Assessment and Comparison of Temporomandibular Joint for Occurrence and Severity of Disorders in Adult Cases with Unilateral Cleft Lip and Palate and Non-cleft Class I: An Observational Study

Background: Cleft Lip and Palate (CLP) are hereditary deformity of craniofacial structure. Temporomandibular disorder has number of clinical problems affecting muscles of mastication and its associated structures. There are several methods used to evaluate temporomandibular dysfunction (MRI, etc), Helkimo index is a settler in advancing indices, other indices used are CMI, MFIQ, FONSECA. The design of the following study was to evaluate the TMJ disorders in UCLP, if any, and compare with the non-cleft cases.

Methodology: Total 30 patients aged 16 to 20 years, will be selected from the patients coming to smile train Out Patient Department (OPD) of Orthodontics and Dentofacial Orthopaedics, Wardha. The total cases will be divided into two groups: a) Group I - unliteral cleft lip and palate cases b) Group II - non cleft class I cases Digital records of the patient (lateral cephalogram, photograph, models) will be taken and stored. Helkimo, MFIQ, CMI, Fonseca will be recorded on all patients participated in study. The Helkimo index will be taken to assess the presence and severity and MFIQ index will be taken to assess mandibular functioning in cleft cases based on the questionnaire.

Expected Results: The dental apparatus (interdental relation of maxillary and mandibular dentition) plays an important role in the temporomandibular joint's well-being. Trauma due to the occlusal instability has definite effect on the TMJ in long run. Cleft is always associated with inter jaw malocclusion and therefore TMDs in the cleft patient is thought to occur. The treatment protocol for grown cases with severe skeletal malocclusion is orthognathic surgery. The TMJ correction remains untouched. It can be expected that altered TMJ anatomy can lead to TMDs in cleft lip and palate cases.

Conclusion: To convey the occurrence of TMDs in cleft due to the inter jaw malocclusion and its early treatment approach for TMJ deprogramming along with dental and surgical correction in CLP.