Successful treatment requires technical skill, knowledge of the abnormal anatomy, and appreciation of threedimensional facial aesthetics. Feb 21, 2020 orofacial cleftsincluding cleft lip cl, cleft lip and palate clp, and cleft palate cp alone, as well as median, lateral transversal, and oblique facial cleftsare among the most common congenital anomalies. There appears to be a greater chance of clefting in a newborn if a relative has. Clefts of the lip andor palate clp are common birth defects of complex etiology. A unique feature of the book is that it largely consists of longitudinal facial and palatal growth studies of dental casts, photographs, panorexes, and. Pdf this chapter is a comprehensive overview regarding the treatment of cleft lip and palate clp patients. Clapa is the only ukwide voluntary organisation specifically helping those with, and affected by, cleft lip and palate. The severity of cleft lip and cleft palate can vary. Introduction according to berkowitz 1996 a cleft of the lip andor palate is a structural defect that usually affects other. A cleft palate can be on one or both sides of the roof of the mouth. A baby can be born with a cleft lip, a cleft palate, or both a cleft lip and palate. Cleft lip and cleft palate can occur on one or both sides of the mouth.
This opening can be small or large enough to connect the upper lip and nose. The etiology of cleft lip cl and or cleft palate cp has been extensively studied in industrialized countries and is suggested to be heterogeneous with increasing evidence that both genetic and environmental factors are operating. Furthermore, separate cellular and genetic etiologies for clp and cleft palate. Approximately 1 in children have a cleft lip or a cleft palate or both.
Cleft lip and palate are considered one of the most common birth. Cleft lip with or without cleft palate can be unilateral or bilateral, and occurs in a variety of combinations with variable expression in the nose, lip, alveolus, and primary and secondary palates. A cleft lip is an opening extending through the upper lip. Ppt cleft lip and palate powerpoint presentation free to.
The causes of cleft lip and cleft palate or both are unknown, although hereditary genetic factors sometimes play a small role. Your cleft team consists of a group of specialists with particular expertise in cleft lip and palate, called a multidisciplinary team mdt. It may involve lip only, lip and palate and palate only. Cleft lip with or without cleft palate is the second most common birth defect in the united states, affecting one in every 940 births and resulting in 4,437 cases every year parker et al. Cleft lip or palate affects one in 700 babies in the united states and the united kingdom. Mar 23, 20 cleft lip, cleft palate, and the combinationof cleft lip and palate are considered tohave a multifactorial cause, including bothenvironmental and genetic elements. It may be in the midline center or left and or right side of the lip. Genetics of cleft lip and cleft palate pubmed central pmc.
Cleft lip appears when there is a split or opening in the lip. Etiology and genetic factors in clefts of lip andor palate reported at childrens hospital, lahore, pakistan. Cleft care requires a collaborative multidisciplinary. Among the cleft lip and palate population, the most common diagnosis is cleft lip and palate at 46%, followed by isolated cleft palate at 33%, then isolated cleft lip at 21%.
In finland, clefts are closed before the childs first birthday. Guidelines for the treatment of cleft lip and palate about 120 babies are born with cleft lip and palate in finland each year. Calzolari e, ciulli l, cordier s, gualandi f, pierini a, et al. The most common types of cleft affecting the palate a unilateral cleft lip with alveolar involvement. Cleft lip and palate presents many features at dif. Normally, the tissues that make up the lip and palate fuse together in the second and third months of pregnancy. Cleft of lip along with alveolus is denoted as cla. Genetics and management of the patient with orofacial cleft. Etiopathogenesis of orofacial clefting revisited ncbi. The management of children with cleft lip and palate presents many. Feb 21, 2020 orofacial clefts ie, cleft lip cl, cleft lip and palate clp, cleft palate cp alone, as well as median, lateral transversal, oblique facial clefts are among the most common congenital anomalies. Cleft lip palate free download as powerpoint presentation.
This joining of tissue forms the facial features, like the lips and mouth. Cleft lip and palate gillette childrens specialty healthcare. If further firstdegree relatives are affected by a cleft palate. Cleft lip, cleft palate, and cleft lip and palate are variations of a congenital deformity caused by abnormal facial development during the first trimester of gestation.
Etiology and pathogenesis of congenital cleft lip and. Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes cleft lip, cleft palate, and both together. In addition, a baby may have a cleft lip, a cleft palate, or both. A cleft palate is an opening of the hard palate the bony front portion of the roof of the mouth or the soft palate the muscular nonbony region in the rear of the roof of the mouth. Cleft lip and palate symptoms, diagnosis and treatment. Numerous combinations and degrees of severity exist, ranging from a unilateral cleft lip to a bilateral cleft lip associated with a fully cleft palate. Orofacial clefts are a heterogeneous group of disorders affecting the structure of the face and oral cavity that have been divided into three general categories. The diagnosis of submucous cleft palate often occurs late in children as a result. Some of the ongoing research studies on cleft lip and cleft palate in germany are secondary cleft nose rhinoplasty. Combined, these suggest that clp and cancer may be mediated by shared environmental and genetic etiologies. Like cleft lip, cleft palate also can occur on one or both sides of the top of the mouth. Cleft lip and cleft palate are common malformations, with an incidence of approximately 1 in births cleft lip and 1 in 2500 births cleft palate.
Cleft lip and palate an overview sciencedirect topics. Your child may have one or both of these conditions at birth. Causes a variety of factors can come into play to determine if a baby is. A combination of genetic predisposition and inutero exposure to teratogens nicotine, alcohol, antiepileptic drugs can arrest the fusion of the facial processes required for normal facial development. Special report etiology and cleft palate, this report was pathogenesis of congenital cleft lip and an nldr state of the art report a. Children with cleft palate may experience temporary hearing loss due to a build up of fluid in the middle ear known as otitis media andor other ear infections. Cleft lip and cleft palate occur when tissues in the babys face and mouth dont fuse properly. Plastic surgeons, audiologists, orthodontists, speech and language therapists and clinical psychologists amongst others. A typical care plan timetable for cleft lip and palate is. Etiology and genetic factors in clefts of lip andor palate. The incidence of orofacial cleft is approximately 1 in every 500550 births. Feeding methods for children with cleft lip andor palate.
For most babies with cleft lip and or cleft palate, the reason for the improper fusion is not known. How should the care for this infant, and his mother, be. Etiology of cleft lip and palate is multifactorial and includes environmental and genetic reasons. Cleft lip and cleft palate are birth defects that occur when the lip or mouth do not form properly during pregnancy. Primary palate, which consists from the lip, alveolar arch, and palate that is anterior to the incisive foramen premaxilla occurs throughout the second month of gestation. Cleft lip and cleft palate symptoms and causes mayo clinic. The causes of orofacial clefts among most infants are unknown. A cleft palate occurs when the roof of the mouth does. Cleft lip and palate american academy of pediatrics. Role of environmental factors in the etiology of non. The majority of bilateral cleft lips 86% and unilateral cleft lips 68% are associated with a cleft palate. Hopper cleft lip and palate are the most common congenital craniofacial anomalies. The oral cleft is the most common craniofacial malformation in the newborn.
It may be in the midline center or left andor right side of the lip. Type of cleft depends on the time where cleft was developed. Approximately 1 case of orofacial cleft occurs in every 500550 births. Orofacial cleftsincluding cleft lip cl, cleft lip and palate clp, and cleft palate cp alone, as well as median, lateral transversal, and oblique facial cleftsare among the most common congenital anomalies. A cleft lip or palate happens when the structures that form the upper lip or palate fail to join together when a baby is developing in the womb. In the recently published article causal attributions of cleft lip and palate across cultures cleft palate craniofac j. Cleft lip and palate represent a major public health problem due to the possible associated lifelong. Introduction according to berkowitz 1996 a cleft of the lip andor palate. A cleft lip involves an opening from the upper lip to one or both nostrils.
The infant was found to have a cleft lip and palate. Cleft lip and cleft palate are congenital anomalies that occur in the face during fetal development. Guidelines for the treatment of cleft lip and palate. Upper lip, nose and palate forms in two developmental phases, primary palate and secondary palate.
Isolated cleft palate cpo is the rarest form of oral clefting. Failure of fusion of the maxillary prominence with the medial nasal prominence causes cleft lip. The reason for this defect lies in defects normal development of the face within the mothers womb. Clefts of the upper lip and or palate may be unilateral only one side of the mouth affected or bilateral both sides affected. Cleft lip and cleft palate what are cleft lip and cleft palate. The purpose of the present paper is to present the etiology of cleft lip and cleft palate both the genetic and the. This type of birth defect also is called a facial anomaly. Historically, cl and clp have been considered variants of the. B illustration depicting the alveolus of the premaxilla, perioral muscles, and typical cleft nasal deformity. This chapter is a comprehensive overview regarding the treatment of cleft lip and palate clp patients.
The opening may be on one side, both sides, or in the middle. A cleft lip contains an opening in the upper lip that may extend into the nose which may be on one side, both sides, or in the middle. The cleft can occur on one or both sides of the lip. Role of environmental factors in the etiology of nonsyndromic cleft lip palate shinie razil goveas1, n s savitha2 1senior resident, department of dental surgery, st. They continue to grow medially merging with the medial nasal processes and then. Cleft lip is easily noticeable because it affects the area between the lip and nose. Some families have a hereditary form of cleft lip andor palate, meaning that multiple family members have been born with a cleft lip or palate. Cleft lip is the congenital failure of the maxillary and median nasal processes to fuse, forming a groove or fissure in the lip. Aug, 2019 children with clefts will have a care plan tailored to meet their individual needs.
Cleft lip with or without a cleft palate clp and cleft palate alone cp differ with respect to embryology, etiology. Cleft lip and cleft palate clp are the most common congenital orofacial deformities. Cleft palate is the congenital failure of the palate to fuse. Medications, intake of anticonvulsants, radiation, smoking, alcohol consumption and more than 300 syndromes are associated with cleft lip and palate 5. Management of children with cleft lip and palate 5 figure 1 schematic representation of the lip and palate to explain the classi. Orofacial clefts ie, cleft lip cl, cleft lip and palate clp, cleft palate cp alone. Cleft lip and palate, etiology of cleft, oral physician and cleft, prenatal diagnosis of cleft, genetic counselling for cleft deformities 1. Some children have a cleft lip or cleft palate because of changes in their genes. Cleft lip and cleft palate commonly occur as isolated birth defects but are also associated with many inherited genetic conditions or syndromes. For most babies with cleft lip andor cleft palate, the reason for the improper fusion is not known. A bilateral cleft lip or palate affects both sides of the mouth.
Cleft lip palate medical specialties diseases and disorders. Infant with unilateral complete cleft lip and palate. Pdf cleft lip and palate are the most common facial deformity. A cleft can be visible and can lead to medical, behavioral, and social difficulties. Cleft lip and cleft palate illinois department of public health. It is understood that the antenatal diagnosis of clefts involving the lip is relatively. Johns medical college and hospital, bengaluru, karnataka, india, 2professor and head, department of pedodontics, kvg dental college and hospital, sullia, karnataka, india. A cleft palate is a separation of the top of the mouth. Well consult with you about cleft lip and palate, share information about current treatment options, provide appropriate counseling, and if you wish, help you plan a course of treatment. Etiology and pathogenesis of congenital cleft lip and cleft. The complex interplay between genetic and environmental factors play a significant role in the incidence and cause of clefting. Pdf congenital cleftlip and cleft palate have been the subject of many genetic studies, but until.
Cleft lip and palate are the result of tissues of the face not joining properly during development. Cleft lip and cleft palate orofacial clefts are birth defects that occur. Cleft lip palate is the fourth most common birth defect in the united states. Failure of merging between the medial nasal and maxillary. A cleft lip occurs when there is a split or opening in the lip. A parent with cleft lip andor palate has a 4% risk of having an affected child. The three main types of oral clefts are cleft lip alone, cleft lip with cleft palate, and cleft palate alone. In addition to determining the type of speech and language treatment that is optimal for individuals with cleft lip and palate, slps consider other service delivery variablesincluding format, provider, dosage. Type of cleft unilateral cleft lip bilateral cleft lip.
Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes cleft. A cleft lip contains an opening in the upper lip that may extend into the. Sometimes, a cleft isnt diagnosed until your baby is born. All of clapas publications are available as free pdf downloads. Because the lip and the palate develop separately, it is possible to have a cleft lip without a cleft palate, a cleft palate. Cleft lip and cleft palate germany pdf ppt case reports. Symptoms, causes, diagnosis and treatment cleft lip and cleft palate are maxillofacial disorders related to the jaws and face. A child can have only a cleft lip, only a cleft palate, or both together. Primary palate, which consists from the lip, alveolar arch, and palate. Most cases consist of isolated cleft palate 60%, while less than one in four cases suffer from complete cleft lip and palate. Face shape of unaffected parents with cleft affected offspring. But in babies with cleft lip and cleft palate, the fusion never takes place or occurs only part way, leaving an opening cleft. Answer in most cases, the cause of cleft lip and cleft palate is unknown.
A unilateral cleft lip or palate affects just one side of the mouth. Etiology and genetic factors in clefts of lip andor. It may also be a complete split in the lip that goes all the way to the base of the nose. Cleft lip and cleft palate are thought to be caused by a combination of genes and other factors, such as things the mother comes in contact with in her environment, or what the mother eats or drinks, or certain medications she uses during pregnancy. A cleft palate is an opening of the hard palate the bony front portion of the roof of the mouth or the soft palate. Environment and genetics in the etiology of cleft lip and cleft palate.573 108 245 229 1346 1043 1429 1236 1365 463 341 207 190 1116 352 622 487 59 333 318 1526 110 945 234 764 532 233 1095 94 235 1426 933 904