
labial supportive appliance
the patient with a repaired cleft lip and palate and an associated
displacement and deficiency of the premaxilla presents problems which
may be of concern to the plastic surgeon, speech pathologist, orthodontist,
and prosthodontist.
the upper lip may appear flat or retruded in relation to the lower lip.
when maxillary anterior teeth are missing, either congenitally, naturally
(as in the mixed dentition period), or because of neglect, the upper lip
may appear to be rolled under the premaxilla.  the lower lip usually
assumes a characteristic 'pouty' appearance.
this complex of tissue deformities also may be important in the articulation
of speech sounds.  fricatives and plosives are difficult to produce
correctly because of the malposition of the lip.  there may be interference
with direction of air current, contact of tongue to alveolar ridge, and
normal contact of lips.
corrective procedures are designed to improve the labial profile and to
establish more normal relationships of intraoral structures.  these
procedures, employed individually or in combination, may include othodontic
movement of maxillary segments, dental prosthesis, and cheiloplasty.
another more recently developed adjunct involves autogenous
osscous implantation in the cleft areas.
