Orthodontic-Prosthetic Rehabilitation of Congenital Alveolar Cleft
A case report from infancy to adulthood
DOI:
https://doi.org/10.5935/2525-5711.20210009Keywords:
Alveolar Bone Grafting, Cleft Palate, Dental Implants, Orthodontics, Case ReportAbstract
Introduction: Cleft lip palate (CLP) treatment is challenging and requires multidisciplinary treatment during patient’s whole life. Aim: To present a case report of a life-time CLP rehabilitation that anatomic features required advanced rehabilitation modalities. Design: A 9-year-old patient was diagnosed as unilateral right CLP. Agenesia and poor prognosis of lateral and central right incisor respectively added complexity to multidisciplinary treatment planning. Results: Orthodontic and surgical procedures performed during infancy and adolescence resulted on satisfactory dental alignment. Anatomical limitations required installation of a hybrid dentogingival implant-supported prosthesis at adulthood. After 3 years of follow-up, implants were osseointegrated and peri-implant tissues were stable, with favorable esthetic and functional outcomes. Conclusions: This challenging case of cleft lip palate, on which tooth with poor prognosis and agenesia were identified, required a multidisciplinary treatment during infancy and adolescence in order to provide adequate conditions for implant placement at adulthood. Implant therapy in complex cases of CLP patients requires advanced treatment modalities, that may include guided bone regeneration, periodontal reconstruction and dentogingival prosthesis.
References
Pigott RW. Organisation of cleft lip and palate services - results of a questionnaire. Br J Plast Surg. 1992 Jul;45(5):385-7.
Farronato G, Cannalire P, Martinelli G, Tubertini I, Giannini L, Galbiati G, et al. Cleft lip and/or palate: review. Minerva Stomatol. 2014;63(4):111-26.
Montes ABM, Oliveira TM, Gavião MBD, Barbosa TS. Orofacial functions and quality of life in children with unilateral cleft lip and palate. Braz Oral Res. 2019;33:e061.
Nadon F, Chaput B, Périssé J, Bérail A, Lauwers F, Lopez R. Interest of mineralized plasmatic matrix in secondary autogenous bone graft for the treatment of alveolar clefts. J Craniofac Surg. 2015 Oct;26(7):2148-51.
Tereza GPG, Santos MAC, Winckler VPSV, Almeida ALPF, Dalben GS. The maxillary lateral incisor in the rehabilitation of cleft lip and palate. J Appl Oral Sci. 2018;26:e20170125.
Wood LW, Oesterle LJ. A case report of a complete unilateral cleft of the lip and the palate from birth to 15 years. Am J Orthod Dentofacial Orthop. 1994;105(1):1-9.
Pucciarelli MGR, Lopes ACO, Lopes JFS, Soares S. Implant placement for patients with cleft lip and palate: a clinical report and guidelines for treatment. J Prosthet Dent. 2019 Jan;121(1):9-12.
Sales PHH, Oliveira-Neto OB, Torres TS, Lima FJC. Effectiveness of dental implants placed in bone graft area of cleft Patients. Int J Oral Maxillofac Surg. 2019 Aug;48(8):1109-14.
Wermker K, Jung S, Joos U, Kleinheinz J. Dental implants in cleft lip, alveolus, and palate patients: a systematic review. Int J Oral Maxillofac Implants. 2014 Mar/Apr;29(2):384-90.
Bergland O, Semb G, Abyholm FE. Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment. Cleft Palate J. 1986 Jul;23(3):175-205.
Rocha R, Ritter DE, Locks A, Paula LK, Santa RM. Ideal treatment protocol for cleft lip and palate patient from mixed to permanent dentition. Am J Orthod Dentofacial Orthop. 2012 Apr;141(4 Suppl 1):S140-8.
González-Sánchez JG, Jiménez-Barragán K. Closure of recurrent cleft palate fistulas with plasma rich in growth factors. Acta Otorrinolaringol Esp. 2011 Nov/Dec;62(6):448-53.
Al-Ahmady HH, Elazeem AFA, Ahmed NEB, Shawkat WM, Elmasry M, Abdelrahman MA, et al. Combining autologous bone marrow mononuclear cells seeded on collagen sponge with Nano Hydroxyapatite, and platelet-rich fibrin: reporting a novel strategy for alveolar cleft bone regeneration. J Craniomaxillofac Surg. 2018 Sep;46(9):1593-600.
Hengjeerajaras P, Froum SJ, Adawi HAA, Yu P, Cho SC. Anterior tooth replacement with an implant in a grafted alveolar cleft site: case report with a 10-year follow-up. Int J Periodontics Restorative Dent. 2019 Jul/Aug;39(4):511-5.
Troeltzsch M, Troeltzsch M, Kauffmann P, Gruber R, Brockmeyer P, Moser N, et al. Clinical efficacy of grafting materials in alveolar ridge augmentation: a systematic review. J Craniomaxillofac Surg. 2016 Oct;44(10):1618-29.
Fiamengui Filho JF, Almeida ALP. Aesthetic analysis of an implant-supported denture at the cleft area. Cleft Palate Craniofac J. 2013;50:597-602.
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Copyright (c) 1969 Renata Scheeren Brum, Camila Rodrigues de-Souza, Daltro Enéas Ritter, Roberto Rocha, Cláudia Ângela Maziero Volpato, César Augusto Magalhães Benfatti
This work is licensed under a Creative Commons Attribution 4.0 International License.
