title: The correction of maxillary defciency with internal distraction devices: a multidisciplinary approach.
abstract: OBJECTIVE
  The purpose of this case report is to present the orthodontic, surgical and restorative treatments in the case of an operated cleft lip and palate and severe maxillary defciency in a 14-year-old female patient.
  
  
  BACKGROUND
  Only orthodontic treatment could be ineffcient for cleft lip and palate patients characterized with maxillary hypoplasia. Orthodontic and surgical treatment shows suffcient results, especially with severe skeletal defciency.
  
  
  METHODS
  A cleft lip and palate patient required complex multidisciplinary treatment to preserve health and restore esthetics. Dental leveling and alignment of the maxillary and mandibular teeth were provided before the surgery. Maxillary advancement and clockwise rotation of the maxillary-mandibular complex was applied by a Le Fort 1 osteotomy with two internal distraction devices. After the active treatment including orthodontic treatment and orthognathic surgery, upper full mouth ceramic restoration was applied.
  
  
  CONCLUSIONS
  This report shows the efficiency of internal distraction devices in cleft lip palate patients and exemplifes the multidisciplinary care required for such diffcult cases. Clinical signifcance: Stable improved occlusion and skeletal relations were observed after a follow-up examination period of 12 months.
authors.affiliation: Assistant Professor, Department of Orthodontics, Ondokuz Mayis University, Turkey, e-mail: alperoz@hotmail.com.
authors.forename: A Alper
authors.initials: AA
authors.lastname: Oz
authors.affiliation: Associate Professor, Department of Orthodontics, Faculty of Dentistry Ondokuz Mayis University, Turkey.
authors.forename: Mete
authors.initials: M
authors.lastname: Ozer
authors.affiliation: Associate Professor, Department of Plastic, Reconstructive and Esthetic Surgery, Faculty of Medicine, Ondokuz Mayis University Turkey.
authors.forename: Lütfi
authors.initials: L
authors.lastname: Eroglu
authors.affiliation: Prosthodontist, Department of Prosthodontics, Dental Care Hospital Samsun, Turkey.
authors.forename: Oguz Suleyman
authors.initials: OS
authors.lastname: Ozdemir
mesh_terms: D000293:Adolescent; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D003779:Denture Design; D003830:Denture, Partial, Fixed; D005115:Extraoral Traction Appliances; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008310:Malocclusion / Q000601:surgery*; D008313:Malocclusion, Angle Class III / Q000601:surgery / Q000628:therapy; D008437:Maxilla / Q000002:abnormalities* / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000379:methods; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D019340:Osteotomy, Le Fort / Q000379:methods; D010347:Patient Care Planning; D010348:Patient Care Team; D011378:Prognathism / Q000601:surgery / Q000628:therapy; D014087:Tooth Movement Techniques / Q000379:methods