협소한 상악과 상악 중절치 및 측절치 사이 치조골 파열을 지닌 편측성 완전 구순구개열 환자에서 골이식 및 매복치 견인을 동반한 교정 치료 치험례

Orthodontic Treatment with Bone Graft and the Traction of Impacted Tooth in an Unilateral Complete Cleft Lip and Palate Patient with Constricted Maxilla and Alveolar Cleft between Central and Lateral Incisors: Case Report

Purpose: We report the case of a skeletal Class III with unilateral complete cleft lip and palate patient who was performed orthodontic treatment with maxillary expansion, protraction, bone graft and impacted tooth traction. Case Report: A 8-year-old boy with cleft lip and palate showed narrow maxilla and anterior crossbite. To solve transverse deficiency of maxilla, median screw, rapid palatal expander, qaudhelix were operated. In addition to solving anteroposterior deficiency of maxilla, facemask was applied. In a period of root development of canine exceed 1/2-2/3, secondary alveolar bone graft with autogenous bone (illiac bone) was performed. After bone graft, the patient strategically took upper orthodontic treatment for sufficient eruption space and traction impacted tooth. As a result, it guided successful eruption of impacted tooth. Comprehensive orthodontic treatment was planned to take after completion of mandibular growth. Conclusions: Depending on the timing of orthodontic treatment and surgical intervention, cleft lip and palate can be managed by various treatment methods. In general, the most appropriate time for secondary bone graft is proposed as a mixed teeth, however depending on the location of alveolar cleft, the times will need to be applied differently to improve the prognosis for the traction of impacted teeth.