Orthopedic treatment of cleft lip and palate child. An update.

Lim,  Sung-Hoon

J Korean Dent Assoc > Volume 55(12); 2017 > Article

The Journal of The Korean Dental Association 2017;55(12):870-882.
Published online December 31, 2017.

성장기 구순구개열 환자의 악정형 치료에 관한 최신 지견

임성훈

조선대학교 치과대학.치의학전문대학원 치과교정학교실

Orthopedic treatment of cleft lip and palate child. An update.

Sung-Hoon Lim

Department of Orthodontics, School of Dentistry, Chosun University

Abstract

Maxillary growth is hindered by the restricting pressure from the scar tissue formed after lip closure and palate closure surgeries of the cleft. Therefore, the anteroposterior skeletal relationship of both jaws exacerbates as patient grows. Conventional facemask treatment is valuable for dentoalveolar compensatory treatment and for very mild maxillary hypoplasia. To achieve further maxillary protraction, bone-anchored facemask or bone-anchored maxillary protraction can be attempted. For moderate maxillary hypoplasia, surgical orthodontic treatment after growth completion can be an efficient treatment reducing uncontrollable problems. For moderate to severe maxillary hypoplasia, distraction osteogenesis (DO) can be used alone or with later surgical orthodontic treatment. To compensate the severe relapse after DO, overcorrection and bone plate placement after DO are recommended. In case of hypernasality, maxillary anterior segmental distraction osteogenesis can be chosen to prevent exacerbation of the hypernasality.

Key Words: Cleft lip and palate;facemask;distraction osteogenesis;maxillary hypoplasia;orthopedic treatment;