ORTHODONTIC AND PROSTHODONTIC TREATMENT IN CLEFT LIP AND PALATE PATIENT

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Journal of the Korean Academy of Pediatric Dentistry 2000;27(3):388-393.
Published online August 31, 2000.

ORTHODONTIC AND PROSTHODONTIC TREATMENT IN CLEFT LIP AND PALATE PATIENT

순/구개열 환자에서의 교정-보철 치험례

장원석, 최영철, 이긍호

경희대학교 치과대학 소아치과학교실

Abstract

Cleft lip and palate is one of the most common congenital defects in oro-maxillo-facial region. Because most patients undergo surgical repair in early life, the sagittal jaw relationships used to be deteriorated gradually from palate surgery up to adulthood. Also, the maxillary lateral incisor may be absent or atypical-shaped in the cleft site and may not erupt or erupt ectopically, so multidisciplinary dental cares are needed for cleft lip and palate patients. The effects of the cleft lip and alveolus seem to be limited to that part of the dentofacial complex that surrounds the cleft area. In the maxillary arch, the anterior part of the non cleft segment has a tendency to be rotated forward. On the other hand, the cleft segment has a tendency to rotated slightly medially ; hence, the tendency for canines to be edge-to-edge and sometimes in crossbite. Lip and alveolus surgery adequetely correct these problems, with little untoward effect on the skeletal maxillary-mandible relationships. In this report, the patient has a repaired lip and cleft alveolus on the left side with congenital missing on '62, '22, oronasal fistula, and skeletal class III malocclusion which is not affected by lip surgery. Dental treatments for this patient including orthodontic(space supervision, functional regulator in mixed dentition, fixed therapy in permanent dentition) and prosthodontic(removable obturator with key and keyway attachment and Konus crown) therapy were performed to improve the patient's functions and esthetics.

Key Words: Cleft lip and palate, Orthodontic treatment, Obturator