[New treatment modalities for patients with cleft lip, jaw and palate]

Cleft lip/palate patients are reported at birth to a national register and are referred to one of the cleft palate teams in Oslo or Bergen. The teams coordinate the active treatment periods by plastic surgery, orthodontics/jaw orthopedics, logopedics, otology, pediatrics, psychology and orthognatic surgery. Presurgical orthopedics is performed early after birth in some total clefts with very asymmetric jaw segments. Lip is closed at 3 months, hard and soft palate at 1 1/2 years. Only a few cases now need early protraction of the upper jaw due to growth restraint. Many need orthodontic repositioning of the jaw segments and establishment of good occlusion. Bone from the ileac crest is grafted to the cleft prior to eruption of the canine. This permits normal development of the alveolar bone and eruption or, if the lateral is missing, orthodontic mesialization of the canine, excluding prosthetic replacement.