Orthodontic treatment of some cleft palate and fracture cases

Abstract

CASE I.-This case well illustrates the benefits derived from orthodontic treatment which was instituted after surgical treatment of a harelip and cleft palate. Hisiori] and Etiology.-Boy sixteen years of age, with a congenital unilateral cleft palate and harelip. The father, mother, sister, and brothers have normal occlusion; th ere were no other cleft palates in the family so far as the parents could recall. Three or four surgical operations were performed during infancy and early childhood for proper closure of cleft and harelip. Description and Proced1(,re.-The facial expression and muscle tone before orthodontic treatment are shown in Fig. 1. Note the protruding mandible ·and lip and the retruding maxilla and lip, also the deviated nasal construction. Fig. 2 shows views of the malocclusion of the teeth and jaws. A mandibular labial arch was fitted to buccal tubes on molar bands, and a maxillary lingual arch was fitted to half round tubes on the maxillary molar bands. Intermaxillary elastic pressure, together with lateral expansion of maxillary lingual arch and lingual contraction of mandibular labial arch, was used in order to place the teeth in better occlusion . For esthetics. better function, and retention a bridge was constructed from maxillary canine to canine and a piece of luxene was used to fill out the maxillary anterior region, thus giving a more normal appearance to the upper lip. See Figs. 3 and 4. The duration of treatment was about one year. Prognosis.-Fig. 4 shows views of the patient about fifteen months after plastic surgery, orthodontia, and general dentistry had been completed. An efficient, fairly esthetic denture has been effected, and there is no reason to expect a relapse.