Volume 92 Number 5

Der Einflup der Lippenplastik auf die Dentofaziale Entwicklung bei Patienten mit Lippen-Kiefer-Gaumen-Spalten 1. Jonas, H. F. Kappert, E. Reider, T. Rakosi, W. Schilli, and U. Joos Fortschr. Kiefemrthop. 1986:4W-1 I

The effect of primary lip repair on the dentofacial morphology was analyzed in 25 adolescents with cleft lip and palate by means of (a) upper lip pressure mea- surement, (b) electromyography of the labial muscu- lature, (c) roentgenocephalometric and soft-tissue anal- yses of the lateral head plate, and (d) plaster model analysis. The results were compared with those of 15 patients presenting with normal occlusal and functional relationships. Only the resting pressure of the upper lip correlated with the vertical and sagittal dentofacial mor- phology in patients with cleft lip and palate. This re- lation is attributed to the unbalanced and unfavorable functional-mechanical strain of the perioral muscles in these cases. The strain of the repaired upper lip on the underlying skeletal structures correlated with (a) the resting activity of the upper lip and (b) the strain di- rection being determined by the length and thickness of the labial sofit tissue. The results were specific for patients with cleft lip and palate, and were not corre- lated to the patient’s age and sex. Contrary to the dental parameters, the skeletal disturbances as a consequence of the muscular imbalance could not be significantly altered by orthodontic treatment. The choice of tech- nique of primaIy upper lip repair in patients with cleft lip and palate is important both for their dento- facial development and for their possible orthodontic Weatment result. Theoretically, from the functional- mechanical aspect, their results indicate that Delaire’s method of primary functional upper lip repair is the most suitable technique.

Alex Jacobson

Reviews and abstracts 447

Kieferorthop&dische Zlele und Ergebnlsse der Behandlung von Llppen-Klefer-Gaumen-Spalten Nach dem ‘Wiener Konzept’ D. Hoffmann and K. Hollmann Fortschr. Kieferorthop. 1986:429-45

The article describes the procedure of the “Viennese Concept” in the treatment of cleft lip and palate: (1) prolabium closure at the end of the first week of life, (2) velorrhaphy at the end of the first year of life, (3) rehabilitation of upper lip and nose at the end of

the fourth year, and (4) palatorrhaphy at the end of the sixth year of life. Conservative orthodontic treatment is only begun following velorrhaphy with a maxillary cover plate and continues until closure of the hard pal- ate. The goals of the “Viennese Concept” are as follows: (1) normal development of the maxilla and of the middle parts of the face, (2) normalized function of the oro- facial and velar muscles in due time to provide normal speech and auditory development, and (3) early reduc- tion of esthetic impairments to avoid late psychologic sequelae. To obtain objective assessment of maxillary growth, measurements on models were done. The re- sults show unimpaired growth of the maxilla up to the age of 12.

Alex Jacobson

Kieferorthopldische Forderungen fiir den VerschluP der Kieferspalten B. Kenig-Toll and J. Koch Fortschr. Kieferorthop. 1986:42/-a

As a result of the existing bone defect in the alveolar process caused by the unilateral and bilateral clefts, there is not only a weak point in the status of the max- illa, but also in the periodontium of the adjacent teeth in the cleft area. This causes early loss of those teeth. To maintain the permanent anterior teeth, the devel- opment of the periodontium should be promoted by bone grafting at the primary cleft palate closure before the eruption of the permanent anterior teeth. The peri- odontium is secured by the bony healing at the site of the cleft.

Alex Jacobson

FrUhversorgung und Wachstum des S&uglingsspaltkiefers P. Koppenburg, R. Schmelzle, M. Bather, D. Dausch-Neumann, N. Schwenzer, E. Leidig, H. Wolf, S. Dagenbach, and P. Lindenmiiller Fortschr. Kieferorthop. 1986:391-9

The integration of early maxillary orthopedic pro- cedures in the management of cleft lip and palate infants helps to provide favorable conditions for surgical treat- ment and further development of the dentition. This study sets out to investigate changes in maxillary mor- phology during early treatment by a three-dimensional approach with the aid of maxillary impressions. A new computer-assisted method is presented that directly re- cords from plaster casts the position of definite points