Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: Oral Rehabilitation
Identifieur interne : 000599 ( Pmc/Corpus ); précédent : 000598; suivant : 000600Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: Oral Rehabilitation
Auteurs : José Alberto De Souza Freitas ; Ana Lúcia Pompéia Fraga De Almeida ; Simone Soares ; Lucimara Teixeira Das Neves ; Daniela Gamba Garib ; Ivy Kiemle Trindade-Suedam ; Renato Yassutaka Faria Yaedú ; Rita De Cássia Moura Carvalho Lauris ; Thais Marchini Oliveira ; João Henrique Nogueira PintoSource :
- Journal of Applied Oral Science [ 1678-7757 ] ; 2013.
Abstract
Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.
Url:
DOI: 10.1590/1679-775720130127
PubMed: 23857655
PubMed Central: 3881907
Links to Exploration step
PMC:3881907Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Rehabilitative treatment of cleft lip and palate: experience of the
Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: Oral
Rehabilitation</title><author><name sortKey="Freitas, Jose Alberto De Souza" sort="Freitas, Jose Alberto De Souza" uniqKey="Freitas J" first="José Alberto De Souza" last="Freitas">José Alberto De Souza Freitas</name><affiliation><nlm:aff id="aff01"> DDS, MSc, PhD, Superintendent, Hospital for Rehabilitation of Craniofacial Anomalies and Full Professor, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="De Almeida, Ana Lucia Pompeia Fraga" sort="De Almeida, Ana Lucia Pompeia Fraga" uniqKey="De Almeida A" first="Ana Lúcia Pompéia Fraga" last="De Almeida">Ana Lúcia Pompéia Fraga De Almeida</name><affiliation><nlm:aff id="aff02"> DDS, MSc, PhD, Assistant Professor, Department of Prosthodontics, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Soares, Simone" sort="Soares, Simone" uniqKey="Soares S" first="Simone" last="Soares">Simone Soares</name><affiliation><nlm:aff id="aff02"> DDS, MSc, PhD, Assistant Professor, Department of Prosthodontics, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Neves, Lucimara Teixeira Das" sort="Neves, Lucimara Teixeira Das" uniqKey="Neves L" first="Lucimara Teixeira Das" last="Neves">Lucimara Teixeira Das Neves</name><affiliation><nlm:aff id="aff03"> DDS, MSc, PhD, Assistant Professor, Department of Biological Sciences, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Garib, Daniela Gamba" sort="Garib, Daniela Gamba" uniqKey="Garib D" first="Daniela Gamba" last="Garib">Daniela Gamba Garib</name><affiliation><nlm:aff id="aff04"> DDS, MSc, PhD, Associate Professor of Orthodontics, Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Trindade Suedam, Ivy Kiemle" sort="Trindade Suedam, Ivy Kiemle" uniqKey="Trindade Suedam I" first="Ivy Kiemle" last="Trindade-Suedam">Ivy Kiemle Trindade-Suedam</name><affiliation><nlm:aff id="aff03"> DDS, MSc, PhD, Assistant Professor, Department of Biological Sciences, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Yaedu, Renato Yassutaka Faria" sort="Yaedu, Renato Yassutaka Faria" uniqKey="Yaedu R" first="Renato Yassutaka Faria" last="Yaedú">Renato Yassutaka Faria Yaedú</name><affiliation><nlm:aff id="aff05"> DDS, MSc, PhD, Assistant Professor, Department of Stomatology, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Lauris, Rita De Cassia Moura Carvalho" sort="Lauris, Rita De Cassia Moura Carvalho" uniqKey="Lauris R" first="Rita De Cássia Moura Carvalho" last="Lauris">Rita De Cássia Moura Carvalho Lauris</name><affiliation><nlm:aff id="aff06"> DDS, MSc, Orthodontist, Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Oliveira, Thais Marchini" sort="Oliveira, Thais Marchini" uniqKey="Oliveira T" first="Thais Marchini" last="Oliveira">Thais Marchini Oliveira</name><affiliation><nlm:aff id="aff07"> DDS, MSc, PhD, Assistant Professor, Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Pinto, Joao Henrique Nogueira" sort="Pinto, Joao Henrique Nogueira" uniqKey="Pinto J" first="João Henrique Nogueira" last="Pinto">João Henrique Nogueira Pinto</name><affiliation><nlm:aff id="aff08"> DDS, MSc, PhD, Prosthodontist of the Dental Division of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23857655</idno><idno type="pmc">3881907</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881907</idno><idno type="RBID">PMC:3881907</idno><idno type="doi">10.1590/1679-775720130127</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">000599</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000599</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Rehabilitative treatment of cleft lip and palate: experience of the
Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: Oral
Rehabilitation</title><author><name sortKey="Freitas, Jose Alberto De Souza" sort="Freitas, Jose Alberto De Souza" uniqKey="Freitas J" first="José Alberto De Souza" last="Freitas">José Alberto De Souza Freitas</name><affiliation><nlm:aff id="aff01"> DDS, MSc, PhD, Superintendent, Hospital for Rehabilitation of Craniofacial Anomalies and Full Professor, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="De Almeida, Ana Lucia Pompeia Fraga" sort="De Almeida, Ana Lucia Pompeia Fraga" uniqKey="De Almeida A" first="Ana Lúcia Pompéia Fraga" last="De Almeida">Ana Lúcia Pompéia Fraga De Almeida</name><affiliation><nlm:aff id="aff02"> DDS, MSc, PhD, Assistant Professor, Department of Prosthodontics, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Soares, Simone" sort="Soares, Simone" uniqKey="Soares S" first="Simone" last="Soares">Simone Soares</name><affiliation><nlm:aff id="aff02"> DDS, MSc, PhD, Assistant Professor, Department of Prosthodontics, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Neves, Lucimara Teixeira Das" sort="Neves, Lucimara Teixeira Das" uniqKey="Neves L" first="Lucimara Teixeira Das" last="Neves">Lucimara Teixeira Das Neves</name><affiliation><nlm:aff id="aff03"> DDS, MSc, PhD, Assistant Professor, Department of Biological Sciences, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Garib, Daniela Gamba" sort="Garib, Daniela Gamba" uniqKey="Garib D" first="Daniela Gamba" last="Garib">Daniela Gamba Garib</name><affiliation><nlm:aff id="aff04"> DDS, MSc, PhD, Associate Professor of Orthodontics, Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Trindade Suedam, Ivy Kiemle" sort="Trindade Suedam, Ivy Kiemle" uniqKey="Trindade Suedam I" first="Ivy Kiemle" last="Trindade-Suedam">Ivy Kiemle Trindade-Suedam</name><affiliation><nlm:aff id="aff03"> DDS, MSc, PhD, Assistant Professor, Department of Biological Sciences, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Yaedu, Renato Yassutaka Faria" sort="Yaedu, Renato Yassutaka Faria" uniqKey="Yaedu R" first="Renato Yassutaka Faria" last="Yaedú">Renato Yassutaka Faria Yaedú</name><affiliation><nlm:aff id="aff05"> DDS, MSc, PhD, Assistant Professor, Department of Stomatology, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Lauris, Rita De Cassia Moura Carvalho" sort="Lauris, Rita De Cassia Moura Carvalho" uniqKey="Lauris R" first="Rita De Cássia Moura Carvalho" last="Lauris">Rita De Cássia Moura Carvalho Lauris</name><affiliation><nlm:aff id="aff06"> DDS, MSc, Orthodontist, Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Oliveira, Thais Marchini" sort="Oliveira, Thais Marchini" uniqKey="Oliveira T" first="Thais Marchini" last="Oliveira">Thais Marchini Oliveira</name><affiliation><nlm:aff id="aff07"> DDS, MSc, PhD, Assistant Professor, Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Pinto, Joao Henrique Nogueira" sort="Pinto, Joao Henrique Nogueira" uniqKey="Pinto J" first="João Henrique Nogueira" last="Pinto">João Henrique Nogueira Pinto</name><affiliation><nlm:aff id="aff08"> DDS, MSc, PhD, Prosthodontist of the Dental Division of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Applied Oral Science</title><idno type="ISSN">1678-7757</idno><idno type="eISSN">1678-7765</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Treatment of patients with cleft lip and palate is completed with fixed prostheses,
removable, total, implants and aims to restore aesthetics, phonetics and function and
should be guided by the basic principles of oral rehabilitation, such as physiology,
stability, aesthetics, hygiene and the expectations of the patient. In order to
obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as
well as the biomechanics of the prosthesis are to be respected. The purpose of this
article is to describe the types of prosthetics treatment, which are performed at
HRAC/USP for the rehabilitation of cleft area in adult patients.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author><author><name sortKey="Esper, La" uniqKey="Esper L">LA Esper</name></author><author><name sortKey="Kaizer, Ro" uniqKey="Kaizer R">RO Kaizer</name></author><author><name sortKey="Fernandes, Js" uniqKey="Fernandes J">JS Fernandes</name></author><author><name sortKey="Greghi, Sl" uniqKey="Greghi S">SL Greghi</name></author><author><name sortKey="Carrilho, Gp" uniqKey="Carrilho G">GP Carrilho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author><author><name sortKey="Esper, La" uniqKey="Esper L">LA Esper</name></author><author><name sortKey="Pegoraro, Ta" uniqKey="Pegoraro T">TA Pegoraro</name></author><author><name sortKey="Valle, Al" uniqKey="Valle A">AL Valle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author><author><name sortKey="Madeira, Lc" uniqKey="Madeira L">LC Madeira</name></author><author><name sortKey="Freitas, Kc" uniqKey="Freitas K">KC Freitas</name></author><author><name sortKey="Greghi, Sl" uniqKey="Greghi S">SL Greghi</name></author><author><name sortKey="Pegoraro, Lf" uniqKey="Pegoraro L">LF Pegoraro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author><author><name sortKey="Pedro, Pf" uniqKey="Pedro P">PF Pedro</name></author><author><name sortKey="Kogawa, Em" uniqKey="Kogawa E">EM Kogawa</name></author><author><name sortKey="Pereira, T" uniqKey="Pereira T">T Pereira</name></author><author><name sortKey="Carrilho, Gp" uniqKey="Carrilho G">GP Carrilho</name></author><author><name sortKey="Aiello, Ca" uniqKey="Aiello C">CA Aiello</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author><author><name sortKey="Sbrana, Mc" uniqKey="Sbrana M">MC Sbrana</name></author><author><name sortKey="Esper, La" uniqKey="Esper L">LA Esper</name></author><author><name sortKey="Greghi, Sl" uniqKey="Greghi S">SL Greghi</name></author><author><name sortKey="Conti, Pc" uniqKey="Conti P">PC Conti</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brasil, Jm" uniqKey="Brasil J">JM Brasil</name></author><author><name sortKey="Pernambuco, Ra" uniqKey="Pernambuco R">RA Pernambuco</name></author><author><name sortKey="Dalben, Gs" uniqKey="Dalben G">GS Dalben</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Esper, La" uniqKey="Esper L">LA Esper</name></author><author><name sortKey="Ferreira, Sb Jr" uniqKey="Ferreira S">SB Jr Ferreira</name></author><author><name sortKey="Kaizer, Rof" uniqKey="Kaizer R">ROF Kaizer</name></author><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Esper, La" uniqKey="Esper L">LA Esper</name></author><author><name sortKey="Sbrana, Mc" uniqKey="Sbrana M">MC Sbrana</name></author><author><name sortKey="Ribeiro, Iwj" uniqKey="Ribeiro I">IWJ Ribeiro</name></author><author><name sortKey="Siqueira, En" uniqKey="Siqueira E">EN Siqueira</name></author><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ferreira, Sb Jr" uniqKey="Ferreira S">SB Jr Ferreira</name></author><author><name sortKey="Esper, La" uniqKey="Esper L">LA Esper</name></author><author><name sortKey="Sbrana, Mc" uniqKey="Sbrana M">MC Sbrana</name></author><author><name sortKey="Ribeiro, Iwj" uniqKey="Ribeiro I">IWJ Ribeiro</name></author><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fiamengui Filho, Jf" uniqKey="Fiamengui Filho J">JF Fiamengui Filho</name></author><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Freitas, Ac Jr" uniqKey="Freitas A">AC Jr Freitas</name></author><author><name sortKey="Silva, Am" uniqKey="Silva A">AM Silva</name></author><author><name sortKey="Lima Verde, Ma" uniqKey="Lima Verde M">MA Lima Verde</name></author><author><name sortKey="Aguiar, Jr" uniqKey="Aguiar J">JR Aguiar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Freitas, Jas" uniqKey="Freitas J">JAS Freitas</name></author><author><name sortKey="Garib, Dg" uniqKey="Garib D">DG Garib</name></author><author><name sortKey="Oliveira, Tm" uniqKey="Oliveira T">TM Oliveira</name></author><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author><author><name sortKey="Trindade Suedam, Ik" uniqKey="Trindade Suedam I">IK Trindade-Suedam</name></author><author><name sortKey="Yaedu, Ryf" uniqKey="Yaedu R">RYF Yaedú</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Freitas, Jas" uniqKey="Freitas J">JAS Freitas</name></author><author><name sortKey="Neves, Lt" uniqKey="Neves L">LT Neves</name></author><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author><author><name sortKey="Garib, Dg" uniqKey="Garib D">DG Garib</name></author><author><name sortKey="Trindade Suedam, Ik" uniqKey="Trindade Suedam I">IK Trindade-Suedam</name></author><author><name sortKey="Yaedu, Ryf" uniqKey="Yaedu R">RYF Yaedú</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fukuda, M" uniqKey="Fukuda M">M Fukuda</name></author><author><name sortKey="Takahashi, T" uniqKey="Takahashi T">T Takahashi</name></author><author><name sortKey="Yamaguchi, T" uniqKey="Yamaguchi T">T Yamaguchi</name></author><author><name sortKey="Kochi, S" uniqKey="Kochi S">S Kochi</name></author><author><name sortKey="Inai, T" uniqKey="Inai T">T Inai</name></author><author><name sortKey="Watanabe, M" uniqKey="Watanabe M">M Watanabe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hickey, Aj" uniqKey="Hickey A">AJ Hickey</name></author><author><name sortKey="Salter, M" uniqKey="Salter M">M Salter</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lopes, Jfs" uniqKey="Lopes J">JFS Lopes</name></author><author><name sortKey="Pinto, Jhn" uniqKey="Pinto J">JHN Pinto</name></author><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author><author><name sortKey="Lopes, Mmw" uniqKey="Lopes M">MMW Lopes</name></author><author><name sortKey="Dalben, Gs" uniqKey="Dalben G">GS Dalben</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mazaheri, M" uniqKey="Mazaheri M">M Mazaheri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Melo, Lgn" uniqKey="Melo L">LGN Melo</name></author><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author><author><name sortKey="Lopes, Jfs" uniqKey="Lopes J">JFS Lopes</name></author><author><name sortKey="Rezende, Ml" uniqKey="Rezende M">ML Rezende</name></author><author><name sortKey="Neto, Js" uniqKey="Neto J">JS Neto</name></author><author><name sortKey="Ciporkin, F" uniqKey="Ciporkin F">F Ciporkin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Melo, Lgn" uniqKey="Melo L">LGN Melo</name></author><author><name sortKey="Ciporkin, F" uniqKey="Ciporkin F">F Ciporkin</name></author><author><name sortKey="Neto, Js" uniqKey="Neto J">JS Neto</name></author><author><name sortKey="Almeida, Alpf" uniqKey="Almeida A">ALPF Almeida</name></author><author><name sortKey="Lopes, Jfs" uniqKey="Lopes J">JFS Lopes</name></author><author><name sortKey="Figueiredo, Cm" uniqKey="Figueiredo C">CM Figueiredo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pinto, Jhn" uniqKey="Pinto J">JHN Pinto</name></author><author><name sortKey="Dalben, Gs" uniqKey="Dalben G">GS Dalben</name></author><author><name sortKey="Pegoraro Krook, Mi" uniqKey="Pegoraro Krook M">MI Pegoraro-Krook</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pinto, Jhn" uniqKey="Pinto J">JHN Pinto</name></author><author><name sortKey="Pegoraro Krook, Mi" uniqKey="Pegoraro Krook M">MI Pegoraro-Krook</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Reisberg, Dj" uniqKey="Reisberg D">DJ Reisberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Reisberg, Dj" uniqKey="Reisberg D">DJ Reisberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ruiz, La" uniqKey="Ruiz L">LA Ruiz</name></author><author><name sortKey="Maya, Rr" uniqKey="Maya R">RR Maya</name></author><author><name sortKey="D Alpino, Php" uniqKey="D Alpino P">PHP D'Alpino</name></author><author><name sortKey="Atta, Mt" uniqKey="Atta M">MT Atta</name></author><author><name sortKey="Svizzero, Nr" uniqKey="Svizzero N">NR Svizzero</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Verdi, Fj Jr" uniqKey="Verdi F">FJ Jr Verdi</name></author><author><name sortKey="Lanzi, Gl" uniqKey="Lanzi G">GL Lanzi</name></author><author><name sortKey="Cohen, Sr" uniqKey="Cohen S">SR Cohen</name></author><author><name sortKey="Powell, R" uniqKey="Powell R">R Powell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Watanabe, I" uniqKey="Watanabe I">I Watanabe</name></author><author><name sortKey="Kurtz, Ks" uniqKey="Kurtz K">KS Kurtz</name></author><author><name sortKey="Watanabe, E" uniqKey="Watanabe E">E Watanabe</name></author><author><name sortKey="Yamada, M" uniqKey="Yamada M">M Yamada</name></author><author><name sortKey="Yoshida, N" uniqKey="Yoshida N">N Yoshida</name></author><author><name sortKey="Miller, Aw" uniqKey="Miller A">AW Miller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wirz, J" uniqKey="Wirz J">J Wirz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zhou, W" uniqKey="Zhou W">W Zhou</name></author><author><name sortKey="Li, W" uniqKey="Li W">W Li</name></author><author><name sortKey="Lin, J" uniqKey="Lin J">J Lin</name></author><author><name sortKey="Liu, D" uniqKey="Liu D">D Liu</name></author><author><name sortKey="Xie, X" uniqKey="Xie X">X Xie</name></author><author><name sortKey="Zhang, Z" uniqKey="Zhang Z">Z Zhang</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Appl Oral Sci</journal-id><journal-id journal-id-type="iso-abbrev">J Appl Oral Sci</journal-id><journal-id journal-id-type="publisher-id">J. Appl. Oral Sci.</journal-id><journal-title-group><journal-title>Journal of Applied Oral Science</journal-title></journal-title-group><issn pub-type="ppub">1678-7757</issn><issn pub-type="epub">1678-7765</issn><publisher><publisher-name>Faculdade de Odontologia de Bauru da Universidade de São
Paulo</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23857655</article-id><article-id pub-id-type="pmc">3881907</article-id><article-id pub-id-type="doi">10.1590/1679-775720130127</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Rehabilitative treatment of cleft lip and palate: experience of the
Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: Oral
Rehabilitation</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>FREITAS</surname><given-names>José Alberto de Souza</given-names></name><xref ref-type="aff" rid="aff01"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>de ALMEIDA</surname><given-names>Ana Lúcia Pompéia Fraga</given-names></name><xref ref-type="aff" rid="aff02"><sup>2</sup></xref><xref ref-type="corresp" rid="c01"></xref></contrib><contrib contrib-type="author"><name><surname>SOARES</surname><given-names>Simone</given-names></name><xref ref-type="aff" rid="aff02"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>NEVES</surname><given-names>Lucimara Teixeira das</given-names></name><xref ref-type="aff" rid="aff03"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>GARIB</surname><given-names>Daniela Gamba</given-names></name><xref ref-type="aff" rid="aff04"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>TRINDADE-SUEDAM</surname><given-names>Ivy Kiemle</given-names></name><xref ref-type="aff" rid="aff03"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>YAEDÚ</surname><given-names>Renato Yassutaka Faria</given-names></name><xref ref-type="aff" rid="aff05"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>LAURIS</surname><given-names>Rita de Cássia Moura Carvalho</given-names></name><xref ref-type="aff" rid="aff06"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>OLIVEIRA</surname><given-names>Thais Marchini</given-names></name><xref ref-type="aff" rid="aff07"><sup>7</sup></xref></contrib><contrib contrib-type="author"><name><surname>PINTO</surname><given-names>João Henrique Nogueira</given-names></name><xref ref-type="aff" rid="aff08"><sup>8</sup></xref></contrib></contrib-group><aff id="aff01"><label>1</label> DDS, MSc, PhD, Superintendent, Hospital for Rehabilitation of Craniofacial Anomalies and Full Professor, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.</aff><aff id="aff02"><label>2</label> DDS, MSc, PhD, Assistant Professor, Department of Prosthodontics, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</aff><aff id="aff03"><label>3</label> DDS, MSc, PhD, Assistant Professor, Department of Biological Sciences, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</aff><aff id="aff04"><label>4</label> DDS, MSc, PhD, Associate Professor of Orthodontics, Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</aff><aff id="aff05"><label>5</label> DDS, MSc, PhD, Assistant Professor, Department of Stomatology, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</aff><aff id="aff06"><label>6</label> DDS, MSc, Orthodontist, Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</aff><aff id="aff07"><label>7</label> DDS, MSc, PhD, Assistant Professor, Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</aff><aff id="aff08"><label>8</label> DDS, MSc, PhD, Prosthodontist of the Dental Division of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.</aff><author-notes><corresp id="c01"><bold>Corresponding address: </bold>Ana Lúcia Pompéia Fraga de Almeida - Hospital de
Reabilitação de Anomalias Craniofaciais - Periodontia - Rua Silvio Marchione, 3-20 -
Bauru - SP - Brasil - 17090-012 - Phone: 55 14 32358081 - e-mail:
<email>analmeida@usp.br</email></corresp></author-notes><pub-date pub-type="ppub"><season>May-Jun</season><year>2013</year></pub-date><volume>21</volume><issue>3</issue><fpage>284</fpage><lpage>292</lpage><history><date date-type="received"><day>27</day><month>1</month><year>2013</year></date><date date-type="rev-recd"><day>13</day><month>3</month><year>2013</year></date><date date-type="accepted"><day>14</day><month>3</month><year>2013</year></date></history><permissions><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative
Commons Attribution Non-Commercial License which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the
original work is properly cited. </license-p></license></permissions><abstract><p>Treatment of patients with cleft lip and palate is completed with fixed prostheses,
removable, total, implants and aims to restore aesthetics, phonetics and function and
should be guided by the basic principles of oral rehabilitation, such as physiology,
stability, aesthetics, hygiene and the expectations of the patient. In order to
obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as
well as the biomechanics of the prosthesis are to be respected. The purpose of this
article is to describe the types of prosthetics treatment, which are performed at
HRAC/USP for the rehabilitation of cleft area in adult patients.</p></abstract><kwd-group><kwd>Cleft palate</kwd><kwd>Cleft lip</kwd><kwd>Periodontal diseases</kwd><kwd>Dental prosthesis</kwd><kwd>Dental implants</kwd></kwd-group></article-meta></front><body><sec><title>INTRODUCTION</title><p>The oral rehabilitation of individuals with cleft lip and palate is directly related to
the severity of anatomical and functional alterations determined by the malformation and
the age at treatment onset<sup><xref ref-type="bibr" rid="r13">13</xref></sup>. The
ideal treatment of the cleft area is closure by bone graft and orthodontics<sup><xref ref-type="bibr" rid="r12">12</xref></sup>. When this is not feasible, many cases
are solved with prosthetic rehabilitations. According to Mazaheri, 60% of individuals
with clefts will require some type of denture, and this percentage tends to increase if
the cleft affects the alveolar ridge<sup><xref ref-type="bibr" rid="r17">17</xref></sup>. </p><p>The dentures may be fixed or removable, tooth-or implant-supported, and aim to
reestablish the aesthetics, phonetics and function<sup><xref ref-type="bibr" rid="r22">22</xref>,<xref ref-type="bibr" rid="r23">23</xref></sup> and their indication
depends on the dental, periodontal and bone conditions and the maxillomandibular
relationship<sup><xref ref-type="bibr" rid="r21">21</xref></sup>. </p><p>Teeth close to the cleft area may present adverse conditions for restorative treatment,
such as presence of crowding, rotation, crown and root malformations<sup><xref ref-type="bibr" rid="r24">24</xref></sup>, partial eruption of teeth, presence of
frenula<sup><xref ref-type="bibr" rid="r01">1</xref></sup>, absence of keratinized
mucosa<sup><xref ref-type="bibr" rid="r01">1</xref></sup>, high prevalence of
gingival recession<sup><xref ref-type="bibr" rid="r02">2</xref>,<xref ref-type="bibr" rid="r03">3</xref>,<xref ref-type="bibr" rid="r05"> 5</xref></sup>, shallow
vestibule<sup><xref ref-type="bibr" rid="r04">4</xref></sup> ,difficult
hygiene<sup><xref ref-type="bibr" rid="r06">6</xref></sup>, and the condition of
supporting periodontal tissue. </p><p>Other aspects to be considered are the interarch discrepancy (in the different segments
of the maxillary arch) and maxillomandibular discrepancies, which require orthodontic
treatment in most cases. However, orthodontics is not always able to solve cases with
marked discrepancy. In these situations, orthognathic surgery is indicated and should be
planned in combination with the prosthodontist, to establish the final predictability of
the outcome<sup><xref ref-type="bibr" rid="r14">14</xref></sup>. </p><p>In individuals with cleft lip and palate, occlusal problems are observed due to these
discrepancies, such as absence of anterior guidance, alteration in vertical dimension
and lack of occlusal stability<sup><xref ref-type="bibr" rid="r11">11</xref></sup>. </p><p>The poor oral hygiene is a goal in the rehabilitation process, because the early tooth
loss may further worsen the complexity of rehabilitation<sup><xref ref-type="bibr" rid="r17">17</xref></sup>. </p><p>Achieving aesthetic outcomes and the search for a normal condition are challenging to
the professional, because the presence of lip frenula, deficiency of bone tissue and
keratinized mucosa may cause serious problems for maintenance of the prosthetic
work.</p><p>An important characteristic to be considered by the professional is the presence of
palatal fistulas, which have a direct influence on impression taking. The fistula is a
communication between the oral and nasal cavities<sup><xref ref-type="bibr" rid="r22">22</xref></sup> that should be temporarily closed without damage to the anatomy of
tissues to be copied in the impression (e.g. lubricated gauze or aluminum foil). Thus,
selection of the impression material is important because it may penetrate this region
causing difficulty in removal and discomfort to the individual. Therefore, more fluid
materials should be avoided because if extrusion occurs through the fistula, the removal
is troublesome and unpredictable. </p><p>The treatment should be guided by the basic principles of rehabilitation, including
physiology, stability, aesthetics, hygiene conditions and the individual's expectations. </p><p>The physiological function of mastication, speech and swallowing should be restored by
the occlusal and articular balance. The retention and stabilization of bone segments are
important to maintain the results achieved by orthodontics. </p><p>The aesthetic function comprises an improvement of the profile at the upper lip and
region and location (alignment) of the teeth. Individuals with cleft lip and alveolus
usually present a low smile line, i.e. most individuals do not present exposure of teeth
and gingival tissues on smiling, which facilitates the achievement of denture aesthetics
even in the absence of bone or gingival tissue<sup><xref ref-type="bibr" rid="r08">8</xref>,<xref ref-type="bibr" rid="r10">10</xref></sup>. </p><p>Finally, the prosthetic rehabilitation contributes directly and positively to the
psychological aspects of the individual<sup><xref ref-type="bibr" rid="r14">14</xref>,<xref ref-type="bibr" rid="r15">15</xref>,<xref ref-type="bibr" rid="r16">16</xref></sup>. </p><p>The main prosthetic treatments involved in the oral rehabilitation of individuals with
cleft lip and palate are fixed partial denture, removable partial denture, overlay
denture, complete denture and implant-supported denture<sup><xref ref-type="bibr" rid="r16">16</xref>,<xref ref-type="bibr" rid="r27">27</xref></sup>. </p><p>Concomitant to the diagnosis and indication of dentures, periodontal principles should
guide their planning and accomplishment, in either tooth- or implant-supported dentures,
because no prosthetic work may be maintained without adequate periodontal health
conditions. Thus the aim of this article is to describe the types of prosthodontic
treatment that are conducted at the Hospital for Rehabilitation of Craniofacial
Anomalies/University of São Paulo (HRAC/USP) for the rehabilitation of the cleft area in
adult patients according to periodontal and prosthetics principles. </p></sec><sec><title>TYPES OF ORAL REHABILITATION</title><sec><title>ADHESIVE FIXED DENTURE (AFD)</title><p>The AFDs were largely indicated in the 1970s, yet with the advent and consolidation
of implants and the difficulties for their indication related to loss of bonding.
Despite the evolution of adhesives, its utilization has been limited over time. </p><p>In individuals with cleft lip and palate, the indication remains because in some
cases, the AFD is a satisfactory prosthetic solution. Its indication is primarily for
small prosthetic spaces. </p><p>Provided that satisfactory conditions and favorable occlusion are present, the
lateral incisor region may receive an AFD, which plays a predominantly aesthetic and
phonetic function (<xref ref-type="fig" rid="f01">Figures 1</xref> and <xref ref-type="fig" rid="f02">2</xref>). </p><fig id="f01" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Frontal view with the absence of the lateral incisor</p></caption><graphic xlink:href="jaos-21-03-0284-g01"></graphic></fig><fig id="f02" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Rehabilitation of the lateral incisor through adhesive fixed denture</p></caption><graphic xlink:href="jaos-21-03-0284-g02"></graphic></fig><p>During denture fitting care should be given to the absence of contact on the lateral
incisor in Central Relationship (CR), Maximum Intercuspation (MI) and during lateral
and protrusive movements. </p><p>Indication of these dentures should also consider the basic principles of fixed
dentures, including overjet and overbite (minimum 1 mm for both), and space for the
framework - either in metal or ceramic, the abutment teeth should have enough enamel
to allow preparation. </p><p>When aesthetic materials are indicated it is possible to use zirconia, ceramics or
ceramic-reinforced resins, however, the conventional adhesive dentures (metallic
framework) are still widely employed for the treatment of these individuals. </p><p>The prosthetic space for placement of an AFD should be analyzed in vertical and
horizontal directions, because the presence of a cleft in this region may cause an
increase or decrease in the horizontal direction, so that only one tooth may be
insufficient to restore the aesthetics and two teeth may not fit in the available
space. Also in the vertical direction, due to the bone and consequent gingival loss,
this region requires special care, because indication of conventional fixed or
adhesive dentures should be comprised of a ceramic gingiva, which may preclude the
indication of an AFD and guide the treatment for a conventional fixed denture. </p><p>The impression taking for cases of AFD is restricted to the indication of a material
that may be able to copy details, and the technique concerns the manual capacity of
each professional. </p><p>Other aspects to be considered are the cements available in the market, which require
adhesion to the enamel and restorative material, otherwise the work would be
impaired, with reduced life span. </p></sec><sec><title>FIXED PARTIAL DENTURE (FPD)</title><p>The treatment with FPD is still widely indicated, especially in cases of failure of
the alveolar bone graft or when its indication is not possible<sup><xref ref-type="bibr" rid="r26">26</xref></sup> (<xref ref-type="fig" rid="f03">Figure 3</xref>). </p><fig id="f03" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Treatment with fixed partial denture from right central incisor to left
canine</p></caption><graphic xlink:href="jaos-21-03-0284-g03"></graphic></fig><p>When planning is initiated, after clinical and radiographic examination, the
professional should achieve maxillary and mandibular dental casts and mount them in a
semi-adjustable articulator to perform a diagnostic wax-up before the onset of the
procedures. The wax-up aims at investigating the area to be restored, especially in
individuals with clefts, because this space, as previously mentioned, may be too
large for restoration with only one tooth or insufficient for placement of two teeth. </p><p>During planning, malpositioned teeth, with small roots and/or peg-shaped crowns may
be extracted and the indication of periodontal surgeries should be considered and
performed, if necessary. </p><p>Care related to the bone support of abutment teeth should receive special attention
concerning the quantity of root inserted in the alveolar bone, which depends on the
quantity of teeth to be replaced (bridges) to be favorable. The larger the number of
bridges, more abutment teeth should be involved. The FPD's aim is that resistance (R)
be greater than or equal to the force (F) applied on the denture - R>F. Adequate
pulp vitality or endodontic treatment should be analyzed, as well as the root/ crown
ratio (3/2). </p><p>In some situations, malpositioned teeth may be corrected after prosthetic preparation
or endodontic treatment should be indicated, if necessary. </p><p>After endodontic treatment, the possibility of fabrication of a metallic cast, resin
or ceramic post should be considered to allow retention of the crown to be placed. </p><p>The bone level of the abutment tooth close to the cleft establishes a critical
relationship, because in some situations, due to the unfavorable root/ crown
relationship inherent to teeth adjacent to a non-grafted cleft area, combined with
periodontal problems or due to root alterations<sup><xref ref-type="bibr" rid="r28">28</xref></sup>, which may lead to indication for extraction. </p><p>The FPDs are indicated when implant placement is not possible, alveolar bone graft or
re-graft failed, and in unfavorable conditions of abutment teeth and adjacent
tissues. </p><p>The preparations of abutment teeth for FPDs are guided by biomechanical principles,
in which grinding is performed with diamond burs and the extent of grinding depends
on the prosthesis indicated, either metal, ceramic and metal, or metal-free. </p><p>The impression technique depends primarily on the ability of the professional,
impression material and location of the cervical limit. The ability of the
professional allows achievement of impressions using impression cups (subgingival
preparations with mercaptan and polyether), or light and putty addition or
condensation silicone (double impression or relining and single or laminated
impression), using subgingival cords. </p></sec><sec><title>REMOVABLE PARTIAL DENTURE (RPD)</title><p>For individuals with cleft lip and palate, the RPDs have been an important treatment
option, because the maxillomandibular do not always allow the indication of an ideal
treatment with fixed or implant-supported dentures. Due to the versatility and
relative simplicity, they may be indicated in borderline and adverse situations
(<xref ref-type="fig" rid="f04">Figure 4</xref>). </p><fig id="f04" orientation="portrait" position="float"><label>Figure 4</label><caption><p>Cleft area rehabilitated with removable partial denture</p></caption><graphic xlink:href="jaos-21-03-0284-g04"></graphic></fig><p>These individuals usually present tissue deficiency in the middle facial third, both
of the bone and soft tissue (lip). The mandible seems protruded, yet in fact there is
retrusion of the midface, as a long-term effect of primary surgeries<sup><xref ref-type="bibr" rid="r12">12</xref></sup>. </p><p>The lip support of these individuals is impaired or inexistent, due to the poor
alveolar ridge and the scar caused by surgical procedures. The removable dentures may
be used effectively and satisfactorily in these situations. </p><p>Planning of the RPD should be combined to clinical and radiographic examinations and
dental casts analysis in a surveyor. The analysis on the surveyor is important to
allow changes in tooth anatomy aiming to enhance the denture retention. </p><p>The occlusal analysis should be considered, as well as the need of stabilization of
posterior contacts and determination of the type and site of retainers, larger and
smaller connectors, dental bar (if necessary) and selection of plastic teeth and base
types. </p><p>The occlusion is very important, because the framework may allow reestablishment of
the occlusal stability. Care should be taken to analyze the interocclusal distance
when the vertical dimension of occlusion is increased, to achieve enough space for
the placement of teeth. </p><p>The RPDs are further indicated for palatal closure in cases without surgical
repair<sup><xref ref-type="bibr" rid="r17">17</xref></sup>. </p></sec><sec><title>OVERLAY DENTURE (OD)</title><p>This resource is indicated basically for individuals with cleft lip and palate, in
extreme cases, with hypoplasia and marked retrusion of the maxilla with tooth loss
and/or malpositioning, when it was not possible to indicate orthodontic treatment and
orthognathic surgery. </p><p>In individuals with clefts, it aims to recover the maxillary arch that is retruded
due to maxillary atresia, large maxillomandibular discrepancy, anterior open bite and
missing or malpositioned teeth. Obviously this is not the ideal prosthetic solution,
yet it allows completion of clinical cases with lip support and favorable vertical
dimension. </p><p>These dentures provide functional and aesthetic benefits and satisfaction to the
individual. </p><p>The planning follows the biomechanical principles of RPDs, modified especially in the
metallic framework, which covers the ridge on the buccal aspect and is covered by the
wax, providing lip support. </p><p>The impression procedure is restricted to the use of irreversible hydrocolloid or
silicones (condensation or addition) to copy details of preparations made for
fabrication of the RPD. </p><p>According to the treatment protocol at HRAC, all individuals receiving an
OD<sup><xref ref-type="bibr" rid="r14">14</xref></sup> should be previously
evaluated and wear a provisional overlay denture to enhance the prognosis and design
of the metallic framework (<xref ref-type="fig" rid="f05">Figure 5</xref>). </p><fig id="f05" orientation="portrait" position="float"><label>Figure 5</label><caption><p>Overlay denture temporary and permanent</p></caption><graphic xlink:href="jaos-21-03-0284-g05"></graphic></fig><p>Overlay dentures should be indicated in individuals with good oral hygiene or
committed to follow the maintenance therapy, especially in case of susceptibility to
caries and periodontal disease<sup><xref ref-type="bibr" rid="r25">25</xref></sup>(<xref ref-type="fig" rid="f06">Figure 6</xref>). </p><fig id="f06" orientation="portrait" position="float"><label>Figure 6</label><caption><p>Proof of the overlay denture framework</p></caption><graphic xlink:href="jaos-21-03-0284-g06"></graphic></fig></sec><sec><title>COMPLETE DENTURE (CD)</title><p>Due to alterations of the alveolar ridge of individuals with cleft lip and palate,
the rehabilitation with CD is challenging to the professional. </p><p>The difficulties occur in relation to denture stability and retention, since physical
factors, such as adhesion, surface tension and cohesion are impaired. Other aspects
to be considered are the alveolar ridge anatomy, presence of fistula or unrepaired
cleft, which may favor the penetration of air and denture displacement. These
individuals receive the denture with aesthetic, functional and obturator functions,
improving the comfort, speech and psychological condition (<xref ref-type="fig" rid="f07">Figure 7</xref>). </p><fig id="f07" orientation="portrait" position="float"><label>Figure 7</label><caption><p>Frontal view of complete denture in position</p></caption><graphic xlink:href="jaos-21-03-0284-g07"></graphic></fig><p>In operated individuals without fistula, the obturator function is not necessary, yet
the alveolar ridge irregularity may compromise the denture stability. In operated
individuals with fistula, the most frequent situation, the anterior region is more
affected, which may influence the success of the denture. </p><p>Anatomical and functional impressions are obtained with variable degrees of
complexity. In the anatomical impression, achieved with stock trays, the
characteristics of the material depend on the remaining alveolar ridge. For open
ridges with wide cleft, the material should be resilient to facilitate removal, such
as condensation and addition silicones. </p><p>When fistulas are present, the indicated material for anatomical impression is high
fusing compound, which does not pose the risk of material overflow, and tissue
retraction allows visualization of the entire area that may be included in the
denture base.</p><p>In palates without fistula, the high fusing compound may be used and relined or
refined with alginate, enhancing the conditions for fabrication of the custom tray.</p><p>The subsequent steps follow the same principles for fabrication of CD in individuals
without clefts. </p></sec><sec><title>IMPLANT-SUPPORTED DENTURE (ISD)</title><p>For decades, the prosthetic rehabilitation of individuals with clefts has been
related to the solution of sequels caused by surgical treatment without follow-up and
inadequate dental procedures, which led to multiple and early losses. Therefore, the
original dentures required complicated design and biomechanics, often leading to
overload on the remaining teeth.</p><p>When osseointegration was discovered more than 50 years ago, it was not possible to
calculate the benefits of this phenomenon to mankind. The edentulism in the cleft
area in adult individuals, up to the mid-1980s, was solved with conventional
dentures. Currently, the edentulous space may receive an implant and the denture.
Complete or removable partial dentures with difficult retention in atresic maxillae
may be replaced by fixed restorations or implant-supported overdentures. </p><p>The size, shape and location of the residual alveolar ridge in edentulous maxillae
provide little support to the CD, thus impairing the retention and stability, often
making them heavy due to extensions of the acrylic base in the vertical and
horizontal directions. The presence of cleft with absence of the premaxilla further
worsens this condition. </p><p>In 1991, the first case report describing the complete technique for placement of an
endosseous implant was published, 18 months after the alveolar cleft was grafted with
cancellous autogenous bone from the tibia<sup><xref ref-type="bibr" rid="r25">25</xref></sup>. </p><p>Implant placement in the grafted bone provides a functional stimulus that is
necessary to maintain the volume, preventing its resorption. </p><p>The alveolar bone graft is performed in young individuals before completion of
development. Until the implants could be placed, this time period may lead to
advanced resorption of grafts. Thus, re-graft of bone from the mandibular symphysis
or oblique line of the mandible may be necessary to recover the thickness and height
of the alveolar ridge in the area to be implanted (<xref ref-type="fig" rid="f08">Figure 8</xref>). </p><fig id="f08" orientation="portrait" position="float"><label>Figure 8</label><caption><p>Re-graft area of the cleft area for dental implant</p></caption><graphic xlink:href="jaos-21-03-0284-g08"></graphic></fig><p>There is consensus on the ideal period between alveolar bone graft and implant
placement, of nearly 4 to 6 months to allow maintenance of sufficient bone volume for
placement of well-positioned implants with proper dimensions. </p><p>When orthodontic finalizes the treatment leaving the space for implant placement in
the grafted cleft area, sufficient bone thickness is necessary in the mesiodistal and
buccolingual directions. </p><p>The success of implants placed in the grafted cleft area has been similar to the
other areas, around 90%<sup><xref ref-type="bibr" rid="r09">9</xref></sup> (<xref ref-type="fig" rid="f09">Figure 9</xref>). </p><fig id="f09" orientation="portrait" position="float"><label>Figure 9</label><caption><p>Implant in the left lateral incisor</p></caption><graphic xlink:href="jaos-21-03-0284-g09"></graphic></fig><p>The great challenge concerns the aesthetics in the implant region, because in many
cases, even after bone graft, defects remain that may prevent or preclude the implant
placement. In those cases, the option would be a fixed denture with artificial
ceramic gingiva to mask the defect, even though in many cases the individual does not
expose the gingival tissue during smiling<sup><xref ref-type="bibr" rid="r08">8</xref></sup>. </p><p>There is no doubt on rehabilitation with implant-supported dentures. However, an
aspect that should be addressed for treatment optimization is the frequent impairment
of soft tissue aesthetics in the cleft area. The absence of keratinized mucosa and
absence of papilla may cause discomfort for oral hygiene and also social constraints
when the individual smiles and exhibits the deficient gingival tissue<sup><xref ref-type="bibr" rid="r07">7</xref>,<xref ref-type="bibr" rid="r10">10</xref></sup>. </p><p>The care in soft tissue handling should be followed since the primary cleft repair,
passing through surgeries for graft, implant placement and prosthetic intermediates,
to allow more predictable achievement of the so-called "pink esthetics" related to
the contour, shape, shade and position of the peri-implant gingival margin similar to
the adjacent teeth<sup><xref ref-type="bibr" rid="r10">10</xref></sup>. </p><p>The vestibuloplasty technique associated with free gingival graft is widely used both
in the cleft area and in other areas rehabilitated with implant-supported dentures for
achievement of high-quality soft tissue and consequent homeostasis of these
tissues<sup><xref ref-type="bibr" rid="r04">4</xref>,<xref ref-type="bibr" rid="r18">18</xref>,<xref ref-type="bibr" rid="r19">19</xref></sup>. </p></sec><sec><title>SPEECH APPLIANCE OR PALATAL PROSTHESIS</title><p>Individuals with cleft lip and palate may often present speech problems due to the
presence of fistula, unrepaired palate or some situations that can damage the
appropriate closure of the velopharyngeal valve. The velopharynx is a tridimensional
muscular valve located between the oral and nasal cavities that control the passage
of air between mouth and nose.</p><p>The velopharyngeal dysfunction may occur when the velopharynx valve is unable to
perform its own closing, due to lack of tissue (velopharyngeal insufficiency) or even
lack of proper movement (velopharyngeal incompetence)<sup><xref ref-type="bibr" rid="r20">20</xref>,<xref ref-type="bibr" rid="r21">21</xref></sup>. </p><p>Particularly in cases of individuals with cleft lip and palate, most are related to
velopharyngeal insufficiency, considering the lack of tissue on the soft palate,
presence of fistula or even due to conditions in which the palate remains open. The
constant communication between the oral and nasal cavities damage the speech
intelligibility, as well as the absent or weak intraoral pressure, hypernasality,
compensatory articulation, and nasal air emission. The speech of individuals with
cleft palate is primarily characterized by abnormalities in nasal resonance. In
addition, there may be articulation errors, including compensatory articulations and
a reduction in speech intelligibility<sup><xref ref-type="bibr" rid="r20">20</xref></sup>. </p><p>Velopharyngeal dysfunction may be treated by speech therapy, surgery, prosthesis or a
combined approach. Although the surgeries (palatoplasty and pharyngoplasty) are the
procedures more often used, speech appliances or palatal prostheses are important
treatment options for velopharyngeal dysfunction. </p><p>The speech prosthesis may be the best choice in several situations, for example, when
surgery may not be performed because of systemic, anatomic, or functional limitations
or if the individual is not willing to undergo surgery. Another very common situation
for indication of palatal prostheses for individuals with cleft lip and palate is
when velopharyngeal dysfunction occurs in individuals with many missing teeth,
requiring a complete or partial removable denture (<xref ref-type="fig" rid="f10">Figure 10</xref>). </p><fig id="f10" orientation="portrait" position="float"><label>Figure 10</label><caption><p>Palatal prosthesis</p></caption><graphic xlink:href="jaos-21-03-0284-g10"></graphic></fig><p>Children may also receive palatal prostheses as a treatment for velopharyngeal
dysfunction and eventually stimulate the muscle movement of the lateral pharyngeal
walls, aiming at a future surgery. </p><p>The palatal prosthesis or speech appliance can be didactically divided in three
portions, anterior, intermediate and posterior. The anterior portion corresponds to
the conventional denture, and it can be a removable partial denture, a complete
denture, an overdenture or even an acrylic plate. </p><p>In some cases, the nasopharynx is so deep that it is necessary to consider an
intermediate portion between these two (anterior and posterior) to properly place and
retain the posterior portion. In some cases the intermediate may close the palate or
fistulae, if necessary. </p><p>Fabrication of the posterior portion is initiated only after the individual has used
the prosthesis with the intermediate portion. A brass wire is adapted to the end of
the prosthesis to mold the posterior portion, which supports the impression compound.
The wire is folded so that it forms a loop, attached to the prosthesis. A very good
attachment is necessary to prevent denture loosening while molding is performed. A
preliminary impression is initially taken, adapting the modeling compound to the
metallic loop. When the material is still plastic, the denture is placed in the
individual's mouth and the individual is properly asked by the speech pathologist to
produce some phonemes, move the head and swallow. The enlargement of the prosthesis
towards the pharynx must be gradual and very well tolerated by the individual, to
avoid discomfort and a gagging reflex<sup><xref ref-type="bibr" rid="r20">20</xref>,<xref ref-type="bibr" rid="r21">21</xref></sup>. </p><p>The completion of anatomical impressions of the velopharynx is performed with wax or
modeling compound, during the nasoendoscopy view. This examination consists of
introducing an optic fiber though the individual's nose up to a point that allows a
superior view of the velopharynx<sup><xref ref-type="bibr" rid="r20">20</xref>,<xref ref-type="bibr" rid="r21">21</xref></sup>. </p><p>The image is presented on a monitor and allows all the staff and even the individual
to observe the molding process. After all adjustments, the impression is properly
included in a master cast, and the posterior portion is also processed with
heat-activated acrylic resin<sup><xref ref-type="bibr" rid="r20">20</xref>,<xref ref-type="bibr" rid="r21">21</xref></sup>. </p><p>Follow-up visits are initially indicated on a weekly basis and then monthly, up to
the individual's discharge, usually six months after treatment onset. The main
purpose of physical or behavioral management in individuals with cleft lip and palate
is the achievement of intelligible speech of pleasing quality. </p><p>Therefore, it may be concluded that palatopharyngeal obturators and pharyngeal bulbs
improve the ability to maintain intraoral air pressure, improving the speech
intelligibility. Speech therapy is needed to eliminate any compensatory articulation
productions developed prior to prosthetic management<sup><xref ref-type="bibr" rid="r20">20</xref>,<xref ref-type="bibr" rid="r21">21</xref></sup>. </p></sec><sec><title>ROLE OF PERIODONTOLOGY IN ORAL REHABILITATION</title><p>Current periodontology plays a fundamental role in the oral and systemic health of
individuals, either with or without clefts. It acts both on the prevention of
gingivitis and periodontitis, on the treatment of established diseases and
maintenance of homeostasis of periodontal tissues. </p><p>Several factors contribute to the difficult oral hygiene of teeth close to the cleft
area, including presence of gingival recessions, frenula (<xref ref-type="fig" rid="f11">Figure 11</xref>), tooth malpositioning (<xref ref-type="fig" rid="f12">Figure 12</xref>), dental anomalies and extended use of fixed orthodontic
appliances<sup><xref ref-type="bibr" rid="r01">1</xref>- <xref ref-type="bibr" rid="r05">5</xref>,<xref ref-type="bibr" rid="r24">24</xref></sup>. </p><fig id="f11" orientation="portrait" position="float"><label>Figure 11</label><caption><p>Presence of frenula, gingival recession on teeth adjacent to the cleft and
generalized dental plaque</p></caption><graphic xlink:href="jaos-21-03-0284-g11"></graphic></fig><fig id="f12" orientation="portrait" position="float"><label>Figure 12</label><caption><p>Malpositioned tooth close to the cleft</p></caption><graphic xlink:href="jaos-21-03-0284-g12"></graphic></fig><p>The periodontology acts in combination with community health for oral hygiene
instructions and control, during surgical, orthodontic and rehabilitative treatment. </p><p>Even though some studies report that teeth adjacent to the cleft area are more
susceptible to periodontal disease, a real relationship has not been found between
the risk of disease and the presence of cleft lip and palate. It has been observed
that the individual may or may not be susceptible to periodontitis, and the presence
of disease is not dependent on whether the site is close to or not to the cleft. It
has been described that these teeth present a longer connective attachment, yet there
is no contraindication to their utilization as abutments during the rehabilitative
process. </p><p>Regardless of the type of oral rehabilitation to which the individual will be
submitted, the periodontal treatment is performed by two different conditions, if the
individual is susceptible or not. If the individual is not susceptible to
periodontitis, i.e. presenting only gingivitis, dental plaque control is indicated by
oral hygiene instructions, crown and root scaling and planning and professional
prophylaxis following the individual's schedule. </p><p>Throughout the dental treatment the individual should be controlled as to the oral
hygiene conditions, with supervised toothbrushing in the Community Dentistry or
Periodontology sectors. The techniques are the same, as well as the indication of
toothbrushes, toothpaste and floss, with the addition of single-tufted toothbrushes
to facilitate the plaque removal in teeth adjacent to the cleft (<xref ref-type="fig" rid="f13">Figure 13</xref>). </p><fig id="f13" orientation="portrait" position="float"><label>Figure 13</label><caption><p>Single-tufted toothbrush indicated for hygiene of malpositioned teeth adjacent
to the cleft</p></caption><graphic xlink:href="jaos-21-03-0284-g13"></graphic></fig><p>In the case of susceptibility, the individual receives the same aforementioned
treatment combined with surgical therapies that may be mucogingival, resective or
regenerative. </p><p>Surgical therapies performed more frequently in individuals with clefts are
gingivoplasty, gingivectomy, free or pediculated gingival graft, vestibule deepening
with or without free gingival graft, removal of frenula, and restoration of
biological dimensions. </p></sec></sec><sec><title>CONCLUDING REMARKS</title><p>The rehabilitation of individuals with cleft lip and palate often requires an
interdisciplinary approach comprising at least medical and dental doctors and speech
pathologists, to allow adequate aesthetic and functional conditions to the individual. </p><p>The rehabilitative and prosthetic treatment of individuals with cleft lip and palate is
one of the last treatment stages, after growth completion, finalization of orthodontic
treatment and the main surgeries. The type of denture should be indicated according to
the need of each individual and according to the oral and systemic health, besides the
individual's expectations.</p></sec></body><back><ref-list><title>REFERENCES</title><ref id="r01"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Almeida</surname><given-names>ALPF</given-names></name><name><surname>Esper</surname><given-names>LA</given-names></name><name><surname>Kaizer</surname><given-names>RO</given-names></name><name><surname>Fernandes</surname><given-names>JS</given-names></name><name><surname>Greghi</surname><given-names>SL</given-names></name><name><surname>Carrilho</surname><given-names>GP</given-names></name></person-group><article-title>Surgical treatment of mucogingival alterations in cleft lip and palate
patients: a clinical report</article-title><source>Perio</source><year>2006</year><volume>3</volume><fpage>31</fpage><lpage>35</lpage></element-citation></ref><ref id="r02"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Almeida</surname><given-names>ALPF</given-names></name><name><surname>Esper</surname><given-names>LA</given-names></name><name><surname>Pegoraro</surname><given-names>TA</given-names></name><name><surname>Valle</surname><given-names>AL</given-names></name></person-group><article-title>Gingival recession in individuals with cleft lip and palate:
prevalence and severity</article-title><source>Cleft Palate J</source><year>2012</year><volume>49</volume><fpage>92</fpage><lpage>95</lpage></element-citation></ref><ref id="r03"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Almeida</surname><given-names>ALPF</given-names></name><name><surname>Madeira</surname><given-names>LC</given-names></name><name><surname>Freitas</surname><given-names>KC</given-names></name><name><surname>Greghi</surname><given-names>SL</given-names></name><name><surname>Pegoraro</surname><given-names>LF</given-names></name></person-group><article-title>Cross-sectional evaluation of the presence of gingival recession in
individuals with cleft lip and palate</article-title><source>J Periodontol</source><year>2007</year><volume>78</volume><fpage>29</fpage><lpage>36</lpage><pub-id pub-id-type="pmid">17199536</pub-id></element-citation></ref><ref id="r04"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Almeida</surname><given-names>ALPF</given-names></name><name><surname>Pedro</surname><given-names>PF</given-names></name><name><surname>Kogawa</surname><given-names>EM</given-names></name><name><surname>Pereira</surname><given-names>T</given-names></name><name><surname>Carrilho</surname><given-names>GP</given-names></name><name><surname>Aiello</surname><given-names>CA</given-names></name><etal>et al</etal></person-group><article-title>Comparative evaluation of two different vestibuloplasty surgical
procedures in cleft patients: a pilot study</article-title><source>Cleft Palate J</source><year>2005</year><volume>42</volume><fpage>439</fpage><lpage>441</lpage></element-citation></ref><ref id="r05"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Almeida</surname><given-names>ALPF</given-names></name><name><surname>Sbrana</surname><given-names>MC</given-names></name><name><surname>Esper</surname><given-names>LA</given-names></name><name><surname>Greghi</surname><given-names>SL</given-names></name><name><surname>Conti</surname><given-names>PC</given-names></name></person-group><article-title>Gingival recession in maxillary canines and central incisors of
individuals with clefts</article-title><source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source><year>2010</year><volume>109</volume><fpage>37</fpage><lpage>45</lpage><pub-id pub-id-type="pmid">19828341</pub-id></element-citation></ref><ref id="r06"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Brasil</surname><given-names>JM</given-names></name><name><surname>Pernambuco</surname><given-names>RA</given-names></name><name><surname>Dalben</surname><given-names>GS</given-names></name></person-group><article-title>Suggestion of an oral hygiene program for orthodontic patient with
cleft lip and palate: findings of a pilot study</article-title><source>Cleft Palate Craniofac J</source><year>2007</year><volume>44</volume><fpage>595</fpage><lpage>597</lpage><pub-id pub-id-type="pmid">18177183</pub-id></element-citation></ref><ref id="r07"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Esper</surname><given-names>LA</given-names></name><name><surname>Ferreira</surname><given-names>SB Jr</given-names></name><name><surname>Kaizer</surname><given-names>ROF</given-names></name><name><surname>Almeida</surname><given-names>ALPF</given-names></name></person-group><article-title>The role of keratinized mucosa in peri-implant health</article-title><source>Cleft Palate Craniofac J</source><year>2012</year><volume>49</volume><fpage>167</fpage><lpage>170</lpage><pub-id pub-id-type="pmid">21417779</pub-id></element-citation></ref><ref id="r08"><label>8</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Esper</surname><given-names>LA</given-names></name><name><surname>Sbrana</surname><given-names>MC</given-names></name><name><surname>Ribeiro</surname><given-names>IWJ</given-names></name><name><surname>Siqueira</surname><given-names>EN</given-names></name><name><surname>Almeida</surname><given-names>ALPF</given-names></name></person-group><article-title>Esthetic analysis of gingival components of smile and degree of
satisfaction in individuals with cleft lip and palate</article-title><source>Cleft Palate Craniofac J</source><year>2009</year><volume>46</volume><fpage>381</fpage><lpage>387</lpage><pub-id pub-id-type="pmid">19642765</pub-id></element-citation></ref><ref id="r09"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ferreira</surname><given-names>SB Jr</given-names></name><name><surname>Esper</surname><given-names>LA</given-names></name><name><surname>Sbrana</surname><given-names>MC</given-names></name><name><surname>Ribeiro</surname><given-names>IWJ</given-names></name><name><surname>Almeida</surname><given-names>ALPF</given-names></name></person-group><article-title>Survival of dental implants in the cleft area - a retrospective
study</article-title><source>Cleft Palate Craniofac J</source><year>2010</year><volume>47</volume><fpage>586</fpage><lpage>590</lpage><pub-id pub-id-type="pmid">20500069</pub-id></element-citation></ref><ref id="r10"><label>10</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Fiamengui Filho</surname><given-names>JF</given-names></name><name><surname>Almeida</surname><given-names>ALPF</given-names></name></person-group><article-title>Esthetic analysis of implant-supported denture at the cleft
area</article-title><source>Cleft Palate Craniofac J</source><year>2012</year><comment>Epub ahead of print</comment><comment>Available from: <ext-link ext-link-type="uri" xlink:href="http://dx.doi.org/10.1597/11-193">http://dx.doi.org/10.1597/11-193</ext-link></comment></element-citation></ref><ref id="r11"><label>11</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Freitas</surname><given-names>AC Jr</given-names></name><name><surname>Silva</surname><given-names>AM</given-names></name><name><surname>Lima Verde</surname><given-names>MA</given-names></name><name><surname>Aguiar</surname><given-names>JR</given-names></name></person-group><article-title>Oral rehabilitation of severely worn dentition using an overlay for
immediate re-establishment of occlusal vertical dimension</article-title><source>Gerontology</source><year>2012</year><volume>29</volume><issue>1</issue><fpage>75</fpage><lpage>80</lpage></element-citation></ref><ref id="r12"><label>12</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Freitas</surname><given-names>JAS</given-names></name><name><surname>Garib</surname><given-names>DG</given-names></name><name><surname>Oliveira</surname><given-names>TM</given-names></name><name><surname>Almeida</surname><given-names>ALPF</given-names></name><name><surname>Trindade-Suedam</surname><given-names>IK</given-names></name><name><surname>Yaedú</surname><given-names>RYF</given-names></name><etal>et al</etal></person-group><article-title>Rehabilitative treatment of cleft lip and palate: experience of the
Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) -part 2:
Pediatric Dentistry and Orthodontics</article-title><source>J Appl Oral Sci</source><year>2012</year><volume>20</volume><issue>2</issue><fpage>272</fpage><lpage>285</lpage></element-citation></ref><ref id="r13"><label>13</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Freitas</surname><given-names>JAS</given-names></name><name><surname>Neves</surname><given-names>LT</given-names></name><name><surname>Almeida</surname><given-names>ALPF</given-names></name><name><surname>Garib</surname><given-names>DG</given-names></name><name><surname>Trindade-Suedam</surname><given-names>IK</given-names></name><name><surname>Yaedú</surname><given-names>RYF</given-names></name><etal>et al</etal></person-group><article-title>Rehabilitative treatment of cleft lip and palate: experience of the
Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 1:
overall aspects</article-title><source>J Appl Oral Sci</source><year>2012</year><volume>20</volume><issue>1</issue><fpage>9</fpage><lpage>15</lpage><pub-id pub-id-type="pmid">22437671</pub-id></element-citation></ref><ref id="r14"><label>14</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Fukuda</surname><given-names>M</given-names></name><name><surname>Takahashi</surname><given-names>T</given-names></name><name><surname>Yamaguchi</surname><given-names>T</given-names></name><name><surname>Kochi</surname><given-names>S</given-names></name><name><surname>Inai</surname><given-names>T</given-names></name><name><surname>Watanabe</surname><given-names>M</given-names></name><etal>et al</etal></person-group><article-title>Dental rehabilitation using endosseous implants and orthognathic
surgery in patients with cleft lip and palate: report of two cases</article-title><source>J Oral Rehabil</source><year>2000</year><volume>27</volume><fpage>546</fpage><lpage>551</lpage><pub-id pub-id-type="pmid">10888283</pub-id></element-citation></ref><ref id="r15"><label>15</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hickey</surname><given-names>AJ</given-names></name><name><surname>Salter</surname><given-names>M</given-names></name></person-group><article-title>Prosthodontic and psychological factors in treating patients with
congenital and craniofacial defects</article-title><source>J Prosthet Dent</source><year>2006</year><volume>95</volume><fpage>392</fpage><lpage>396</lpage><pub-id pub-id-type="pmid">16679134</pub-id></element-citation></ref><ref id="r16"><label>16</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lopes</surname><given-names>JFS</given-names></name><name><surname>Pinto</surname><given-names>JHN</given-names></name><name><surname>Almeida</surname><given-names>ALPF</given-names></name><name><surname>Lopes</surname><given-names>MMW</given-names></name><name><surname>Dalben</surname><given-names>GS</given-names></name></person-group><article-title>Cleft palate obturation with Brånemark protocol implant-supported
fixed denture and removable obturator</article-title><source>Cleft Palate Craniofac J</source><year>2010</year><volume>47</volume><fpage>211</fpage><lpage>215</lpage><pub-id pub-id-type="pmid">20210640</pub-id></element-citation></ref><ref id="r17"><label>17</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mazaheri</surname><given-names>M</given-names></name></person-group><article-title>Indications and contraindications for prosthetic speech appliances in
cleft palate</article-title><source>Plast Reconstr Surg Transplant Bull</source><year>1962</year><volume>30</volume><fpage>663</fpage><lpage>669</lpage><pub-id pub-id-type="pmid">13934193</pub-id></element-citation></ref><ref id="r18"><label>18</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Melo</surname><given-names>LGN</given-names></name><name><surname>Almeida</surname><given-names>ALPF</given-names></name><name><surname>Lopes</surname><given-names>JFS</given-names></name><name><surname>Rezende</surname><given-names>ML</given-names></name><name><surname>Neto</surname><given-names>JS</given-names></name><name><surname>Ciporkin</surname><given-names>F</given-names></name><etal>et al</etal></person-group><article-title>A modified approach for vestibuloplasty in severely resorbed mandible
using an implant-retained postoperative stent: a case report</article-title><source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source><year>2008</year><volume>106</volume><fpage>e7</fpage><lpage>14</lpage><pub-id pub-id-type="pmid">18657455</pub-id></element-citation></ref><ref id="r19"><label>19</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Melo</surname><given-names>LGN</given-names></name><name><surname>Ciporkin</surname><given-names>F</given-names></name><name><surname>Neto</surname><given-names>JS</given-names></name><name><surname>Almeida</surname><given-names>ALPF</given-names></name><name><surname>Lopes</surname><given-names>JFS</given-names></name><name><surname>Figueiredo</surname><given-names>CM</given-names></name><etal>et al</etal></person-group><article-title>Correction of mucogingival defect using an implant-retained
postoperative stent in a severely resorbed mandible: case report</article-title><source>Int J Periodontics Restorative Dent</source><year>2008</year><volume>28</volume><fpage>617</fpage><lpage>623</lpage><pub-id pub-id-type="pmid">19146058</pub-id></element-citation></ref><ref id="r20"><label>20</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pinto</surname><given-names>JHN</given-names></name><name><surname>Dalben</surname><given-names>GS</given-names></name><name><surname>Pegoraro-Krook</surname><given-names>MI</given-names></name></person-group><article-title>Speech intelligibility of patients with cleft lip and palate after
placement of speech prosthesis</article-title><source>Cleft Palate Craniofacial J</source><year>2007</year><volume>44</volume><issue>6</issue><fpage>635</fpage><lpage>641</lpage></element-citation></ref><ref id="r21"><label>21</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pinto</surname><given-names>JHN</given-names></name><name><surname>Pegoraro-Krook</surname><given-names>MI</given-names></name></person-group><article-title>Evaluation of palatal prosthesis for treatment of velopharyngeal
dysfunction</article-title><source>J Appl Oral Sci</source><year>2003</year><volume>11</volume><fpage>192</fpage><lpage>197</lpage><pub-id pub-id-type="pmid">21394393</pub-id></element-citation></ref><ref id="r22"><label>22</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Reisberg</surname><given-names>DJ</given-names></name></person-group><article-title>Dental and prosthodontic care for patients with cleft or craniofacial
conditions</article-title><source>Cleft Palate Craniofacial J</source><year>2000</year><volume>37</volume><fpage>534</fpage><lpage>537</lpage></element-citation></ref><ref id="r23"><label>23</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Reisberg</surname><given-names>DJ</given-names></name></person-group><article-title>Prosthetic rehabilitation of patients with clefts</article-title><source>Clin Plast Surg</source><year>2004</year><volume>31</volume><fpage>353</fpage><lpage>360</lpage><pub-id pub-id-type="pmid">15145675</pub-id></element-citation></ref><ref id="r24"><label>24</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ruiz</surname><given-names>LA</given-names></name><name><surname>Maya</surname><given-names>RR</given-names></name><name><surname>D'Alpino</surname><given-names>PHP</given-names></name><name><surname>Atta</surname><given-names>MT</given-names></name><name><surname>Svizzero</surname><given-names>NR</given-names></name></person-group><article-title>Prevalence of enamel defects in permanent teeth of patients with
complete cleft lip and palate</article-title><source>Cleft Palate Craniofac J</source><year>2012</year><comment>Epub ahead of print</comment><comment>Available from: <ext-link ext-link-type="uri" xlink:href="http://dx.doi.org/10.1597/11-200">http://dx.doi.org/10.1597/11-200</ext-link></comment></element-citation></ref><ref id="r25"><label>25</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Verdi</surname><given-names>FJ Jr</given-names></name><name><surname>Lanzi</surname><given-names>GL</given-names></name><name><surname>Cohen</surname><given-names>SR</given-names></name><name><surname>Powell</surname><given-names>R</given-names></name></person-group><article-title>Use of the Brånemark implant in the cleft palate
patient</article-title><source>Cleft Palate Craniofac J</source><year>1991</year><volume>28</volume><fpage>301</fpage><lpage>303</lpage><pub-id pub-id-type="pmid">1911819</pub-id></element-citation></ref><ref id="r26"><label>26</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Watanabe</surname><given-names>I</given-names></name><name><surname>Kurtz</surname><given-names>KS</given-names></name><name><surname>Watanabe</surname><given-names>E</given-names></name><name><surname>Yamada</surname><given-names>M</given-names></name><name><surname>Yoshida</surname><given-names>N</given-names></name><name><surname>Miller</surname><given-names>AW</given-names></name></person-group><article-title>Multi-unit fixed partial denture for a bilateral cleft palate patient:
a clinical report</article-title><source>J Oral Rehabil</source><year>2005</year><volume>32</volume><fpage>620</fpage><lpage>622</lpage><pub-id pub-id-type="pmid">16011642</pub-id></element-citation></ref><ref id="r27"><label>27</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wirz</surname><given-names>J</given-names></name></person-group><article-title>Prosthetic planning and therapy for repaired cleft lip, maxilla and
palate patients</article-title><source>Quintessence Int</source><year>1971</year><volume>2</volume><fpage>57</fpage><lpage>61</lpage></element-citation></ref><ref id="r28"><label>28</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zhou</surname><given-names>W</given-names></name><name><surname>Li</surname><given-names>W</given-names></name><name><surname>Lin</surname><given-names>J</given-names></name><name><surname>Liu</surname><given-names>D</given-names></name><name><surname>Xie</surname><given-names>X</given-names></name><name><surname>Zhang</surname><given-names>Z</given-names></name></person-group><article-title>Tooth lengths of the permanent upper incisors in patients with clefts
lip and palate determined with cone bean computed tomography</article-title><source>Cleft Palate Craniofac J</source><year>2013</year><volume>50</volume><fpage>88</fpage><lpage>95</lpage><pub-id pub-id-type="pmid">22428573</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/EdenteV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000599 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 000599 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Santé
|area= EdenteV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:3881907
|texte= Rehabilitative treatment of cleft lip and palate: experience of the
Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: Oral
Rehabilitation
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:23857655" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a EdenteV1
| This area was generated with Dilib version V0.6.33. |  |