Multidisciplinary Rehabilitation of an Adult with a Cleft Lip and Palate: An Illustration of a Dental Substitution Approach for the Management of Unilateral Agenesis of Central and Lateral Incisors

Abstract

Cleft lip and Palate (CLP) is the most common craniofacial condition. Management of patients with clefts often requires multi-disciplinary rehabilitation of the orofacial structures. This case report demonstrates the multi-disciplinary management of an adult with a cleft lip and palate, highlighting the benefits of 3-Dimensional (3D) diagnosis, treatment planning and clinical execution of the plan. The patient presented with a severe maxillary deficiency, mandibular asymmetry, and congenitally missing maxillary right central and lateral incisors. This case report demonstrates an alternative approach for the management of cases with ipsilateral missing central and lateral incisors. The maxillary right canine substituted the congenitally missing maxillary right central incisor, while the maxillary right first premolar substituted the congenitally missing right lateral incisor, eliminating the need for prosthetic replacements. Total treatment time was 19 months, and the burden of care for the patient was minimized. An acceptable occlusion was achieved, and the patient’s esthetics improved significantly at the end of treatment. More importantly, the patient reported a marked improvement in his quality of life.