[Contribution of immediate orthopedic-orthodontic treatment in maxillo-palatine-labial clefts]

Labio-maxillo-palatine clefts are pathological conditions accompanied by severe handicaps, congenital malformations of particular interest for medical assistance because of several reasons, including the following: they are the most frequent congenital malformations of the bucco-maxillo-facil region: in certain cases there are other teratologic conditions in other parts of the organism that are associated to these clefts; there are no disturbances from the intellectual viewpoint; there are efficient possibilities for therapy as a result of a multidisciplinary approach, and the progress achieved in each of the fields involved may contribute to continuous improvement of the therapeutical prognosis; because of the therapeutical problems that these pathological conditions may raise, and because of the long duration of the treatment, the pathology involved in labio-maxillo-palatine clefts has a special social character which renders necessary the support of extra-medical factors (special schooling, special conditions for work, etc.). All these aspects explain the world-wide interest for this type of pathology, as it is also reflected in the large number of scientific manifestations dedicated exclusively, or in association to this problem, aimed at achieving a permanent therapeutic progress in this field. In the period between 1986 and 1987 the authors have selected 60 patients out of those hospitalized for this defect in the Clinic. The patients were aged between 2 and 43 years. Orthodontal therapy is the type of therapy which takes the longest time in these patients. This is achieved by the successive application of orthodontal devices, which necessitate a long-term therapeutic strategy. In the course of this therapy a permanent cooperation is necessary between the specialist in orthodontics and the maxillofacial surgeon. A common approach is beneficial for both specialties. The number of specialists in orthodontics involved in the orthodontal therapy of labio-maxillo-palatine clefts is alarmingly low, and thus there is no possibility to evolve a special program for their further special education. Another difficulty is the fact that patients from all over the country demand the services of the same specialist, and a series of aspects evolve from this situation, as follows: the patients (usually accompanied by one of the parents) have to perform long trips, which are also expensive; when incidents occur, in relation with the use of a orthodontal device these patients cannot require immediately the assistance of specialized services, and, as a result, the number of recidives is alarmingly high.(ABSTRACT TRUNCATED AT 400 WORDS)