Multidisciplinary Oral Rehabilitation of Complex Frontonasal Dysplasia: A Case Report

Abstract

This case report presents the multidisciplinary treatment of a male patient with a complex form of frontonasal dysplasia who presented with a 0 to 14 facial cleft, mild hypertelorism, absence of the nasal medial process of the nose, and frontonasal encephalocele. Cranial and plastic surgeries were performed to correct hypertelorism and improve the esthetic appearance of the frontonasal region. In the permanent dentition, the patient presented a Class II, division 1 malocclusion with severe maxillary constriction and bilateral posterior crossbite. Comprehensive orthodontic treatment started at 12 years of age and included rapid maxillary expansion followed by fixed appliance. Orthognathic surgery was performed at 21 years of age involving a forward movement of both maxilla and mandible. After debonding, veneers were made in maxillary anterior teeth to improve tooth shape and Bolton discrepancies. An improvement in facial esthetics and an adequate final occlusion were achieved. Multidisciplinary treatment was essential for morphological rehabilitation and social inclusion in patients with rare craniofacial anomalies.

Keywords: cleft lip and palate; dental occlusion; facial esthetics; malocclusion; orthodontics; orthognathic surgery; orthopedic treatment.