title: Comprehensive treatment approach for bilateral cleft lip and palate in an adult with premaxillary osteotomy, tooth autotransplantation, and 2-jaw surgery.
abstract: We report the successful treatment of a woman aged 25 years 3 months with bilateral cleft lip and palate. She had a protruded premaxilla, collapsed posterior segments, wide alveolar defects with oronasal fistulae, a congenital missing tooth, and severe facial asymmetry with a transverse occlusal cant. The comprehensive treatment approach included (1) premaxillary osteotomy combined with alveolar bone grafting to reposition the premaxilla and minimize the wide alveolar defects, (2) autotransplantation of a tooth with complete root formation to the grafted bone region to restore the missing tooth without a prosthesis such as a dental implant or bridge, and (3) 2-jaw surgery to improve facial asymmetry. The premaxillary osteotomy was managed orthodontically, in combination with bone grafting. The results suggest that surgical orthodontic treatment with tooth autotransplantation might be useful to improve the occlusion and facial esthetics without prosthetics.
authors.affiliation: Assistant professor, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: skokai.orts@tmd.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kokai
authors.affiliation: Clinical professor, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Fukuyama
authors.affiliation: Assistant professor, Department of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Postgraduate student, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Jui-Chin
authors.initials: JC
authors.lastname: Hsu
authors.affiliation: Hospital director, Center for Dent-Oral and Maxillofacial Surgery, Tokyo, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Professor and chairman, Department of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Harada
authors.affiliation: Professor and chairman, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ono
mesh_terms: D000328:Adult; D064728:Alveolar Bone Grafting / Q000379:methods; D000848:Anodontia / Q000601:surgery; D064592:Autografts / Q000637:transplantation*; D001641:Bicuspid / Q000637:transplantation*; D002508:Cephalometry / Q000379:methods; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005146:Facial Asymmetry / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000002:abnormalities; D008313:Malocclusion, Angle Class III / Q000601:surgery / Q000628:therapy; D063166:Maxillary Osteotomy / Q000379:methods*; D009668:Nose Diseases / Q000601:surgery; D016155:Oral Fistula / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods; D010155:Palatal Expansion Technique; D010347:Patient Care Planning; D016156:Respiratory Tract Fistula / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome