Tratamento ortopédico de expansão rápida da maxila e protração maxilar com máscara facial em paciente com fissura labiopalatina unilateral completa – caso clínico

Abstract

Patients with unilateral complete cleft lip and palate (UCLP) tend to have a maxillary deficiency as a consequence of the primary cleft repair surgeries that are performed in the first year of life. Despite being the most frequent type of non-syndromic oral cleft, it is common that the dentist when faced with this type of patient does not know how to perform the correct management and referral for treatment. The objective of this study is to report the clinical management of a patient with complete unilateral cleft lip and palate through orthopedic treatment of rapid maxillary expansion and maxillary protraction with a face mask, evaluating its efficiency in correcting the class III skeletal pattern. The rapid maxillary expansion was performed using the Haas-type dento-mucus-supported appliance, after a week of activation, maxillary protraction was started with the face mask that lasted eleven months and three weeks, totaling one year of treatment. Cone beam computed tomography scans were performed before starting treatment (T1) and at the end (T2), showing cephalometric variables. When analyzing the SNA angle together with the linear measurement Co-A, both increased from T1 to T2, and it is possible to note that the maxillary protrusion proposed by the adopted therapy was significant. The early treatment protocol used brought great benefits to the patient, promoting the correction of class III skeletal and improving facial aesthetics.