Orthodontic Consideration of SecondarySkeletal Deformity of Cleft/Palate Through surgery first approach orthognathic surgery
Eric Liou, DDS, MS
Department of Craniofacial Orthodontics
Chang Gung Memorial Hospital
The surgical and orthodontic managementsin surgery first approach are more complicated and difficult in patients with cleft due to the scar tissue, anatomical aberration, and the deformed and severe crowded maxillary arch. Not only to improve the facial profile, the orthognathic surgery in surgery first isto establish a “treatable malocclusion” that could be treated easier through orthodontic tooth movement postoperatively. Itis therefore a treatable malocclusion could be different among orthodontists. The general principles for setting up a treatable malocclusion in patients with cleft are at least 3 interocclusal contacts for the postoperative stability, no obvious vertical/transverse occlusal interferences, coordination of the dental midline whenever it is possible, and no buccal crossbite, no matter it is a simple or complicated case. In this presentation, thestrategies of surgical designs, postoperative orthodontic treatment, and management surgical complications and relapse will be presented through case presentations.