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Case Reports
. 2025 Mar 14;13(3):131.
doi: 10.3390/dj13030131.

Successful Correction of Crossbite with Multi-Segment Le Fort I Osteotomy in a Patient with Cleft Lip and Palate

Naoko Nemoto  1 , Hitoshi Kawanabe  2 , Akihiko Oyama  3
Affiliations
Case Reports

Successful Correction of Crossbite with Multi-Segment Le Fort I Osteotomy in a Patient with Cleft Lip and Palate

Naoko Nemoto et al. Dent J (Basel). .

Abstract

Objectives: Cleft lip and palate is a multifactorial disease that causes various problems, such as maxillary and facial morphological abnormalities, oral dysfunction, and postoperative scarring due to lip and palate formation after birth. This condition can easily cause obstruction and may require surgical orthodontic treatment in the future. Methods: In this study, we performed multi-segment Le Fort type 1 osteotomy on a patient with a cleft lip and palate who presented with a crossbite, horizontal inclination of the occlusal plane due to dental arch stenosis on the left side of the maxilla, and deviation of the mandible. Results: In this case, close occlusion was achieved by improving the patient's facial appearance and occlusal relationship by combining sagittal division of the mandibular ramus, and the stability of the occlusion was measured without relapse 1 year after the surgery. Conclusions: This case is considered of great medical significance, as there have been few reports of cases showing a stable course.

Keywords: Le Fort I osteotomy; cleft lip and palate; crossbite; maxillary bone; occlusal plane.

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Conflict of interest statement

The authors declare no conflicts of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Pre-treatment record. (A) Facial photographs. (B) Intraoral photographs.
Figure 2
Figure 2
Pre-treatment record. (A) Panoramic radiograph. (B) Lateral and front cephalogram.
Figure 9
Figure 9
Post-treatment record. (A) Facial photographs. (B) Intraoral photographs. (C) a: at the time of initial examination: anterior width 25.1 mm, posterior width 38.0 mm; b: at the end of preoperative correction: anterior width 29.1 mm, posterior width 38.7 mm; c: immediately before retention: anterior width 34.2 mm, posterior width 43.8 mm. (D) Panoramic radiograph. (E) Lateral and front cephalogram.
Figure 3
Figure 3
Model surgery for orthognathic planning.
Figure 4
Figure 4
Pre-treatment record. Frontal prediction. (a) ZL–ZR plane. (b) Midline. Jaw surgery prediction. Red line: Intraoperative prediction of the maxilla. Blue line: Intraoperative prediction of mandible.
Figure 5
Figure 5
Treatment progress. (A) Attach nickel titanium wires to the upper and lower jaws and begin leveling. (B) After extracting the mandibular right lateral incisor, attach an angle wire and continue to level. (C) Contain the upper maxilla wire and improve the width and diameter.
Figure 6
Figure 6
An open coil creates a space between the upper right central incisor and canine to create a gap for the bone chisel.
Figure 7
Figure 7
Preoperative intraoral photograph and radiographs and CT. (A) Intraoral photographs. (B) Panoramic radiograph. (C) Cephalograms and CT.
Figure 8
Figure 8
Under surgical orthodontic treatment.
Figure 10
Figure 10
Superposition at the end of preoperative correction and end of dynamic treatment. Black line: before surgery. Red line: After surgery.
See this image and copyright information in PMC

References

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