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Cleft maxillary alveolar ridge

MedGen UID:
488995
•Concept ID:
C2919907
•
Congenital Abnormality
Synonym: Cleft of alveolar ridge of maxilla
SNOMED CT: Cleft of alveolar ridge (445306000)
 
HPO: HP:0010289

Definition

A gap (cleft) affecting one of the alveolar ridges, which are the protuberances in the mouth that contain the sockets (alveoli) of the teeth. An alveolar cleft can affect all structures of the alveolar ridge, including the gingiva, other mucosa, periosteum, alveolar bone, and teeth. Alveolar cleft occurs in response to divergence from normal development during frontonasal prominence growth, contact, and fusion. The most common alveolar portion of the cleft is located between the lateral incisor and the canine. [from HPO]

Conditions with this feature

Anencephaly 2
MedGen UID:
1794155
•Concept ID:
C5561945
•
Congenital Abnormality
Anencephaly-2 (ANPH2) is a severe neural tube defect caused by failure of neural tube closure anteriorly. Features in addition to anencephaly may include frontonasal dysplasia with midline cleft of the upper lip and alveolar ridge, bifid nose, and clinical anophthalmia. For a discussion of genetic heterogeneity of anencephaly, see ANPH1 (206500).
See: Condition Record
Anencephaly 2

Professional guidelines

PubMed

Management of the premaxilla in the treatment of bilateral cleft of lip and palate: what can the literature tell us?
Bittermann GK, de Ruiter AP, Janssen NG, Bittermann AJ, van der Molen AM, van Es RJ, Rosenberg AJ, Koole R
Clin Oral Investig 2016 Mar;20(2):207-17. Epub 2015 Sep 16 doi: 10.1007/s00784-015-1589-y. PMID: 26374747Free PMC Article
Management of the alveolar cleft.
Santiago PE, Schuster LA, Levy-Bercowski D
Clin Plast Surg 2014 Apr;41(2):219-32. doi: 10.1016/j.cps.2014.01.001. PMID: 24607190
Treatment of alveolar cleft performing a pyramidal pocket and an autologous bone grafting.
Morselli PG, Giuliani R, Pinto V, Oranges CM, Negosanti L, Tavaniello B, Morellini A
J Craniofac Surg 2009 Sep;20(5):1566-70. doi: 10.1097/SCS.0b013e3181b0dacd. PMID: 19816297

Recent clinical studies

Etiology

The Effects of NAM on the Symmetry of the Face and Maxillary Arch in Babies With Unilateral Cleft.
de Souza TM, Batista ST, de Souza RXS, Rezende SE, Alessi MS, Almeida TFA, Frazão DC, Pretti H, Freitas RDS, Macari S
J Craniofac Surg 2023 Sep 1;34(6):1618-1624. Epub 2023 Jun 12 doi: 10.1097/SCS.0000000000009469. PMID: 37307242
Bone Tissue Engineering Strategies for Alveolar Cleft: Review of Preclinical Results and Guidelines for Future Studies.
Park JJ, Rochlin DH, Parsaei Y, Shetye PR, Witek L, Leucht P, Rabbani PS, Flores RL
Cleft Palate Craniofac J 2023 Nov;60(11):1450-1461. Epub 2022 Jun 9 doi: 10.1177/10556656221104954. PMID: 35678607
Three-Dimensional Measurement of the Zygomatic-Maxillary Complex in Unilateral Cleft Lip and Palate Patients With Maxillary Retrusion.
Zheng Y, Jiang C, Ma H, Yin N, Zhai J, Tong H, Song T
J Craniofac Surg 2022 Mar-Apr 01;33(2):e179-e182. doi: 10.1097/SCS.0000000000008259. PMID: 35385238
Microstructured beta-tricalcium phosphate for alveolar cleft repair: a two-centre study.
Janssen NG, Schreurs R, de Ruiter AP, Sylvester-Jensen HC, Blindheim G, Meijer GJ, Koole R, Vindenes H
Int J Oral Maxillofac Surg 2019 Jun;48(6):708-711. Epub 2018 Dec 26 doi: 10.1016/j.ijom.2018.11.009. PMID: 30594478
Alveolar bone morphology of maxillary central incisors near grafted alveolar clefts after orthodontic treatment.
Yatabe M, Natsumeda GM, Miranda F, Janson G, Garib D
Am J Orthod Dentofacial Orthop 2017 Oct;152(4):501-508.e1. doi: 10.1016/j.ajodo.2017.01.029. PMID: 28962735

Diagnosis

Comparison of Three-Dimensional and Conventional Orthodontic Imaging Modalities for Localization of Impacted Maxillary Canines in Patients With Alveolar Cleft.
Padisar P, Tofangchiha M, Salari B, Oveisi S
Cleft Palate Craniofac J 2021 Feb;58(2):202-207. Epub 2020 Aug 12 doi: 10.1177/1055665620946980. PMID: 32783463
Symmetry of palatal shape during the first year of life in healthy infants.
Bruggink R, Baan F, Kramer GJC, Kuijpers-Jagtman AM, Bergé SJ, Maal TJJ, Ongkosuwito EM
Clin Oral Investig 2021 Mar;25(3):1069-1076. Epub 2020 Jun 24 doi: 10.1007/s00784-020-03403-4. PMID: 32583240Free PMC Article
Segmental Maxillary Osteotomy to Close Wide Alveolar Clefts.
Wilson AT, Wu RT, Sawh-Martinez R, Steinbacher DM
J Oral Maxillofac Surg 2019 Apr;77(4):850.e1-850.e5. Epub 2018 Nov 26 doi: 10.1016/j.joms.2018.11.011. PMID: 30576673
First-Trimester Sonographic Evaluation of Palatine Clefts: A Novel Diagnostic Approach.
Lakshmy SR, Deepa S, Rose N, Mookan S, Agnees J
J Ultrasound Med 2017 Jul;36(7):1397-1414. Epub 2017 Apr 18 doi: 10.7863/ultra.16.05084. PMID: 28417474
Treatment algorithm for bilateral alveolar cleft based on the position of the premaxilla and the width of the alveolar gap.
Koh KS, Kim H, Oh TS, Kwon SM, Choi JW
J Plast Reconstr Aesthet Surg 2013 Sep;66(9):1212-8. Epub 2013 May 21 doi: 10.1016/j.bjps.2013.04.060. PMID: 23702194

Therapy

Secondary alveolar cleft grafting using autogenous mineralized plasmatic matrix (MPM) versus cancellous bone particles derived from anterior iliac crest.
Omara M, Raafat L, Elfaramawi T
Clin Oral Investig 2023 Aug;27(8):4259-4270. Epub 2023 May 5 doi: 10.1007/s00784-023-05042-x. PMID: 37145153Free PMC Article
Short-Term Efficacy of Presurgical Vacuum Formed Nasoalveolar Molding Aligners on Nose, Lip, and Maxillary Arch Morphology in Infants With Unilateral Cleft Lip and Palate: A Prospective Clinical Trial.
Al Khateeb KA, Fotouh MA, Abdelsayed F, Fahim F
Cleft Palate Craniofac J 2021 Jul;58(7):815-823. Epub 2020 Oct 27 doi: 10.1177/1055665620966189. PMID: 33107321
Early Progressive Maxillary Changes with Nasoalveolar Molding: Randomized Controlled Clinical Trial.
Saad MS, Fata M, Farouk A, Habib AMA, Gad M, Tayel MB, Marei MK
JDR Clin Trans Res 2020 Oct;5(4):319-331. Epub 2019 Dec 20 doi: 10.1177/2380084419887336. PMID: 31860800
Alternatives to Autologous Bone Graft in Alveolar Cleft Reconstruction: The State of Alveolar Tissue Engineering.
Liang F, Leland H, Jedrzejewski B, Auslander A, Maniskas S, Swanson J, Urata M, Hammoudeh J, Magee W 3rd
J Craniofac Surg 2018 May;29(3):584-593. doi: 10.1097/SCS.0000000000004300. PMID: 29461365
Maxillary alveolar cleft repair in dogs using recombinant human bone morphogenetic protein-2 and a polymer carrier.
Mayer M, Hollinger J, Ron E, Wozney J
Plast Reconstr Surg 1996 Aug;98(2):247-59. doi: 10.1097/00006534-199608000-00006. PMID: 8764712

Prognosis

Early Progressive Maxillary Changes with Nasoalveolar Molding: Randomized Controlled Clinical Trial.
Saad MS, Fata M, Farouk A, Habib AMA, Gad M, Tayel MB, Marei MK
JDR Clin Trans Res 2020 Oct;5(4):319-331. Epub 2019 Dec 20 doi: 10.1177/2380084419887336. PMID: 31860800
Canine Eruption After Secondary Alveolar Bone Graft in Unilateral Cleft Lip and Palate Patients.
Vellone V, Cirignaco G, Cavarretta B, Cascone P
J Craniofac Surg 2017 Jul;28(5):1206-1210. doi: 10.1097/SCS.0000000000003659. PMID: 28570399
Skeletal stability of maxillary advancement with and without a mandibular reduction in the cleft lip and palate patient.
Wong FX, Heggie AA, Shand JM, Schneider PM
Int J Oral Maxillofac Surg 2016 Dec;45(12):1501-1507. Epub 2016 Aug 27 doi: 10.1016/j.ijom.2016.08.007. PMID: 27575393
Are there bone dehiscences in maxillary canines orthodontically moved into the grafted alveolar cleft?
Yatabe MS, Ozawa TO, Janson G, Faco RA, Garib DG
Am J Orthod Dentofacial Orthop 2015 Feb;147(2):205-13. doi: 10.1016/j.ajodo.2014.10.027. PMID: 25636554
Treatment of alveolar cleft performing a pyramidal pocket and an autologous bone grafting.
Morselli PG, Giuliani R, Pinto V, Oranges CM, Negosanti L, Tavaniello B, Morellini A
J Craniofac Surg 2009 Sep;20(5):1566-70. doi: 10.1097/SCS.0b013e3181b0dacd. PMID: 19816297

Clinical prediction guides

Function of Nasoalveolar Molding Devices in Bilateral Complete Cleft Lip and Palate: A 3-Dimensional Maxillary Arch Analysis.
Tankittiwat P, Pisek A, Manosudprasit M, Punyavong P, Manosudprasit A, Phaoseree N, Wangsrimongkol B, Pisek P, Manosudprasit A
Cleft Palate Craniofac J 2021 Nov;58(11):1389-1397. Epub 2021 Mar 4 doi: 10.1177/1055665621990184. PMID: 33657892
Evaluation of the Microbiological Profile of Alveolar Residual Screws and Cleft-Adjacent Teeth in Individuals With Complete Unilateral Fissures.
Iurovschi R, Joaquim CR, de Faveri M, de Miranda TS, Feres M, de Figueiredo LC
Cleft Palate Craniofac J 2020 Oct;57(10):1182-1189. Epub 2020 Aug 4 doi: 10.1177/1055665620945568. PMID: 32748644
Early Progressive Maxillary Changes with Nasoalveolar Molding: Randomized Controlled Clinical Trial.
Saad MS, Fata M, Farouk A, Habib AMA, Gad M, Tayel MB, Marei MK
JDR Clin Trans Res 2020 Oct;5(4):319-331. Epub 2019 Dec 20 doi: 10.1177/2380084419887336. PMID: 31860800
Segmental Maxillary Osteotomy to Close Wide Alveolar Clefts.
Wilson AT, Wu RT, Sawh-Martinez R, Steinbacher DM
J Oral Maxillofac Surg 2019 Apr;77(4):850.e1-850.e5. Epub 2018 Nov 26 doi: 10.1016/j.joms.2018.11.011. PMID: 30576673
A re-evaluation of the premaxillary bone in humans.
Barteczko K, Jacob M
Anat Embryol (Berl) 2004 Mar;207(6):417-37. Epub 2004 Feb 4 doi: 10.1007/s00429-003-0366-x. PMID: 14760532

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