Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies-USP (HRAC-USP)--part 2: pediatric dentistry and orthodontics.
The aim of this article is to present the pediatric dentistry and orthodontic treatment protocol of rehabilitation of cleft lip and palate patients performed at the Hospital for Rehabilitation of Craniofacial Anomalies-University of São Paulo (HRAC-USP). Pediatric dentistry provides oral health information and should be able to follow the child with cleft lip and palate since the first months of life until establishment of the mixed dentition, craniofacial growth and dentition development. Orthodontic intervention starts in the mixed dentition, at 8-9 years of age, for preparing the maxillary arch for secondary bone graft procedure (SBGP). At this stage, rapid maxillary expansion is performed and a fixed palatal retainer is delivered before SBGP. When the permanent dentition is completed, comprehensive orthodontic treatment is initiated aiming tooth alignment and space closure. Maxillary permanent canines are commonly moved mesially in order to substitute absent maxillary lateral incisors. Patients with complete cleft lip and palate and poor midface growth will require orthognatic surgery for reaching adequate anteroposterior interarch relationship and good facial esthetics.
Hospital for Rehabilitation of Craniofacial Anomalies, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
José Alberto de Souza
JA
Freitas
Daniela Gamba
DG
Garib
Marchini
M
Oliveira
Rita de Cássia Moura Carvalho
Rde C
Lauris
Ana Lúcia Pompéia Fraga de
AL
Almeida
Lucimara Teixeira
LT
Neves
Ivy Kiemle
IK
Trindade-Suedam
Renato Yassutaka Faria
RY
Yaedú
Simone
S
Soares
João Henrique Nogueira
JH
Pinto
D001938:Brazil; D002648:Child; D002971:Cleft Lip / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D002972:Cleft Palate / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D004954:Esthetics; D006785:Hospitals, University; D006801:Humans; D009971:Orthodontics, Corrective / Q000379:methods*; D010377:Pediatric Dentistry / Q000379:methods*; D011859:Radiography; D016896:Treatment Outcome