Orthodontisch-chirurgische aspecten bij dentale en beenderige correcties van schisis

Abstract

Orthodontic-surgical considerations of dental and bone corrections in cleft Cleft lip and palate is a collective term for a heterogeneous group of congenital abnormalities at the level of the lips and mouth. It is the most frequent congenital craniofacial disorder and is subdivided into cleft palate and cleft lip with or without cleft palate. The condition has a major impact on the patient’s speech, hearing, appearance, nutritional intake and mental stress. Therefore, the goal of the treatment is to restore function and form with ultimately a satisfied patient. After primary surgery, closing lip and palate clefts, dento-maxillofacial growth should be monitored, adjusted and corrected. Orthodontic-surgical treatment should provide restoration of the jaw wall, tooth arch, occlusion and facial relationships. This aspect of multidisciplinary treatment is subject to specific clinical challenges for the orthodontist, oral and maxillofacial surgeon and restorative dentistry team. The orthodontic-surgical interventions in dental and bony corrections run from birth to adult age and include a postnatal presurgical orthopedic intervention (0 to 4 months), an early orthopedic-orthodontic treatment (2,5 to 6/7 years), a conventional orthopedic-orthodontic treatment (from the age of 7), the placement of a bone graft or bone-in-gnatho (BIG) intervention, a definitive orthodontic treatment (12 to 14 years) and finally, if necessary, orthognathic surgery (from the age of 17).