title: Interdisciplinary treatment of an adult with complete bilateral cleft lip and palate.
abstract: Interdisciplinary treatment was used for an adult patient born with complete bilateral cleft lip and palate. He had a severe maxillary deficiency with a wide cleft involving the alveolar and maxillary bone and palate. Reconstruction of the arches and occlusion in patients who missed the optimal treatment time is a difficult task for orthodontists. The clinical examination showed severe hypogenesis of the maxillary bone with a total crossbite. The maxillary dental arch was extremely narrow, and the maxillary incisors showed extensive caries caused by improper oral hygiene. Fixed and removable expansion appliances were used to improve the lateral crossbite. Alveolar bone grafting and unilateral LeFort I maxillary osteotomy were performed on the right side for alignment of the maxillary arch. Mandibular setback with bilateral sagittal split ramus osteotomy was also performed to correct the anteroposterior skeletal discrepancy. After postsurgical orthodontic treatment, prosthetic treatment was carried out for final reconstruction of esthetics and orthognathic function. Interdisciplinary treatment was necessary for this patient to achieve a proper occlusion and better esthetics.
authors.affiliation: Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Okada
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Fukui
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Saito
authors.forename: Chikahiro
authors.initials: C
authors.lastname: Ohkubo
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hamada
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nakamura
mesh_terms: D000543:Alveoloplasty / Q000009:adverse effects / Q000379:methods*; D001862:Bone Resorption; D016025:Bone Transplantation / Q000009:adverse effects; D002508:Cephalometry; D002971:Cleft Lip / Q000150:complications; D002972:Cleft Palate / Q000150:complications* / Q000601:surgery; D003731:Dental Caries / Q000209:etiology; D003832:Denture, Partial, Removable; D006801:Humans; D007180:Incisor / Q000601:surgery; D008046:Lip / Q000601:surgery; D008297:Male; D008310:Malocclusion / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D008334:Mandible / Q000002:abnormalities / Q000601:surgery; D008437:Maxilla / Q000002:abnormalities* / Q000601:surgery; D018704:Orthodontic Retainers; D009971:Orthodontics, Corrective; D019340:Osteotomy, Le Fort; D059229:Osteotomy, Sagittal Split Ramus; D010155:Palatal Expansion Technique / Q000009:adverse effects / Q000295:instrumentation; D010348:Patient Care Team; D012225:Rhinoplasty; D014081:Tooth Extraction; D055815:Young Adult