Two Cleft Lip and Palate Cases with Congenitally Missing Upper Lateral Incisors on One Side Treated by Orthodontic Therapy and Auto-transplantation of the Lower Incisor

• Published in: Journal of Japanese Cleft Palate Association Vol. 38; no. 3; pp. 291 - 299
• Main Authors: YAMAZAKI, Yasuharu, TAKEDA, Akira, TORIKAI, Katsuyuki, SUZUKI, Kazufumi, MATSUBAYASHI, Yukie, ISHIWATA, Yasuo, HASHIMOTO, Koji
• Format: Journal Article
• Language: Japanese
• Published: Japanese Cleft Palate Association 30.10.2013; 一般社団法人 日本口蓋裂学会
• Subjects: auto-transplantation; cleft lip and palate; congenitally missing of lateral incisors; mucosal grafts and flaps method; orthodontic treatment; 側切歯先天欠如; 唇顎口蓋裂; 矯正歯科治療; 粘膜移植粘膜弁法; 自家歯牙移植
• ISSN: 0386-5185; 2186-5701
• DOI: 10.11224/cleftpalate.38.291

We report two cleft lip and palate cases with congenitally missing upper lateral incisors on one side. In both cases, we improved the occlusion and facial profile with orthodontic treatment and auto-transplantation of the lower incisor without prosthodontic treatment. Case 1: A boy aged 8 years and 2 months, with a left-side cleft lip and palate. A narrow upper dental arch and an anterior crossbite to the molar teeth were observed. After using an expansion appliance to correct the occlusion, secondary bone grafting was performed. After performing the first stage of the orthodontic treatment with a sectional arch and during the observation period, the second stage of the treatment plan was planned and executed when the patient was 17 years and 3 months. The lower incisor was transplanted to the upper alveolar part of the missing tooth during the early stage of the fixed appliance. When the patient was 19 years and 4 months, the retention period was initiated. At 3 years and 10 months after the transplantation, the patient shows a good prognosis. Case 2: A girl aged 8 years and 7 months, with a bilateral cleft lip and palate. The premaxillary segment had shifted to the front and right side, and a severe deep bite, narrow upper dental arch, and an anterior crossbite to the molar teeth were revealed. After using an expansion appliance to correct the occlusion, premaxillary osteotomy and secondary bone grafting were performed. After performing the first stage of the orthodontic treatment with a sectional arch and during the observation period, the second stage of the treatment plan was planned and executed when the patient was 14 years and 11 months. The lower incisor was transplanted to the upper alveolar part of the missing tooth during the early stage of the fixed appliance. When the patient was 17 years and 1 month, the retention period was initiated. At 6 years and 8 months after the transplantation, the patient shows a good prognosis.