The cleft palate is a congenital malformation with a large number of newborns. Among the various types are cleft lip isolated or associated with cleft palate, more frequent in men, and isolated cleft palate, more frequent in women.
Causes of cleft palate or cleft palate
Less than a quarter of the cases of this disease have a syndromic character, and of the remaining part, half is associated with systemic malformations. It can also be associated with different syndromes such as Goldenhar Syndrome (congenital disease affecting cheek bones, maxilla and mandible, mouth, ears, eyes and bones of the spine), and Larsen Syndrome (multiple congenital dislocations with skeletal dysplasia and deformations in bones, joints and tendons), among others.
Consequences of cleft palate or cleft palate
The lack of fusion of the mamelones that give rise to a correct development of that part of the facial massif can be classified in different types:
Types of Cleft Lip
- Scarring cleft lip: slight mucosal edge depression
- Simple cleft lip: with continuity of the alveolar arch
- Total Cleft Lip: affects the entire lip and the primary palate
- Central palatal lip
Types of Palate Cleft
- Alveolar cleft palate
- Simple Palatine cleft
- Total unilateral cleft palate (includes primary palate)
- Cleft Palate bilateral total (includes primary palate)
- Central Palatine Cleft (more Central Cleft Lip)
All of this leads, obviously, to the affectation of the functions of phonation, chewing, swallowing and aesthetic deficits, which will be the objective of the different phases of treatment.
Treatment of cleft palate or cleft palate
The treatment in Dentistry is very complex and lengthens for years. As a possible protocol to treat the cleft palate or fissure of a newborn are the following points to consider:
- A first consultation with a medical team and an orthodontist should be done until the first week of birth.
- During the first month, a basic analysis, a chest x-ray, a genetic analysis, an abdominal ultrasound, an echocardiogram, a consultation with a pediatrician, a geneticist, and a radiologist should be performed.
- From the first to the third month it is advisable to carry out a cheiloplasty and a primary rhinoplasty with a maxillofacial surgeon.
- From the sixth to the ninth month parents should be more actively involved with speech therapy and speech therapy.
- During the ninth month it is important to perform an audiometry, an evaluation of the middle ear with an otolaryngologist.
- Between 12 and 18 months a palatoplasty should be performed.
- From 3 to 5 years old a mixed dentition control, maxillary expansion with a dentist. - During the first year to age 6, speech checks should be performed every six months by a speech therapist.
- At 5 years, an evaluation of velopharyngeal insufficiency, a nasofibroscopy with a maxillofacial surgeon and a speech-pathologist.
- Between 5 and 6 years a pharyngoscopy, secondary rhinoplasty, adenoids and tonsils with a maxillofacial surgeon and an otolaryngologist.
- Between 7 and 9 years old, an alveoplasty, orthodontic and periodontics with a maxillofacial surgeon and a dentist.
- Between the ages of 9 and 14 an orthodontics and an assessment for possible implants performed by a dentist.
- Between the ages of 16 and 18 an orthognathic surgery to correct possible sequelae on the lip and nose. Performed by a maxillofacial surgeon and a dentist.