title: [The treatment of cleft lip, cleft palate and other dysmorphisms: the ideal technic and therapeutic reality].
abstract: Good results in any surgical or orthodontic procedure require expert technique, well adapted to the problem and scrupulously executed. A technique that would achieve the best results can be described as "ideal" and can serve as a theoretical model for all similar cases. But, in dealing with apparently similar problems: cleft lips and palates, Class II or Class III cases... in reality, we are treating individual patients, none quite the same as any other. These differences derive from the varying characteristics of individual patients and from the varying and unpredictable responses of their tissues, and from their varying capacities to accommodate to and withstand insults, suffering, and the sensory-motor effects of their deformities and of the treatment they undergo, and, finally, from their variable readiness to submit to and to pay for treatment with their time and with their money. Any therapeutic technique must take into account these realities which sometimes oblige us to modify an ideal technique so that it will fit the specialized needs of a patient, an accommodation that can be defined as "therapeutic realism". When we ignore this reality, we risk the paradox of providing patients with technically ideal results that they find unsatisfactory or discover that what we thought was a technically mediocre outcome has delighted our patient: ultimately, it is the patient's judgment that determines the "therapeutic result" and is, in effect, the Final Evaluation of the technical result.
authors.forename: A R
authors.initials: AR
authors.lastname: Chancholle
authors.forename: J
authors.initials: J
authors.lastname: Saboye
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002648:Child; D002971:Cleft Lip / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D002972:Cleft Palate / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D019465:Craniofacial Abnormalities / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D003812:Dentist-Patient Relations; D004955:Esthetics, Dental; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010347:Patient Care Planning; D010349:Patient Compliance; D017060:Patient Satisfaction; D011368:Professional-Family Relations; D016896:Treatment Outcome