Multidisciplinary approach to the treatment of children with congenital cleft lip and palate in Ukraine

Abstract

Children with congenital cleft lip and palate (CLP) develop a composite complex of anatomical, functional and aesthetic disorders that increase with growth and require comprehensive and multi-stage treatment. Treatment and diagnostic measures require a multidisciplinary approach to overcome the identified problems. The main task of orthodontic support for children with CLP at the stages of primary surgical interventions is aimed at preventing orthognathic surgical correction in the future, by optimizing the choice and tactics of orthodontic treatment within the framework of multidisciplinary comprehensive rehabilitation measures. The purpose of the work is the substantiation, approval and introduction into clinical practice of a complex of medical and diagnostic measures aimed at the rehabilitation of children with CLP. It confirmed that providing the necessary conditions for sucking creates optimal conditions for surgical intervention on the lip and palate. The tactics of orthodontic treatment depended on the period of development of the dentognathic apparatus, age, type of cleft, staging, timing and volume of surgical interventions, quality and methods of surgery, severity of deformations in the transversal and sagittal planes and components of the symptom complex of anomalies and deformations complicating the pathology, psychological and emotional child state, factors of parents and patients communication with the doctor, social and economic components. Removable and fixed orthodontic appliances are used in most cases at the initial stage of treatment for the treatment of dentognathic deformities, obtaining satisfactory sagittal and vertical overlap and normalization of transversal ratios. A separate area of rehabilitation was prevention and treatment of diseases of hard tissues of teeth and periodontal tissues. Speech therapy and psychological support started from 2–3 months. The proposed complex of treatment and diagnostic measures, determined in time, terms, sequence and volume, aimed at the rehabilitation of children with CLP, made it possible to obtain positive anatomical, functional and aesthetic results in 87.6% of children. Keywords: therapeutic and diagnostic measures, orthodontic treatment, speech therapy and psychological support, rehabilitation algorithm.