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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses. For details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Titolo originale
Multi Disciplinary Approach to Cleft Lip and Palate / orthodontic courses by Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses. For details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses. For details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Leader in continuing dental education www.indiandentalacademy.com
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
www.indiandentalacademy.com 8. Surgical aspect 9. Alveolar bone grafting 10. Orthognathic surgery 11. Distraction osteogenesis 12. Conclusion 13. References www.indiandentalacademy.com INTRODUCTION
www.indiandentalacademy.com EMBRYOLOGY The first pharyngeal arch (mandibular arch), develops two prominences: The maxillary prominence The mandibular prominence www.indiandentalacademy.com www.indiandentalacademy.com www.indiandentalacademy.com www.indiandentalacademy.com www.indiandentalacademy.com As the medial nasal prominences merge with the maxillary prominence, they form an intermaxillary segment. www.indiandentalacademy.com The intermaxillary segment gives rise to :- 1. philtrum of the upper lip. 2. The premaxillary part of the maxilla 3. The primary palate.
www.indiandentalacademy.com PALATE EMBRYOLOGY
www.indiandentalacademy.com www.indiandentalacademy.com 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.
Group II - Cleft of hard and soft palate, extending no further than the incisive foramen thus involving the secondary palate alone.
www.indiandentalacademy.com 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.
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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 www.indiandentalacademy.com 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
www.indiandentalacademy.com 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 www.indiandentalacademy.com 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. www.indiandentalacademy.com MILLARDS CLASSIFICATION (1977):
A modification of Kernahans striped Y classification. . The inverted triangles represent the nasal arch the upright triangles represent the nasal floor.
www.indiandentalacademy.com Role of various specialities www.indiandentalacademy.com NEONATES TO 2 YEARS PEDIATRICIANS ROLE ORTHODONTISTS ROLE SPEECH THERAPIST ROLE SURGEONS ROLE www.indiandentalacademy.com FEEDING DIFFICULTIES www.indiandentalacademy.com PRESURGICAL ORTHOPEDICS www.indiandentalacademy.com PRIMARY DENTITION PERIOD
www.indiandentalacademy.com MIXED DENTITION PERIOD
www.indiandentalacademy.com PERMANENT DENTITION PERIOD
www.indiandentalacademy.com SURGICAL TECHNIQUES www.indiandentalacademy.com Cleft lip Timing of surgery
www.indiandentalacademy.com www.indiandentalacademy.com Cleft palate Timing of surgery www.indiandentalacademy.com History
www.indiandentalacademy.com Primary and secondary palate
www.indiandentalacademy.com Von Langenbeck procedure www.indiandentalacademy.com Secondary palate
www.indiandentalacademy.com www.indiandentalacademy.com ALVEOLAR BONE GRAFTING(ABG) www.indiandentalacademy.com ORTHOGNATHIC SURGERY/ DISTRACTION OSTEOGENESIS
www.indiandentalacademy.com SECONDARY SURGERIES
www.indiandentalacademy.com CONCLUSION
www.indiandentalacademy.com 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.
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