Test on Orthodontic Management of Cleft Lip and Palate

Question 1: In the primary dentition, transverse expansion procedures are preferred for correcting posterior crossbites to avoid delaying treatment.

A. Ano

B. Ne

Explanation: Transverse expansion is usually delayed in the primary dentition until the patient is older and just prior to secondary alveolar bone-grafting procedures typically undertaken in the transitional dentition. This is because, once completed, it has to be retained until a bone graft is placed.

Question 2: Which of the following statements accurately describe aspects of orthodontic preparation for alveolar bone grafting according to the study materials?

A. Orthodontic treatment should be initiated based on the patient's chronological age rather than dental development.

B. The primary goals are to address malposition of incisors and anterior collapse of the maxillary arch.

C. The expansion required should aim for well-aligned maxillary segments with a minimal increase in alveolar gap size.

D. Self-ligating brackets and highly flexible wires are used for rapid tooth movement with high risk of root resorption.

Explanation: The study materials state that orthodontic treatment for surgical site preparation should be initiated based on dental development of permanent teeth, not chronological age. The goals include addressing malposition of incisors and anterior collapse of the maxillary arch. The expansion required should provide well-aligned maxillary segments with a minimal increase in the alveolar gap size. Self-ligating brackets and highly flexible orthodontic wires permit slow and highly efficient tooth movement with minimal trauma and risk of root resorption.

Question 3: Postsurgical nasal stents are typically maintained for only a few weeks after lip surgery to avoid prolonged discomfort.

A. Ano

B. Ne

Explanation: Postsurgical nasal stents are maintained for at least 2–3 months or for as long as the patient can deal with it comfortably, not just a few weeks.

Question 4: What adjustments are made to the nasoalveolar molding plate and surrounding structures to achieve nasal molding and narrow the maxillary segments?

A. Increasing the length of the supporting wire and reshaping the nasal stent

B. Selectively grinding acrylic medial to the palatal shelves

C. Adding acrylic lateral to the alveolar processes

D. Utilizing facial taping to apply transverse pressure to the cleft segments

Explanation: During nasoalveolar molding, adjustments include increasing the length of the supporting wire and reshaping the nasal stent. To narrow the maxillary segments, acrylic is selectively ground medial to the palatal shelves and added lateral to the alveolar processes. Additionally, facial taping is used to apply transverse pressure to the cleft segments, aiding in both cleft narrowing and nasal molding.

Question 5: The intraoral splint utilized for maxillary and midface distraction with rigid external distraction incorporates removable hooks.

A. Ano

B. Ne

Explanation: Fig. 27.22 explicitly illustrates "Views of the intraoral splint with removable hooks used for maxillary and midface distraction with rigid external distraction."