Craniofacial cleft patients commonly present with under-developed maxilla, which may have a profound effect not only on their soft tissue facial appearance but also skeletal discrepancy and dental malocclusion. This case report presents the treatment of a 14-year-old girl with a Class III skeletal and dental malocclusion. Her occlusion is complicated by a maxillary anterior right osseous cleft, retrognathic narrow maxilla with associated anterior and posterior crossbite, dental crowding, retained primary teeth, and several missing permanent teeth including maxillary premolars, both permanent maxillary lateral incisors, and all third molars. Our treatment plan consisted of extractions of the remaining primary teeth, maxillary expansion, protraction of maxilla and substitution of the maxillary left premolar for a lateral incisor tooth. The need for orthognathic surgery was also explained to the patient prior to the start of the treatment. The treatment was successfully completed with fixed appliances, rapid palatal expander (RPE), facemask (FM), maxillary segmental advancement with the fistula closure, and alveolar bone graft and elastics. Septorhinoplasty was completed towards the end of the treatment. Orthodontic treatment was completed in 48 months. The maxillary anterior teeth were aesthetically restored after the orthodontic treatment was completed. The retention consisted of maxillary and mandibular Hawley retainers.
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Case Report
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