Orthopedic and surgical rehabilitation children with unilateral cleft/palat
Keywords:presurgical orthopedic, nasoalveolar molding, cleft lip and palate
Introduction. Maxillofacial fissures are the most common form of congenital malformations of the face and the maxillofacial region. These forms of malformations may vary from simple shapes to particularly non-specific forms. The cleft lip and palate are characterized by anatomical and functional disorders. In unilateral total splits, anatomical disorders are characterized by bone deformities. The upper jaw is divided into two segments by the fissure that passes on the upper lip, alveolar and hard palatal process and soft palatal region. The clinical manifestations of these forms of malformations appear with severe aesthetic facial deformities and functional disorders that can lead to a chain of clinical diseases that endagers even the vital functions of the child. Background. During the years of research in order to find a better optimal way to treat the cleft palate, there was described a lot of controversary methods and steps to reduce the dimension of the cleft, using prenasoalveolar molding appliances and different types of surgical methods(one or 2 steps plasty of the palate). Materials and methods. Six patients with total palatal splitting were examined. There were done impression and obtained study gypsum models during preoperative to the primary stage of plasty and postoperatively to the secondary stage of plasty of the hard palate. Results. According to the measurements and calculations, we came to the conclusion that the two-stage plasty, only with passive therapy of separation of the nasal cavity from the oral cavity with the help of palatal plates, has a displacement efficiency of the splitting segments of 46%, while one-stage palatal plasty with active preoperative nasal-alveolar molding with intermaxillary traction has a closure value of 76% (after Elcin). Conclusion. One-stage cleft palate surgery, which preoperatively undergoes orthodontic nasal-alveolar molding therapy, is more effective in closing the cleft at the level of the alveolar processes than two-stage plastic surgery without preoperative nasal-alveolar orthodontic therapy.
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