Cleft lip and/or palate: review

Aim: The aim of the review is to provide a literature overview of the birth defects of cleft lip and /or cleft palate, also reporting the skeletal and dental anomalies associated with them and the multidisciplinary treatment approach at the different time of life, from prenatal to adult period. Material and methods: The systematic review of the literature was operated through the use of the PunMed database. The keywords used were “cleft lip/palate” and “orofacial clefts”. Articles were selected regarding inclusion criteria like: epidemiology, anatomical features, role of genetics, role of environmental factors, diagnosis, treatment. Articles that deal exclusively on single technical aspects were excluded to provide a global and multidisciplinary vision. Results and conclusion: In conclusion, CL/P are birth effects that affect different structures and functions, including language, breathing, nutrition, esthetics, growth and development of the craniofacial district. Since their etiology involves both genetic and environmental factors and there are different phenotypes and clinical manifestations, diagnosis and treatment are complex and diversified according to the characteristics and type of malformation and individual response. Therefore, it is not possible to define a single optimal treatment for CL/P. these is a considerable variability in craniofacial morphology and response to treatment, even among children with the same type of cleft. All surgeries lead to scar formation, which may inhibit maxillary growth. The use of agents aimed at reducing scarring should be avoided due to potential negative effects on growth. The timing of the various surgical procedures is guided mainly by functional and esthetic needs rather than growth considerations. However the reconstruction requires adequate maxillary development with minimal residual defects. Palatal surgery performed at 9-12 months improves speech and phonetic outcomes. The analysis of cephalometries has shown that adult patients with isolated cleft palate achieve better results after orthodontic and surgical treatment compared to those with complete clefts.