Orthodontic camouflage treatment for a patient with bilateral cleft lip and palate, bilateral crossbite, and microdontic maxillary lateral incisors

Abstract

Cleft lip and palate is a congenital craniofacial anomaly that affects the lip and oral cavity. The management and orthodontic treatment of this anomaly is important but challenging. This article reports the successful treatment of a patient with bilateral cleft lip and palate, Class III malocclusion, bilateral crossbite, crowding and microdontic maxillary lateral incisors. One mandible incisor was extracted, and three miniscrew anchorages were utilized to distalize the maxillary left dental arch and retract the mandibular arch. After treatment, ideal occlusion and a better profile were established, and long-term stability was confirmed by a 4-year follow-up. This article represents a successful attempt of orthodontic camouflage treatment of severe dentofacial discrepancy, as an important part of the series treatment of cleft lip and palate, to provide some insight into the clinical field.

Keywords: Cleft lip and palate; Malocclusion; Mini-implant; Orthodontics.

Fig. 1

Pretreatment facial and intraoral photographs

Fig. 2

Pretreatment study models

Fig. 3

Pretreatment lateral radiograph and panoramic radiograph

Fig. 4

Pretreatment three-dimensional model reconstruction

Fig. 5

Initial alignment and leveling

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Implantation of mandibular OMIs

Fig. 7

Mandibular retraction by OMIs

Fig. 8

Posttreatment facial and intraoral photographs

Fig. 9

Posttreatment study models

Fig. 10

Posttreatment lateral cephalogram and panoramic radiograph

Fig. 11

Superimposed tracings

Fig. 12

Four-year follow-up facial and intraoral photographs