Interrelationship between implant and orthognathic surgery for the rehabilitation of edentulous cleft palate patients: a case report

Abstract

A 43-year-old woman with a unilateral cleft lip and palate, presenting a totally edentulous maxilla and mandible with marked maxillomandibular discrepancy, attended the Prosthodontics section of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo for treatment. She could not close her mouth and was dissatisfied with her complete dentures. Treatment planning comprised placement of six implants in the maxilla, four in the mandible followed by prostheses installation and orthognathic surgery. The mandibular full arch prosthesis guided the occlusion for orthognathic positioning of the maxilla. The maxillary complete prosthesis was designed to assist the orthognathic surgery with a provisional prosthesis (no metal framework), allowing reverse treatment planning. Maxillary and mandibular realignment was performed. Three months later, a relapse in the position of the maxilla was observed, which was offset with a new maxillary prosthesis. This isa complex interdisciplinary treatment and two-year follow-up is presented and discussed. It should be considered that this type of treatment could also be applied in non-cleft patients.

Quality of life of individuals with cleft lip and palate pre- and post-surgical correction of dentofacial deformity

“…This surgery for dentofacial deformity correction is performed after the conclusion of facial growth (18) , which justified the sample having mean age of 24 years.…”

“…It can also be associated to the fact that changes are perceived by individuals when cleft lip and palate and dentofacial deformities were repaired, leading to positive impact on QoL (18) . In some studies, using the WHOQOL, it was found that, in general, individuals with cleft lip and palate show good QoL.…”

Ampliação e validação do protocolo de avaliação miofuncional orofacial para indivíduos com fissura labiopalatina

“…The surgery objective is to heal maxillomandibular discrepancies once the orthodontic treatment was not enough to correct skeletal disharmony and of the soft tissue (19) . This kind of surgery intervention turns it possible the facial harmony, balanced occlusion and recovery of functional standards (20,21) . The comparison of the obtained results of the pre and post-surgery assessment for the construct validation, showed differences for the following aspects: occlusion, cheeks, tongue, breathing and speech/voice analysis.…”

Cirurgia Ortognática em paciente com Fissura Labiopalatina: Relato de caso

“…Essa sequela impede o crescimento maxilar adequado, resultando em hipoplasia maxilar e deformidade dentofacial do tipo Classe III de Angle (LOPES et al, 2015;LURENTT et al, 2012;YAMAGUCHI, LONIC, LO, 2016;YUN et al, 2015).…”

“…Nesses casos o tratamento ortodôntico isolado não é suficiente para correção do problema e a cirurgia ortognática deve ser associada a fim corrigir discrepâncias maxilomandibulares ao fim do crescimento facial possibilitando uma oclusão estável e o reestabelecimento de padrões funcionais e harmonia facial (FREITAS et al, 2012;LOPES et al, 2015;YUN et al, 2015).…”