Abstract

Embryonic development of the head and face are among the most complex prenatal developmental events. Any disturbance during the developmental stage can result in craniofacial abnormalities, and the timing of the disturbance and intensity of the interruption affect the severity and type of the anomaly. Cleft lip and palate are relatively common congenital malformations and are readily diagnosed. Treating cleft lip and palate defects is important because of the severe aesthetic, functional, and serious psychological problems faced by both patients and their parents. It is recommended that cleft lip and palate patients from 0 to 18 years old undergo treatment with a multidisciplinary team. In this series of clinical reports, we describe clinical orthodontic treatment approaches using a presurgical nasoalveolar moulding (PNAM) in newly born unilateral and bilateral cleft lip and palate babies. Three boys and one girl were selected from among other cleft lip and palate patients because some information about the possible aetiology of the clefts was observed and the parents were cooperative during treatment. The objectives of PNAM use in unilateral and bilateral cleft lip and palate patients are to presurgically decrease the severity of the cleft size, maintain a narrower cleft palate, and increase the length of the columella and height of the nostrils. With parental cooperation, the treatment goals were achieved in these cases

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“The image shows five month’s improvement in health of the baby girl who was born with severe multiple syndromes. She had nasogastric feeding till the feeding plate was made at 10 days old. The parent’s approach to the baby with utmost care and love is praiseworthy”.

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Background The aim of this study was two-fold; (1) to evaluate the prevalence and patterns of impacted canines and transmigrated canine teeth, and (2) to evaluate the possible relationships between impacted teeth, malocclusions and systemic conditions in an orthodontic patient population. Methods The clinical records and panoramic radiographs of 453 patients [201 (44.3%) male and 252 (55.7%) female] referred to our outpatient clinic between January 2008 and January 2012 were retrospectively evaluated. The number, position, localization (right/left) and transmigration of teeth, as well as sex, age and systemic conditions of patients, were noted. An impacted canine was considered to be transmigrated when at least part of its length had crossed the midline. Complications related to impacted teeth (pain, cystic changes, root resorption or eruption disturbance of adjacent teeth) were also noted. A p-value less than 0.05 was considered statistically significant. Results Impacted and transmigrated canine teeth were found in 16 (3.53%) and two (0.44%) patients in the study group, respectively. Root resorption was seen in four teeth adjacent to impacted canines. No statistical difference was found among gender, location, malocclusion and impaction of the teeth (p>0.05). However, maxillary canine impaction occurred significantly more frequently than mandibular canine impaction (p<0.05). Conclusions The early detection of impacted as well as transmigrated teeth is crucial for successful treatment, therefore demographic studies are important. Although larger samples are required, this study provides a baseline regarding the frequency and type of impacted canines in this particular population.

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Cleft lip and/or cleft palate are congenital anomalies(present at birth). At intrauterine period palate starts developing at 6th week and until the 12th week the development continues. Palate formation between 6th- 9th weeks of pregnancy is very important. Disrupting of the structure of a gene interrupts face parts making up the fusion and it leads to different facial clefts including lips and palate clefts.

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Dudak-damak yarıkları konjenital (doğumsal) anomalilerdir. İntrauterin dönemin (hamilelik dönemi) 6. haftasında damak gelişmeye başlar ve 12. haftaya kadar gelişmeye devam eder. Damak oluşumunda hamilelikte 6. haftanın sonu ile 9. haftanın başlangıcı önemlidir. Yüz gelişimi gebeliğin 4-12. haftalarında tamamlanan kompleks bir olaydır. Başlangıçta birkaç tomurcukla başlayan gelişim aşamaları, orta hatta doğru tomurcukların büyümeleri ve birbirleriyle birleşmeleri ile yüzün son hali belirlenir. Birleşmeyi sağlayan gen yapısının bozulması, yüzü oluşturan parçaların kaynaşmasını engeller ve yarık dudak-damak başta olmak üzere farklı yüz yarıklarının oluşmasına yol açar.

Abstract

Cleft lip and palate are common congenital malformations in populations. There is an increase in number of both syndromic and nonsyndromic cleft lip and palate cases as well as in additional malformations The treatment of cleft lip and palate is done between 0-18 years and is a multidisciplinary treatment. The treatment process is long, tiring withhigh costs.In Turkish Republic of Northern Cyprus newborn babies with cleft lip and/or palate are treated with PNAM appliance before the lip, nose and palate operations.

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Dudak damak yarıkları populasyonlarda sık görülen konjenital malformasyonlardır. Dudak damak yarıklarının sayısında, onlarla birlikte görülebilen ek malformasyonlarda ve sendromik dudak damak yarıklarında yıllar içersinde artış gözlenmiştir. Dudak damak yarıklarının tedavisi 0-18 yaş arasında ve multidisipliner olarak yapılmaktadır. Tedavi süreci uzun, yorucu ve maliyeti yüksektir. Günümüzde dudak damak yarıklarında değişik ekollerle tedavi yapılmaktadır. Kuzey Kıbrıs Türk Cumhuriyetinde yeni doğmuş dudak damak yarıklı bebeklere dudak ve damak operasyonları öncesinde preoperatif nazoalveoler şekillendirme plağı uygulanmaktadır.

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Basic knowledge to clinical staff

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