Worth V, Perry R, Ireland T Are people with an orofacial cleft at a higher risk of dental caries? A systematic review and meta-analysis. Br Dent J. 2017; 223:37-47 https://doi.org/10.1038/sj.bdj.2017.581
Global registry and database on craniofacial anomalies: report of a WHO Registry Meeting on craniofacial anomalies. 2001. https://iris.who.int/handle/10665/42840
Trindade-Suedam IK, Gaia BF, Cheng CK Cleft lip and palate: recommendations for dental anesthetic procedure based on anatomic evidences. J Appl Oral Sci. 2012; 20:122-127 https://doi.org/10.1590/s1678-77572012000100021
Gallagher N A general dental practitioner's role in treating patients with a cleft lip and/or palate. Br Dent J. 2020; 228:19-21 https://doi.org/10.1038/s41415-019-1116-7
Kappen IFPM, Yoder WR, Mink van der Molen AB, Breugem CC Long-term craniofacial morphology in young adults treated for a non-syndromal UCLP: a systematic review. J Plast Reconstr Aesthet Surg. 2018; 71:504-517 https://doi.org/10.1016/j.bjps.2017.12.007
Bartkowska P, Komisarek O Scar management in patients after cleft lip repair – systematic review. Cleft lip scar management. J Cosmet Dermatol. 2020; 19:1866-1876 https://doi.org/10.1111/jocd.13511
Krikken JB, de Jongh A, Veerkamp JS Longitudinal changes in dental fear and coping behavior in children, adolescents, and young adults with cleft lip and/or cleft palate. Cleft Palate Craniofac J. 2015; 52:e73-80 https://doi.org/10.1597/12-262
Al-Dajani M Comparison of dental caries prevalence in patients with cleft lip and/or palate and their sibling controls. Cleft Palate Craniofac J. 2009; 46:529-531 https://doi.org/10.1597/08-003.1
Altug-Atac AT, Erdem D Prevalence and distribution of dental anomalies in orthodontic patients. Am J Orthod Dentofacial Orthop. 2007; 131:510-514 https://doi.org/10.1016/j.ajodo.2005.06.027
Akcam MO, Evirgen S, Uslu O, Memikoğlu UT Dental anomalies in individuals with cleft lip and/or palate. Eur J Orthod. 2010; 32:207-213 https://doi.org/10.1093/ejo/cjp156
Tomaszewska IM, Zwinczewska H, Gładysz T, Walocha JA Anatomy and clinical significance of the maxillary nerve: a literature review. Folia Morphol (Warsz). 2015; 74:150-156 https://doi.org/10.5603/FM.2015.0025
Cheng LL, Moor SL, Ho CT Predisposing factors to dental caries in children with cleft lip and palate: a review and strategies for early prevention. Cleft Palate Craniofac J. 2007; 44:67-72 https://doi.org/10.1597/05-112
da Silva Dalben G, Costa B, Gomide MR, das Neves LT Dental anesthetic procedures for cleft lip and palate patients. J Clin Pediatr Dent. 2000; 24:153-158
Considerations in dental local anaesthesia for the patient with cleft lip and palate Daniel Dilworth Edward Fahy Mishaim A Mian Emily Lordan Aisling O'Mahony Dental Update 2024 51:10, 707-709.
Authors
DanielDilworth
BDS, MFDS RCPS(Glasg), PGCert (ClinEd), Registrar in Restorative Dentistry, St James's Hospital, Dublin, Ireland
Patients who have had a history of surgical repair of cleft lip and palate can often develop scar tissue post-operatively that can make it more difficult for dentists to achieve sufficient local anaesthesia. In addition, the presence of a cleft can result in anatomical variation of nerve supply to the maxillary region, which can result in further complications for achieving sufficient anaesthesia. This article reviews the anatomical variations that can occur, and posits a technique to allow for more predictable and successful local anaesthesia in this cohort of patients.
CPD/Clinical Relevance:
GDPs may have difficulty in achieving sufficient local anaesthesia for patients with a cleft lip and palate.
Article
The incidence of cleft lip and/or palate (CLP) worldwide is about 1 in 700 live births.1,2 Clefts may be classed as unilateral or bilateral, as complete, incomplete or microform, and may involve the lip with or without the palate, or be isolated to the palate. A final group of patients with CLP present with atypical facial clefts and may occur in combination with other syndromes, e.g. Treacher Collins syndrome.3,4 Cleft lip, either with or without palatal involvement, is more common than isolated cleft palate,4 and isolated cleft palates occur more frequently among females than males.4 The aetiology of the orofacial cleft is unknown.5,6
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