My Orthodontic Treatment in Patients with Cleft Lip and/or Palate

• Published in: Journal of Japanese Cleft Palate Association Vol. 49; no. 3; pp. 191 - 201
• Main Author: SUSAMI, Takafumi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Cleft Palate Association 2024; 一般社団法人 日本口蓋裂学会
• Subjects: cleft lip and palate; orthodontic treatment; surgical-orthodontic treatment; team approach; チーム医療; 口唇裂・口蓋裂; 外科的矯正治療; 矯正歯科治療
• ISSN: 0386-5185; 2186-5701
• DOI: 10.11224/cleftpalate.49.191

I have been providing orthodontic treatment for patients with cleft lip and palate for more than 40 years. This article describes my policy for orthodontic treatment based on my personal experience, including considerations regarding presurgical orthopedics, alveolar bone grafting, orthodontic treatment, surgical-orthodontic treatment, retention/ management of missing teeth, management of bilateral patients and feedback to surgeons. 　For orthodontic treatment, my basic treatment policy for deciduous, mixed and permanent dentition is: a) minimum maxillary expansion, b) correction of posterior crossbite by maxillary dentition advancement, c) closure of dental space by tooth movement, d) extraction of palatally located teeth due to scar tissue, e) minimization of alveolar cleft problems by mixed dentition, f) preference of surgical-orthodontic treatment in borderline cases, and g) effcient treatment planning to reduce the patient′s burden.　 　I hope this paper will help young clinicians who will take charge of treatment in the future.