Analysis of treatment methods for children with bilateral complete cleft of the lip and palate in mixed bite

Relevance. According to the World Health Organization, it was found that cleft lip and palate cases ranges from 0.6 to 1.6 cases per 1000 newborns. According to the severity of the lesion, bilateral cleft lip and palate takes the first place, however, it occurs much less common – 15-25%.

Purpose – to analyze methods of treatment in children with bilateral cleft lip and palate during the period of the mixed dentition.

Materials and methods. An analysis of 51 sources Russian and foreign articles for the period from 1951 to 2019 was carried out. The features of the development of occlusion in children with bilateral cleft lip and palate during the period of a changeable occlusion, as well as methods of treating this pathology, are considered.

Results. It was found that the main anatomical features of the maxillofacial region in children with bilateral cleft lip and palate during the period of a changeable bite are -narrowing of the upper and lower jaws, the presence of soft tissue scars. The main methods of treatment for such children are reconstructive surgery, including the closure of a hard palate defect using a mucoperiosteal flap cut out in the lateral part of the hard palate, as well as orthodontic treatment methods, the main purpose of which is to expand and extend the dentition using single jaw removable plate apparatuses, fixed plate apparatuses.

Conclusions. Taking everything into account, surgical reconstructive operations, as well as complex orthodontic treatment, the main purpose of which is to expand and extend the upper and lower jaws, are the integral methods of treating such children. Orthodontic treatment should be aimed at eliminating myofunctional disorders with the helpof orthodontic trainers and elastopositioners. Conducting a comprehensive surgical and orthodontic treatment can reduce the rehabilitation time of children with bilateral cleft lip and palate.

1. N. J. Prescott, S. Malcolm. Evaluating the Evidence for the Influence of Folate Genes on Craniofacial Development. Cleft Palate Craniofacial Journal. 2002;39(3):327-331. https://doi.org/10.1597/1545-1569_2002_039_0327_fatfet_2.0.co_2.

2. N. Vason. Management of children with clefts of the lip or palate: an overview. New-York Dental Journal. 2009;95(4):14-20. https://pubmed.ncbi.nlm.nih.gov/10208080/.

3. N. A. Panakhov, E. J. Hasanli, N. C. Hasanli. Features of dentition and occlusion in patients with cleft lip and palate.World of Medicine and Biology. 2015;4(53):60-63. (In Russ.). https://cyberleninka.ru/article/n/osobennosti-zubnyh-ryadov-i-okklyuzii-u-lits-s-rasschelinami-guby-i-neba.

4. O. I. Arsenina, E. I. Malashenkova, S. A. Pashchenko. Algorithm of orthodontic treatment of cleft lip and palate patients before and after autogenous bone grafting.Stomatology. 2017;5:62-65. (In Russ.). https://doi.org/10.17116/stomat201796562-65.

5. A. G. Nadtochiy, N. V. Starikova, I. U. A. Safronova and others authors. Tongue Structure, Position and Function in Cleft Lip and Palate Children Assessed by Ultrasound Examination. Stomatologiia. 2012;91(3):56-60. https://pubmed.ncbi.nlm.nih.gov/22968616/.

6. Chad A Perlyn, Jeffrey N Brownstein, Donald V Huebener and others authors. Occlusal relationship in patients with bilateral cleft lip and palate during the mixed dentition stage: does neonatal maxillary arch configuration predetermine outcome? Cleft Palate Craniofacial Journal. 2002;39(3):317-321. https://doi.org/10.1597/1545-1569_2002_039_0317_oripwb_2.0.co_2.

7. F. S. Ayupova, M. N. Mitropanova, V. V. Volobuev and other authors. Comprehensive rehabilitation of disabled children with bilateral through-cleft lip and palate in Krasnodar region. Kubanskii nauchnyi meditsinskii vestnik. 2018;25(5):14-21. (In Russ.). https://doi.org/10.25207/1608-6228-2018-25-5-14-21.

8. A. G. Nadtochii, N. V. Starikova, G. I. Fomina. Morphofunctional tongue features revealed by multispiral CT in cleft lip and palate patients. Stomatology. 2012;4:54-59. (In Russ.). https://www.elibrary.ru/item.asp?id=18022680.

9. N. S. Tuturov. Normalizatsiya okklyuzii zubnyih ryadov u bolnyih s vrozhdennoy polnoy rasschelinoy gubyi i neba: Avtoref. dis. ... kand. med. nauk. Moscow. 2010:9-17. (In Russ.). https://www.dissercat.com/content/normalizatsiya-okklyuzii-zubnykh-ryadov-u-bolnykh-s-vrozhdennoi-polnoi-rasshchelinoi-guby-i-.

10. G. V. Dolgopolova. Rannee ortopedicheskoe lechenie v kompleksnoy reabilitatsii detey s vrozhdennoy rasschelinoy verhney gubyi, alveolyarnogo otrostka i neba: Avtoref. dis. ... kand. med. nauk. Moscow. 2005:31. (In Russ.). https://www.dissercat.com/content/rannee-ortopedicheskoelechenie-v-kompleksnoi-reabilitatsii-detei-s-vrozhdennoi-rasshchelino.