RESUMEN
Cleft lip and palate (CLP) is a prevalent congenital craniofacial deformity that can be unilateral or bilateral. This case report highlights the interdisciplinary approach to managing a 24-year-old male with unilateral CLP (UCLP), emphasizing the complexity of associated dental and skeletal challenges. The patient had undergone multiple surgeries, including lip closure at three months, palate repair at seven years, and alveolar bone grafting at 12 years. Clinical assessments revealed a retruded maxilla, an absence of lateral incisors, and scars from previous surgeries. Radiographic evaluations indicated a Class III skeletal pattern and confirmed the presence of a cleft on the left side. Orthodontic treatment commenced with maxillary arch alignment, followed by Le Fort I surgery to address maxillary retrusion, correct skeletal malocclusion, and close the alveolar cleft space. The post-surgical phase involved orthodontic adjustments, crossbite correction, and alignment of the mandibular arch. Despite the discontinuation of treatment due to the patient's relocation, the interdisciplinary collaboration achieved significant improvements, including a corrected facial profile, maxillary advancement, closure of the cleft space, and enhanced dental alignment. The patient's confidence and functionality were positively impacted. This case underscores the importance of a coordinated interdisciplinary approach to addressing the multifaceted challenges associated with UCLP, aiming to optimize both aesthetic and functional outcomes for improved patient well-being.
RESUMEN
Cleft lip and palate (CLP) represent a multifaceted congenital deformity encompassing skeletal, dental, and functional discrepancies. This case report presents the management of a 13-year-old female with bilateral CLP, focusing on the challenges associated with permanent dentition and retained deciduous teeth. The patient's history included prior lip and palate repair surgeries, leading to poor aesthetics and functional concerns. A multidisciplinary approach involving orthodontics, oral surgery, and prosthodontics was implemented. Clinical examinations revealed dental abnormalities, oro-nasal fistula, and skeletal discrepancies, necessitating a comprehensive treatment plan. The orthodontic intervention aimed at aligning the dentition, followed by surgical closure of the oro-nasal fistula and alveolar bone grafting (ABG) to facilitate permanent canine eruption. Prosthetic replacement of missing maxillary lateral incisors was accomplished, enhancing aesthetics with minimal invasiveness. Results demonstrated significant improvements in profile, dental alignment, and functional stability. Cephalometric and dental parameter analyses confirmed the corrections and enhancements achieved, affirming the success of the multidisciplinary treatment. This case report emphasizes the importance of a collaborative multidisciplinary approach in effectively addressing the complexities of bilateral CLP in patients with permanent dentition and retained deciduous teeth. The comprehensive treatment strategy rectified dental and skeletal issues and positively impacted the patient's overall well-being and self-confidence.
RESUMEN
Introduction Cleft of the lip and/or the palate is commonly inherited defect which involves cleft of lip and palate. Maxillary second molar inclination has been studied in various malocclusion. Every abnormality in body is compensated to some extend by compensation. Our objectives were to evaluate maxillary second molar inclination in Angle's Class I, Class III malocclusion, and unilateral cleft lip and palate (UCLP) patients in transverse plane and to compare variation in maxillary second molar inclination in Angle's Class I, Class III malocclusion, and UCLP cases buccopalatally in transverse plane. Material and method Model of 45 subjects were analyzed. The maxillary second molar inclination was measured using aid of protractor fixed on the surveyor. Axis under consideration was the axis along the long axis of the central fossa of maxillary second molar. Various standardization regarding measurement of second molar inclination were set. The maxillary second molar inclination was compared among 3 groups Angle's Class I, Class III malocclusion, and UCLP cases. Results Data was analyzed using one-way analysis of variance (ANOVA) and post-hoc Tukey test. There was a significant difference between inclination of maxillary second molar when Angle's Class I malocclusion was compared with Angle's Class III malocclusion and UCLP cases (p = 0.003 and p = 0.011, respectively). There was not a significant difference between Angle's Class III malocclusion and UCLP cases (p = 0.87). Conclusion Amongst Class III patients and UCLP patients the inclination of maxillary second molar had greater buccal inclination. Maxillary second molar correction would alleviate the effect of deleterious force on periodontium and bone generated by malpositioned teeth.
