CLEFT LIP AND PALATE
3.9 هزار بار بازدید -
4 سال پیش
-
CLEFT LIP AND PALATE INTRODUCTION
CLEFT LIP AND PALATE
INTRODUCTION • DEVELOPMENT OF LIP AND PALATE. • PATHOPHYSIOLOGY OF CLEFT LIP AND PALATE. • CLASSIFICATION OF CLEFT LIP AND PALATE. • TREATMENT PROTOCOLS. DIAGNOSIS AND TREATMENT PLANNING. SURGICAL MANAGEMENT Primary palate. Secondary palate. ORTHODONTIC MANAGEMENT. Phase 1. Phase 2 Phase 3
PROSTHETIC MANAGEMENT. Maxillary orthopedics Naso-alveolar molding. Speech appliances. • Pharyngeal obturator. • Hard palate obturator For children • Anterior prosthesis. • Fixed • Removable For adults
affected infants are born every day
EMBRYOLOGY Development of facial structures starts at the end of 4th week
2 medial nasal processes fuse in midline – upper lip. • Mandibular processes fuse in midline – lower lip
Primary palate. – maxillary and medial nasal process merge
Parts of palate Primary
Clefts of the lip and alveolar processes
Unilateral cleft lip
Cleft Lip and Palate Q&A
ANTERIOR CLEFT PALATE POSTERIOR CLEFT PALATE COMPLETE CLEFT PALATE (ANTERIOR & POSTERIOR)
Etiology Multifactorial Genetic Environmental factors
PREDISPOSING FACTORS
Davis and Ritchie’s classification
Pre-alveolar process cleft
VEAU CLASSIFICATION
KERNAHAN AND STARK
American Cleft Palate–Craniofacial Association
KERNAHAN CLASSIFICATION
TESSI
Oro-facial clefts
MODIFIED STRIPED Y • Triangle 1: right nostril floor
DIAGNOSIS AND TREATMENT PLANNING
General case history
Impressions for study casts
Photographs. • For diagnosis, teaching
Otologic and hearing examination
Transabdominal US. - Not reliable till gestational age of 15 weeks
PALATAL OBTURATOR CLEFT LIP SOFT PALATE HARD PALATE SPEECH THERAPY BONE GRAFTING
PROBLEMS ASSOCIATED WITH CLEFT LIP & PALATE
MULTIDISCIPLINARY MANAGEMENT
SURGICAL MANAGEMENT “RULE OF 10s
Bilateral cleft Major problems
Unilateral cleft TIMING OF SURGERY. • Cleft of hard palate
ORTHODONTIC MANAGEMENT PHASE
MAXILLARY ORTHOPEDICS
McNeil School to stimulate the growth of tissues to obtain closure of palatal defects without surgical interventions
Fixing a Cleft Palate with Craniofacial Surgery - The Science of Healing CLIP
presurgical step of treatment have been cited
TYPES OF APPLIANCES PASSIVE OR HOLDING ACTIVE OR EXPANSION
EXPANSION APPLIANCE collapse
Dentomaxillary advancement (DMA) appliance Latham
HOLDING APPLIANCE
NASOALVEOLAR MOLDING Samuel Berkowitz. Celft Lip and Palate
Naso alveolar molding appliance
CORRECTION OF THE UNILATERAL ORONASAL CLEFT DEFORMITY
Infant • Maxillary and mandibular trays must be constructed • Irreversible hydrocolloid is used • Maxillary impression
CONVENTIONAL MOLDING PLATE
WEEKLY MODIFICATIONS
EXTRAORAL RETENTIVE BUTTON
NASAL STENT • When the alveolar cleft width has been reduced to less than 6mm
NASAL STENT
Cleft Diagnosis - Pediatric Playbook - Hospital
NASOALVEOLAR MOLDING AFTER NASAL MOLDING JUST PRIOR TO SURGERY
CORRECTING THE BILATERAL ORONASAL CLEFT DEFORMITY
intraoral molding plate is fabricated that encompasses the lateral alveolar segments and the premaxilla
PROSTHETIC SPEECH APPLIANCES FOR CHILDREN
PHARYNGEAL OBTURATOR
RATIONALE FOR PHARYNGEAL BULB
Irreversible hydrocolloid is used • Maxillary impression is made with the infant’s head tilted downward at an angle of 15 degrees • Head is tilted upward for mandibular impressions • Tray should not be overloaded Older children and adults • Stock tray of adequate dimensions is selected • Early morning & empty stomach appointments. • Topical anaesthetic used in case of severe gagging • Tray should not be overloaded • All oral perforations should be packed with gauze saturated with petroleum jelly
CONSTRUCTION
High fusing modelling
Patient is instructed to flex the neck fully to achieve contact of the chin to the chest
Vowels: produced with resonated sound and little air flow
After even reduction of compound a coating of mouth temperature wax is applied
Cleft Treatment - Pediatric Playbook - Boston Children's Hospital
HARD PALATE OBTURATOR
Two Methods of Cleft Palate Repair in Patients With Complete Unilateral Cleft Lip and Palate
Method 2. : Unilateral cleft palate repair
RECENT ADVANCES. • Fetal surgery – done in intrauterine life
CONCLUSION. • Oral clefts are the second most common congenital anamoly, having multifactorial origin
Cleft lip and palate repair: Jane's Journey
A considerable knowledge about the etiology and embryology is required for proper diagnosis and treatment planning of such patients. patient with clefts palate presents a complex biologic, sociologic and psychologic problems. • Treatment begins soon after birth continues till adulthood requiring a team approach. team approach with the members including the paediatrician, plastic surgeon, pedodontist, otolaryngologist, orthodontist, speech pathologist, prosthodontist, geneticist, paediatric psychiatrist and social workers.
lectures dentist : Playlist: All Lectures
MINIMAL INTERVENTION DENTISTRY
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INTRODUCTION • DEVELOPMENT OF LIP AND PALATE. • PATHOPHYSIOLOGY OF CLEFT LIP AND PALATE. • CLASSIFICATION OF CLEFT LIP AND PALATE. • TREATMENT PROTOCOLS. DIAGNOSIS AND TREATMENT PLANNING. SURGICAL MANAGEMENT Primary palate. Secondary palate. ORTHODONTIC MANAGEMENT. Phase 1. Phase 2 Phase 3
PROSTHETIC MANAGEMENT. Maxillary orthopedics Naso-alveolar molding. Speech appliances. • Pharyngeal obturator. • Hard palate obturator For children • Anterior prosthesis. • Fixed • Removable For adults
affected infants are born every day
EMBRYOLOGY Development of facial structures starts at the end of 4th week
2 medial nasal processes fuse in midline – upper lip. • Mandibular processes fuse in midline – lower lip
Primary palate. – maxillary and medial nasal process merge
Parts of palate Primary
Clefts of the lip and alveolar processes
Unilateral cleft lip
Cleft Lip and Palate Q&A
ANTERIOR CLEFT PALATE POSTERIOR CLEFT PALATE COMPLETE CLEFT PALATE (ANTERIOR & POSTERIOR)
Etiology Multifactorial Genetic Environmental factors
PREDISPOSING FACTORS
Davis and Ritchie’s classification
Pre-alveolar process cleft
VEAU CLASSIFICATION
KERNAHAN AND STARK
American Cleft Palate–Craniofacial Association
KERNAHAN CLASSIFICATION
TESSI
Oro-facial clefts
MODIFIED STRIPED Y • Triangle 1: right nostril floor
DIAGNOSIS AND TREATMENT PLANNING
General case history
Impressions for study casts
Photographs. • For diagnosis, teaching
Otologic and hearing examination
Transabdominal US. - Not reliable till gestational age of 15 weeks
PALATAL OBTURATOR CLEFT LIP SOFT PALATE HARD PALATE SPEECH THERAPY BONE GRAFTING
PROBLEMS ASSOCIATED WITH CLEFT LIP & PALATE
MULTIDISCIPLINARY MANAGEMENT
SURGICAL MANAGEMENT “RULE OF 10s
Bilateral cleft Major problems
Unilateral cleft TIMING OF SURGERY. • Cleft of hard palate
ORTHODONTIC MANAGEMENT PHASE
MAXILLARY ORTHOPEDICS
McNeil School to stimulate the growth of tissues to obtain closure of palatal defects without surgical interventions
Fixing a Cleft Palate with Craniofacial Surgery - The Science of Healing CLIP
presurgical step of treatment have been cited
TYPES OF APPLIANCES PASSIVE OR HOLDING ACTIVE OR EXPANSION
EXPANSION APPLIANCE collapse
Dentomaxillary advancement (DMA) appliance Latham
HOLDING APPLIANCE
NASOALVEOLAR MOLDING Samuel Berkowitz. Celft Lip and Palate
Naso alveolar molding appliance
CORRECTION OF THE UNILATERAL ORONASAL CLEFT DEFORMITY
Infant • Maxillary and mandibular trays must be constructed • Irreversible hydrocolloid is used • Maxillary impression
CONVENTIONAL MOLDING PLATE
WEEKLY MODIFICATIONS
EXTRAORAL RETENTIVE BUTTON
NASAL STENT • When the alveolar cleft width has been reduced to less than 6mm
NASAL STENT
Cleft Diagnosis - Pediatric Playbook - Hospital
NASOALVEOLAR MOLDING AFTER NASAL MOLDING JUST PRIOR TO SURGERY
CORRECTING THE BILATERAL ORONASAL CLEFT DEFORMITY
intraoral molding plate is fabricated that encompasses the lateral alveolar segments and the premaxilla
PROSTHETIC SPEECH APPLIANCES FOR CHILDREN
PHARYNGEAL OBTURATOR
RATIONALE FOR PHARYNGEAL BULB
Irreversible hydrocolloid is used • Maxillary impression is made with the infant’s head tilted downward at an angle of 15 degrees • Head is tilted upward for mandibular impressions • Tray should not be overloaded Older children and adults • Stock tray of adequate dimensions is selected • Early morning & empty stomach appointments. • Topical anaesthetic used in case of severe gagging • Tray should not be overloaded • All oral perforations should be packed with gauze saturated with petroleum jelly
CONSTRUCTION
High fusing modelling
Patient is instructed to flex the neck fully to achieve contact of the chin to the chest
Vowels: produced with resonated sound and little air flow
After even reduction of compound a coating of mouth temperature wax is applied
Cleft Treatment - Pediatric Playbook - Boston Children's Hospital
HARD PALATE OBTURATOR
Two Methods of Cleft Palate Repair in Patients With Complete Unilateral Cleft Lip and Palate
Method 2. : Unilateral cleft palate repair
RECENT ADVANCES. • Fetal surgery – done in intrauterine life
CONCLUSION. • Oral clefts are the second most common congenital anamoly, having multifactorial origin
Cleft lip and palate repair: Jane's Journey
A considerable knowledge about the etiology and embryology is required for proper diagnosis and treatment planning of such patients. patient with clefts palate presents a complex biologic, sociologic and psychologic problems. • Treatment begins soon after birth continues till adulthood requiring a team approach. team approach with the members including the paediatrician, plastic surgeon, pedodontist, otolaryngologist, orthodontist, speech pathologist, prosthodontist, geneticist, paediatric psychiatrist and social workers.
lectures dentist : Playlist: All Lectures
MINIMAL INTERVENTION DENTISTRY
Facebook: Facebook: cudman.buck
4 سال پیش
در تاریخ 1399/04/17 منتشر شده
است.
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