Multidisciplinary Rehabilitation of an Adult with a Cleft Lip and Palate: An Illustration of a Dental Substitution Approach for the Management of Unilateral Agenesis of Central and Lateral Incisors

FACE ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 30-38
Author(s):  
Rany M. Bous ◽  
Anand Kumar ◽  
Manish Valiathan
Keyword(s):  
Case Report ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Time ◽  
3 Dimensional ◽  
Mandibular Asymmetry ◽  
Total Treatment Time ◽  
Patient Reported ◽  
Total Treatment ◽  
Congenitally Missing

Cleft lip and Palate (CLP) is the most common craniofacial condition. Management of patients with clefts often requires multi-disciplinary rehabilitation of the orofacial structures. This case report demonstrates the multi-disciplinary management of an adult with a cleft lip and palate, highlighting the benefits of 3-Dimensional (3D) diagnosis, treatment planning and clinical execution of the plan. The patient presented with a severe maxillary deficiency, mandibular asymmetry, and congenitally missing maxillary right central and lateral incisors. This case report demonstrates an alternative approach for the management of cases with ipsilateral missing central and lateral incisors. The maxillary right canine substituted the congenitally missing maxillary right central incisor, while the maxillary right first premolar substituted the congenitally missing right lateral incisor, eliminating the need for prosthetic replacements. Total treatment time was 19 months, and the burden of care for the patient was minimized. An acceptable occlusion was achieved, and the patient’s esthetics improved significantly at the end of treatment. More importantly, the patient reported a marked improvement in his quality of life.

scholarly journals Two-phase orthodontic treatment in a unilateral cleft lip and palate patient with 1-year follow-up results

2017 ◽  
Vol 7 ◽  
pp. 101-107
Author(s):  
Prashant M. Dhole ◽  
Divya O. Maheshwari
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Time ◽  
Two Phase ◽  
Total Treatment Time ◽  
Total Treatment ◽  
Growth Modification ◽  
Palate Patient

Treatment of a patient with cleft lip and palate can be challenging. A 10-year and 10-month-old girl presented with uneven and crowded teeth. She had unilateral cleft lip and palate on left side for which she had undergone primary lip repair and palatoplasty when she was younger. On examination, she had concave facial appearance, crossbite of upper arch with reverse overjet of 2 mm, wits appraisal of 6 mm and impacted 23. She was treated with two-phase orthodontic treatment; growth modification appliances followed by fixed mechanotherapy. Total treatment time was 5 years. 1-year follow-up shows that results have been stable with good facial aesthetics and functional occlusion.

scholarly journals Bimaxillary Protrusion - A Case Report

2019 ◽  
Vol 7 (1) ◽  
pp. 70-73
Author(s):  
Hemant Kumar Halwa ◽  
Sumit Kumar Yadav ◽  
Kishor Dutta ◽  
Sandeep Kumar Gupta ◽  
Raju Shrestha ◽  
...  
Keyword(s):  
Case Report ◽  
Orthodontic Treatment ◽  
Treatment Time ◽  
Facial Appearance ◽  
Total Treatment Time ◽  
Total Treatment ◽  
Bimaxillary Protrusion ◽  
Maximum Anchorage

Correction of a severe bimaxillary protrusion with maximum anchorage can be challenging. This case report describes the treatment of a girl with a bimaxillary protrusion. Orthodontic treatment included extraction of her 4 first premolars. The total treatment time was 18 months. Her dental proclination and facial appearance was significantly improved.

scholarly journals TAD’s for the Derotation of 90° Rotated Maxillary Bicuspids

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hasan Sabah Hasan ◽  
Ayshan Kolemen ◽  
Mohamed Elkolaly ◽  
Anand Marya ◽  
Shreyas Gujjar ◽  
...  
Keyword(s):  
Treatment Time ◽  
Chief Complaint ◽  
Overall Treatment Time ◽  
Pattern Class ◽  
Deep Bite ◽  
Mini Implants ◽  
Total Treatment Time ◽  
Patient Reported ◽  
Total Treatment ◽  
Skeletal Pattern

It is undeniable that the advent of extra-alveolar mini-implants for anchorage purposes has revolutionized the field of Orthodontics. This case report sheds light on an innovative anchorage plan using TADs, to carry out treatment for a 15-year-old female patient. The patient reported to the clinic with a chief complaint of rotated second premolars, crowding, and a deep bite. On examination, it was seen that the patient had a Class I skeletal pattern, Class II subdivision molar relationship, 90-degree maxillary second premolar rotations, crowding in both the arches, and a deep bite. In this case, the clinicians decided to use TADs for premolar derotation as it not only provides a pure rotational couple without any deleterious effects on the adjacent teeth but also helps shorten the overall treatment time. The total treatment time for this case was 10 months.

scholarly journals The combined use of corticotomy and clear aligners: A case report

2015 ◽  
Vol 86 (5) ◽  
pp. 862-870 ◽  
Author(s):  
Michele Cassetta ◽  
Federica Altieri ◽  
Ersilia Barbato
Keyword(s):  
Case Report ◽  
Treatment Time ◽  
Cortical Layer ◽  
Total Treatment Time ◽  
Combined Use ◽  
Total Treatment ◽  
Related Quality ◽  
Health Related ◽  
Dental Crowding

ABSTRACT Objective:  To describe an orthodontic treatment that combines an esthetic approach (clear aligners) with surgery (alveolar corticotomy). Materials and Methods:  A patient with moderate dental crowding and Class I skeletal and molar relationships was selected. Orthodontic records of the patient were taken. Periodontal indexes, oral health–related quality of life (OHRQoL), and treatment time were evaluated. After we reflected a full-thickness flap beyond the teeth apices, the cortical bone was exposed on the buccal aspect and a modified corticotomy procedure was performed. Interproximal corticotomy cuts were extended through the entire thickness of the cortical layer, just barely penetrating into medullary bone. Orthodontic force was applied on the teeth immediately after surgery. Results:  Total treatment time was 2 months. Periodontal indexes were improved after correction of crowding. A deterioration of OHRQoL was limited to 3 days following surgery. Conclusion:  This case report may encourage the use, limited to selected cases, of corticotomy associated with clear aligners to treat moderate crowding.

scholarly journals Evaluation of upper arch changes in patients with unilateral cleft lip and palate after maxillary expansion using digital dental casts

2020 ◽  
Vol 7 (3) ◽  
pp. 184-190
Author(s):  
Fabrizia d’Apuzzo ◽  
◽  
Ludovica Nucci ◽  
Abdolreza Jamilian ◽  
Rosario Rullo ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Time ◽  
Young Patients ◽  
Maxillary Expansion ◽  
Significance Level ◽  
Total Treatment Time ◽  
Expansion Time ◽  
Before And After ◽  
Dental Casts

Objective To compare the upper arch dimensions of young patients with unilateral cleft lip and palate (UCLP) before and after treatment with bonded maxillary expander and hybrid activation protocol using digital dental casts. Methods Sixteen subjects with UCLP, aged between 7 and 14 years (mean age 10.9 ± 2.7 years) consecutively treated with bonded maxillary expander and hybrid activation were included. The dental casts before and after treatment were digitalized using a 3Shape scanner. Intercanine, interpremolar and intermolar widths (at cusp and gingival levels) and arch perimeters were measured. The significance level for statistical analyses was set as p < 0.05. Results The total treatment time using the hybrid expansion protocol lasted 12 ± 1.9 months while the active expansion time lasted 4 ± 0.2 months. Patients with UCLP showed significant differences in all transverse upper arch dimensions both at cusp and gingival level. Conclusion The use of a bonded maxillary expander with a hybrid activation protocol during growth may be efficient to improve all transverse upper arch widths in patients affected by UCLP

Vital Tooth Whitening Techniques. A literature Review

2020 ◽  
Vol 02 ◽  
Author(s):  
Pia Chatterjee Kirk
Keyword(s):  
Soft Tissues ◽  
Treatment Time ◽  
Tooth Bleaching ◽  
Tooth Whitening ◽  
Easy Method ◽  
Tooth Structure ◽  
Dental Esthetics ◽  
Total Treatment Time ◽  
Restorative Materials ◽  
Total Treatment

Background: Vital tooth whitening has become an integral part of esthetic dentistry and remains one of the safest and most economic options today to improve dental esthetics without removing tooth structure. The tooth whitening materials have evolved into three categories: dentist-prescribed/dispensed (in office and patient home-use), and over-thecounter purchased and applied by patients. Objective: This review outlines the latest advances in dentist prescribed vital teeth whitening techniques, effects on tooth structure, soft tissues, and dental restoratives. Areas requiring additional research are also discussed. Methods: Electronic and manual literature search was conducted for key words such as tooth bleaching, and dental bleaching techniques using PubMed/MEDLINE, followed by manual selection of the studies that included whitening procedures in vital teeth. Results: The two main whitening agents are carbamide peroxide (CP) and hydrogen peroxide (HP or H2O2) whose concentration, duration of contact, and total treatment time can alter results. In addition, factors including the type of stain, and age of patient can affect results. Although whitening agents can affect tooth structure, restorative materials, and gingival tissues, the changes are temporary or can be treated using minimally invasive techniques. Conclusion: Areas requiring further research include the actual mechanism of whitening, its effect on tooth structure and restorative materials, and the development of an easy method to quantitate the degree of whitening in the dental office.

scholarly journals Immediate rehabilitation with feeding appliance of a three day old neonate with cleft lip and palate- a case report

2017 ◽  
Vol 13 (2) ◽  
pp. 293-295
Author(s):  
Deepika Kapoor ◽  
Deepanshu Garg
Keyword(s):  
Case Report ◽  
Cleft Lip ◽  
Multidisciplinary Approach ◽  
Cleft Lip And Palate ◽  
Facial Growth ◽  
Orofacial Clefts ◽  
High Incidence ◽  
Negative Effect ◽  
Growth Development ◽  
Very High

Orofacial clefts (OFC) are one of the most common congenital problems seen with a very high incidence. It imparts a negative effect on the overall health of the child by hindering in his feeding practices, normal facial growth, development of dentition and hence speech. Infants born with orofacial clefts have oronasal communication which creates a problem with the creation of negative pressure inside the oral cavity required for suckling.The treatment for such patients is with the multidisciplinary approach but the preliminary  concern for the neonate is to help with the feeding for which a feeding appliance is given. This case report presents a case of a 3-day old infant to whom a feeding appliance was given to aid in suckling. 

Three-Dimensional Printing in Cleft Care: A Systematic Review

2021 ◽  
pp. 105566562110131
Author(s):  
Farrukh R. Virani ◽  
Evan C. Chua ◽  
Mary Roz Timbang ◽  
Tsung-yen Hsieh ◽  
Craig W. Senders
Keyword(s):  
Systematic Review ◽  
3D Printing ◽  
Clinical Outcomes ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Secondary Outcome ◽  
Exclusion Criteria ◽  
3 Dimensional ◽  
Dimensional Printing

Objective: To determine the current applications of 3-dimensional (3D) printing in the care of patients with cleft lip and palate. We also reviewed 3D printing limitations, financial analysis, and future implications. Design: Retrospective systematic review. Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used by 3 independent reviewers. Articles were identified from Cochrane library, Ovid Medline, and Embase. Search terms included 3D printing, 3 dimensional printing, additive manufacturing, rapid prototyping, cleft lip, and cleft palate. Exclusion criteria included articles not in English, animal studies, reviews without original data, oral presentations, abstracts, opinion pieces, and articles without relevance to 3D printing or cleft lip and palate. Main Outcome Measures: Primary outcome measure was the purpose of 3D printing in the care of patients with cleft lip and palate. Secondary outcome measures were cost analysis and clinical outcomes. Results: Eight-four articles were identified, and 39 met inclusion/exclusion criteria. Eleven studies used 3D printing models for nasoalveolar molding. Patient-specific implants were developed via 3D printing in 6 articles. Surgical planning was conducted via 3D printing in 8 studies. Eight articles utilized 3D printing for anatomic models/educational purposes. 3-Dimensional printed models were used for surgical simulation/training in 6 articles. Bioprinting was utilized in 4 studies. Secondary outcome of cost was addressed in 8 articles. Conclusion: 3-Dimensional printing for the care of patients with cleft lip and palate has several applications. Potential advantages of utilizing this technology are demonstrated; however, literature is largely descriptive in nature with few clinical outcome measures. Future direction should be aimed at standardized reporting to include clinical outcomes, cost, material, printing method, and results.

Treatment of Unilateral Cleft Lip and Palate Patient With Intraoral Tooth Tissue Borne Distractor and Facemask Therapy: A Case Report

2021 ◽  
pp. 105566562199336
Author(s):  
Akansha Bansal Agrawal ◽  
Harshavardhan Kidiyoor ◽  
Anand K. Patil Morth
Keyword(s):  
Case Report ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Face Mask ◽  
Rapid Maxillary Expansion ◽  
Growth Potential ◽  
Maxillary Expansion ◽  
Long Term Stability ◽  
Tooth Tissue

This case report demonstrates the successful use of intraoral distractor/hygenic rapid expander (HYRAX) for rapid maxillary expansion in anteroposterior direction with an adjunctive use of face mask therapy for anterior orthopedic traction of maxillary complex in a cleft patient with concave profile. The patient was a 13-year-old girl who reported with a chief complaint of backwardly positioned upper jaw and a severely forward positioned lower jaw. Therefore, a treatment was chosen in which acrylic bonded rapid maxillary expansion was done with tooth tissue borne intraoral distractor/HYRAX having a different activation schedule along with Dr Henri Petit facemask to treat maxillary retrognathism. As a result, crossbite got corrected and attained a positive jet with no bone loss in cleft area over a period of 5 months which was followed by fixed mechanotherapy achieving a well settled occlusion in 1 year. After completion of expansion and fixed mechanotherapy, ANB became +1 post-treatment which was −4 pretreatment. The prognathic profile was markedly improved by expansion and taking advantage of the remaining growth potential, thus minimizing the chances of surgery later in life. This provided a viable alternative to orthognathic surgery with good long-term stability.

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