Search

We have already reported that the maxillary was markedly contracted 1 month after a cleft palate operation. Since we thought that this was mainly attributable to cicatrized contraction of the operation region, we prepared a palatal plate and inserted it from an early stage after palate plasty. In this paper we present our summarized findings on the use of the palatal plate. We report on its use both immediately after the operation, and for a period of 3 months after the operation. Its use in both cases is intended to prevent maxillary contraction following surgical treatment of the cleft palate.

Cleft lip and palate patients have narrow maxillary arches and mesio-distal disharmony between the jaws caused by cicatricial contracture from cleft lip and palate surgeries. In such cases, early orthodontic treatment is required including improvement of the mesio-distal disharmony of the jaws. Following orthodontic treatment, prosthodontic treatment is required to improve the masticatory function and esthetic appearance in the cleft area. Thus, improving the occlusion of cleft lip and palate patients takes a long time. This case report concerns such a longterm handling of over 17 years from the initial treatment at 5 years 3 months till the final prosthodontic treatment for an under-developed maxilla with partial closure of the fistula to which ilium was later grafted following orthodontic treatment. Considerations are discussed about timing of the initiation of orthodontic treatment, closure of the oronasal fistula and the final prosthodontic restoration.