The fourth paper in this series on cleft lip and palate discusses the surgery involved in the care of children and young people with clefts of the lip and/or palate, orthodontic treatment and psychological support for this group of patients and their families.

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Finite model analysis of different anchorage sites for bone-supported facemask application in unilateral cleft lip and palate.

Am J Orthod Dentofacial Orthop

January 2025

Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey. Electronic address:

Introduction: The objective of this study was to evaluate the effects of the miniplate application sites in the maxilla and the applied force vector changes during skeletally supported facemask application in adolescent patients with unilateral cleft lip and palate (UCLP) using finite element model (FEM) analysis.

Methods: A FEM was obtained from a cone-beam computed tomography image of a 12-year-old female patient with UCLP. Miniplates were placed on 3 different sites of the maxilla; 500 g of advancement force was applied bilaterally, parallel (0°), and downward (-30°) to the occlusal plane.

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Median Craniofacial Hypoplasia.

J Craniofac Surg

January 2025

Division of Plastic & Reconstructive Surgery, John H. Stroger Hospital of Cook County, Chicago, IL.

Median craniofacial hypoplasia is characterized by tissue deficiency of the midline facial structures and/or brain. Patients can present with a wide variety of facial differences that may or may not require operative intervention. Common reconstructive procedures include cleft lip and/or palate repair, rhinoplasty, and orthognathic surgery, among others.

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Background: Cleft lip and/or palate is the most common congenital orofacial deformity, affecting 1/800 births. A thorough review of the literature has shown that children with cleft have poorer oral hygiene and dental health than other children, with higher levels of caries in both temporary and permanent teeth and poorer periodontal health. Cleft patients are treated by a multidisciplinary team that aims to provide comprehensive care from pre- or post-natal diagnosis to early adulthood and the end of growth.

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Background: Unilateral cleft lip secondary nasal deformities are common and require surgical correction frequently. The nasal dome on the cleft side is depressed, and the nasal ala is in an extended and flattened position compared with the noncleft side. In addition, the nasal septum is deviated into the cleft nostril.

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