Cleft Palate Patients
Dr Lydia Lim has many years of experience treating Cleft Lip and Palate patients and has worked closely with Orthodontists associated with the Cleft Lip and Palate Clinics at the Children’s Hospital at Westmead and Sydney Children’s Hospital.
What oral surgery procedures do cleft patients need during growth?
Many cleft patients have specific dental issues during growth that require minor oral surgical procedures in conjunction with orthodontic treatment such as presence of extra teeth (supernumerary teeth) that need removal and unerupted/impacted teeth (canines usually) that require surgical exposure and placement of chain to orthodontically erupt them into the mouth.
What oral maxillofacial surgery procedures do cleft patients need after growth?
Many cleft patients have restricted upper jaw growth as a result of the cleft palate surgery performed during childhood. The reasons are due to disruption of growth from the necessary early surgery to close the cleft palate and the resulting scar tissue that forms often restricts the forward growth of the maxilla (upper jaw). As a result, the upper jaw is retruded in comparison to the lower jaw and rest of the face. There is often a negative or reverse bite with the lower teeth placed in front of the upper front teeth. The maxilla is also often constricted and narrow and upper jaw expansion may often be required. Expansion of the upper jaw can occur as part of the pre-surgical orthodontics during growth. Sometimes it is not sufficient and surgically assisted rapid maxillary expansion (SARME) may be required after cessation of growth. If the maxilla is very retruded, many cleft patients benefit from orthognathic surgery. In mild cases, it may be possible to do upper jaw surgery only , le fort 1 maxillary osteotomy advancement. In most cases, it is necessary to do bimaxillary surgery.