A Novel Technique To Correct Multiplanar Maxillary Hypoplasia

Abstract

Dental malocclusion and facial deformity are frequent observations in patients with clefts of the orofacial region. These patients have a low self perception secondary to their aesthetic appearance. Cleft palate patients are further affected in their speech and oral function with direct impediment to their quality of life. Early identification and treatment in cleft lip and palate patients may directly enhance their overall well being and productivity with sustainable prognosis when managed by skilled and evidence informed operators. We present a successful case management of a patient with a cleft palate and dentofacial deformity with a past surgical history, treated with an anterior maxillary advancement osteotomy, stabilized with an interpositional non vascular iliac bone graft. The posterior open bite was corrected using overlay full coverage crowns. Both these techniques are rarely reported in the literature. The procedure positively improved the quality of life in our patient with regards to her aesthetics, speech and function. This treatment approach could be considered in similar cases to achieve predictable outcomes.

The Psychosocial Patient-Reported Outcomes of End of Pathway Cleft Surgery: A Systematic Review

“…This study found 8 of 9 patients were satisfied with their postsurgical appearance. The only case study included in this review reported high patient satisfaction (10/10, where 10 = most satisfied) with treatment (Simon et al, 2016) and suggests this was maintained at 5-year telephone review. However, the lack of detail about the measure used or when it was administered perhaps indicates prioritization of surgical outcomes and makes it hard to interpret findings from the patient perspective.…”

“…This study also administered the presurgery measures immediately before surgery which may have introduced a bias with patients amplifying distress or concern about appearance to justify undergoing surgery. Unfortunately, 7 studies did not report the time period when postsurgery outcomes were collected (Pitak-Arnnop et al, 2011;Scopelliti et al, 2013;Tiong et al, 2014;Karabekmez et al, 2015;Gassling et al, 2015;Simon et al, 2016;Jones et al, 2017).…”

<p>Review of Etiology of Posterior Open Bite: Is There a Possible Genetic Cause?</p>

“…Additionally, several case reports have documented concomitant POB in Class III malocclusions (skeletal and/or dental). 1,3,18,20,[43][44][45][46] The POB, however, occurs often in the presence of other factors such as tongue thrust habits, 18,20 vertical underdevelopment of the dentoalveolar process, 18 a narrow maxilla with mandibular asymmetry, 1 a history of cleft palate, 46 perioral muscle strain, 43 and multiple missing teeth. 44…”