A young 18-year-old girl from Kerala visited Richardsons Dental and Craniofacial Hospital, Nagercoil with her parents last year. She had undergone cleft lip and palate and other corrective surgeries elsewhere and wanted help in improving her appearance. Our oral and maxillofacial surgeon specializing in treating craniofacial deformities suggested Anterior Maxillary Distraction; a procedure where the maxillary hypoplasia is corrected. It involves bringing the upper jaw forward using an intra-oral distractor. Rhinoplasty helps to correct the cleft nasal deformity while lip revision surgery helps enhance the patient’s overall appearance.
Congenital absence of teeth is common in patients with cleft lip and palate deformities. Normally, teeth develop from the tooth buds present within the jawbones. Since cleft patients show defective bone development, tooth buds are absent. Thus, congenital missing or palatal eruption of lateral incisors on the cleft side is common. Even if present they would be peg-shaped.
After all these corrective surgeries, as a final step, the patient came for dental rehabilitation. We advised intentional root canal treatment for all upper anterior teeth. We prepared the teeth by grinding them and creating space for the new prosthesis and we made impressions with irreversible hydrocolloid material and assessed the try-in from the dental lab to suggest corrections. Finally, the finished prosthesis checked in to the patient’s mouth brought a shiny twinkling smile from the patient and her parents.