The Later Years: Post-Graft to Orthognathic Surgery/Prosthodontics

This lecture is the last of a 3-part series covering the management of patients afflicted with cleft lip and palate. This segment picks up the orthodontic care of these patients after an alveolar bone graft has been completed and concludes with the completion of all orthodontic and prosthodontic care by early adulthood. Comprehensive (i.e. "second phase") orthodontic treatment, orthognathic surgery, distraction osteogenesis, interim treatment/appliances, speech appliances, implants and prosthodontic care will be reviewed.

Learning Objectives:

Describe the treatment objectives and goals for patients with cleft lip and palate from completion of the alveolar bone graft through adolescence to adulthood
Describe the unique orthodontic treatment issues related to patients with both unilateral and bilateral clefts of the lip and palate as well as solitary clefts of the palate
Describe the role of orthognathic surgery and distraction osteogenesis in the treatment of patients with clefts

Maxillary Morphology in Cleft and Non-Cleft Subjects: A 3D Evaluation Approach

Cleft lip and palate (CLP) is the most common craniofacial malformation that an orthodontist will encounter. However, the management of this condition still presents a challenge to the practitioner. A patient with CLP exhibits a multitude of problems, including functional impairments and aesthetic compromise, but maxillary hypoplasia is the major complication. To date, very little 3D data on the maxillary morphology of these patients is available. This presentation will show 3D differences in maxillary morphology in untreated subjects with and without CLP in the mixed dentition phase.Treatment options and protocols in the management of patients with CLP during different phases of growth will also be presented and discussed.

Learning Objectives:

Measure intermolar and intercanine transverse distances at the cusp and gingival levels, surface area and volume of the palatal vault
Analyze the differences between these parameters in CLP and non-CLP subjects
Determine optimal timing for orthodontic treatment and examine the benefits of mixed dentition treatment in CLP patients

Letizia Perillo MD, MS, PhD

Appearances