Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies-USP (HRAC-USP)--part 2: pediatric dentistry and orthodontics |
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Authors: | Freitas José Alberto de Souza Garib Daniela Gamba Oliveira Marchini Lauris Rita de Cássia Moura Carvalho Almeida Ana Lúcia Pompéia Fraga de Neves Lucimara Teixeira Trindade-Suedam Ivy Kiemle Yaedú Renato Yassutaka Faria Soares Simone Pinto João Henrique Nogueira |
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Institution: | Hospital for Rehabilitation of Craniofacial Anomalies, Department of Stomatology, Bauru School of Dentistry, University of S?o Paulo, Bauru, SP, Brazil. |
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Abstract: | The aim of this article is to present the pediatric dentistry and orthodontic
treatment protocol of rehabilitation of cleft lip and palate patients performed at
the Hospital for Rehabilitation of Craniofacial Anomalies - University of São Paulo
(HRAC-USP). Pediatric dentistry provides oral health information and should be able
to follow the child with cleft lip and palate since the first months of life until
establishment of the mixed dentition, craniofacial growth and dentition development.
Orthodontic intervention starts in the mixed dentition, at 8-9 years of age, for
preparing the maxillary arch for secondary bone graft procedure (SBGP). At this
stage, rapid maxillary expansion is performed and a fixed palatal retainer is
delivered before SBGP. When the permanent dentition is completed, comprehensive
orthodontic treatment is initiated aiming tooth alignment and space closure.
Maxillary permanent canines are commonly moved mesially in order to substitute absent
maxillary lateral incisors. Patients with complete cleft lip and palate and poor
midface growth will require orthognatic surgery for reaching adequate anteroposterior
interarch relationship and good facial esthetics. |
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Keywords: | Cleft lip Cleft palate Pediatric dentistry Orthodontics |
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