Orthodontic-Surgical Approach for Treating Skeletal Class III Malocclusion With Severe Maxillary Deficiency in Isolated Cleft Palate

• Published in: The Cleft palate-craniofacial journal Vol. 56; no. 3; pp. 400 - 407
• Main Authors: Nakatsugawa, Kohei, Kurosaka, Hiroshi, Mihara, Kiyomi, Tanaka, Susumu, Aikawa, Tomonao, Kogo, Mikihiko, Yamashiro, Takashi
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-03-2019; SAGE PUBLICATIONS, INC
• Subjects: Adolescent; Birth defects; Cleft Lip; Cleft Palate; Dental occlusion; Dentistry; Female; Females; Humans; Malocclusion; Malocclusion, Angle Class III; Maxilla; Maxillofacial surgery; Medical procedures; Orthodontics; Palatal Expansion Technique; Patients; Surgical techniques; dental arch; hard palate; distraction osteogenesis
• ISSN: 1055-6656; 1545-1569
• DOI: 10.1177/1055665618777573

Orthodontic treatment in patients with orofacial cleft such as cleft lip and palate or isolated cleft palate is challenging, especially when the patients exhibit severe maxillary growth retardation. To correct this deficiency, maxillary expansion and protraction can be performed in the first phase of orthodontic treatment. However, in some cases, the malocclusion cannot be corrected by these procedures, and thus, skeletal discrepancy remains when the patients are adolescents. These remaining problems occasionally require various orthognathic treatments according to the degree of the discrepancy. Here, we describe one case of a female with isolated cleft palate and hand malformation who exhibited severe maxillary deficiency until her adolescence and was treated with multiple orthognathic surgeries, including surgically assisted maxillary expansion (surgically assisted rapid palatal expansion), LeFort I osteotomy, and bilateral sagittal split osteotomy in order to correct severe skeletal discrepancy and malocclusion. The treatment resulted in balanced facial appearance and mutually protected occlusion with good stability. The purpose of this case report is to show the orthodontic treatment outcome of 1 patient who exhibited isolated cleft palate and subsequent severe skeletal deformities and malocclusion which was treated by an orthodontic-surgical approach.