Abstract
Cleft lip and palatal patients require treatment planning to decide the necessity and timing of orthodontic therapy, secondary bone grafting, orthognathic surgery and prosthodontic treatment for various problems of discrepancies between the upper and lower jaws, cleft jaw with tooth defects, alveolar bone and maxillary bone, and malocclusion. We report two cases with unilateral cleft lip and palate who were borderline cases between non-surgical and surgical treatment. In both cases, occlusion was improved by orthodontic therapy and prosthodontic treatment. Case 1 was a 5-year-old boy. The patient was diagnosed with a left-side cleft lip and palate and presented as follows: overjet, 0 mm; overbite, 0 mm; a narrow upper arch; and lateral crossbite. Orthodontic treatment was performed with an expansion appliance in the first stage and with a multi-bracket appliance at 13 years old. After orthodontic treatment, secondary bone grafting was performed at 19 years old and prosthodontic treatment was performed at 20 years old. As a result of the treatment steps, the patient's facial profile was improved and the occlusion was relatively stabilized. Case 2 was a 9-year-old boy. The patient was diagnosed with right-side cleft lip and palate and presented as follows: overjet, −5 mm; overbite, +1 mm; maxilla posteriorly located; and narrow maxillary dental arch. Orthodontic treatment was performed with an expansion appliance and orthopedic appliance in the first stage, and with a multi-bracket appliance at 13 years old. After orthodontic treatment, secondary bone grafting was performed at 24 years old and prosthodontic treatment was performed at 25 years old. As a result of the treatment steps, the patient's facial profile was improved and the occlusion was relatively stabilized.
