Cleft Lip and Palate : a clinical case
“Congenital labiomaxillary clefts result from the absence of fusion or incomplete fusion of the maxillary and medial nasal processes. It is generally accepted that a congenital labiomaxillary cleft forms about the 36th or 37th day of gestation and that the earliest points of ossification in the maxilla and premaxilla appear about the end of the 6th week of gestation, when the elements of the cartilaginous nasal capsule and facial muscle precursors are already present (Cleft Lip and Palate: A Review for Dentists).”
This is a clinical case of an eight years old male with a labio-maxillary cleft. He has anterior crossbite due to a retrognatic maxillae.
Treatment plan proposed :
- Maxillary 3D expansion
- Fixed appliance
Maxillary expansion was made by a removable palatal 3D expansion screw.
The fixed appliance was a multibraces self ligating low friction. The problem encountered was the palatal position and atypical shape of 22 which was extracted with the agreement of parents.
Pictures 11 to 16 show the end of treatment and an harmonious face and optimal occlusion.
Would it be better with saving the 22 ?