Cleft Lip and Palate: Early Orthopedic Intervention, Surgery, and Rehabilitation

Cleft Lip and Palate: Early Orthopedic Intervention, Surgery, and Rehabilitation

Category: Orthodontics

Instructor(s): Martyn Cobourne, Maria Costanza, Adaia Valls, Ann Kummer

Course structure: Lessons: 6 lessons | Duration: 4 h 42 min

Course overview

A one-of-a-kind interdisciplinary approach to manage the most challenging cleft lip and palate cases.

This course brings together the expertise of

Course lessons

Lesson 1: Cleft Lip and Palate: From Embryogenesis to Clinical Protocols in Early Treatment

• Cleft lip and palate (CLP): genetics, etiology, and epidemiology
• Embryogenesis and fusion of the lips
• CLP: prenatal diagnosis
• Presurgical infant orthopedics in CLP cases
• The functional matrix theory
• Does passive palate improve maxillary growth?
• Nasoalveolar molding (NAM) and primary columella lengthening
• Modifications: differences between the original Grayson-NY NAM and Milano NAM
• Analysis of clinical cases.

Lesson 2: Orthodontic Expansion and Intervention in Cleft Lip and Palate Patients

• When should expansion be carried out?
• Indications for expansion in cleft lip and palate (CLP) cases
• Special indications for expansion in early mixed dentition
• Maxillary expansion and auditory improvement
• Audiometric tests and otoendoscopy before and after early rapid expansion (ERE)
• Orthodontic expansion prior to bone augmentation: analysis of clinical cases and results.

Lesson 3: Craniofacial Growth and Early Maxillary Protraction in Unilateral Cleft Patients

• Progressive maxillary hypoplasia in unilateral cleft lip and palate (UCLP)
• Growth in untreated cleft patients
• Theories of craniofacial growth regulation
• Early maxillary protraction in unilateral cleft lip and palate (UCLP) cases
• Surgery-first approach
• Analysis of clinical cases.

Lesson 4: Alveolar Cleft Surgical Repair: Protocols and Clinical Applications

• Alveolar bone graft and dental eruption
• Gingivoperiosteoplasty (GPP) and secondary alveolar bone graft (SABG) in children with cleft palate
• Protocols of one-step vs. two-step surgery
• Three-wall reconstruction: nasal, buccal, and palatal
• Closure of large fistulae before bone grafting:
• Maxillary expansion prior to surgery: before or after bone graft?
• When to start orthodontics in cleft palate patients?
• Protocols of maxillary expansion and protraction
• Step-by-step protocols of premaxillary osteotomy
• 3D virtual planning: accuracy and intraoperative time
• Application of platelet-rich plasma in the cleft alveolus
• Post-operative recommendations
• Analysis of clinical cases.

Lesson 5: Speech and Resonance Disorders in Cleft Lip and Palate

• Physical factors influencing articulation
• Structural relationships critical for proper speech production
• Obligatory distortions vs. compensatory productions
• Impact of abnormal structure on articulation
• Dental anomalies and malocclusion
• Effects on speech due to clefts of the lip and alveolar ridge
• Velopharyngeal insufficiency
• Pharyngeal obstruction and other resonance issues
• Effects of clefts of the hard palate and velum.
• Interdisciplinary Management of Speech Disorders:
• Role of speech therapists, surgeons, and orthodontists
• Importance of team-based care for cleft patients.

Lesson 6: The Epidemiological and Etiological Basis of Orofacial Clefting

• Overview of the epidemiology and clinical presentation of cleft lip, cleft palate, and isolated cleft palate
• Embryonic development mechanisms of the upper lip and palate
• Genetic, environmental, and multifactorial factors contributing to orofacial clefting
• Syndromic forms of orofacial clefts
• Current therapeutic interventions for orofacial clefting
• Identification of genes in rare diseases associated with orofacial clefts.
• Course includes next lessons:
• 22min
• Lesson 1
• Exclusive Library
• Cleft Lip and Palate: From Embryogenesis to Clinical Protocols in Early Treatment
• Maria Costanza
• Show lesson program
• 40min
• Lesson 2
• Exclusive Library
• Orthodontic Expansion and Intervention in Cleft Lip and Palate Patients
• Maria Costanza
• Show lesson program
• 47min
• Lesson 3
• Exclusive Library
• Craniofacial Growth and Early Maxillary Protraction in Unilateral Cleft Patients
• Maria Costanza
• Show lesson program
• 56min
• Lesson 4
• Exclusive Library
• Alveolar Cleft Surgical Repair: Protocols and Clinical Applications
• Adaia Valls
• Show lesson program
• Show more (2)
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This online course is designed for dentists and dental professionals interested in orthodontics, clinical decision-making and evidence-informed dental practice.