Orthodontic Treatment of Malocclusion Associated with Repaired Complete Clefts of the Lip and Palate

Abstract

The literature concerning orthodontic treatment of malocclusion associated with cleft lip and palate has been reviewed. The aims of treatment and a number of skeletal, soft tissue, dento-alveolar and general care factors which influence treatment planning are discussed. The effect of early orthopaedic treatment, examined solely on the grounds of eventual arch form in the deciduous dentition, reveals a prophylactic benefit in some, but not all reports. There would appear to be little benefit in carrying out orthodontic treatment in the deciduous dentition but it is suggested that the progressive development of severe overclosure during the mixed dentition phase should be intercepted using simple appliances. The most important phase of treatment follows eruption of the permanent dentition and appliances are described which are capable of substantial radial and vertical corrections in preparation for a permanent prosthesis.