唇顎口蓋裂患者で口蓋裂のみ成人まで未処置であった２症例の顎・顔面の所見

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  • Craniofacial morphology of lip and palate with the cleft unoperated on until adulthood: Report of two cases.

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Underdevelopment of the maxilla is frequently seen in post-operative cleft lip and palate patients. This is considered mainly due to cleft lip and palate repair, or the retarded growth potential of the disease itself, but the cause still remains unexplained. Accordingly, cephalometric roentgenograms and oral casts of two unoperated adult cleft palate patients were analyzed.<BR>Case 1. A male, aged 41, with unilateral (left side) cleft lip and palate, had a lip closure operation just after birth. Unfortunately, he had no further palate operation.<BR>Oral findings; The right upper first incisor, left upper first incisor, left upper second incisor, and left upper canine were missing. Bridge work was found from the right upper second incisor to the left upper first premolar. Reversed relation of the jaws was not observed, but the right upper second incisor was significantly displaced towards the palate. A slightly narrow upper dental arch was found.<BR>Cephalometric findings; A slightly concave type of skeletal pattern because of the undergrowth of the anterior part of maxilla was observed. The mandibule was located anteriorly and a slightly prognatia type of skeletal pattern was observed.<BR>Oral cast findings; The maxillary dental arch width was a little less than average.<BR>Case 2. A female, aged 22, with unilateral (right side) cleft lip and palate, had a lip closure operation at the age of 12.<BR>Oral findings; The left and right upper second incisors were congenitally missing. The left and right upper first incisors were slightly inclined towards the palate, but the fore teeth relationship was normal.<BR>Both the results of the cephalometric analysis and oral casts analysis were almost within normal limits.<BR>This is the presentation of two cases. However, these findings suggest that early lip closure seems to be a factor restricting the development of the maxilla. But, the development of maxilla and especially the maxillary dental arch width were not affected in our cases compared with the case which had palatoplasty during infancy.

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