2. INTRODUCTION
It is the art and science of functional or cosmetic
reconstruction by means of non - living
substitutes for those regions in the maxillae,
mandible and face that are missing because of
surgical intervention, trauma, pathology,
developmental or congenital malformation.
3. CLASSIFICATION OF ORAL &
MAXILLOFACIAL DEFECTS
Based on the Etiology of Defects
CONGENTIAL
Cleft lip & Palate.
ACQUIRED
Oral cancers
Benign tumours
Trauma
Gunshot wounds
4. CLASSIFICATION OF ORAL &
MAXILLOFACIAL DEFECTS
Based on location of defects
EXTRA ORAL
Ocular defects
Nasal defects
Facial defects
Auricular defects
5. CLASSIFICATION OF ORAL &
MAXILLOFACIAL DEFECTS
Based on location of defects
INTRAORAL
Defects of hard palate
Defects of soft palate
Defects of mandible
Defects of tongue
7. INTRODUCTION
“An opening in the hard and soft
palate due to improper union of the
maxillary process and the median
nasal process during the second
month of intrauterine life”
GPT 2005
8. INTRODUCTION
• Clefts of the lip, alveolus and palate are
the most common congenital
malformations of the head and neck.
• Second most common congenital
• malformation of the entire body.
Bailey BJ et al. TEXT BOOK OF GENERAL SURGERY 3rd ed
9. INCIDENCE & PREVALANCE
IN PAKISTAN
• More than 200,000 reported
cases at present
• 1: 570 live births
• 4th country with largest
population of cleft lip and palate
babies.
WHO.2008
23. Functional problems in cleft lip & palate
Oro nasal communication
Decreased negative pressure
Nasal regurgitation
Feeding time is prolonged
Weight loss
Excessive air intake
Choking
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25. TEAM OF CONSULTANTS
• Obstetrician and Gynecologist
• Pediatrician and Neonatologist
• Psychiatrist
• Prosthodontist
• Plastic Surgeon
• Orthodontist
• Speech therapist
• Medical social worker
29. CLEFT LIP & PALATE INVOLVES MORE THAN A
SINGLE SURGERY
30. SURGICAL REPAIR
LIP ADHESION: 2 WEEKS
CLEFT LIP REPAIR 10 WEEKS
CLEFT PALATE REPAIR: 6- 18 MONTH
ALVEOLAR BONE GRAFTING: 12 YEARS
MID FACIAL ADVANCEMENT: 18 YEARS
RHINOPLASTY: 20 YEARS.
31. ROLE OF PROSTHODONTIST
A prosthodontist provides the final active
treatment for the patient with a cleft.
He must anticipate and decide upon the
prosthodontic procedures in collaboration
with the plastic surgeon and/or the
orthodontist during the period of their
interventions
32. Role of a Prosthodontist
PRESURGICAL PHASE POST SURGICAL PHASE
FEEDING PLATES
PALATAL
OBTURATOR
INTERIM
OBTURATOR
PALTAL
OBTURATOR
DENTAL
IMPLANTS
REPLACEMENT
OF TEETH
SPEECH AID
PROSTHSIS
38. PROTOCOAL OF TAKING INFANTS
IMPRESSION.
• Neonatal intensive care unit in the presence of
surgeon.
• High volume suction.
• Not to feed the child 2 hours before
• No premadication ,or anaesthesia.
39.
40.
41.
42.
43.
44. COMPLICATIONS WHILE TAKING IMPRESSIONS.
• TEARING OF IMPRESSION MATERIAL.
• ASPHYXIATION.
• CHOKING.
• SCALDING OR BURNING.
• INCREASED RESPIRATORY DIFFICULTY.
• DEVELOPMENT OF CYNOSIS.
• LOSS OF CONSIOUSNESS.
47. Feeding Aids
Specially designed teats with enlarged
openings
Specially designed feeding bottles
Orogastic and nasogastric tubes
Feeding obturators
48.
49. Feeding obturator
“An ancillary prosthesis constructed for a
child
with cleft palate to permit normal sucking
and feeding.”
GPT-2005
50. PURPOSE
Rigid platform to assist neonate suckling
Facilitates feeding
Reduces nasal regurgitation
Reduces choking
Shortens the time of feeding
Prevents the tongue from entering the defect
Contributes to speech development
Reduces the incidence of nasopharyngeal
infection
