By:Group C

FAKULTAS KEDOKTERAN GIGIUNIVERSITAS AIRLANGGASURABAYA2014

LABIOPALATOSCHISIS AND ITS RELATION WITH GODS CURSE

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Dea Delicia 021411131023Rara Anjani Kusuma D. 021411131024Nihal Dea Ananda 021411131025Rizantika Alvanta 021411131026Annisa Noor Ragilia 021411131028Vitra Nuraini Helmi 021411131029Fenella Andrata 021411131030Raissa Tryantakarina N. 021411131031M. Yudhistira R. K. J 021411131032Zhafira Nur Shabrina 021411131033Ulfi Putriadi G. 021411133009Karunia Nurensa 021411133010Mahardika Sri J. 021411133012Khairal Fataya 021411133049

BACKGROUNDthe incidence of cleft lip averaged8 per 10,000 births in the worldpatients with cleft lip that happen in Indonesia increased by anaverage of 7,500 people per yearLabiopalatoschisis or so-called cleft lip and cleft

Peternakan merupakan sektor yang berpeluang sebagai sebuah usaha. Salah satu subsektor yang berpeluang untuk dikembangkan adalah peternakan kambing dan domba. Menurut data dirjen peternakan 2012, populasi ternak kecil nasional tahun 2011 mengalami peningkatan dibanding tahun 2010 yaitu .*

1. What is cleft lip and cleft palate?2. What causes cleft lip and cleft palate?3. How does cleft lip and cleft palate work?4. What is the impact to the body or system organ?5. Are they a curse?FORMULATION OF PROBLEM

Theoretical basis

Cleft palate is a state that does not close completely, leaving the opening of which can be extended to the nasal cavity and also involve the other side of the palate, which extends to the anterior hard palate in the mouth extends to the soft palate to the throat (Kim EK, et al, 2010).

Labioschisis or cleft lip is a congenital abnormalities which caused by facial malformation during the gestation period. This deformity is due to the failure of the facial process fusions to grow accurately and connect to one another. This bonding process involves ectoderms cover contacts each other (Medicine:Cleft- lips Craft, 1997).

PURPOSE OF WRITINGTo know about cleft lip and cleft palate.To know the causes and factors of cleft lip and cleft

palate.To know the impact of cleft lip and cleft palate.To explains how to prevent from cleft lip and cleft

palate.To explains how to handling cleft lip and cleft palate.To explains that the cleft lip and cleft palate are not a

curse from God.To make students think critically and selective in

choosing resources.

BENEFIT OF WRITING

Pengkajian terhadap morfometri spermatozoa semen segar perlu dilakukan untuk mengetahui karakteristik ukuran-ukuran spermatozoa pada berbagai hewan, Selain itu pengetahuan terhadap morfometri spermatozoa diperlukan untuk pengkajian terhadap upaya kriopreservasi semen mengingat terdapat perbedaan yang signifikan terhadap ukuran spermatozoa semen segar dengan semen yang telah mengalami kriopreservasi,serta pengembangan teknologi reproduksi yaitu pemisahan kromosom X dan Y.*

Classification of Cleft PalateAccording Veau divided into 4 groups (Sudiono, 2008) :

Figure 2.1 Classification of cleft palates (Ross & Johnston, 1972)

1. Class I (Cleft palatum molle) : Cracks in the soft palate.2. Class II (Cleft palatum molle and durum ) : Cracks in the soft palate and hard palate behind the incisive foramen. defects in soft and hard palate , extends not beyond the incisive foramen and is confined to the secondary palate.

REVIEW OF THE LITERATURE

3. Class III (Cleft lip and palatum unilateral complete): Cracks in the soft palate and hard over the alveolar bone and the lip on one side.cleft palate can be complete or incomplete . Cleft palate complete covering soft and hard palate until incisive foramen . Incomplete cleft include soft and hard palate but does not extend to the incisive foramen . Complete unilateral cleft and extends from the uvula to the incisive foramen underlined the central and unilateral alveolar process also includes class III.4. Class IV (Cleft lip and palatum bilateral complete): Cracks in the soft palate and hard over the alveolar bone and the lip on two sides.

Classification of cleft lip

Table 1 : Simple classification of cleft lip and palateSource : King Nigel M, dan Wei Stephen HY. The Management of Children With Cleft Lip and Palate in Pediatric Dentistry: Total Patient Care.

Defect structureDefect locationDefect areaLipUnilateral (right or left)BilateralComplete or not completeAlveoliUnilateral (right or left)BilateralComplete or not completePalateHard palate or soft palateComplete or not complete, submucous

CHAPTER 3CONCEPTUAL FRAMEWORK

IMPACT OCCURS IN BABY

Children with cleft sometimes have a hearing loss. This is due to the possibility of Tuba Eustachias infection. All of normal childrens ears produce a sticky ear fluid. This fluid can accumulate behind the eardrum. The existence of cleft can increase the possibility of ear drums formation, causing disruption or teven temporary hearing loss. (Patu, 2010; Valentine, 2010).Symptoms includes: Lips separation Palate separation Lip and palate separation Nasal distortion Bones infection Weight doesnt increase Nasal regurgitation when breastfeeding (The milk out of the nostrils)CHAPTER 4DISCUSSION

Genetic factors: 1. Gene Mutation This factor is usually genetically inherited from family history genetic mutation. Genetic factors only 20% -30% effect the occurrence of cleft lip or cleft palate. The incidence of cleft lipwith or without cleft palate 1: 750-1000. 2. Ethnic / racial Factor ethnically incidence of cleft lip with or without cleft palate in the Asian race 1: 500 births, Caucasian, 1: 1,750 births, African American race 1: 2000 births.

Environmental factors: 1. Nutritional deficiencies 2. Radiation 3. Several types of drugs example: phenytoin, alcohol, retinoic acid, cigarette 4. Virus 5. Lack of vitamin

TREATMENTDue to the number of oral health and medical problems associated with cleft lip and palate, treatment to care of the patient need a team consists of doctor and specialist in their field. In the treatment of Cleft Lip and Cleft Palate there are phases where the patient is treated based on the ages. Implementation of Treatment Based On The Ages (Erlianda, 2008).

This is an implementation table treatment of cleft lip and cleft palate (Erlianda, 2008)

VON LANGENBECK PALATOPLASTY

Use mucoperiosteal flap bipedicle in palatum durum and palatum molle to cover the defect crack of the palate(+) This technique is easy to do within short operating time(-) Its not able to elongate palatum to posterior thus the possibility of velopharyngeal incompetence is higher and speech function is not optimal

V-Y PUSHBACK (VEAUWARDILLKILNERPALATOPLASTY)V-Y procedure is performed so that the whole mucoperiosteal flap and the soft palate are retro posed and the palate is lengthenen (Sudiono, 2008)To increase the lengthening of the soft palate George Dorrance advocated horizontal back cut in the nasal lining at the junction of hard and soft palate leave a large raw area on the nasal surface

Surgery to repair the lip shape quickly performed in cases with any age, but the babies were all done at an early age, usually around the age of 3 months based on the Rules of Ten. There are: Body weight at least 4,5 kg (10 pon) Age at least 10 weeks Hemoglobin level more than 10% The number of leukocyte less than 10.000/mm3

Surgery TechniqueMilliard SurgeryThe Millard Procedure rotates the tissue and creates a "Z" shaped scar instead. The "Z" shape gives the tissue more elasticity, resulting in greater flexibility and restoration of the Cupids Bow (Medicine: Cleft Lip Craft)

Tennison-Randall SurgeryIt is use the method of triangular repair. Why used it? Because the rotation advancement technique of Millard has the greatest number of followers and is recognized as a simple method once experience is obtained.

Image Source : Smith HW (1983). Comprehensive surgical atlases in otolaryngology and head and neck surgery: The atlas of cleft lip and cleft palate surgery. New York: Grune & Stratton, Inc.

Onizuka Surgery Same like Milliard Surgery, but this is the modification from Milliard Surgery and Tennison Randal. Therefore the percentage of the success surgery can be increased

But in this case the patient is the patient is 5 years old boys so this ruled cant be use anymore.There are several technique of labioplasty surgery what can be use for children or adult above 3 months, like Milliard, Tennison-Randall and Onizuka Surgery. Every technique has different functions and ways to get the main purpose of the labioplasty surgery.

VITAMIN B6FOLIC ACIDWHAT WE SHOULD DO?

ConclusionCHAPTER 5FINALELabiopalatoschisisGenetic factors

Environmental factorsAvoid marriage with a cleft lip or cleft palateAvoid smoking and alcohol consumptionConsumption of folic acid

Millard SurgeryOnizuka SurgeryLe Messurier SurgeryTennison-randal Surgery

Cleft Lip and Cleft Palate not a curse from the God

Suggestion

For mothers during pregnancy can prevent the occurrence of congenital abnormalities by eating nutritious foods and vitamin B - 6 , whereas that must be avoided is the consumption of alcohol , drugs , and nicotine . A pregnant woman must often read to find out information about pregnancy and baby health so that if there are problems in the fetus , parents can consult to the gynecologist .

THANK YOU

*Peternakan merupakan sektor yang berpeluang sebagai sebuah usaha. Salah satu subsektor yang berpeluang untuk dikembangkan adalah peternakan kambing dan domba. Menurut data dirjen peternakan 2012, populasi ternak kecil nasional tahun 2011 mengalami peningkatan dibanding tahun 2010 yaitu .*Pengkajian terhadap morfometri spermatozoa semen segar perlu dilakukan untuk mengetahui karakteristik ukuran-ukuran spermatozoa pada berbagai hewan, Selain itu pengetahuan terhadap morfometri spermatozoa diperlukan untuk pengkajian terhadap upaya kriopreservasi semen mengingat terdapat perbedaan yang signifikan terhadap ukuran spermatozoa semen segar dengan semen yang telah mengalami kriopreservasi,serta pengembangan teknologi reproduksi yaitu pemisahan kromosom X dan Y.*