8 Cleft 2022

maria claudia martinez

Dra. Maria Claudia Martínez

Dra. Maria del Pilar Bernal


Poster Dra. Maria Claudia Martinez

Conference Dra. Maria Claudia Martinez


Poster Dra. Maria del Pilar Bernal


Poster Dra. Francina Escobar


Poster Dr. Ignacio Zarante



5.4.- Clinical Case 4: G. Q.

34 years old adult patient with severe complete bilateral cleft lip and palate.

Severe Class III esqueletal maloclussion implicating transversal, anteroposterior and vertical dimensions

Very poor general oral conditions



Photographic record: Before /After

Speciaities



5.3.-Clinical Case 3: A. B.

Long – term evolution, comprehensively treated and finished clinical cases

7 years old boy presenting :

  • Complete unilateral right lip and  palate non syndromic cleft sequeales
  • 3 D maxilofacial esqueletal discrepancy  with facial, functional, dental and aestheticimplications.
  • Hipernasality, dislalias, otitis media diagnosis, mixed breathing, atipical deglutionand  lingual interposition habit. 
  • High risk of caries 
  • Adjusted psychosocial development.
  • Comprehensive treatment evolution from 7 – 18 years of age.            

Photographic record 2007 / 2018: Before /After



5.2.- Clinical Case 2: S. C.

Surgical Pin Placement

Virtual Surgical Planning

Orthognatic Surgery – Mandibular advancement with transversal correction

Surgical procedure: Maxillary impactation and Mentoplastia.

2018 – Photographic record

2021 – Final photographic record


Photograpic record: Before / After



5.1.- Clinical Case 1: G. H.

2010

LEFT UNILATERAL COMPLETE LIP – INCOMPLETE PALATE CLEFT SEQUEALE

Kernahan and Stark Y Classification.
Extraoral photography

Squeletal Diagnosis

  • Symmetric patient 
  • Class I profile 
  • Class III maloclusssion
  • Maxillary retrusion and micrognatism
  • No transversal maxillary discrepancy
  • Horizontal growth tendency
  •  Cervical maduration stage  CVS1

Dental Diagnosis

Early mixed  dentition

OB :  -1mm (51, 61), -2mm (52), -3mm (62) 

  • OJ : – 2.0 MMS
  • Anterior crossbite 
  • Posterior bilateral open bite

ST Functional Diagnosis

  • Anterior atypical deglution with lingual protrusión and interposition 
  • Orofacial muscular  imbalance
  • Sigmatism 

Treatment Plan

Phase I

  • Genetic Evaluation 
  • Speech Therapy evaluation  
  • Psychologic support
  • Pediatric Dentistry evaluation . Minimal invassive procedures 
  • Maxillofacial Orthopaedic evaluation and management : Maxillary expansión and protraction / facial mask ,maxillary expansión / Alt Ramec Protocol

Phase II

  • Corrective Orthodontic treatment
  • Orthodontic management to prepare the cleft área for the alveolar bone graft 
  • Mucoexpangraft technique 
  • Periodontal mucogingival management 
  • Alveolar bone graft

Phase III

  • Prostetic Dentistry
  • Orthodontic Retention
Timeline
2010 Extra – intraoral photographic sequence.
2011 Intraoral photographic sequence.
2011 Panoramic radiography
Cephalometric Analysis
Treatment evolution 2010 – 2011 – 2013
Treatment evolution 2015 – 2018 – 2021
Treatment evolution 2010 – 2011 – 2013
Treatment evolution 2010 – 2011 – 2013
2021 – Final records
2021 – Final records
Retention
2021 – x-ray
2021 – Cephalometric Analysis
2021 – Overlap

Prostetic

Photographic record 2010 / 2021: Before /After