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A cleft lip is an opening of the upper lip, mainly due to the failure of fusion of the medial nasal processes with the palatal processes; a cleft palate is the opening of the soft and hard palate in the mouth, which is due to the failure of the palatal shelves to fuse together. [10]
In cleft palate patients bone grafting during the mixed dentition has been widely accepted since the mid-1960s. The goals of surgery are to stabilize the maxilla, facilitate the healthy eruption of teeth that are adjacent the cleft, improving the esthetics of the base of the nose, create a bone base for dental implants, and to close any oro-nasal fistulas.
Alveolar bone grafting in the mixed dentition is an essential part of the reconstructive journey for cleft lip and cleft palate patients. The reconstruction of the alveolar cleft can provide both aesthetic and practical advantages to the patient. [ 24 ]
Note: Additional shades of passive articulation are sometimes specified using pre-or post-, for example prepalatal (near the border between the postalveolar region and the hard palate; prevelar (at the back of the hard palate, also post-palatal or even medio-palatal for the middle of the hard palate); or postvelar (near the border of the soft ...
The upper lip is formed earlier than the palate, from the first three lobes named a to c above. Formation of the palate is the last step in joining the five embryonic facial lobes, and involves the back portions of the lobes b and c. These back portions are called palatal shelves, which grow towards each other until they fuse in the middle. [30]
The mucosa of the cheeks and floor of the mouth are freely moveable and fragile, whereas the mucosa around the teeth and on the palate are firm and keratinized. Where the two tissue types meet is known as a mucogingival junction. There are three mucogingival junctions: on the facial of the maxilla and on both the facial and lingual of the mandible.
The mouth consists of two regions: the vestibule and the oral cavity proper. The vestibule is the area between the teeth, lips and cheeks. [3] The oral cavity is bounded at the sides and in front by the alveolar process (containing the teeth) and at the back by the isthmus of the fauces. Its roof is formed by the hard palate.
The upper surface of the palatine process is concave from side to side, smooth, and forms the greater part of the floor of the nasal cavity. It presents, close to its medial margin, the upper orifice of the incisive canal. The lateral border of the process is incorporated with the rest of the bone.