2022 Volume 34 Issue 2 Pages 111-116
In an orthodontic treatment during the permanent dentition period of patients with skeletal class Ⅲ malocclusion, it is sometimes difficult to decide which orthodontic treatment, with or without orthognathic surgery, is better. For patients with cleft lip and palate, we consider not only skeletal discrepancy between maxillary and mandibular morphology but also other factors including the number of congenitally missing teeth, abnormal morphology in permanent teeth, and soft tissue morphology. A 23-year-old female patient with bilateral cleft lip and palate had anterior crossbite and open bite malocclusion. The lateral cephalometric analysis found skeletal class Ⅲ （ANB, 0.3°; Wits appraisal, −4.5mm）. After the treatment plans were thoroughly discussed with the patient, orthodontic treatment without orthognathic surgery was started, including the maxillary left lateral incisor and mandibular bilateral first premolars and third molars extraction using a standard edgewise system. The active orthodontic treatment lasted approximately 3 years, and the patient obtained proper overjet, overbite, and interdigitation. However, a slightly concave profile remained. Although camouflage orthodontic treatment is possible to prevent invasive surgery and improve malocclusion in patients, orthodontists should share with the patient the camouflage orthodontic treatment advantages and limitations relative to orthodontic-orthognathic treatment before starting treatment.
