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Page 1: Orthodontic & Orthopedic Treatment

Orthodontic & Orthopedic TreatmentNita Viwattanatipa, DDS., MSD.

Orthodontic Departmant, Faculty of DentistryKhon-Kaen University

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Infancy: Feeding Problems

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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

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Esthetics Problems

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Case 1: 15 D

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Presurgical orthopedics: PSO

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Modified Nasoalveolar Molding

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Primary lip & nose surgery

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Case 2: Left Unilateral CL/CP 4.5 Y

14/6/39

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Radiographics

Supernumerary

B

2

19/3/42

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Quad Helix Appliance

Unilateral Post. X-bite: Left

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After Arch Expansion

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3/9/42 Before B Removal

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Alveolar Bone Graft: 8 Y

11/11/42 B removed 2 M. before ABG 25/11/42 After

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Unerupted Teeth

16/11/44 2 y after BG11/5/43 6 M. after BG

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Artificial Eruption 11.5 Y

24/6/46

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Laser Inflammatory Tissue

28/8/46 Aligning 2 & 3

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Orthopaedic Rx 11.8 Y

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Retrognathic Maxilla

16/11/44 2 y after BG

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Face Mask

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Comparison

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Long Term Follow-UpMidfacial Growth

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Case 3: Maxillary Distraction

Complete Bilateral Cleft Lip and Cleft Palate14 Y , Midface Hypoplasia, 2nd Deformities CLN

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Maxilla HypoplasiaAlveolar cleft

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Lefort I Osteotomy

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Distraction Period 20 days

Rate: 2-3 mm/day due to buckling of intraoral DeviceRhythm: 1-2 times/day

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After

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2 months in consolidation

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Superimposition

Maxilla forward 7.5 mmMandible rotate CWUpper Lip forward 7 mmTip Nose forward 3.5 mm

BeforeAfter

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AfterBefore

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Max Distraction & Rhinoplasty

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AfterBefore

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Thank you for your attention


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