INTRODUCTION :-
Clefts of the lip, alveolus and hard palates are the most common congenital deformities affecting
the upper jaw leading to difficulty in feeding. However, cleft lip alone generally doesn’t interfere
with feeding. There are chances of regurgitation of milk, associated lung infections and chronic
otitis media, Conductive hearing loss and delayed speech in the patients of cleft palate. They
generally occur as isolated deformities and very rarely are associated with congenital heart
disease and genetic conditions such as Apert’s or Down’s syndrome.
INCIDENCE: 1 in 2500 live births. Clefts are highest among Asians and lowest among blacks.
cleft lip and palate in conjoint predominate in males. Cleft palate alone is more common in
females.
ETIOLOGY:- possible etiology include maternal drug exposure during pregnancy, syndrome
malformation complex, or genetic . This condition of cleft lip and palate is inherited in a
dominant fashion, (van der woude syndrome)
Embryology of Normal fetus: the masticatory muscles in conjoint with internal pterygoid
Muscle allows the mandibular teeth to forcefully contact the maxillary teeth. When teeth meet
simultaneously, the force is distributed over a large area of bone to tooth attachment and
resulting to the joining of medial nasal and maxillary processes.
Embryo histology: The cleft of the lip appears because of the hypoplasdia of the mesenchymal
layer, resulting in failure of the medial nasal and maxillary processes to join. Cleft of the palate
appears to represent failure of the palatal shelves to approximate or fuse. Genetic influences
more significant in cleft lip/palate than cleft palate alone where environmental factors exert a
greater influence.
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