Interdisciplinary treatment of an adult with a unilateral cleft lip and palate

The management of cleft lip and palate (CLP) requires an interdisciplinary team providing comprehensive care. The present report presents an interdisciplinary approach for the care of a cleft patient. A 17-year-old male patient presented with a a chief complaint of “unpleasant appearance of my teeth” and a history of surgical repair of unilateral CLP on the left side. He presented with Class III molar relationships, Class II canine relationships, crossbite related to maxillary right first premolar and lateral incisor, severe maxillary and mandibular crowding, maxillary anterior tooth size deficiency, congenitally missing upper left lateral incisor. Patient was treated with a pre-adjusted edgewise appliance in conjunction with extraction of multiple teeth and distalization of the lower right first molar using a temporary anchorage device. In addition, alveolar bone graft and implant were placed to restore the missing upper left lateral incisor and a final esthetic work was performed for anterior teeth. The case was finished with Class I molar and canine relationships, minimal overjet and overbite. Total treatment time was about 31 months with satisfactory results. Post-treatment evaluation after 8 months showed stable results.