Treatment of mandibular prognathism in cleft palate patients

Abstract

T he purpose of this article is to outline procedures for diagnosis and treatment of mandibular prognathism in patients with cleft lip and/or palate. Mandibular prognathism is mueh more common in the cleft lip/palate population than in the general population. Its appearance is often due more to the lack of soft-tissue balance than to the bone or skeletal profile relationship. With rare exceptions, however, all clefts are characterized by tissue hypoplasia. A deficiency of soft tissue is sometimes more difficult to demonstrate than a deficiency of hard tissue. We have had little success in treating true mandibular prognathism by orthodontic procedures alone,l? 2 but we have achieved most gratifying results in the orthodontic treatment of mandibular pseudo-prognathism in patients with clefts of the maxilla. In order to provide the most valuable service, the orthodontist should examine a cleft lip/palate infant at birth, in conjunction with the surgical review. The orthodontist and especially the restorative dentist will be treating the patient during and long after the surgical treatment period,