PROBLEMS IN CLEFT LIP AND PALATE (CLP)

Congenital anomalies Feeding Hearing Speech Disruption of facial growth Disruption of dental development Dental anomalies Psychosocial

Disturbances in dental and skeletal development caused by the clefting process itself depend upon the site an severity of the cleft

Lip only there’s lil effect in this type, although notching of the alveolus

adjacent to the cleft lip may sometimes be seen. Lip and alveolus Unilateral cleft lip and alveolus unsually associated with

segmental displacement. Bilateral casese the premaxilla may be rotated forwards. Lat inc on the affected side may exhibit

i. Congenital absenceii. An abnormality of tooth size and/or shapeiii. Enamel defectiv. Two conical teeth, one on each side of the cleft

Lip and Palate In unilateral cleft rotation and collapse of both

segments inwards anteriorly is usually seen( on the affected side)

In bilateral clefts both lateral segments are often collapsed behind a prominent premaxilla

Palate only A widening of the arch post[usually] Cleft pt has more concave profile & a degree

of this is d/t a restriction of growth. Pt tends to have more retrognathic maxilla &

mand & reduced upper face height

Babies with cleft palates can swallow once the material being fed reaches hypopharynx

Have extreme difficulty producing negative pressure in their mouth to allow sucking.

Overcome by use of specially designed large syringes with rubber extension tubes connected to them or use of obturator.

Individuals with unoperated clefts they do not experience significant restriction of

facial growth, although there is a lack of development in the region of the cleft itself, possibly because of hypoplasia.

Individuals who have undergone surgical repair to CLP exhibit marked restriction of mid-face growth

anteroposteriorly (maxillary retrusion) and transversely.

This is attributed to the restraining effects of the scar tissue , which result from surgical intervention.

Cleft affecting the alveolus result in non-eruption or displacement of lateral incisors or canines.

Bilateral cleft premaxilla (prolabium) is displaced along with the incisors.

Delayed eruption (delays increases with severity of cleft)

Hypodontia General reduction in tooth

size.eg;microdontia Abnormalities of tooth size and shape. Enamel defects.eg;hypomineralized Impacted teeth (maxillary canines) Missing teeth Supernumerary tooth

Space maintenance and control is instituted during childhood.

Appliances to maintain or increase the width of dental arch are frequently used.

This treatment is usually begin with eruption of the first maxillary permanent molars.

Comprehensive orthodontic care is deferred until later, when most of permanent teeth erupted.

Consideration of orthognathic surgical intervention for skeletal discrepancies and malocclusion.

Poor self image Lack of self confience