Cleft lip and palate outcomes: Multidisciplinary approach for comprehensive management

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic and Reconstructive Surgery
• Dental Implantology

Background:

• Cleft lip and palate (CLP) frequently presents with lateral incisor agenesis, impacting facial aesthetics and dental function.
• Surgical adhesions and skeletal discrepancies in CLP patients often necessitate complex interventions like orthognathic surgery and rhinoseptoplasty.
• Existing treatments may not fully address the combined dental and nasal aesthetic challenges.

Purpose of the Study:

• To describe a comprehensive dental rehabilitation strategy for a CLP patient with lateral incisor agenesis.
• To introduce the innovative use of a custom titanium prosthesis during rhinoseptoplasty for nasal tip projection.
• To evaluate the psychological impact of the combined treatment on patient outcomes.

Main Methods:

• Dental rehabilitation involved canine substitution and posterior prosthetic-implant treatment.
• A customized titanium prosthesis was utilized during rhinoseptoplasty to enhance nasal tip support and projection.
• Patient-reported outcomes were assessed using validated questionnaires focusing on psychological well-being and treatment influence.

Main Results:

• Successful dental restoration was achieved through canine substitution and implant-supported prosthetics.
• The custom titanium nasal prosthesis effectively improved nasal tip definition and projection.
• Questionnaire data indicated positive psychological adjustments and perceived benefits from the integrated treatment approach.

Conclusions:

• This case report highlights a successful multidisciplinary approach to managing complex dental and aesthetic issues in CLP patients.
• The use of a custom titanium prosthesis in rhinoseptoplasty offers a novel solution for nasal tip support.
• Combined dental and surgical interventions can significantly improve both functional and psychological outcomes for individuals with cleft lip and palate.