Clefts of the primary palate involve....
structures in front of the incisive foramen and affect the lip, nose, and sometimes extend into the alveolar ridge.
Clefts of the primary palate follow...
embryological suture lines, including the philtral ridges and the incisive suture lines of the alveolar ridge.
Clefts of the primary palate can be categorized as...
incomplete or complete.
An incomplete cleft of the primary palate does not extend....
all the way to the incisive foramen.
A forme fruste or microform cleft is...
a minor form of incomplete cleft, causing a small notch in the upper lip.
Simonart's band...
a band of tissue that bridges a cleft lip, often resulting from partial fusion that has separated.
A complete cleft of the primary palate extends....
through the entire lip, nostril sill, and alveolar ridge to the incisive foramen. "Complete cleft lip" usually refers to a complete cleft of the primary palate, which also includes the alveolar ridge.
Clefts of the primary palate can be either...
unilateral (occurring on one side) or bilateral (occurring on both sides), depending on whether they affect one or both sides of the face.
Unilateral clefts of the primary palate most commonly occur on...
the left side.
In cases of a bilateral complete cleft of the primary palate that extends to the incisive foramen on both sides, the cleft affects...
both the philtrum (referred to as the prolabium) and the triangular-shaped premaxilla bone.
Clefts of the primary palate lead to more than just tissue separation; they also...
cause underdevelopment (hypoplasia) of nearby tissues and misalignment of related structures.
In unrepaired cleft lip still contains recognizable structures like...
the philtral dimple and philtral ridges, but the cleft runs just to the side of the philtral ridge.
If the cleft extends through the entire lip, it causes...
discontinuity and misalignment of the upper portion of the orbicularis oris muscle, curving upward along the edges of the vermilion.
Clefts of the primary palate can impact the formation of the...
nose, even if they are incomplete and don't reach the nasal sill.
After surgical repair of a cleft of the primary palate, children may have a...
residual nasolabial fistula (intentional fistula) located in the alveolar ridge just below the labial sulcus of the upper lip. This fistula is initially left open by the surgeon to allow for unrestricted maxillary growth. It is later closed with an alveolar bone graft before the permanent teeth start to come in.
Severity and Impact
An incomplete cleft of the primary palate generally raises more aesthetic concerns and might not result in significant functional issues. However, a complete cleft of the primary palate can lead to various functional challenges.
Dental and Occlusal Abnormalities
A complete cleft of the primary palate can result in dental and occlusal (bite) abnormalities. The gap in the alveolar ridge caused by the cleft can affect the proper alignment of teeth, leading to malocclusion (misalignment of teeth when the jaws are closed). This can have implications for chewing and proper dental hygiene.
Oral Cavity Size
Individuals with a complete cleft of the primary palate may have a smaller oral cavity size. The cleft can impact the growth and development of oral structures, including the maxilla and mandible. A smaller oral cavity size can potentially affect speech production, particularly in terms of articulation and resonance.
Nasal Cavity Size
In cases of unilateral cleft lip and palate, the nasal cavity on the affected side can be smaller compared to the unaffected side. This is due to the nasal septum skewing toward the unaffected side. Surgical correction and inherent underdevelopment of structures can restrict the growth of the nasal cavity. While the nasal cavity continues to grow with age, it remains around 30% smaller than normal, affecting nasal breathing and resonance during speech.