Comprehensive interdisciplinary treatment of patient with unilateral cleft palate and oroantral fistula using archwise Interdental distraction osteogenesis: A case report with 1-year follow-up

Abstract

A unilateral cleft palate with a wide oroantral fistula necessitates meticulous treatment planning and precise execution to mitigate the risk of relapse. It is arduous to address substantial gaps through conventional surgeries using buccal, labial mucosal flaps, or tongue flaps and is associated with heightened failure rates. In recent years, the introduction of interdental distraction osteogenesis (DO) has facilitated successful interventions in mending extensive cleft defects. In this case report, an adult patient with unilateral cleft palate and oronasal fistula has been successfully managed with orthodontic treatment and interdental DO using a custom-made device. The patient received successful treatment through orthodontic treatment and interdental DO utilizing a custom-made device abiding by Ilizarov’s principles. The size of the oroantral fistula was reduced significantly with a successful approximation of the segments. Subsequently, prosthetic replacement of the distracted segment was performed to restore esthetics. Follow-up images and radiographs showcase the stability and integrity of the arches. The epilogue of this case report is that the implementation of transport distraction can be accounted as an effective treatment approach when meticulously planned and followed through. By integrating early detection, multidisciplinary interventions, and ongoing support, healthcare professionals can significantly enhance outcomes and empower individuals to lead fulfilling lives despite their condition.