OLIINYK M. Evaluation of long-term results of orthopedic treatment of defects and deformations of dentitions and occlusion in patients with congenital cleft lip and palate.

Satisfaction with the quality of life of patients with congenital cleft lip and palate (CCLAP) depends on many components, which include the quality of surgical interventions on the upper lip and palate, the results of orthodontic treatment, external aesthetic effects on the face and more. One of the possible options for improving the quality of life of such patients and their social adaptation is orthopedic rehabilitation using numerous options for orthopedic designs of dentures, which reproduce both functional and, in part, aesthetic capabilities. The aim of the study was to increase the effectiveness of orthopedic treatment of adult patients with congenital cleft lip and palate after surgery by developing various options for temporary and permanent orthopedic structures to ensure their functional and aesthetic rehabilitation and determine their quality of life. To achieve this goal, five tasks have been set. To implement the tasks clinically and by additional methods, a total of 56 patients aged 16 to 48 years with congenital cleft lip and palate were examined after completion of all surgical interventions. 37 of them, aged 17 to 42 years have completed the treatment of defects and deformities of the dental system by orthopedic rehabilitation, including 22 patients with unilateral nonunion and 15 patients with bilateral nonunion. Research methods included: general clinical methods - to determine the complaints, anamnesis and condition of the dental system in patients with congenital cleft lip and palate after surgery; photo documentation - to create a computer database of examination of patients with the subsequent data processing; radiological methods - to visualize the dental system of patients; occlusographic methods - to determine the number of contacts before and after orthopedic rehabilitation of patients with congenital cleft lip and palate; profilometric methods - to determine the aesthetic profile of the face before and after orthopedic rehabilitation of patients with congenital cleft lip and palate; questionnaire - to determine the quality of life before and after orthopedic rehabilitation of patients with congenital cleft lip and palate with the use of validated questionnaires; statistical method - to determine the statistical reliability of the results. In all cases of final orthopedic rehabilitation of patients with congenital malformations of the upper lip and palate, an important step is pre-temporary prosthetics, due to the fact that the manufacture of future dentures largely depends on the use of the previous temporary constructio, which, depending on the proposed typing of defects and deformations can be both non-removable and removable. In the process of orthopedic rehabilitation of adult patients with CCLAP after surgery and orthodontic treatment, both fixed and removable (combined) permanent structures were used. The results of determining the occlusal contacts of patients with CCLAP before and after orthopedic treatment were carried out both depending on the design of prostheses and depending on the type of nonunion.