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Reverse Engineering Orthognathic Surgery and Orthodontics in Individuals with Cleft Lip and/or Palate: A Case Report
Jaemin Ko1, Mark M Urata2, Jeffrey A Hammoudeh2
1Craniofacial and Special Care Orthodontics, Division of Dentistry, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.
Bioengineering (Basel, Switzerland)
|August 29, 2024
Summary
This case report details a virtual simulation for treating cleft lip and alveolus with Class III malocclusion. Early orthodontic treatment and virtual surgical planning significantly reduced overall treatment time.
Area of Science:
- Craniofacial Surgery
- Orthodontics
- 3D Virtual Planning
Background:
- Class III malocclusion with facial asymmetry in a repaired unilateral cleft lip and alveolus patient.
- Significant negative overjet, missing teeth, and midline discrepancy presented complex treatment challenges.
Observation:
- A novel approach involved early orthodontic treatment at age 11, seven years before orthognathic surgery.
- Three-dimensional virtual planning using Nemostudio software facilitated precise surgical and orthodontic sequencing.
Findings:
- The treatment incorporated a two-piece segmental maxillary osteotomy, LeFort I maxillary advancement, and mandibular setback with bilateral sagittal split osteotomy.
- Early orthodontic preparation and virtual planning eliminated the need for pre-surgical orthodontics, reducing overall treatment duration.
Implications:
- Multi-step virtual planning is a powerful tool for managing complex craniofacial anomalies requiring multidisciplinary care.
- This approach demonstrates efficient management of cleft lip and palate cases, improving aesthetic and functional outcomes.
