Results of Long-term Orthodontic Care for an Individual with an Isolated Cleft Palate Treated with Intermaxillary Suture Splitting

Abstract

This report presents the results of a long-term care of an individual with an isolated cleft palate by a Showa University cleft palate team.
The primary palate closure was performed at 12 months of age. Orthodontic care was initiated at 4 years; thereafter the patient was put under observation for more than 10 years.
At the age of 11 years and 3 months, maxillary rapid expansion was carried out for 2 months by taking advantage of a fan-type rapid expansion, which is capable of expanding the greater amount of the anterior portion of the lateral segment, followed by retention for 3 months as the rapid expansion appliance set in place, expecting osteogenesis in the intermaxillary suture.
The unavailability of a temporary retainer after removal of the appliance, however, has an advantage of assuring how much an expanded maxillary dental arch would relapse in reference to the establishment of a treatment plan and prognostication later on. Corrective orthodontic treatment by the multibracket system was done successfully from the ages of 12 years and 3 months to 13 years and 9 months. The occlusion of the permanent teeth seems to be stable so far. Fortunately, no major problems have been found in the gnathic relationship through the growing period. The expansion of the maxillary arch was not enough to solve the arch length discrepancy. The 1st premolar on the left and the 2nd premolar on the right were selected for eventual extraction, according to the principle that extraction should not be made on the tooth expanded.