Multidisciplinary Treatment of a Patient with Bilateral Cleft Lip-Palate with Severe Functional Disability

Abstract

In this case report, multidisciplinary treatment of a 12 years old female patient with bilateral complete cleft lip-palate having disability in mastication and speaking functions is presented. In extraoral examination of the patient, it was observed that she had a convex profile, scar tissue causing difficulty in smiling, extremely strained upper lip, a flat nose tip and did not have columella. In intraoral examination, it was observed that the patient was in mixed dentition stage, showing extreme mobility in the premaxilla, had Angle class II molar relationship, congenital absence of upper lateral teeth and increased overjet-overbite. In functional examination, it was observed that the patient had severe velopharyngeal deficiency originating speaking disorder. Treatment of the patient started by using quad-helix appliance for treatment of the maxillary constriction and continued with fixed appliance treatment after eruption of permanent teeth. In this phase, the patient was directed to a speech therapist. At the end of the orthodontic treatment of 32 months in total, the maxilla was expanded, maxillary and mandibular arches were leveled, mastication function was gained by providing a proper occlusion and an aesthetic smile was achieved. With the help of the speech therapist, the speech of the patient improved and at the end of the rhinoplasty operation applied 1 year after the end of the treatment, a substantial contribution was provided in the facial view of the patient.

Keywords

• bilateral cleft lip-palate
• multidisciplinary treatment
• secondary alveolar bone grafting