title: Interdisciplinary treatment of a patient with bilateral cleft lip and palate and congenitally missing and transposed teeth.
abstract: The comprehensive treatment of a patient with cleft lip and palate requires an interdisciplinary approach for functional and esthetic outcomes. A 20-year-old woman with bilateral cleft lip and palate had a chief complaint of unesthetic appearance of her teeth and the presence of oronasal fistulae. Her clinical and radiographic evaluation showed a dolichofacial growth pattern, a Class II skeletal relationship with retroclined maxillary central incisors, 5 mm of negative overjet, maxillary constriction, maxillary and mandibular crowding, congenitally missing maxillary right incisors and left lateral incisor, and a transposed maxillary left canine. Her treatment plan included the extraction of 3 premolars, maxillary expansion, segmental maxillary osteotomy, repair of the oronasal fistulae, rhinoplasty, periodontal surgery, and prosthodontic rehabilitation. To obtain a better occlusion and reduce the dimensions of the fistulae, orthognathic surgery comprising linear and rotational movements of the maxillary segments (premaxilla, right and left maxillary alveolar segments) in all 3 axes was planned by performing 3-dimensional virtual surgery on 3-dimensional computerized tomography. At the end of the interdisciplinary treatment, a functional occlusion, a harmonious profile, and patient satisfaction were achieved. Posttreatment records after 1 year showed stable results.
authors.affiliation: Associate professor, Department of Orthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey. Electronic address: dgermec@gmail.com.
authors.forename: Derya
authors.initials: D
authors.lastname: Germec-Cakan
authors.affiliation: Associate professor, Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Acibadem University, Istanbul, Turkey.
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Canter
authors.affiliation: Assistant professor, Department of Prosthodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey.
authors.forename: Umut
authors.initials: U
authors.lastname: Cakan
authors.affiliation: Periodontist in private practice, Istanbul, Turkey.
authors.forename: Becen
authors.initials: B
authors.lastname: Demir
mesh_terms: D000848:Anodontia / Q000628:therapy*; D002971:Cleft Lip / Q000628:therapy*; D002972:Cleft Palate / Q000628:therapy*; D003481:Cuspid / Q000473:pathology; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007180:Incisor / Q000002:abnormalities; D008312:Malocclusion, Angle Class II / Q000628:therapy; D009668:Nose Diseases / Q000601:surgery; D016155:Oral Fistula / Q000601:surgery; D019516:Orthodontic Space Closure / Q000379:methods; D056948:Orthognathic Surgical Procedures / Q000379:methods; D019340:Osteotomy, Le Fort / Q000379:methods; D010155:Palatal Expansion Technique; D010347:Patient Care Planning; D010348:Patient Care Team; D017060:Patient Satisfaction; D016156:Respiratory Tract Fistula / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D014079:Tooth Eruption, Ectopic / Q000628:therapy*; D014087:Tooth Movement Techniques / Q000379:methods; D014584:User-Computer Interface; D055815:Young Adult