in shape and structure, as well as maxillary atresia, posterior cross bites and dental crowding. Also, the presence of CLP can result in problems for individuals during feeding, pronunciation of some phonemes, hearing and social integration, which could affect the individual's quality of life and family dynamics. When the oral health of children and adolescents with CLP was investigated, greater retention of microbial biofilm on dental surfaces, gingival inflammation and the occurrence of dental caries were observed. For an adequate diagnosis and treatment, a multidisciplinary and individualized approach is essential to guide and plan the treatment of individuals with the malformation, from birth to adulthood. The knowledge of the effects of FLP on oral health and on the well-being of affected individuals and families is fundamental to changes in public health practice policies and to reduce the burden of the presence of the congenital malformation. Keywords: Cleft Lip. Cleft Palate. Dental Caries. Oral Health.

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Section: Fissuras Labiopalatinasunclassified

Cárie Dentária em Indivíduos com Fissuras Labiopalatinas: Revisão de Literatura

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“…Thus, from birth to adulthood, full professional support will be available, assisting in the treatment of cleft patients in order to provide satisfactory aesthetic and functional results (phonation and dental occlusion), allowing these patients better inclusion in society 18 . o Special Cares…”

Section: O Classification Of Orofacial Cleftsmentioning

confidence: 99%

Orofacial clefts: treatment based on a multidisciplinary approach

Matos¹,

Nakano²,

Rodrigues³

et al. 2020

Arch Health Invest

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Objective: The present study aims to expose through a literature review the cleft lip and/or cleft palate (CL/CP) and its treatment in a multidisciplinary approach. Methodology: This literature review was conducted by the leading health databases: Pubmed (https://www.ncbi.nlm.nih.gov/pubmed). The keywords for the textual search were: Cleft Lip; Cleft Palate; Dental Staff; Classification; Embryology. The inclusion criteria were: literature on the subject under study, literature of the last years, english language, laboratory and clinical studies and systematic review. Literature Review: Fissures can be defined by a space at the junction between two bones, usually where there would be a suture. Orofacial clefts are part of the congenital facial anomalies resulted from the non-junction of the embryonic facial processes. These changes occur due to an alteration in the migratory velocity of the neural crest cells, in charge of the phenomenon of fusion of the facial prominences between the 6th and 9thweek of embryonic life. Conclusion: The treatment of patients with orofacial clefts requires the approach of a multidisciplinary team that involves physicians in the area of plastic surgery, otorhinolaryngology, pediatrics, geneticists, dentists, prosthetics, nurses and speech pathologists, focusing on patient prevention, recovery and rehabilitation. However, further studies are needed for a better understanding of the subject and the steps that should be applied for each particular case.Descriptors: Cleft Lip; Cleft Palate; Dental Staff; Classification; Embryology.ReferencesShaw WC, Brattström V, Mølsted K, Prahl-Andersen B, Roberts CT, Semb G. The Eurocleft study: intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 5: discussion and conclusions. Cleft Palate Craniofac J. 2005;42(1):93-8. Friede H, Lilja J. The Eurocleft Study: Intercenter study of treatment outcome in patients with complete cleft lip and palate. Cleft Palate Craniofac J. 2005;42(4):453-54.Rosenstein SW, Grasseschi M, Dado D. The Eurocleft Study: Intercenter study of treatment outcome in patients with complete cleft lip and palate. Cleft Palate Craniofac J. 2005;42(4):453.Semb G, Brattström V, Mølsted K, Prahl-Andersen B, Zuurbier P, Rumsey N, Shaw WC. The Eurocleft study: intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 4: relationship among treatment outcome, patient/parent satisfaction, and the burden of care. Cleft Palate Craniofac J. 2005;42(1):83-92. Watkins SE, Meyer RE, Strauss RP, Aylsworth AS. Classification, epidemiology, and genetics of orofacial clefts. Clin Plast Surg. 2014;41(2):149-63. Coleman JR Jr, Sykes JM. The embryology, classification, epidemiology, and genetics of facial clefting. Facial Plast Surg Clin North Am. 2001;9(1):1-13.Pengelly RJ, Arias L, Martínez J, Upstill-Goddard R, Seaby EG, Gibson J, Ennis S, Collins A, Briceño I. Deleterious coding variants in multi-case families with non-syndromic cleft lip and/or palate phenotypes. Sci Rep. 2016;6:30457.Ren Y, Steegman R, Dieters A, Jansma J, Stamatakis H. Bone-anchored maxillary protraction in patients with unilateral complete cleft lip and palate and Class III malocclusion. Clin Oral Investig. 2019;23(5):2429-2441.Alberconi TF, Siqueira GLC, Sathler R, Kelly KA, Garib DG. Assessment of Orthodontic Burden of Care in Patients With Unilateral Complete Cleft Lip and Palate. Cleft Palate Craniofac J. 2018;55(1):74-78.Eriguchi M, Watanabe A, Suga K, Nakano Y, Sakamoto T, Sueishi K, Uchiyama T. Growth of Palate in Unilateral Cleft Lip and Palate Patients Undergoing Two-stage Palatoplasty and Orthodontic Treatment. Bull Tokyo Dent Coll. 2018;59(3):183-91.Smane L, Pilmane M. Evaluation of the presence of MMP-2, TIMP-2, BMP2/4, and TGFβ3 in the facial tissue of children with cleft lip and palate. Acta Med Litu. 2018;25(2):86-94. AlHayyan WA, Pani SC, AlJohar AJ, AlQatami FM. The Effects of Presurgical Nasoalveolar Molding on the Midface Symmetry of Children with Unilateral Cleft Lip and Palate: A Long-term Follow-up Study. Plast Reconstr Surg Glob Open. 2018;6(7):e1764. Thakur S, Singh A, Thakur NS, Diwana VK. Achievement in Nasal Symmetry after Cheiloplasty in Unilateral Cleft Lip and Palate Infants Treated with Presurgical Nasoalveolar Molding. Contemp Clin Dent. 2018;9(3):357-60. Turri de Castro Ribeiro T, Petri Feitosa MC, Almeida Penhavel R, Zanda RS, Janson G, Mazzottini R, Garib DG. Extreme maxillomandibular discrepancy in unilateral cleft lip and palate: Longitudinal follow-up in a patient with mandibular prognathism. Am J Orthod Dentofacial Orthop. 2018;154(2):294-304. Perillo L, Vitale M, d'Apuzzo F, Isola G, Nucera R, Matarese G. Interdisciplinary approach for a patient with unilateral cleft lip and palate. Am J Orthod Dentofacial Orthop. 2018;153(6):883-94. Hoffmannova E, Moslerová V, Dupej J, Borský J, Bejdová Š, Velemínská J. Three-dimensional development of the upper dental arch in unilateral cleft lip and palate patients after early neonatal cheiloplasty. Int J Pediatr Otorhinolaryngol. 2018;109:1-6. Tan ELY, Kuek MC, Wong HC, Ong SAK, Yow M. Secondary Dentition Characteristics in Children With Nonsyndromic Unilateral Cleft Lip and Palate: A Retrospective Study. Cleft Palate Craniofac J. 2018;55(4):582-89. Rodrigues R, Fernandes MH, Monteiro AB, Furfuro R, Sequeira T, Silva CC, Manso MC. SPINA classification of cleft lip and palate: A suggestion for a complement. Arch Pediatr. 2018;25(7):439-41. Ortiz-Posadas MR, Vega-Alvarado L, Maya-Behar J. A new approach to classify cleft lip and palate. Cleft Palate Craniofac J. 2001;38(6):545-50.Spina V, Psillakis JM, Lapa FS, Ferreira MC. Classificação das fissuras lábio-palatinas. Sugestão de modificação [Classification of cleft lip and cleft palate. Suggested changes]. Rev Hosp Clin Fac Med Sao Paulo. 1972;27(1):5-6. Allori AC, Mulliken JB, Meara JG, Shusterman S, Marcus JR. Classification of Cleft Lip/Palate: Then and Now. Cleft Palate Craniofac J. 2017;54(2):175-88. Spina V. A proposed modification for the classification of cleft lip and cleft palate. Cleft Palate J. 1973;10:251-2. Yun-Chia Ku M, Lo LJ, Chen MC, Wen-Ching Ko E. Predicting need for orthognathic surgery in early permanent dentition patients with unilateral cleft lip and palate using receiver operating characteristic analysis. Am J Orthod Dentofacial Orthop. 2018;153(3):405-14. Garib D, Yatabe M, de Souza Faco RA, Gregório L, Cevidanes L, de Clerck H. Bone-anchored maxillary protraction in a patient with complete cleft lip and palate: A case report. Am J Orthod Dentofacial Orthop. 2018;153(2):290-97. De Stefani A, Bruno G, Balasso P, Mazzoleni S, Baciliero U, Gracco A. Teeth agenesis evaluation in an Italian sample of complete unilateral and bilateral cleft lip and palate patients. Minerva Stomatol. 2018;67(4):156-64. Chang SY, Lonic D, Pai BC, Lo LJ. Primary Repair in Patients With Unilateral Complete Cleft of Lip and Primary Palate: Assessment of Outcomes. Ann Plast Surg. 2018;80(2S Suppl 1):S2-6.Vura N, Gaddipati R, Palla Y, Kumar P. An Intraoral Appliance to Retract the Protrusive Premaxilla in Bilateral Cleft Lip Patients Presenting Late for Primary Lip Repair. Cleft Palate Craniofac J. 2018;55(4):622-25.Massie JP, Bruckman K, Rifkin WJ, Runyan CM, Shetye PR, Grayson B, Flores RL. The Effect of Nasoalveolar Molding on Nasal Airway Anatomy: A 9-Year Follow-up of Patients With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J. 2018;55(4):596-601. Jabbari F, Wiklander L, Reiser E, Thor A, Hakelius M, Nowinski D. Secondary Alveolar Bone Grafting in Patients Born With Unilateral Cleft Lip and Palate: A 20-Year Follow-up. Cleft Palate Craniofac J. 2018;55(2):173-79.Jones CM, Roth B, Mercado AM, Russell KA, Daskalogiannakis J, Samson TD, Hathaway RR, Smith A, Mackay DR, Long RE Jr. The Americleft Project: Comparison of Ratings Using Two-Dimensional Versus Three-Dimensional Images for Evaluation of Nasolabial Appearance in Patients With Unilateral Cleft Lip and Palate. J Craniofac Surg. 2018;29(1):105-8. Gatti GL, Freda N, Giacomina A, Montemagni M, Sisti A. Cleft Lip and Palate Repair. J Craniofac Surg. 2017;28(8):1918-24.

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“…The nomenclature committee of the American Cleft Palate Rehabilitation Association has published criteria for an ideal classification and mainly concern certain parameters: Definitions should be concise and clear, a logical distribution with the economy of expression and promotion of academic and clinical research by standardized procedures [3]. Indeed, a simple and comprehensive classification is better accepted scientifically [4]; it must be clearly defined and based on embryological criteria [5] and must allow the establishment of communication, the development of a treatment plan and the comparison of results between the different centers [6]. Since 1922, several classifications of orofacial clefts have been proposed with the aim of generalizing rational criteria allowing communication and exchange between the various practitioners.…”

Section: Introductionmentioning

confidence: 99%

“…Since 1922, several classifications of orofacial clefts have been proposed with the aim of generalizing rational criteria allowing communication and exchange between the various practitioners. [4]. The most accepted classification is the Kernahan and Stark's classification 1958 and who used the incisor foramen as a separating elements between the anterior and posterior structures.…”

Section: Introductionmentioning

confidence: 99%

A Beumer Classification of Labial-alveolar-palatal Clefts: Suggestion for Complement

Hawari¹,

Habibou²,

Merzouk³

et al. 2021

Integr J Med Sci

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Orofacial clefts are a common birth defect characterized by involvement of the nasal and oral structures. Several classifications of orofacial clefts have been proposed in the aim of generalizing rational criteria allowing communication and exchange between the different practitioners. Among these classifications, the classification of Beumer has got surgical and prosthodontic interest (making an orthopedic plate).The authors propose to update this classification by modifying it and proposing a class that did not exist in the original classification. This modification seems important to us as a complement to this classification.

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SPINA classification of cleft lip and palate: A suggestion for a complement

Cited by 19 publications

References 7 publications

Cárie Dentária em Indivíduos com Fissuras Labiopalatinas: Revisão de Literatura

Cárie Dentária em Indivíduos com Fissuras Labiopalatinas: Revisão de Literatura

Orofacial clefts: treatment based on a multidisciplinary approach

A Beumer Classification of Labial-alveolar-palatal Clefts: Suggestion for Complement

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