Nonsurgical orthodontic treatment after one-stage repair (cheilo-palatoplasty with gingivoperiosteoplasty) in a patient with incomplete unilateral cleft lip and palate: a case report

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.