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Fenda lábio-palatina: tratamento interdisciplinar

Authors: Correia, Catarina das Neves Morais;

Fenda lábio-palatina: tratamento interdisciplinar

Abstract

As fendas lábio-palatinas são malformações congénitas de alta incidência e com origem embriológica. Ocorrem em virtude da falta de fusão entre os processos faciais embrionários e os processos palatinos, apresentando etiologia multifatorial. Os portadores destas anomalias apresentam más oclusões características, em consequência da atresia dos arcos dentários, principalmente do arco dentário superior, deficiência de crescimento do terço médio da face, problemas dentários de anomalias de forma, número e de posição. Podem desencadear uma série de alterações que podem comprometer a fala, nutrição, audição, estética, alterações dentárias e psicológicas. Desta forma, o completo estabelecimento da saúde oral e geral do paciente só será possível se todos os profissionais envolvidos no seu tratamento interagirem de forma multidisciplinar. O tratamento reabilitador destes pacientes tem sido um constante desafio, que deve ser iniciado no nascimento, visando o melhor tratamento para todas as demandas funcionais. Inicia-se no primeiro ano de vida e pode terminar aos 18 anos. O tratamento deverá ser iniciado com cirurgias plásticas primárias reparadoras, denominadas de queiloplastia e palatoplastia. Em seguida estes pacientes serão acompanhados durante todo o seu crescimento por profissionais que incluem médicos dentistas, ortodontistas, terapeutas da fala, psicólogos, assistentes sociais, entre outros. A alta incidência das fendas lábio-palatinas e a sua complexidade favoreceram o aparecimento de vários centros de tratamento com diferentes protocolos. Como clínico, pode ser difícil selecionar um método ótimo de tratamento, devido à falta de estudos clínicos bem documentados do resultado do tratamento. A tendência da comunidade científica, que coordena as pesquisas direcionadas à excelência da reabilitação de pacientes com fendas lábio-palatinas, é atuar em consonância com um comité internacional, estabelecendo um protocolo único e universal de reabilitação que proporcione bons resultados, estéticos e funcionais. Atualmente, não há total consenso na literatura quanto ao melhor protocolo de tratamento a ser seguido. Estudos comparativos entre a escolha do tipo de técnica, momento ideal para as intervenções cirúrgicas e para o apoio multidisciplinar são amplamente estudados. The lip and palate clefts are birth defects of high incidence and with embryological origin. They occur due to the lack of fusion of the embryonic facial process and the palatine processes, showing a multifactorial etiology. The bearers of these anomalies present malocclusions characteristics, as a result of atresia of the dental arches, mainly of the upper dental arch, growth deficiency of the middle third of the face, dental problems of anomalies of form, number and position. It can trigger a series of changes that can compromise the talk, nutrition, hearing, dental and psychological changes, so as aesthetics. In this way, the complete establishment of the oral and general health of the patient will only be possible if all professionals involved in their treatment to interact correctly with each other. The rehabilitation treatment of these patients has been a constant challenge, which should be started at birth, aiming to the best treatment for all functional demands. It begins in the first year of life and can it finish by the age of 18. The treatment should be initiated with primary repairing plastic surgery, called cheiloplasty and palatoplasty. These patients will be monitored throughout its growth, by professionals including dentists, surgeons, orthodontists, speech therapists, psychologists, Social watch, among others. The high incidence of cleft lip and palate and its complexity favored the appearance of several treatment centers with different protocols. As a clinician, it may be difficult to select an optimal method of treatment, due to lack of clinical studies and documented the treatment outcome. The current trend of the scientific community who coordinates the research directed to the rehabilitation of patients with lip-palate clefts is acting in line with an International Committee, establishing a unique and universal rehabilitation protocol that provides aesthetic and functional results. Currently, there is no full consensus in the literature as to the best treatment protocol to be followed. Comparative studies between the choice of the technique ideal time for surgery and multidisciplinary support are widely studied.

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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