A New Study to Aid Cleft Palate Patients

Each year, about one in every 750 babies born in the United States has a cleft palate.

Those with this birth defect face breathing, hearing and speech issues, as well as social and psychological difficulties. In addition, about three-fourths of cleft palate patients are missing a lateral incisor tooth. Researchers at the College of Dentistry have completed a five-year study of narrow-diameter dental implants for patients with cleft palates.

“These patients present a unique set of challenges when dentists consider implants to replace missing teeth because of the compromised bone resulting from the cleft defect,” explained Lisa Knobloch, ’91 DDS, ’94 MS, a professor and vice chair of the Division of Restorative and Prosthetic Dentistry. “Since cleft palate patients often have compromised bone in which to place an implant, they require bone grafting, which is often significant to prepare for an implant.” While external cleft defects are addressed early in life, initial bone grafting takes place at a time when the permanent teeth are erupting. Depending on the severity and outcome of the primary bone grafting, some patients need a second graft before the implant is placed when growth is complete.” 

For the study, Dr. Knobloch and her team followed fourteen patients for five years, placing seventeen implants. “Our goal in conducting this research was to replace a missing lateral incisor using narrow-diameter implants, which had not been studied specifically in the cleft palate population in a prospective study,” she said. “Our hope was to be able to minimize or even eliminate the need for grafting.” Clinical assessments suggest that narrow-diameter implants performed well in cleft palates, with no failures resulting among participants.

What happens next? The study is now complete and the results are being analyzed for manuscript preparation. For Dr. Knobloch, the study has fueled her passion for making a difference in patients’ lives.

“The best thing about being a dentist is the ability to help people,” she said. “Although there are several professions that help people, dentistry is unique in that we are working in an area that is highly visible. The services we provide help people in pain, help them eat, and can affect their speech and their self-confidence.”

Dr. Knobloch has been interested in dentistry since her undergraduate days at John Carroll University. Ironically, her high school friend and college roommate had a cleft lip and palate. “We both graduated from John Carroll and ended up in professions that help patients with a cleft,” she said. “My roommate became a speech therapist and I chose a prosthodontics residency when became interested in children with craniofacial conditions, one of which is cleft palate.”

She became a faculty member at the College of Dentistry in 1994, and she currently works as an attending dentist in the predoctoral comprehensive care clinics and the advanced prosthodontics clinic. She also maintains a private practice in the Ohio State Dental Faculty Practice and is the lead for the College Craniofacial Treatment Center Referral Program. “Patients as young as two years old are referred to our clinic after diagnosis with a medical condition that includes the absence of teeth,” she said. “Sometimes they have no primary or adult teeth and require dentures at a very early age.”

For Lisa Knobloch, dentistry is a creative pursuit. “You’re always creating things while working with your hands,” she said. “It’s a good combination of creativity and helping people.”