Early Orthodontic Treatment in Cleft Lip/Palate Patients

Abstract

Etiology of Cleft lip/cleft palate (CLP) is multifactorial. All cases are unique; the problems are both skeletal and dental and in three dimensions. Therefore, the treatment is more complicated than in the non-CLP cases. An interdisciplinary team composes of gynecologist, pediatrician, nurse, dentist, orthodontist, oral-maxillofacial surgeon, plastic surgeon, ENT doctor, audiologist, otolaryngologist, speech therapist, psychiatrist, social worker, and patient’s family, play important role in giving CLP care and treatment. Clinical Practice Guidelines (CPG) will indicate how the team works. Orthodontists can start dentofacial orthopedic and orthodontic treatment in CLP patients during active growth period. To treat early and if successfully will be advantageous as major surgeries such as orthognathic surgery, distraction osteogenesis can likely be avoided. These major surgeries certainly cause much pain to the patients and cost a lot of money. The author suggests the use of Class III Activator of Thomas Rakosi in the initial stage of the treatment in combination with the use of removable and/or fixed appliances in later stage.