Abstract
Patients with cleft lip and palate require consistent treatment over time. Here, we describe a patient with left cleft lip and palate who underwent bone grafting at another hospital and was unable to undergo consistent treatment at our hospital due to schizophrenia. A 48-year-old man had been previously diagnosed with left cleft lip and palate, as well as schizophrenia. He had been born with a left cleft lip and palate; he had previously undergone cheiloplasty at 6 months of age, palatoplasty at 18 months of age, and bone graft into the alveolar cleft at 6 years of age. Subsequently, he had discontinued follow-up; therefore, he did not undergo necessary orthodontic treatment. The patient presented to our clinic with the following clinical manifestations: scar after cheiloplasty and palatoplasty, left anterior alveolar bone loss (detected by panoramic tomography), ANB angle of 0° (detected by cephalometric analysis), retruded maxillary position, narrow upper arch, lateral crossbite, and oronasal fistula. The patient’s psychiatrist confirmed that the patient could undergo orthodontic treatment and surgery. Therefore, we planned to improve malocclusion with a multi-bracket appliance and a W-type expansion appliance, oronasal fistula closure, and bone graft. However, the patient’s schizophrenia worsened after approximately 1 year of active orthodontic treatment. Although
https://ror.org/03bwzch55 
