Orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft
백승학, 박윤희, 정지혁, 김석화, 최진영,
소속 상세정보
백승학 ( Baek Seung-Hak ) - Seoul National University School of Dentistry Department of Orthodontics
박윤희 ( Park Yoon-Hee ) - Seoul National University School of Dentistry Department of Orthodontics
정지혁 ( Chung Jee-Hyeok ) - Seoul National University Hospital Department of Plastic and Reconstructive Surgery
김석화 ( Kim Suk-Wha ) - Seoul National University College of Medicine Department of Plastic and Reconstructive Surgery
최진영 ( Choi Jin-Young ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery
Abstract
The purpose of this case report was to introduce the concept of orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft. A 5-year-old boy patient with Tessier number 0 cleft presented congenitally missing maxillary central incisors (MXCI), a bony defect at the premaxilla, a constricted maxillary arch, an anterior openbite, and maxillary hypoplasia. His treatment was divided into three stages: management of the bony defect at the premaxilla and the congenitally missing MXCIs using a fan-type expansion plate, iliac bone grafting, and eruption guidance of the maxillary lateral incisors into the graft area for substitution of MXCIs; management of the maxillary hypoplasia using sequential facemask therapy with conventional and skeletal anchorage; and management of the remaining occlusal problems using fixed orthodontic treatment. The total treatment duration was 15 years and 10 months. Class I canine and Class II molar relationships and normal overbite and overjet were achieved at the end of treatment. Although the long-term use of facemask therapy resulted in significant protraction of the retrusive maxilla, the patient exhibited Class III profile because of continued mandibular growth. However, the treatment result was well maintained after 2 years of retention. The findings from this case suggest that interdisciplinary and customized approaches are mandatory for successful management of maxillary hypoplasia, bony defect, and dental problems in Tessier number 0 cleft. Moreover, considering the potential of orthognathic surgery or distraction osteogenesis, meticulous monitoring of mandibular growth until growth completion is important.
키워드
Tessier number 0 cleft; Orthodontic treatment; Orthopedic treatment; Growing patient
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