Cleft lip and alveolus

Cleft lip and alveolus is a congenital craniofacial malformation characterized by a gap or split in the upper lip that extends into the alveolar ridge (the bony ridge of the upper jaw that contains the tooth sockets). This condition occurs when the tissues of the face do not fully fuse during early embryonic development, typically between the 4th and 7th weeks of gestation. It may be unilateral (affecting one side) or bilateral (affecting both sides), and can be complete (extending fully through the lip and alveolus) or incomplete. Cleft lip and alveolus differs from cleft lip and palate in that the palate itself remains intact. The condition primarily affects the orofacial structures, including the upper lip, the nose, and the alveolar bone of the upper jaw. Key clinical features include a visible gap in the upper lip, nasal asymmetry (particularly in unilateral cases), dental anomalies such as missing, malformed, or supernumerary teeth in the cleft area, and potential difficulties with feeding in the neonatal period. Speech development may also be affected, though typically less severely than in cases involving palatal clefts. The alveolar involvement can lead to disruption of the dental arch and affect the eruption pattern of both primary and permanent teeth. Treatment is primarily surgical and typically involves a multidisciplinary team approach. Initial lip repair (cheiloplasty) is usually performed within the first few months of life, often around 3 to 6 months of age. Nasoalveolar molding may be used preoperatively to improve alignment of the lip and nasal structures. Alveolar bone grafting, typically using cancellous bone from the iliac crest, is generally performed later in childhood (around 8 to 11 years of age) to restore the continuity of the dental arch and support permanent tooth eruption. Orthodontic treatment is commonly required, and some patients may need secondary surgical revisions for optimal aesthetic and functional outcomes. With appropriate multidisciplinary care, outcomes are generally very favorable.

Common questions about Cleft lip and alveolus