Presurgical and postsurgical orthodontics in patients with cleft lip and palate

Patients with cleft lip and palate (CLP) usually have skeletal Class III malocclusion with maxillary deficiency due to the cleft itself and fibrous scar tissue formation caused by the reconstructive surgery. In adult CLP patients with excessive jaw discrepancies, orthognathic surgery is often indicated to correct their functional and esthetic problems. However, CLP patients have different inherent structures that may require a strategic approach compared with noncleft Class III patients. Main differences in skeletal and dental findings of lateral cephalograms between CLP and noncleft Class III surgical patients are to be demonstrated. Furthermore, a strategic approach with various mechanics in the presurgical orthodontic stage will be applied to suit the distinct characteristic of the case. Successful clinical outcome was critically dependent on the close communication among the related specialists.