A Case Report of Adult Unilateral Cleft Lip and Palate Treated with Closure of Wide Alveolar Cleft by Le Fort I Osteotomy

DOI 17 References Open Access
  • HONDA AYA
    Maxillofacial Orthognathics, Department of Maxillofacial Neck Reconstruction, Division of Maxillofacial Reconstruction and Function, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • BABA YOSHIYUKI
    Maxillofacial Orthognathics, Department of Maxillofacial Neck Reconstruction, Division of Maxillofacial Reconstruction and Function, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Global Center of Excellence (GCOE) Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo, Japan
  • KATAOKA KEIICHI
    Maxillofacial Orthognathics, Department of Maxillofacial Neck Reconstruction, Division of Maxillofacial Reconstruction and Function, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • SUZUKI SHOICHI
    Maxillofacial Orthognathics, Department of Maxillofacial Neck Reconstruction, Division of Maxillofacial Reconstruction and Function, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Global Center of Excellence (GCOE) Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo, Japan
  • MORITA KEIICHI
    Global Center of Excellence (GCOE) Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo, Japan Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • OMURA KEN
    Global Center of Excellence (GCOE) Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo, Japan Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • MORIYAMA KEIJI
    Maxillofacial Orthognathics, Department of Maxillofacial Neck Reconstruction, Division of Maxillofacial Reconstruction and Function, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Global Center of Excellence (GCOE) Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo, Japan

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Other Title
  • Le Fort I型骨切り術により幅の広い顎裂を閉鎖した成人片側性口唇口蓋裂の1症例

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The residual wide alveolar cleft often causes potential risk in bone grafting and prosthodontic treatment for cleft lip and palate patients. While performing cleft reduction, maxillary advancement is required because closure of the cleft space itself with orthodontic/orthognathic treatment will result in a crossbite. In this paper, we report the case of a 21-year 4-month old male with left cleft lip and palate. The patient had undergone orthodontic treatment once at another institute, and he visited our Orthodontic Clinic at the University Hospital of Dentistry, Tokyo Medical and Dental University with a chief complaint of residual cleft space. Overjet and overbite were both 2.0 mm and the intercuspation of the buccal segments was optimal. However, the residual cleft space was 14.5 mm with no history of bone grafting. The right maxillary lateral incisor lacked congenitally, and the left lateral incisor was a lingually malpositioned conical tooth. The midline of the maxillary had right deviation of 6.5 mm. A multibracket appliance was used for the presurgical orthodontic treatment and a Le Fort I osteotomy was performed when the patient was 22-years and 4-months old. During the operation, the left maxillary lateral incisor in the cleft area was extracted. A Twin-Track device was placed along with the maxillary dental arch to guide the surgical movement of the alveolar segments into place. After complete cleft closure was achieved along this splint, maxillary segments were fixed using mini-plates and bone grafting was simultaneously performed. After 2 years of post-surgical orthodontic treatment, acceptable occlusion was achieved and no further prosthetic treatment was required.

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