Protração maxilar ancorada em miniplacas na fissura labiopalatina – do diagnóstico à maturidade esquelética

Abstract

The purpose of this study was to report a case with complete unilateral cleft lip and palate (CLP) treated with bone anchored maxillary protraction (BAMP) in miniplates followed up until the end of facial growth. A 7-year-old girl with complete left side CLP started the orthodontic treatment in a rehabilitation center. She presented a Class III skeletal pattern due to maxillary deficiency, a GOSLON 4 sagittal interarch relationship, a negative overjet of 1.5mm and agenesis of left upper lateral incisor. In the mixed dentition, the patient was submitted to rapid maxillary expansion followed by the secondary alveolar bone grafting procedure. At 12y 3m two miniplates were installed in the maxilla and two in the mandible with BAMP therapy. The patient was instructed to use full time Class III elastics with force of 250g/side together with a bite lifting plate in the upper arch. BAMP therapy duration was 19 months leading to a positive overjet and GOSLON 1 sagittal interarch relationship. The cephalometric analysis demonstrated a mild maxilla advancement. Class III elastics started to be used only at night as an active retention concomitantly with Phase II orthodontic treatment. Compensatory corrective orthodontic treatment established adequate occlusion between the dental arches with significant improvement of facial aesthetics after the intervention. Le Fort 1 surgery with maxillary advancement was not necessary.