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Orthodontic treatment of dento- maxillo-facial malformations in patients with unilateral cleft lip and palate


Author: Mazen Husni A. Al Momani
Degree:doctor of medicine
Speciality: 14.00.21 - Stomatology
Year:2005
Scientific adviser: Ion Lupan
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution:
Scientific council:

Status

The thesis was presented on the 2 February, 2005
Approved by NCAA on the 24 February, 2005

Abstract

Adobe PDF document – 0.29 Mb / in romanian

Summary

The aim of present study was to study anatomical and functional disorders of maxillofacial malformations in patients with clefts of upper lip and palate for development of methods of orthodontic correction of jaw and dental deformities which are concomitant with these conditions.

Was carried out thorough analysis of functional condition of jaw and dental system in 73 patients with unilateral clefts of lip and palate (UCLP) from 3 to 17 years old, from which 44 (60,27%) were male and 29 (39,73%) female; in 62 (84,93%) were revealed different types of jaws' and dental malformations.

In children with UCLP which passed surgical intervention were revealed three principal types of maxillary malformations: narrowing of maxilla, deformities of frontal segment in form of retrognatia, and deformity of alveolar process. In children with congenital clefts of lip and palate which are not treat with surgical intervention were also revealed three types of maxillary deformities: less pronounced narrowing of maxilla alveolar process and deformity of dental row, and deformity of frontal segment with prognatia.

More prevalent was narrowing of maxilla – in 43 patients (58,90 %), but also were revealed flattening of frontal segment – in 11 patients (15,07 %), as well as deformity of dental row – in 8 patients (10,96 %).

To increase the efficiency of treatment of children with UCLP author developed and introduced multifunctional orthodontic device with three-dimensional action. This device was also applied in unilateral cleft of lip and palate. For redressing of flattened frontal segment of maxilla or teeth's palatal deviation in 11 patients were used removable acrele plate with breaking screw. For consolidation of treatment's results it is necessary to apply adequate retention in dependence of type and severity of deformity. After redressing of maxilla's narrowing in 27 patients with UCLP was used orthodontic device with palatal plastic plate and vestibular arch, which precluded possibility of relapsing. The same device can be used for prophylaxis of maxilla's narrowing after plastics of palate.

By study of control jaw's models before and after using of orthodontic device proposed by author was noted redressing of maxillary deformity, uniform growth of upper dental arch with preserving intervals between teeth's which are necessary for correct teeth's eruptions, and forming of satisfactory dental occlusion. Especially advantage of presented orthodontic device was shortening of therapeutic course as well as high quality of aesthetic result, which is attained after palatal plastics.