The Correction of Maxillary Deficiency With Internal Distraction Devices: A Multidisciplinary Approach

Abstract

Aim: The purpose of this case report is to present the orthodontic, surgical and restorative treatments in the case of an operated cleft lip and palate and severe maxillary deficiency in a 14-year-old female patient. Background: Only orthodontic treatment could be inefficient for cleft lip and palate patients characterized with maxillary hypoplasia. Orthodontic and surgical treatment shows sufficient results, especially with severe skeletal deficiency. Case report: A cleft lip and palate patient required complex multidisciplinary treatment to preserve health and restore esthetics. Dental leveling and alignment of the maxillary and mandibular teeth were provided before the surgery. Maxillary advancement and clockwise rotation of the maxillary-mandibular complex was applied by a Le Fort 1 osteotomy with two internal distraction devices. After the active treatment including orthodontic treatment and orthognathic surgery, upper full mouth ceramic restoration was applied. Conclusion: This report shows the efficiency of internal distraction devices in cleft lip palate patients and exemplifies the multidisciplinary care required for such difficult cases. Clinical significance: Stable improved occlusion and skeletal relations were observed after a follow-up examination period of 12 months.