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Esthetic and functional rehabilitation in patients with cleft lip and palate.

Bousdras VA, Ayliffe PR, Barrett M, Hopper C - Ann Maxillofac Surg (2015 Jan-Jun)

Bottom Line: Oral rehabilitation of missing teeth in cleft patients has acceptable success rates.A 3-unit bridge did replace functional and esthetic demands.This article demonstrates that overall esthetic and functional rehabilitation is feasible in cleft lip and palate patients.

View Article: PubMed Central - PubMed

Affiliation: Private Practice, Al. Mihailidi 9, Thessaloniki 54640, Greece.

ABSTRACT
Oral rehabilitation of missing teeth in cleft patients has acceptable success rates. A two-stage approach is indicated; however, timing of implant placement in the grafted maxilla varies within existing protocols. This case highlights successful implant osseointegration and esthetic oral rehabilitation following placement of two implants at 5 months after maxillary grafting (alveolar bone grafting) with a corticocancellous block obtained from the iliac crest. A 31-year-old male patient had already undergone repair of his bilateral cleft lip and soft palate according to established guidelines for cleft patients. Initial closure of his alveolar clefts and further correction of the maxillary hypoplasia with a bi-maxillary osteotomy were completed in 2002. However, bone resorption due to infection in 2003 necessitated removal of all maxillary incisors. The patient was not satisfied with the removable partial denture provided. In 2007, he did undergo anterior maxillary augmentation under general anesthesia, and 5 months later two implants were placed. A 3-unit bridge did replace functional and esthetic demands. Postoperative recovery was uneventful, and overall bone loss, and oral health remain within standards 28 months following implant placement. Optimal outcome is achievable when replacing missing teeth in cleft patients when timing does not exceed approximately a 6-month interval from bone grafting to implant placement. This article demonstrates that overall esthetic and functional rehabilitation is feasible in cleft lip and palate patients. In this patient, overall oral treatment was achieved with an implant prosthesis.

No MeSH data available.


Related in: MedlinePlus

Orthopantomogram following attachment of the implant fixed bridge. A third implant was not accommodated due to infection of the grafted right maxilla
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Figure 3: Orthopantomogram following attachment of the implant fixed bridge. A third implant was not accommodated due to infection of the grafted right maxilla

Mentions: A 31-year-old patient had already undergone repair of his bilateral cleft lip and soft palate according to established guidelines for cleft patients in the UK. Initial closure of his alveolar clefts and further correction of the maxillary hypoplasia with a bimaxillary osteotomy were completed in 2002. The palatal fistula was closed with an anteriorly based tongue flap.[1213] However, bone resorption due to severe oral infection in 2003 necessitated removal of all maxillary incisors [Figure 1a and b]. The patient was not satisfied with the removable partial denture provided. In 2007, he did undergo anterior maxilla augmentation with two corticocancellous blocks obtained from the anterior iliac crest under general anesthesia, secured with 10 mm screws [Figure 2]. Five months later two 10 mm 4.1Ø Straumann implants (Basel, Switzerland) were placed, which were left another 7 months, prior second stage surgery and abutment connection. A 3-unit bridge did replace functional and esthetic demands [Figures 3 and 4]. Healing was uneventful and marginal bone loss and gingival health remains within standards 28 months following implant placement. Overall, the patient was satisfied with improved appearance and masticatory function.


Esthetic and functional rehabilitation in patients with cleft lip and palate.

Bousdras VA, Ayliffe PR, Barrett M, Hopper C - Ann Maxillofac Surg (2015 Jan-Jun)

Orthopantomogram following attachment of the implant fixed bridge. A third implant was not accommodated due to infection of the grafted right maxilla
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555933&req=5

Figure 3: Orthopantomogram following attachment of the implant fixed bridge. A third implant was not accommodated due to infection of the grafted right maxilla
Mentions: A 31-year-old patient had already undergone repair of his bilateral cleft lip and soft palate according to established guidelines for cleft patients in the UK. Initial closure of his alveolar clefts and further correction of the maxillary hypoplasia with a bimaxillary osteotomy were completed in 2002. The palatal fistula was closed with an anteriorly based tongue flap.[1213] However, bone resorption due to severe oral infection in 2003 necessitated removal of all maxillary incisors [Figure 1a and b]. The patient was not satisfied with the removable partial denture provided. In 2007, he did undergo anterior maxilla augmentation with two corticocancellous blocks obtained from the anterior iliac crest under general anesthesia, secured with 10 mm screws [Figure 2]. Five months later two 10 mm 4.1Ø Straumann implants (Basel, Switzerland) were placed, which were left another 7 months, prior second stage surgery and abutment connection. A 3-unit bridge did replace functional and esthetic demands [Figures 3 and 4]. Healing was uneventful and marginal bone loss and gingival health remains within standards 28 months following implant placement. Overall, the patient was satisfied with improved appearance and masticatory function.

Bottom Line: Oral rehabilitation of missing teeth in cleft patients has acceptable success rates.A 3-unit bridge did replace functional and esthetic demands.This article demonstrates that overall esthetic and functional rehabilitation is feasible in cleft lip and palate patients.

View Article: PubMed Central - PubMed

Affiliation: Private Practice, Al. Mihailidi 9, Thessaloniki 54640, Greece.

ABSTRACT
Oral rehabilitation of missing teeth in cleft patients has acceptable success rates. A two-stage approach is indicated; however, timing of implant placement in the grafted maxilla varies within existing protocols. This case highlights successful implant osseointegration and esthetic oral rehabilitation following placement of two implants at 5 months after maxillary grafting (alveolar bone grafting) with a corticocancellous block obtained from the iliac crest. A 31-year-old male patient had already undergone repair of his bilateral cleft lip and soft palate according to established guidelines for cleft patients. Initial closure of his alveolar clefts and further correction of the maxillary hypoplasia with a bi-maxillary osteotomy were completed in 2002. However, bone resorption due to infection in 2003 necessitated removal of all maxillary incisors. The patient was not satisfied with the removable partial denture provided. In 2007, he did undergo anterior maxillary augmentation under general anesthesia, and 5 months later two implants were placed. A 3-unit bridge did replace functional and esthetic demands. Postoperative recovery was uneventful, and overall bone loss, and oral health remain within standards 28 months following implant placement. Optimal outcome is achievable when replacing missing teeth in cleft patients when timing does not exceed approximately a 6-month interval from bone grafting to implant placement. This article demonstrates that overall esthetic and functional rehabilitation is feasible in cleft lip and palate patients. In this patient, overall oral treatment was achieved with an implant prosthesis.

No MeSH data available.


Related in: MedlinePlus