Tek ve Çift Taraflı Dudak ve Damak Yarıklı Hastalarda Maksiller Genişletme ve İlerletme Uygulamasının Değerlendirilmesi

Year 2021, , 328 - 334, 01.09.2021

Luay Ali Zaidan , Alev Aksoy

https://doi.org/10.19127/bshealthscience.872315

Abstract

Dudak ve damak yarıkları; genetik ve çevresel nedenlerden dolayı ortaya çıkan en yaygın kraniyofasiyal anomalilerdir. Dudak ve damak yarıklı bireylerde solunum, işitme ve konuşma gibi fonksiyonel ve psikososyal sorunlar meydana gelmekte ve bu nedenle de bu bireyler multidisipliner tedavilere gereksinim duymaktadır. Dudak ve damak yarıklarının onarımı sonrası iyi bir fonksiyon, estetik ve yumuşak doku rekonstrüksiyonu elde etmek için erken yaşta alveolar yarıkların onarılması gerekmektedir. Alveolar kemik grefti uygulanan cerrahi işlemler, kemik formasyonunu oluşturur; oronasal fistülü ortadan kaldırır, ortodontik problemin nüksetmesini önler ve protetik tedavileri kolaylaştırır. Bu cerrahi işlemler, avantajlarına rağmen dudak damak yarıklı bireylerde skar oluşumuna sebep olur. Bu skar dokusu maksillanın sagital, vertikal ve transversal gelişimini ve pozisyonunu olumsuz yönde etkiler. Dolayısıyla maksiller diş kavsi daralır ve bu durum posterior çapraz kapanışa neden olur. Maksillanın genişletilmesi (maksiller genişletme apareyleri ile) ve ilerletilmesi (yüz maskesi ile) oluşan pozisyonel ve gelişimsel yetersizliklerin giderilmesinde kullanılır. Bu derlemenin amacı; tek veya çift taraflı dudak ve damak yarıklı bireylerin genişletme ve ilerletme uygulamaları sonucunda fasiyal morfolojilerinde meydana gelen iskeletsel, dentoalveolar ve yumuşak doku değişikliklerinin değerlendirilmesidir.

Keywords

Dudak ve damak yarıkları, Kemik grefti, Maksiller genişletme ve ilerletme

Evaluation of Maxillary Expansion and Protraction in Unilateral and Bilateral Cleft Lip and Palate Patients

Abstract

Cleft lip and palate are the most common craniofacial anomalies that occur due to genetic and environmental reasons. The deformities of the dentofacial system in patients with cleft lip and palate patients cause functional and psychosocial problems such as respiration, hearing and speech in the individual and therefore multidisciplinary work needs of specialization areas in different departments. İn early age; cleft lip and palate need to be repaired to obtain a good aesthetic and functional result and a good soft tissue reconstruction after repair. The defects in the bones can be removed by secondary bone grafting which considered as accepted treatment now. These surgical procedures, which form bone formation, eliminate oronasal fistulae and at the same time preventing the relapse of orthodontic treatment and facilitates prosthetic treatments, all of these consider a good advantageous, but in these patients, premature scar formation of the lip and palate repair caused by developmental or positional anomalies are seen in sagittal, vertical and transversal area in the upper jaw affected in the negative direction, caused by maxillary dental arch narrowing and posterior crossbite formation, mostly inhibiting maxillary development. Maxillary expansion and protraction are performed at the correction of this positional and developmental retardation by using maxsillary expandors and face mask respectivly. The purpose of this article is to evaluate skeletal, dentoalveolar and soft tissue changes in facial morphology of individuals with unilateral or bilateral cleft lip and palate with Class III malocclusion that treated with maxillary expantion and protraction.

Keywords

Cleft lip and palate, Bone grafting, Rapid maxillary expansion

References

• Agostino P, Ugolini A, Signori A, Silvestrini‐Biavati A, Harrison JE, Riley P. 2014. Orthodontic treatment for posterior crossbites. Cochrane Database of Systematic Rev, (8). DOI: 10.1002/14651858.CD000979.pub2.
• Allori AC, Mulliken JB, Meara JG, Shusterman S, Marcus JR. 2017. Classification of cleft lip/palate: then and now. Cleft Palate Craniofac J, 54(2): 175-188.
• Batra P, Sharma J, Duggal R, Parkash HARI. 2004. Secondary bone grafting in cleft lip and palate with eruption of tooth into. J Indian Soc Pedo Prev Dent, 22(1): 8-12.
• Bell RA. 1982. A review of maxillary expansion in relation to the rate of orthopedies. Am J Orthod, 81: 32-37.
• Bergland O, Abyholm A. 1986. Bone grafting at the stage of mixed dentition in cleft lip and palate patients. Cleft Palate J, 23: 175-205.
• Berkowitz S. 2006. Cleft lip and palate: diagnosis and management. Springer., South Miami, USA. 785 pages.
• Bhattacharya S, Khanna V, Kohli R. 2009. Cleft lip: The historical perspective. Indian J Plastic Surg, 42(Suppl): S4.
• da Silva Filho OG, Boiani E, de Oliveira CA, Santamaria Jr M. 2009. Rapid maxillary expansion after secondary alveolar bone grafting in patients with alveolar cleft. The Cleft Palate-Craniofacial J, 46 (3): 331-338.
• da Silva Filho OG, Teles SG, Ozawa TO, Filho LC. 2000. Secondary bone graft and eruption of the permanent canine in patients with alveolar clefts: literature review and case report. The Angle Orth, 70(2): 174-178.
• Davis JS, Ritchie HP. 1922. Classification of congenital clefts of the lip and palate: with a suggestion for recording these cases. J American Medical Assoc, 79(16): 1323-1327.
• De Almeida AM, Ozawa TO, Alves ACM, Janson G, Lauris JRP, Ioshida MSY, Garib DG. 2017. Slow versus rapid maxillary expansion in bilateral cleft lip and palate: a CBCT randomized clinical trial. Clin Oral Investig, 21(5): 1789-1799.
• Delaire J, Verdon P, Lumineau JP, Cherga-Negrea A, Talmant J, Boisson M. 1972. Quelques resultats des tractions extraorales a appui frontomentonnier dans le traitment orthopedique des malformations maxillomandibulaires de classe III et des sequelles osseuses des fentes labiomaxillaires. Revue de Stomatologie, 73: 633-642.
• Dogan E, Seckin O. 2020. Maxillary protraction in patients with unilateral cleft lip and palate. J Orofac Orthop, 81: 209-219.
• Dogan S. 2012. The effects of face mask therapy in cleft lip and palate patients. Annals of Maxillofacial Surg, 2(2): 116-120.
• Ellis E. 1998. Management of patients with orofacial clefts. Oral and Maxillofacial Surgery. Peterson LJ, ed., Ellis III E., Hupp JR., TuckerMR. Mosby, St Louis, USA, pages: 656-679.
• Emodi O, Noy D, Hazan-Molina H, Aizenbud D, Rachmiel A. 2015. Secondary bone grafting of the cleft maxilla following reverse quad-helix expansion in 103 patients. Annals of Maxillofacial Surg, 5(1): 32.
• Enacar A. 1999. Dudak ve damak yarıkları. Dudak damak yarıklarında orta yüz büyümesinin kontrolü: Maksiller ortopedik ve ortodontik tedavi Hacettepe Ün, Tıp Fak. Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı. Ankara.
• Eppley BL. 1996. Alveolar cleft bone grafting (Part I): Primary bone grafting. J Oral Maxillofac Surg, 54: 74-82.
• Fogh-Andersen P. 1966. Thalidomide and congenital deformities, Acta Chir Scand, 131: 197-200.
• Friedman HI, Sayetta RB, Coston GN, Hussey JR. 1991. Symbolic representation of cleft lip and palate. The Cleft Palate-Craniofacial J, 28(3): 252-260.
• Graber TM. 1992. Orthodontics, principles and practice, Bölüm 11, W. B. Saunders co, Philadelphia, USA, 805 pages.
• Grayson BH, Santiago PE, Brecht LE. 1999. Presurgical nasoalveolar molding in infants with cleft lip and palate. Cleft Palate Craniofac J. 36: 486-498.
• Haas AJ. 1970. Palatal expansion: Just the beginning of dentofacial orthopedics. Am J Orthod, 57: 219-255.
• Huang W, Li YH, Guo KL, Zhou YC, Li XJ. 2020. Finite element analysis of the comprehensive impact of scar and maxillary expansion combined with protraction on the development of maxilla with cleft lip and palate after repair operation. West China J Stomatol, 38(6): 642-646.
• Ishikawa H, Kitazawa S, Iwasaki H, Nakamura S. 2000. Effects of maxillary protraction combined with chin-cap therapy in unilateral cleft lip and palate patients. The Cleft palate-Craniofac J, 37(1): 92-97.
• Jain S, Shrivastav S, Jain NK. 2015. Maxillary expansion in cleft lip and palate cases- a review. Int J, 3(9): 1455-1461.
• Kawakomi M, Yagi T, Takada K. 2002. Maxillary expasion and protraction in correction of midface retrusion in a complete unilateral cleft lip and palate patient. Angle Orthod, 72: 355-361.
• Keçik D. 2017. Evaluation of protraction face-mask therapy on the craniofacial and upper airway morphology in unilateral cleft lip and palate, J Craniofac Surg, 28(7): e627-e632.
• Kernahan DA, Rosenstein SW. 1990. Cleft Lip and Palate, A System of Management. Williams & Wilkins, Baltimore, USA, 330 pages.
• Kettle MA, Burnapp DR. 1955. Occipitomental anchorage in the orthodontic treatment of dental deformities due to cleft lip and palate. British Dental J. 99: 11-14.
• Lilja J. 2003. Cleft lip and palate surgery. Scand J Surg, 92: 269-273.
• Liou EJW, Tsai WC. 2005. A new protocol for maxillary protraction in cleft patients: repetitive weekly protocol of alternate rapid maxillary expansions and constrictions. The Cleft Palate-Craniofac J, 42(2): 121-127.
• Lowry RB, Sibbald B, Bedard T. 2014. Stability of orofacial clefting rate in Alberta, 1980–2011. The Cleft Palate-Craniofac J, 51(6): 113-121.
• Marazita ML, Mooney MP. 2004. Current concepts in the embryology and genetics of cleft lip and cleft palate. Clinics in Plastic Surg, 31(2): 125-140.
• McNamara JA. 1987. An orthopedic approach to the treatment of Class III malocclusion in young patients. J Clin Orthod, 21: 598-608.
• Meazzini MC, Zappia LB, Tortora C, Autelitano L, Tintinelli R. 2019. Short-and long-term effects of late maxillary advancement with the Liou-Alt-RAMEC protocol in unilateral cleft lip and palate. The Cleft Palate-Craniofac J, 56(2): 159-167.
• Molsted K, Dahl E. 1987. Face mask therapy in children with cleft lip and palate. The European J of Orthodon, 9(3): 211–215.
• Moreau JM. 2006. A Novel cyclic acetal biomaterial and its use in cleft palate repair. , MSc Theis, University of Maryland, USA. 74 pages.
• Tindlund RS. 1994. Skeletal response to maxillary protraction in patients with cleft lip and palate before age 10 years. Cleft Palate Craniofac J. 31(4): 295-308.
• Turley PK. 1988. Orthopedic correction of Class III malocclusion with palatal expansion and custom protraction headgear. J Clin Orthod, 22: 314-325.
• Vanderas AP. 1987. Incidence of cleft lip, cleft palate, and cleft lip and palate among races: a review. Cleft Palate J, 24(3): 216-225.
• Vasant M, Menon S, Kannan S. 2009. Maxillary expansion in cleft lip and palate using Quad helix and rapid palatal expansion screw. Med J Armed Forces India, 65(2): 150-153.
• Vieira GL, de Menezes LM, de Lima EMS, Rizzatto S. 2009. Dentoskeletal effects of maxillary protraction in cleft patients with repetitive weekly protocol of alternate rapid maxillary expansions and constrictions. The Cleft Palate-Craniofac J, 46(4): 391-398.
• Yağcı A, Uysal T. 2007. Tek taraflı dudak-damak yarığına sahip bebeklerde nazoalveolar şekillendirme yönteminin yarık segmentler ve alveol genişlikleri üzerine etkilerinin değerlendirilmesi. Türk Ortodonti Derg,16: 1-10.
• Yang CJ, Pan XG, Qian YF, Wang GM. 2012. Impact of rapid maxillary expansion in unilateral cleft lip and palate patients after secondary alveolar bone grafting: review and case report. Oral Surg, Oral Med, Oral Pathol Oral Radiol, 114(1): e25-e30.
• Yang IH, Chang YI, Kim TW, Ahn SJ, Lim WH, Lee NK, Baek SH. 2012. Effects of cleft type, facemask anchorage method, and alveolar bone graft on maxillary protraction: a three-dimensional finite element analysis. The Cleft Palate-Craniofac J, 49(2): 221-229.
• Yen SLK. 2011. Protocols for late maxillary protraction in cleft lip and palate patients at Childrens Hospital, Los Angeles. Semin Orthodont, 17(2): 138-148.
• Zhang Y, Jia H, Fu Z, Huang Y, Wang Z, Guo R, Shen J, Li W. 2018. Dentoskeletal effects of facemask therapy in skeletal Class III cleft patients with or without bone graft. American J Orthodont Dentofac Orthoped, 153(4): 542-549.