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Savoldelli C, Bailleux S, Chamorey E, Vandersteen C, Lerhe B, Afota F. Impact of a new combined preoperative cleft assessment on dental implant success in patients with cleft and palate: a retrospective study. BMC Oral Health 2022; 22:73. [PMID: 35291983 PMCID: PMC8925145 DOI: 10.1186/s12903-022-02040-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022] Open
Abstract
Background Bone height assessment alone is frequently used to guide rehabilitation choice, without consideration for soft tissues or adjacent teeth. This study aimed to evaluate the impact of different preoperative cleft assessments on implant success and patient satisfaction. Methods The study involved a retrospective assessment of records from 40 patients with cleft lip and palate (CLP). The alveolar cleft score (ACS; clinical criteria), interdental alveolar bone height (IABH) score (radiological criteria), patient compliance score (dental hygiene, medical visit observance, and smoking), and a novel combined score (IABH-ACS-Compliance) were assessed from patient records. Patients who required prosthetic tooth rehabilitation in the cleft dental arch space were included. Twenty-six patients (Group 1) were treated with dental implants, and 14 patients (Group 2) selected another prosthetic option (fixed prosthodontics, removal prosthesis), orthodontic space closure, or no rehabilitation. The main outcomes measured were relative implant success (no implant loss involving marginal bone loss ≤ 1.9 mm) for patients treated with dental implant therapy (Group 1) and patient satisfaction for all patients (Groups 1 and 2). Results Forty dental implants were placed in the patients in Group 1. Four implants in four patients (Group 1 relative failure, RF) were lost (implant survival rate of 90%) after 36 (± 12.4) months of follow-up. Twenty-two patients who received implants belonged to the relative implant success group (Group 1 RS). The average “IABH-ACS-Compliance” scores were significantly different (p < 0.05): 16.90 ± 2.35 and 12.75 ± 0.43 for the Group 1 RS and RF groups, respectively. Conclusions Preoperative cleft parameters have an impact on relative implant success and patient satisfaction. The new cleft assessment combined-score (“IABH-ACS-Compliance”) allows an accurate selection of cleft cases eligible for dental implants, thereby improving postoperative outcomes.
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Affiliation(s)
- Charles Savoldelli
- Oral and Maxillo-Facial Surgery Department, Head and Neck Institute, University Hospital of Nice, 30 Avenue Valombrose, 06100, Nice, France. .,Paediatric Maxillofacial Surgery and ENT Department, Lenval Hospital, Nice, France.
| | - Sonanda Bailleux
- Paediatric Maxillofacial Surgery and ENT Department, Lenval Hospital, Nice, France
| | - Emmanuel Chamorey
- Clinical Research, Innovation and Statistics Department, Centre Antoine Lacassagne, Nice, France
| | - Clair Vandersteen
- Oral and Maxillo-Facial Surgery Department, Head and Neck Institute, University Hospital of Nice, 30 Avenue Valombrose, 06100, Nice, France
| | - Barbara Lerhe
- Oral and Maxillo-Facial Surgery Department, Head and Neck Institute, University Hospital of Nice, 30 Avenue Valombrose, 06100, Nice, France.,Paediatric Maxillofacial Surgery and ENT Department, Lenval Hospital, Nice, France
| | - Franck Afota
- Oral and Maxillo-Facial Surgery Department, Head and Neck Institute, University Hospital of Nice, 30 Avenue Valombrose, 06100, Nice, France
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Abreu A, Londono J, Torosian A, Yu J, Levy-Bercowski D. Aesthetic Concepts and Interdisciplinary Approach in a Patient With Bilateral Cleft Lip and Palate and Missing Premaxilla: A Case Report. Cleft Palate Craniofac J 2020; 58:1056-1062. [PMID: 33251853 DOI: 10.1177/1055665620969290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The smile is an important part of the individual's facial expression, it allows the communication of emotions and ideas. However, its aesthetics can be severely compromised in patients with cleft lip and palate due to multiple missing, malformed and malposed teeth, abnormal soft tissue morphology, upper lip scar tissue, and altered anatomy in the lower third of the face. This clinical case reports the interdisciplinary treatment approach of a young male patient with complete bilateral cleft lip and palate and missing premaxilla. Prosthodontic rehabilitation included a zirconia-based fixed dental prosthesis, with pink porcelain to camouflage the bony defect and restore the facial and dental aesthetics. Maxillary second premolars received lithium disilicate crowns to obtain a more harmonious smile line and adequate occlusion. A resin-bonded fixed partial denture restored a missing mandibular central incisor. Tooth proportions, gingival contours and facial ratios routinely used in noncleft patients, were used to achieve a consonant smile. The final restorations satisfied the patient's expectations, restored an aesthetically pleasant smile, and provided an adequate occlusion.
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Affiliation(s)
- Amara Abreu
- Department of Restorative Sciences, Dental College of Georgia, 1421Augusta University, GA, USA
| | - Jimmy Londono
- Ronald Goldstein Center for Esthetic & Implant Dentistry, Department of Restorative Sciences, Dental College of Georgia, 1421Augusta University, GA, USA
| | - Aram Torosian
- Ronald Goldstein Center for Esthetic and Implant Dentistry, Dental College of Georgia, 1421Augusta University, GA, USA
| | - Jack Yu
- Department of Surgery, Plastic Surgery and Department of Pediatrics, Medical College of Georgia, 1421Augusta University and Craniofacial Center, Children's Hospital of Georgia, Augusta, GA, USA
| | - Daniel Levy-Bercowski
- Department of Orthodontics, Dental College of Georgia, 1421Augusta University, and Craniofacial Center, Children's Hospital of Georgia, Augusta, GA, USA
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Arshad M, Ameri N, Heidari A, Shirani G. Dental rehabilitation of a cleft lip and palate patient by implant-supported overdenture: A case report. Clin Case Rep 2020; 8:1932-1936. [PMID: 33088522 PMCID: PMC7562862 DOI: 10.1002/ccr3.3032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/26/2020] [Indexed: 12/04/2022] Open
Abstract
Our patient was a 27‐year‐old male with a unilateral cleft lip and palate. Considering the mobility of bone segments around the cleft, an implant‐supported removable overdenture (obturator) was fabricated, which improved the function and esthetics and led to patient satisfaction. The treatment results are still satisfactory after 5 years of follow‐up.
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Affiliation(s)
- Mahnaz Arshad
- Department of Prosthodontics Dental Research Center Dentistry Research Institute School of Dentistry Tehran University of Medical Sciences International Campus Tehran University of Medical Sciences Tehran Iran
| | - Narges Ameri
- Department of Prosthodontics Dental Research Center Dentistry Research Institute School of Dentistry Tehran University of Medical Sciences International Campus Tehran University of Medical Sciences Tehran Iran
| | | | - Gholamreza Shirani
- Department of Oral and Maxillofacial Surgery Dental Research Center Dentistry Research Institute School of Dentistry Tehran University of Medical Sciences Tehran Iran
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Szmidt M, Górski M, Bendyk-Szeffer M, Stogiera A, Buczkowska-Radlińska J. An Alternative Prosthodontic Management of Maxillary Dentoalveolar Defect in a Patient With Cleft Palate and Lip: Case Report. Cleft Palate Craniofac J 2019; 56:1256-1259. [PMID: 31079482 DOI: 10.1177/1055665619844440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Cleft palate/lip is a frequently occurring congenital anomaly; one in every 800 births results in such a problem. Different treatment options are available for replacing missing soft and hard tissues, including removable dental prostheses, fixed dental prostheses (FDPs), and implant prostheses. In the literature, according to different authors, there are different option standard for prosthetic treatment of cleft palate/lip. Some authors report that removable prosthesis is the choice in such cases, some of them regard conventional tooth-supported FDPs as a standard of care. In this case report, the prosthetic treatment of congenital cleft palate/lip was described. Upon the choice of the patient and patient's agreement, the direct construction Fibre-reinforced composite (FRC) adhesive bridge with pink composite gingival epithesis was performed.
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Affiliation(s)
- Monika Szmidt
- 1 Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Maciej Górski
- 1 Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Maja Bendyk-Szeffer
- 1 Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Anna Stogiera
- 1 Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Szczecin, Poland
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Levy-Bercowski D, Abreu A, Londono J, Haeberle CB. Use of an esthetic overdenture as an alternative treatment in a patient with bilateral cleft lip and palate. J Prosthet Dent 2018; 121:200-205. [PMID: 30017159 DOI: 10.1016/j.prosdent.2018.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 04/06/2018] [Accepted: 04/09/2018] [Indexed: 12/01/2022]
Abstract
Stable occlusion and a pleasing esthetic appearance are often difficult to achieve in patients with congenital defects and severe midfacial deficiencies. Conventional therapy, such as orthodontic treatment followed by orthognathic surgery, is often not sufficient to fully correct the dental and esthetic problems. An interdisciplinary approach for these patients should include prosthodontic treatment that will assist in establishing a harmonious occlusion and improve facial appearance. This clinical report describes the interdisciplinary approach for a young patient with a history of bilateral cleft lip and palate, spina bifida, hydrocephalus, and ventriculoperitoneal shunt. The patient was treated with conventional orthodontic treatment and orthognathic surgery that failed to fully correct the malocclusion. A removable overlay prosthesis made of crystallized acetyl resin was used to reestablish esthetics and create a stable occlusion.
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Affiliation(s)
- Daniel Levy-Bercowski
- Associate Professor, Department of Orthodontics, Dental College of Georgia, Augusta University, Augusta Ga; Associate Director, Craniofacial Center, Children's Hospital of Georgia, Augusta, Ga
| | - Amara Abreu
- Associate Professor and Section Director of Removable Prosthodontics, Department of Restorative Sciences, Dental College of Georgia, Augusta University, Augusta, Ga.
| | - Jimmy Londono
- Associate Professor, Department of Restorative Sciences, Dental College of Georgia, Augusta University, Augusta, Ga
| | - C Brent Haeberle
- Assistant Professor, Department of Restorative Sciences, Dental College of Georgia, Augusta University, Augusta, Ga
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Yu D, Xing G, Nie P, Zhang X, Steve Shen G. Multidimensional esthetic evaluation of patients with a cleft lip and palate wearing a maxillary partial removable dental prosthesis: A 5-year retrospective study. J Prosthet Dent 2015; 115:456-61. [PMID: 26581658 DOI: 10.1016/j.prosdent.2015.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 08/10/2015] [Accepted: 08/12/2015] [Indexed: 11/18/2022]
Abstract
STATEMENT OF PROBLEM No published quantitative or qualitative studies are available of the 2-dimensional (2D) and 3D esthetic evaluation of patients with a cleft lip and palate (CLP) wearing a maxillary partial removable dental prosthesis (MPRDP). PURPOSE The purpose of this retrospective clinical study was to qualitatively and quantitatively evaluate the facial esthetic improvements of patients with CLP wearing an MPRDP for 5 years by using 2D cephalometric and 3D photogrammetry methods. MATERIAL AND METHODS Six patients, 2 men and 4 women, with CLP deformity were recruited and treated with an MPRDP by the same dentist over 5 years. Results of the clinical examination were recorded before and after wearing the MPRDP. Sella-nasion-A (SNA) point, the U1-SN, 0-meridian to SN, nasolabial angle, and maxillary incisor exposure were measured by 2D cephalometric analysis before and after wearing the MPRDP. 3D photographs were captured by 3dMD software. Geomagic Spark Studio software was also used to measure the patients' improved upper lip projection after the MPRDP was worn. The paired sample t test was used to compare the participants (α=.05). RESULTS U1-SN (P<.05) and 0-meridian to SN (P<.01) had significant deviation statistically. After patients underwent clinical examination, SNA and nasiolabial angles were found to have improved, although no statistical significance was observed. CONCLUSIONS A maxillary partial removable dental prosthesis (MPRDP) can advance the upper lip forward, restoring the subnasal and upper lip projection. Patients' nasiolabial angles with MPRDPs were decreased, which led to a more harmonious facial contour.
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Affiliation(s)
- Dedong Yu
- Resident, Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Guofang Xing
- Attending Physician, Department of Prosthodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Ping Nie
- Associate Chief Physician, Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Xiuyin Zhang
- Chief Physician. Department of Prosthodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Guofang Steve Shen
- Chief Physician, Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, PR China.
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Abreu A, Levy-Bercowski D, Yu J, Salgueiro M, Kalathingal S, Ferreira Susin L, Baker P. Interdisciplinary treatment of an adult with bilateral cleft lip and palate with missing premaxilla: The prosthodontic perspective. J Prosthet Dent 2015; 114:609-13. [DOI: 10.1016/j.prosdent.2014.09.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 09/05/2014] [Accepted: 09/08/2014] [Indexed: 11/24/2022]
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