Skip to main content
SpringerLink
Log in

Orofaziale Entwicklung unter erschwerten Bedingungen

  • Published:
Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Zusammenfassung

Die orofaziale Entwicklung von Kindern mit Lippen-Kiefer-Gaumenspalten wird unter folgenden Aspekten analysiert: Ausgangslage im Vergleich zu neugeborenen Nichtspaltträgern, spätere morphologische und funktionelle Befunde in Relation zu unterschiedlichen Behandlungsmethoden. Die Untersuchungsergebnisse führen zur Feststellung, daß Neugeborene mit Lippen-Kiefer-Gaumenspalten in der Mehrzahl im übrigen durchaus gesunde Kinder sind und alle Anlagen für eine befriedigende orofaziale Entwicklung besitzen. Dieses Potential kann sich aber nur manifestieren, sofern sich alle therapeutischen Maßnahmen optimal in den Entwicklungsverlauf einfügen. Die weitreichenden Auswirkungen von scheinbar geringfügigen Modifikationen des chirurgischen Vorgehens werden an Fallbeispielen dargestellt; verschiedene Wachstumshypothesen werden im Lichte eigener Erfahrung an Spaltpatienten diskutiert.

Summary

Two main aspects of the orofacial development of children with cleft lip and palate are investigated: the initial state as compared to non-cleft neonates, and morphological and functional follow-up findings in relation to various treatment procedures. There is evidence that the majority of neonates with CLP anomalies are otherwise healthy children and have the prerequisites for satisfactory orofacial development. This can only be attained however, if treatment procedures optimally fit into spontaneous development. Clinical examples illustrate the possible sequelae of so-called minor modifications in surgical technique; several hypotheses on maxillary growth mechanisms are dicussed in the light of the author's experience with cleft palate patients.

Résumé

Le développement du complexe orofacial des enfants atteints de divisions labio-alvéolo-palatines est analysé des points de vue suivants: situation initiale en comparaison aux nouveau-nés «normaux», morphologie et fonction ultérieures selon des approches thérapeutiques diverses. Il en résulte que les nouveau-nés affligés de divisions labio-alvéolo-palatines possèdent les fondements pour un développement orofacial satisfaisant à condition que toute intervention thérapeutique s'adapte parfaitement au développement spontané. Les conséquences, souvent sérieuses, des modifications de méthode chirurgicale apparamment mineures sont mises en évidence au moyen de cas cliniques. La discussion de plusieures hypothèses relatives à la croissance maxillaire est basée sur l'expérience de l'auteur au sujet des divisions labio-alvéolo-palatines.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Schrifttum

  1. Aitchison, J. Discussion of congenital oral deformities. Brit. dent. J. 101 (1956), 197.

    Google Scholar 

  2. Björk, A., V. Skieller Growth of the maxilla in three dimensions as revealed by the implant method. Brit. J. Orthodont. 4 (1977), 53–64.

    Google Scholar 

  3. Čelešnik, F. Notre procédé de traitement chirurgical du bec-de-lièvre bilatéral total. Rev. Stomat. 63 (1961), 386–388.

    Google Scholar 

  4. Derichsweiler, H. Investigation on children with clefts. Trans. Europ. Orthodont. Soc. 35 (1959), 214–226.

    Google Scholar 

  5. Friel, E. S. Occlusion. Observations on its development from infancy to old age. Int. J. Orthodont. 13 (1927), 322–343.

    Google Scholar 

  6. Friel, E. S. The development of ideal occlusion of the gum pads and the teeth. Amer. J. Orthodont. 40 (1954), 196–227.

    Google Scholar 

  7. Galton, F. English men of science, their, ‘nature and nurture’. Quoted by Hadorn, E. (1975). Erbanlage und Umweltentwicklung. Neujahrsblatt der Naturforschenden Gesellschaft Zürich. Leemann AG, Zürich 1874.

    Google Scholar 

  8. Gillies, H. D., W. K. Fry: A new principle in the surgical management of ‘congenital cleft palate’, and its mechanical counterpart. Brit. med. J. (1921), 335–338.

  9. Graber, T. M. Changing philosophies in cleft palate management. J. Pediat. 37 (1950), 400–415.

    PubMed  Google Scholar 

  10. Graber, T. M. A study of cranio-facial growth and development in the cleft palate child from birth to six years of age. In:Hotz, R. (Ed): Early treatment of cleft lip and palate. H. Huber, Bern 1964, p. 30–43.

    Google Scholar 

  11. Graf-Pinthus, B. Possibilities of ambulant early orthopaedic treatment of cleft lip and palate. In:Hotz, R. (Ed.): Early treatment of cleft lip and palate. H. Huber, Bern 1964, p. 83–89.

    Google Scholar 

  12. Grob, M. Surgery of preoperative treated cleft lips and palates. In:Hotz, R. (Ed.): Early treatment of cleft lip and palate. H. Huber, Bern 1964, p. 90–94.

    Google Scholar 

  13. Harvey, W.: Generation, and exercises on the generation of animals (1651). In: Works ofWilliam Harvey. Sydenham Society, 1847.

  14. Herfert, O. Experimenteller Beitrag zur Frage der Schädigung des Oberkiefer-Wachstums durch vorzeitige Gaumenspaltoperation. Dtsch. Zahn-, Mund- u. Kieferheilk. 20 (1954), 369–381.

    Google Scholar 

  15. Hotz, R. The indication for preoperative and postoperative orthopaedic treatment of cleft lip and palate. In:Hotz, R. (Ed.): Early treatment of cleft lip and palate. H. Huber, Bern 1964, p. 78–82.

    Google Scholar 

  16. Hotz, M. M. Pre- and early postoperative growth-guidance in cleft lip and palate cases by maxillary orthopedics (an alternative procedure to primary bone-grafting). Cleft Palate J. 6 (1969), 368–372.

    PubMed  Google Scholar 

  17. Hotz, M., W. Gnoinski Comprehensive care of cleft lip and palate children at Zürich University: A preliminary report. Amer. J. Orthodont. 70 (1976), 481–504.

    Google Scholar 

  18. Hotz, M., W. Gnoinski Traitement coordonné des fentes labio-maxillo-palatines (le calendrier zurichois). Orthodont franç. 49 (1978), 519–532.

    Google Scholar 

  19. Hotz, M. M., W. M. Gnoinski Effects of early maxillary orthopaedics in cordination with delayed surgery for cleft lip and palate. J. maxillo-facial Surg. 7 (1979), 201–210.

    Google Scholar 

  20. Hotz, M., M. Perko Early management of bilateral cleft lip and palate. Scand. J. plast. reconstr. Surg. 8 (1974), 104–108.

    PubMed  Google Scholar 

  21. Hotz, M., M. Perko, W. Gnoinski, H. Nussbaumer, E. Hof Das Zürcher Vorgehen in der Primärbehandlung von Patienten mit totalen Lipen-Kiefer-Gaumen-Spalten. I. Teil. In:Pfeifer, G. (Ed.): Lippen-Kiefer-Gaumenspalten. 3. Internationales Symposium, Hamburg 1979. G. Thieme, Stuttgart 1982.

    Google Scholar 

  22. Hotz, M., M. Perko, W. Gnoinski, H. Nussbaumer, E. Hof Das Zürcher Vorgehen in der Primärbehandlung von Patienten mit totalen Lippen-Kiefer-Gaumenspalten. II. Teil. In:Pfeifer, G. (Ed.): Lippen-Kiefer-Gaumenspalten. 3. Internationales Symposium, Hamburg 1979. G. Thieme, Stuttgart 1982.

    Google Scholar 

  23. Kremenak jr., C. R., W. C. Huffman, W. H. Olin Maxillary growth inhibition by mucoperiosteal denudation of palatal shelf bone in non-cleft beagles. Cleft Palate J. 7 (1970), 817–825.

    PubMed  Google Scholar 

  24. Kremenak jr., C. R., J. Searls Experimental manipulation of midfacial growth: a synthesis of five years of research at the Iowa Maxillofacial Growth Laboratory. J. dent. Res. 50 (1971), 1488–1491.

    PubMed  Google Scholar 

  25. McKenzie, J. The role of vascular anomalies: Failure of standard circulation in production of craniofacial anomalies. In:Longacre, J. J. (Ed.): Craniofacial anomalies: Pathogenesis and repair. Pitman Medical/Lippincott, London 1968, p. 61–63.

    Google Scholar 

  26. McNeil, C. K. Congenital oral deformities. Brit. dent. J. 101 (1956), 191–196.

    Google Scholar 

  27. Ortiz-Monasterio, F., A. R. Serrano, G. P. Barrera, H. Rodriguez-Hoffmann, E. Vinageras A study of untreated adult cleft palate patients. Plast. reconstr. Surg. 38 (1966), 36–41.

    PubMed  Google Scholar 

  28. Perko, M. Two-stage closure of cleft palate — progress report. J. maxillo-facial Surg. 7 (1979), 76–80.

    Google Scholar 

  29. Schweckendiek, H. Zur zweiphasigen Gaumenspaltoperation bei primärem Velumverschluß. In: Fortschritte der Kiefer- und Gesichts-Chirurgie, Bd. 1. G. Thieme, Stuttgart 1955, S. 73–76.

    Google Scholar 

  30. Schweckendiek, W.: Die Spätergebnisse der primären Veloplastik. Excerpta Medica Congress 1967, Series No. 174, p. 435–438.

  31. Slaughter, W. B., A. G. Brodie Facial clefts and their surgical management in view of recent research. Plast. reconstr. Surg. 4 (1949), 311–332.

    Google Scholar 

  32. Slaughter, W. B., S. Pruzansky The rationale of velar closure as a primary repair of cleft palate defects. Plast. reconstr. Surg. 13 (1954), 341–357.

    PubMed  Google Scholar 

  33. Stutzmann, J. J., A. G. Petrovic Experimental analysis of general and local extrinsic mechanisms controlling upper jaw growth. In:McNamara jr., J. A. (Ed.): Factors affecting the growth of the midface. Monograph No. 6 Craniofacial Growth Series Center for Human Growth and Development. University of Michigan, Ann Arbor (Michigan) 1976, p. 205–238.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Zahnärztliches Institut der Universität Zürich, Abt. für Kieferorthopädie und Kinderzahnmedizin, Germany

    M. Hotz

Authors
  1. M. Hotz
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Sheldon Friel Memorial Lecture beim 58. Kongreß der European Orthodontic Society in Bonn 1982 (aus der englischen Originalfassung ins Deutsche übertragen vonW. Gnoinski).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hotz, M. Orofaziale Entwicklung unter erschwerten Bedingungen. Fortschritte der Kieferorthopädie 44, 257–271 (1983). https://doi.org/10.1007/BF01996848

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01996848

Search

Navigation