Orthodontics in A Cleft Patient Healthy Life Arch Expansion and Alignment
History
- Age: 16 (b.2007)
- K/C/O Unilateral Left Clap
- Past Surgeries: Cheiloplasty, Palatoplasty and SABG
- Recently did a Rhinoplasty and Lip Revision
- She has Now Reported for Dental Rehab
Cheiloplasty
Palatoplasty
Pre-OP Facial
Profile Acceptable
Pre-OP Smile
Pre-OP Intraoral
- Retained deciduous teeth: 51, 52, 61
- Ectopic eruption of 11, 21 lower anterior crowding
Pre-OP Lateral Views
Pre-OP Occlusal View
- Retained 55, 65
- Rotated 14, 15
- Missing: 14, 12, 13, 22, 23 constricted maxillary arch
Pre-OP Views
OPG Findings and Clinical Co-relation
- Impacted inverted odontome between roots of 21, 23.
- Retained deciduous 51, 52, 53, 55, 65.
- Ectopic eruption of 14 with a 90-degree rotation.
- 90-degree rotation of 24.
Hypodontia
- Missing max. 2nd premolars
- Missing 12, 11, 22
Problem List
- Retained deciduous teeth
- Hypodontia missing permanent incisors and premolars
- Constricted maxillary arch
- The presence of odontome might hinder the movement of 21, 23
Treatment Goals
- Maxillary arch expansion
- Alignment
- Prosthetic rehabilitation
Treatment Plan
- Extraction of retained deciduous 51, 52, 61, 62
- Retain 55, and 65 as placeholders
- Extraction of lingually placed 43
- Posterior bite plane, raise the bite and enable arch expansion
- Posterior arch expansion – Quad Helix
- Alignment
Posterior Bite Plan Inserted
Bite Raised By 4mm
Quad Helix Inserted
3 Months Intra OP
Treatment Ongoing
Further Treatment Plan
- Alignment
- +/- AMD
- Prosthetic Rehab