ajisha cleft orthodontics

Orthodontics in A Cleft Patient Healthy Life Arch Expansion and Alignment

History

  • Age: 16 (b.2007)
  • K/C/O Unilateral Left Clap
  • Past Surgeries: Cheiloplasty, Palatoplasty and SABG
  • Recently did a Rhinoplasty and Lip Revision
  • She has Now Reported for Dental Rehab

cleft orthodontics ajisha

Cheiloplasty

cheiloplasty ajisha

Palatoplasty

palatoplasty ajisha

Pre-OP Facial

Profile Acceptable

pre op facial ajisha

Pre-OP Smile

pre op smile ajisha

Pre-OP Intraoral

  • Retained deciduous teeth: 51, 52, 61
  • Ectopic eruption of 11, 21 lower anterior crowding

pre op intraoral ajisha

Pre-OP Lateral Views

pre op lateral ajisha

Pre-OP Occlusal View

pre op occlusal ajisha

  • Retained 55, 65
  • Rotated 14, 15
  • Missing: 14, 12, 13, 22, 23 constricted maxillary arch

Pre-OP Views

pre op views ajisha

OPG Findings and Clinical Co-relation

opg findings ajisha

clinical corelation ajisha

  1. Impacted inverted odontome between roots of 21, 23.
  2. Retained deciduous 51, 52, 53, 55, 65.
  3. Ectopic eruption of 14 with a 90-degree rotation.
  4. 90-degree rotation of 24.

Hypodontia

  1. Missing max. 2nd premolars
  2. Missing 12, 11, 22

Problem List

  • Retained deciduous teeth
  • Hypodontia missing permanent incisors and premolars
  • Constricted maxillary arch
  • The presence of odontome might hinder the movement of 21, 23

problem list ajisha

Treatment Goals

  • Maxillary arch expansion
  • Alignment
  • Prosthetic rehabilitation

Treatment Plan

  • Extraction of retained deciduous 51, 52, 61, 62
  • Retain 55, and 65 as placeholders
  • Extraction of lingually placed 43
  • Posterior bite plane, raise the bite and enable arch expansion
  • Posterior arch expansion – Quad Helix
  • Alignment

Posterior Bite Plan Inserted

Bite Raised By 4mm

posterior bite plane

Quad Helix Inserted

3 Months Intra OP

intra op ajisha

Treatment Ongoing

Further Treatment Plan

  • Alignment
  • +/- AMD
  • Prosthetic Rehab
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