Authors : Abhay Kumar Jain, Ambesh Rai, Anand K Patil, Sanjay V Ganeshkar
DOI : 10.18231/j.jco.2019.018
Volume : 3
Issue : 2
Year : 2019
Page No : 44-49
Cleft Lip and Palate is the most common congenital abnormalities of the orofacial region. Management of these patients requires a multispeciality approach. A 13-year-oldpost-pubertal female patient presented with cleft lip and palate, collapsed upper arch, oroantral fistula, missing upper left lateral incisor, deviated nasal septum (DNS) and hypernasality of voice. The orthodontic treatment objectives were to align and expand the arches to correct the crossbite and provide sufficient space for bone grafting to close the oro-antral fistula and replacement of lateral incisor to achieve acceptable facial aesthetics. The patient was treated using a preadjusted edgewise appliance. Arch expansion was carried out using quad helix; subsequently alveolar bone grafting was performed to close oroantral fistula, Maryland bridge was placed to replace missing upper left lateral incisor. Adjunctively, septoplasty was done to address DNS and speech therapy for hypernasality. At the end of treatment Class I canine and molar relationship were achieved bilaterally, the crossbite was corrected and the missing maxillary lateral incisor was replaced with a Maryland’s bridge as an interim prosthesis till future implant placement. Posttreatment records showed excellent results with good occlusion, facial balance and esthetic harmony
Keywords: Twin Block, MRI, Skeletal Class II malocclusion.