European International Journal of Multidisciplinary Research
and Management Studies
102
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TYPE
Original Research
PAGE NO.
102-105
DOI
OPEN ACCESS
SUBMITED
20 February 2025
ACCEPTED
19 March 2025
PUBLISHED
21 April 2025
VOLUME
Vol.05 Issue04 2025
COPYRIGHT
© 2025 Original content from this work may be used under the terms
of the creative commons attributes 4.0 License.
The Epidemiology,
Aetiology, Prevention,
And Treatment of Children
with This Disease
Turaev Alimjan Bahriddinovich
Samarkand State Medical University, Uzbekistan
Abstract:
Developmental lip deformity, cleft alveolar
process, and cleft palate represent some of the most
challenging malformations within the maxillofacial
region, with an incidence of 1 in 1000 newborns, a
figure that continues to rise [3, 4, 13, 18]. The
rehabilitation and care of these patients is a pressing
issue due to atypical facial development, secondary
abnormalities, speech and mastication difficulties,
prolonged recovery periods, and the necessity for the
child's social adaptability [8]. Current research
discusses how to manage children with cleft lip and
palate issues, and some people believe that an
integrated strategy is necessary [11, 19].
Keywords:
Atypical facial development, secondary
abnormalities, speech and mastication difficulties,
prolonged recovery periods.
Introduction:
Developmental lip deformity, cleft
alveolar process, and cleft palate represent some of the
most
challenging
malformations
within
the
maxillofacial region, with an incidence of 1 in 1000
newborns, a figure that continues to rise [3, 4, 13, 18].
The rehabilitation and care of these patients is a
pressing issue due to atypical facial development,
secondary abnormalities, speech and mastication
difficulties, prolonged recovery periods, and the
necessity for the child's social adaptability [8]. Current
research discusses how to manage children with cleft
lip and palate issues, and some people believe that an
integrated strategy is necessary [11, 19]. Children
afflicted with this disease can undergo comprehensive
rehabilitation and social integration in specialised
medical facilities [7, 14]. The work's goal is to show how
European International Journal of Multidisciplinary Research
and Management Studies
103
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European International Journal of Multidisciplinary Research and Management Studies
well orthodontists and maxillofacial surgeons can
collaborate by using a challenging rehabilitation case
involving a patient who has a congenital cleft palate,
alveolar process, and left upper lip.
METHODS
A diagnosis of "congenital complete left-sided cleft of
the upper lip, alveolar process and palate" was made
for Patient I on August 5, 2003 [23]. [23]. The kid
received early orthopaedic treatment based on G.V.
Dolgopolova's approach, lasting from 15 days to 5
months, to correct the position of the palate.
Normalising the palatine plate's position and
minimising the disparity between the large and tiny
pieces of the maxillary alveolar process were the goals
[5]. Once this phase of treatment was finished,
ureteroplasty was done at 12 months of age and
primary rhinoplasty at 5 months [10, 15]. Following
surgery, the patient received yearly examinations from
an orthodontist and a surgeon. An irregular placement
of individual teeth in the anterior maxillary region and
a slight constriction of the maxillary dentition were
observed at the age of eight, during the era of tooth
development. The patient received a partial 2*4
bracket system to correct the axial positioning of the
maxillary incisors [1, 2, 11, 16, 21]; following the
alignment of teeth 1.1 and 2.1, the braces were
removed, concluding a treatment duration of 11
months. The diagnosis at the point of withdrawal: "Late
tooth change, narrowing and shortening of the
dentition, abnormal position of individual teeth and
absence of an alveolar process on the left upper jaw."
In order to establish ideal conditions for alveolar
osteogenesis, preparatory orthodontic therapy was
subsequently carried out at the age of 10 years
following consultation with an orthodontist and a
maxillofacial surgeon [9, 17, 22, 25]. The patient's
postoperative orthodontic therapy commenced at age
11, utilising the fixed straight arch approach. All of the
permanent maxillary teeth erupted at the start of
treatment, allowing the diagnosis to be established and
justified: "neutral bite (molars of class I according to
Engl), narrowing and shortening of the maxillary
dentition, palatal position of teeth 1.2 and 2.2,
excessive fullness of the tooth 2.2, and the absence of
an alveolar process on the left side of the upper jaw."
There were multiple phases to the additional
treatment: 1. Active orthodontic treatment stage
(12/25/2014): teeth 1.2 and 2.2 were placed, Gemini
braces were put in, and CuNiTi 0.014, CuNiTi 0.016, and
CuNiTi 0.016*022 arches were horizontally aligned to
generate space. Following the first stage, which
involved switching to the SS 0.016*022 arc, a
maxillofacial surgeon inspected the patient and
decided on the alveolar osteoplasty strategy. 2. During
the surgical phase (05.04.2016), a bone autograft from
the iliac crest and a Bio-Gide biodegradable membrane
were employed to address the paraphyseal deficiency
of the alveolar bone, utilising a technique established
at the Bonum Medical Centre [6, 12, 20, 24]. To create
a bed for the implantation of a bone autograft, a muco-
periosteal flap that had been intraoperatively removed
and mobilised was sewn. A biodegradable Bio-Gide
membrane, with both smooth and rough surfaces, was
positioned on the soft tissues 1-2 mm from the bone
border to facilitate the installation of a bone graft. After
placing the bone autograft (good iliac bone) on a bed
that had been prepared, it was covered with an
absorbable BioGide membrane that overlapped the
edge of the bone defect by 1-2 mm and had a rough
surface compared to the bone. The membrane was
secured under mild pressure during the coagulation of
blood. The area beneath the membrane is essential for
bone repair and the maintenance of the blood clot. A
muco-rib flap was utilised on the absorbable
membrane, and the wound was sealed and sutured.
Following surgery, the teeth's proportions and bite
restored to normal. Considering the preferences of the
patient and parents, the decision was made to remove
the bracket system and put fixed retainers on the upper
teeth. The aggressive orthodontic therapy and alveolar
osteoplasty required a duration of 18 months. The
outcome of an intricate rehabilitation process is
depicted in the picture. The patient underwent all
rehabilitation from specialised professionals, including
a paediatric dentist, ENT physician, neurologist, and
speech therapist, up to the age of 15, during dynamic
follow-up at the Bonhomme International International
Medical Centre. An evaluation of face aesthetics was
conducted when the patient was taken off dynamic
observation. A minor facial asymmetry was evident due
to scars after jaw surgery; nonetheless, the profile
remained straight. The patient and her mother
assessed the appearance as satisfactory. The speech
therapist assessed the child's speech as satisfactory.
CONCLUSION
Using the most recent technologies created at the
International Medical Centre (early orthognathic
treatment of the author, alveolar osteogenesis with a
bio-controlled
biodegradable
membrane)
in
conjunction with a conventional non-removable
orthodontic device, this case illustrates the
collaboration of orthodontists and maxillofacial
surgeons. For children with congenital cleft lip, alveolar
process, and cleft palate, such an integrated approach
guarantees prompt rehabilitation with successful
outcomes.
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