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Purpose Follow-up reports of orthodontic treatment after one-stage repair until the completion of jaw development are scarce. We report a case of a child with unilateral incomplete cleft lip and palate who underwent presurgical orthopaedic treatment, one-stage repair (cheilo-palatoplasty with gingivoperiosteoplasty), and orthodontic treatment and was followed up until 19 years of age.Materials and methods The patient visited our orthodontic clinic at the age of 4 years with the chief complaint of crossbite. His facial profile was slightly concave and accompanied by an anterior crossbite. The ANB angle was −3.0° (maxillary growth deficiency). Treatment was initiated with a maxillary protraction appliance (MPA) to correct the overjet. Upon eruption of the permanent anterior teeth, an anterior crossbite was observed, which was treated with multi-bracket appliances to correct the overjet during phase I treatment. After the complete eruption of the permanent dentition, phase II treatment was initiated without dental extractions.Results Three years after treatment, slight maxillary growth deficiency remained. Although an anterior crossbite was observed at the initial visit, lateral expansion of the maxilla was unnecessary. Long-term stable occlusion was achieved through MPA, phase I, and phase II treatments, without requiring further surgical procedures, such as secondary alveolar bone grafting or jaw osteotomy.Conclusion In the present case, the one-stage repair was performed with minimal impact on jaw development, which greatly reduced the burden on the patient and family. One-stage repair followed by appropriate orthodontic treatment resulted in good outcomes and patient satisfaction.

Summary Background and aims In bilateral cleft lip and palate (BCLP) with premaxillary protrusion, a good outcome with adequate maxillary development is difficult to achieve. The purpose of this article is to evaluate the maxillary growth after using presurgical orthopedics (PSO), gingivoperiosteoplasty (GPP), Furlow palatoplasty, and maxillary protraction appliance (MPA) for BCLP with premaxillary protrusion. Patients and methods Seven patients with complete BCLP with premaxillary protrusion were treated by PSO, cheiloplasty, GPP, and Furlow palatoplasty. MPA was used as part of the protocol for 6 months to 1 year for postoperative retardation of maxillary growth cases. Maxillary growth was evaluated by cephalometric analysis at 4 and 10 years of age, and bone formation at the alveolar cleft was evaluated by computed tomography (CT) imaging at 5 years of age. Results At 4 years of age, three of seven patients had apparent retardation of maxillary growth. The maxillary growth at 10 years of age was equivalent to the average value of normal Japanese after using MPA in three cases. At 5 years of age, only two of seven patients showed sufficient bone formation at the alveolar cleft to avoid alveolar bone grafting (ABG). Subsequently, ABG was performed in five patients. Discussion Although three of seven patients had apparent crossbite at 4 years of age, the maxillary growth of all patients at 10 years of age was approximately equivalent to the average value of normal Japanese after using MPA. A treatment protocol based on PSO, GPP, Furlow palatoplasty, and MPA may be an option, but long-term growth is unknown. [ABSTRACT FROM AUTHOR]

We describe the treatment of a young adult male (aged 14 years 9 months) with Class III malocclusion using a mini maxillary protraction appliance, and discuss the results. The patient was treated with an acrylic cap splint-type expander and a modified maxillary protractor until a positive overjet was achieved. Edgewise fixed appliances were used to align the teeth. The treatment resulted in Class I molar occlusion, an ideal overjet, overbite and incisor angulation. A Class I molar relationship was achieved after 6 months of treatment, and the total treatment time was 1 year 6 months. Modified maxillary protractor treatment is effective for correcting skeletal Class III malocclusion. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the orthopedic effects of combined maxillary protraction appliance (MPA) and chincap therapy on growing Japanese girls and the posttreatment changes after growth is complete. To estimate the actual effects of treatment and posttreatment changes, we used a series of templates that had been constructed from semilongitudinal data of Japanese girls with normal occlusion. During treatment, forward movement of the maxilla with counterclockwise rotation, and backward and downward movement of the mandible with clockwise rotation and growth retardation were observed. The forward movement of the maxilla persisted until growth was complete. During the posttreatment period, the mandible maintained its improved position but showed excessive growth, which could be a rebound change. These results indicate that combined MPA and chincap treatment is effective for correcting skeletal Class III malocclusion. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the influence of maxillary protraction combined with maxillary molar distalization appliance therapy on skeletal Class III cross bite malocclusion. METHODS: 60 patients with cross bite and crowding malocclusion were treated with maxillary protraction combined with maxillary molar distalization appliance. The arch length was analyzed before wearing appliance (T1), after debonding appliance(T2), and one year after debonding appliance (T3). SPSS10.0 software package was used for ANOVA. RESULTS: Before therapy, the maxillary arch length was not enough with arch length discrepancy. After active treatment, the device had extended the length of the upper dental arch significantly to relieve crowding and change the cross bite. Esthetics were greatly enhanced. CONCLUSIONS: Maxillary protraction combined with maxillary molar distalization appliance therapy change the maxillary arch length. However, further study is necessary to understand the long-term clinical effect. [ABSTRACT FROM AUTHOR]