Multi-unit fixed partial denture for a bilateral cleft palate patient: a clinical report

Prosthodontic Rehabilitation of a Residual Post-surgical Cleft Defect

Cleft lip/palate is a common birth defect globally, and the impact of this condition on the dental health of affected individuals can be profound. During intricate rehabilitation of cleft lip and palate patients, the final phase is achieved with definitive prosthodontic treatment. Prosthodontic rehabilitation is often necessary due to missing teeth and the alveolar ridge, malocclusion, residual defects, and the discrepancy between maxillary and mandibular arches. This article presents a case report of a young female patient with residual post-surgical cleft palatal defect having a mobile anterior segment with missing lateral incisors rehabilitated by a cast partial denture. The prosthesis utilized provided improvements in the patient's speech and esthetics but at a low level of cost and ongoing maintenance.

Conventional prosthodontic management of partial edentulism with a resilient attachment-retained overdenture in a patient with a cleft lip and palate: a clinical report

Recent advances in surgery and orthodontics have resulted in improvements in the management of patients with a cleft lip or palate. Early surgical intervention and bone-grafting procedures have frequently been used to ensure closure of the cleft and continuity of the alveolar bone. However, a need for the prosthodontic management of patients with a cleft palate still exists. Most frequently, the indication is to restore the edentulous spaces located anteriorly in the vicinity of the residual cleft defect. In addition to improving the esthetic outcome, prosthodontic management also is required to restore function, especially occlusion and speech. This clinical report illustrates the management of an adult patient with a unilateral cleft of the lip and palate who required prosthodontic rehabilitation after surgery. The patient had previously undergone multiple surgeries and did not want to consider implant therapy as a treatment option. Thus, the patient was managed with fixed and removable prosthodontics with a maxillary overdenture prosthesis retained by microextracoronal resilient attachments, which were laser welded onto crowns on abutment teeth to obtain a functionally and esthetically acceptable result.

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: oral rehabilitation

Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.

Esthetic and functional rehabilitation of a bilateral cleft palate patient with fixed prosthodontic therapy

Patients with bilateral cleft lip and palate present with multiple challenges to the prosthodontist. Some of them include mobility of the premaxillary segment, multiple missing and malposed anterior teeth, unfavorable soft tissues, and a tense maxillary lip. This clinical report describes the fixed prosthodontic management of a bilateral cleft lip and palate patient with a surgically corrected lip and a mobile premaxillary segment. The patient presented with an 11-unit metal-ceramic fixed partial denture made of a base metal alloy that was made 25 years ago. He had multiple porcelain fractures over the years that compromised his esthetics and function. Prosthodontic therapy involved sectioning the old prosthesis, followed by careful treatment planning and fabrication of a new fixed dental prosthesis with improved design and superior materials. At a 3-year follow-up, the fixed dental prosthesis remained intact and functional, and no further complications were noted. A discussion of approaches to treatment planning, biomechanical principles involved, and choice of biomaterials in designing a fixed prosthesis for such patients is presented.

CLINICAL SIGNIFICANCE

As cleft palate patients require life-long prosthodontic follow-up and maintenance, revisional treatments should incorporate superior materials and methods to minimize future complications.

A case report of multidisciplinary treatment of an adult patient with bilateral cleft lip and palate

This is a case report about the successful orthodontic treatment of a bilateral cleft lip and palate patient by using a combination of bone grafting and subsequent prosthodontic rehabilitation. An adult patient with a bilateral cleft lip and palate presented with a concave profile, anterior and lateral crossbite, a markedly deep overbite, and residual bilateral alveolar clefts. His jaw movement patterns were unstable and irregular due to his collapsed bite. Orthodontic treatment with bilateral bone grafting improved his concave profile by downward and backward rotation of the mandible within the freeway space, and optimum occlusion and functionally stable and smooth jaw movements were obtained. After a 6-year retention period, no skeletal relapse could be detected, and his occlusal stability was satisfactory.

Prosthetic rehabilitation of a patient with bilateral cleft lip and palate using osseointegrated implants and extracoronal resilient attachments: a case report

This case study reports on the prosthetic rehabilitation of a patient with an unrepaired bilateral cleft lip and palate using osseointegrated implants, extracoronal resilient attachments, a combination of metal-ceramic cement-retained fixed partial restorations, and removable prosthesis. Preoperative clinical examination of a 32-year-old woman with bilateral cleft lip and palate revealed a large oronasal communication, hyperplastic soft tissue surrounding the hard palate defect, and a severely resorbed alveolar ridge. A maxillary obturator prosthesis supported by implants and retained with an extracoronal resilient attachment was designed to cover the oronasal communication in the hard palate and fulfill the patient's functional and aesthetic requirements. The patient has been wearing the prosthesis for 1 year. Her speech quality has greatly improved, and her aesthetic and functional expectations have been met.

Removable partial denture in a cleft lip and palate patient: a case report

This clinical report described the oral rehabilitation of a cleft lip and palate patient with removable partial denture. Although implant-supported fixed treatment was presented as part of the optimum treatment plan to achieve the best result, the patient declined this option due to the significant financial burden. Persons with a congenital or craniofacial defect are unique, and oral problems must be evaluated individually to the most ideal treatment. The changes in appearance, function, and psychological wellbeing have an enormous impact on patients' personal lives and are rewarding for the maxillofacial prosthodontist providing this care.