Transcript
Orthodontic & Orthopedic TreatmentNita Viwattanatipa, DDS., MSD.
Orthodontic Departmant, Faculty of DentistryKhon-Kaen University
Infancy: Feeding Problems
Problems encountered in Bilateral Cleft lip/Cleft Palate
• Protruded primary palate• Distance between the prolabium &
lateral lip segments• Staged lip repairs: one side • Unesthetic Nose
• Unesthetic upper lip form
Esthetics Problems
Case 1: 15 D
Presurgical orthopedics: PSO
Modified Nasoalveolar Molding
Primary lip & nose surgery
Case 2: Left Unilateral CL/CP 4.5 Y
14/6/39
Radiographics
Supernumerary
B
2
19/3/42
Quad Helix Appliance
Unilateral Post. X-bite: Left
After Arch Expansion
3/9/42 Before B Removal
Alveolar Bone Graft: 8 Y
11/11/42 B removed 2 M. before ABG 25/11/42 After
Unerupted Teeth
16/11/44 2 y after BG11/5/43 6 M. after BG
Artificial Eruption 11.5 Y
24/6/46
Laser Inflammatory Tissue
28/8/46 Aligning 2 & 3
Orthopaedic Rx 11.8 Y
Retrognathic Maxilla
16/11/44 2 y after BG
Face Mask
Comparison
Long Term Follow-UpMidfacial Growth
Case 3: Maxillary Distraction
Complete Bilateral Cleft Lip and Cleft Palate14 Y , Midface Hypoplasia, 2nd Deformities CLN
Maxilla HypoplasiaAlveolar cleft
Lefort I Osteotomy
Distraction Period 20 days
Rate: 2-3 mm/day due to buckling of intraoral DeviceRhythm: 1-2 times/day
After
2 months in consolidation
Superimposition
Maxilla forward 7.5 mmMandible rotate CWUpper Lip forward 7 mmTip Nose forward 3.5 mm
BeforeAfter
AfterBefore
Max Distraction & Rhinoplasty
AfterBefore
Thank you for your attention
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