Alternative Craniofacial Orthodontics Treatment Approaches for Differential Severity in Patients with Unilateral Cleft Lip with/without Palate

Abstract

The treatment of patients with cleft lip with/without cleft palate is still a challenge for its correct team management. The fact that not all clefts are alike, based on anatomical findings and ortho/surgical alternatives used in their correction, requires that clinicians -working in interdisciplinary or multidisciplinary teams- direct efforts not only to repair the facial and oral characteristics of the cleft, but also to work in the context of the patient’s craniofacial growth and development, tri-dimensionally affected by this type of craniofacial difference. The first part of this chapter is focused on the diagnostic approach for patients with unilateral cleft lip and palate (UCLP), using a modified version of the GOSLON yardstick (GOSLON+) that considers not only dental components but also 3D facial aspects of a complex malocclusion originated from this congenital malformation. Second, current treatment alternatives based on patient’s stages of dental development and cleft width, using either straight-wire or passive self-ligation appliances are presented, directed to avoid dental prosthetic replacements if possible. Finally, our treatment algorithms summarized in a step-by-step fashion the treatment of such differences with approaches that will focus on these two key aspects, essential for a successful, patient-based, interdisciplinary treatment protocol.