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A Novel Approach in Developing Facial Esthetics in Cleft Lip and Palate Patients

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Alveolar Distraction Osteogenesis

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Abstract

The main aim in the treatment of cleft lip and palate cases is to achieve labial, palatal, velopharyngeal closure, a balanced profile, harmonic facial appearance, and a good occlusion (Eppley and Sadove 2000; Phua and de Chalain 2008; Cheung and Chua 2006; Jackson et al. 2004; Williams et al. 2001). Most of the time, these goals are accomplished in the early ages. However, in 20–25 % of the patients (Kumar et al. 2006), dentofacial skeletal deformities, and in 4–45 % (Phua and de Chalain 2008) of the patients, oronasal fistula occurrence, which require secondary surgical corrections can be seen. In this subgroup, if there is oronasal fistula, the main needs can be listed as surgical interventions for complete soft tissue coverage and secondary alveolar bone grafting. Also, surgeries that involve both jaws (either orthognathic surgery or distraction osteogenesis) may be necessary too. In severe cases with wide oronasal fistula, the usual approach is covering the gap with buccal, labial mucosal flaps or tongue flaps (Nakakita and Utsugi 1990; Argamaso 1990; Diah et al. 2007). However, tongue flaps may not always be very successful. Some complications, such as flap failure, bleeding, swelling, pain, infection, hematoma, contour deformities, temporary loss of tongue sensation, gustatory changes, requirement for a two-stage or three-stage procedures, and in rare cases, partial or total necrosis of flap can be observed (Elyassi et al. 2011).

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Acknowledgments

The authors would like to thank Dr. Kemal Ugurlu, Dr. Mesut Sarac for the surgical planning and performing the osteotomies, Dr. Buket Coskuner Gonul for the orthodontic preparation of the second case, Dr. Ali Murat Kokat for the prosthetic restorations and the illustrations, and Dr. Rifat Gozneli for the prosthetic restorations.

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Authors and Affiliations

  1. Faculty of Dentistry Department of Orthodontics, University of Marmara, Istanbul, Turkey

    Nejat Erverdi

  2. Henry M. Goldman School of Dental Medicine Department of Orthodontics & Dentofacial Orthopedics, Boston University, Boston, Massachusetts, USA

    Melih Motro

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  1. Nejat Erverdi
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  2. Melih Motro
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Erverdi, N., Motro, M. (2015). A Novel Approach in Developing Facial Esthetics in Cleft Lip and Palate Patients. In: Alveolar Distraction Osteogenesis. Springer, Cham. https://doi.org/10.1007/978-3-319-07707-9_4

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  • DOI: https://doi.org/10.1007/978-3-319-07707-9_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-07706-2

  • Online ISBN: 978-3-319-07707-9

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