TREATMENT OF CLEFT CASE WITH

DISTRACTION OSTEOGENESIS LEFORT I AND

BSSO

In cleft patients due to multiple surgical interventions there is scar tissue

formation which impedes maxillary growth resulting in a hypoplastic maxilla
leading to a class III appearance with a concave profile. Hence various surgical
protocols like distraction osteogenesis and bi jaw surgeries are advocated in
bringing out positive results for a better profile and smile.
This paper discusses a case of 19 year old male patient who was reported to
department of orthodontics with a chief complaint of backwardly placed upper
jaw and difficulty in mastication and speech.
On Extra oral examination patient had a unilateral cleft which was treated ,
deficient malar eminence, concave profile and gross facial asymmetry.
On Intra oral examination it was noticed that patient had Angle’s class III Molar
relationship with severe negative overjet, constricted arch, midline shift ,
crowding and posterior crossbite .
Cephalometric values showed a class 3 skeletal base with vertical growth
pattern.
Initially case was bonded and quad helix was placed for expansion once the
expansion was achieved , maxillary distractor was used to bring the maxilla
forward. After distraction osteogenesis was performed a second surgery was
planned and performed which included LEFORT 1 with BSSO.
Hence Maxilla was brought forward and Mandible was set back .
All the expected results were achieved. Currently patient is in finishing and
detailing stage.