© 1984 European Orthodontic Society Treatment of severe unilateral open bite and crossbite in cleft lip and palate patients

Summary. Twenty complete unilateral cleft lip and palate patients 14-17 years of age were.treated for severe crossbite and lateral open bite. Ten patients had the distorted lesser maxillary segment corrected surgically to improve dental occlusion and facial aesthetics. In the same operative procedure a residual oro-nasal fistula was closed, and bone grafting of the maxillary alveolar process bony defect was performed. The immediate results were good, but later complications were observed in form of gingival retraction and vertical segmental relapse. In another group of 10 patients a combined orthodontic-surgical treatment was carried out. The maxillary segment was loosened by a palatal and buccal osteotomy. After one week the maxilla was transversely expanded for 2-3 weeks. The lateral open bite was then corrected by differential vertical elastic traction from flexible sectional arches in the upper jaw to heavy lower ideal arches. The 10 patients treated by this partial maxillary mobilization procedure had, after observation over nearly 2 years, no complications. The treatment is also advantageous in the simplicity of the surgical procedure and reduced treatment time compared with conventional orthodontic treatment