Acharya Varun, Brecht Lawrence E
Fellow, Department of Head and Neck Surgery, Section of Oral Oncology and Maxillofacial Prosthodontics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Clinical Associate Professor, Jonathan and Maxine Ferencz Advanced Education Program In Prosthodontics, NYU College of Dentistry, New York, NY; Clinical Assistant Professor of Plastic Surgery, Institute of Reconstructive Plastic Surgery, NYU Langone Medical Center, New York, NY.
J Prosthet Dent. 2014 Aug;112(2):117-21. doi: 10.1016/j.prosdent.2013.11.007. Epub 2014 Feb 14.
Recent advances in surgery and orthodontics have resulted in improvements in the management of patients with a cleft lip or palate. Early surgical intervention and bone-grafting procedures have frequently been used to ensure closure of the cleft and continuity of the alveolar bone. However, a need for the prosthodontic management of patients with a cleft palate still exists. Most frequently, the indication is to restore the edentulous spaces located anteriorly in the vicinity of the residual cleft defect. In addition to improving the esthetic outcome, prosthodontic management also is required to restore function, especially occlusion and speech. This clinical report illustrates the management of an adult patient with a unilateral cleft of the lip and palate who required prosthodontic rehabilitation after surgery. The patient had previously undergone multiple surgeries and did not want to consider implant therapy as a treatment option. Thus, the patient was managed with fixed and removable prosthodontics with a maxillary overdenture prosthesis retained by microextracoronal resilient attachments, which were laser welded onto crowns on abutment teeth to obtain a functionally and esthetically acceptable result.
