TAILIEUCHUNG - Cleft Lip and Palate 2nd Edition - Part 2

7 Lip Pits; Orthodontic Treatment, Dentition and Occlusion; Associated Skeletal Structures Samuel Berkowitz Lip Pits Pits of the Lower Lip in Cleft Lip and/or Palate – Genetic Considerations Frequency Pits of the lower lip such as fistulas of lower lip, paramedian sinuses of lower lip, humps of lower lip, or labial cysts are a very rare congenital malformation, first described by Demarquay in 1845 [1]. This minimally deforming anomaly is remarkable chiefly for its association with facial clefts. The fact that clefts that occur with lip pits seem to run stronger in families than clefts without lip pits has attracted the attention of professionals dealing with. | 7 Lip Pits Orthodontic Treatment Dentition and Occlusion Associated Skeletal Structures Samuel Berkowitz Lip Pits Pits of the Lower Lip in Cleft Lip and or Palate -Genetic Considerations Pits of the lower lip such as fistulas of lower lip paramedian sinuses of lower lip humps of lower lip or labial cysts are a very rare congenital malformation first described by Demarquay in 1845 1 . This minimally deforming anomaly is remarkable chiefly for its association with facial clefts. The fact that clefts that occur with lip pits seem to run stronger in families than clefts without lip pits has attracted the attention of professionals dealing with cleft patients Figs. . Frequency No survey of lip pits has been carried out among the general population hence the frequency of this rare anomaly has been only roughly estimated from its incidence in hospital records. Assuming that 70 2 to 80 3 of patients with pits of the lower lip have associated cleft lip and or palate and that the frequency of clefts is 1 650 one in every 650 births it can be estimated that the frequency of lip pits among the general population is about 1 75 000-1 100 000 one in every 75 000 to 100 000 births . Fig. . Lower lip pits in a child with a bilateral cleft lip and palate. a Before lip surgery. b After lip surgery at 6 months 202 S. Berkowitz Fig. . a Pits in the upper and lower lips in a 20-year-old with a bilateral cleft lip and palate. b Close-up view Fig. . Lip pits in the upper and lower lips in a bilateral cleft lip and palate Morphology Fistulas of the lower lip usually appear as two pits or humps on the vermilion portion of the lower lip generally equidistant from the midline. Various kinds of asymmetry may be observed with regard to the midline or one pit may be positioned more orally. Some pits are mere depressions others are channels 10-15 mm deep with openings at the top of nipple-like elevations. Some secrete small amounts of viscous saliva but most

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