Abstract
Introduction: Severe midface hypoplasia is a common craniofacial deformity in patients with cleft lip and palate (CLP), often linked to functional impairment and esthetic concerns. Although surgical and orthodontic advances have improved outcomes, long-term stability remains challenging. This report presents the management of a bilateral CLP patient and evaluates stability after more than 12 years of follow-up. Diagnosis: A 31-year-old male with bilateral CLP showed a concave facial profile, widened lip scars, reverse overjet of –30 mm, complete crossbite, and missing teeth (12, 22, 36). Palatally displaced premolars (15, 25) produced an hourglass-shaped arch. The diagnosis was skeletal Class III malocclusion with midface hypoplasia and secondary lip and nasal deformities. Treatment Overview: One year of presurgical orthodontics with alignment, decompensation, and extractions (15, 25) preceded two-jaw orthognathic surgery: Le Fort I advancement, bilateral sagittal split osteotomy, mandibular anterior segmental osteotomy and extractions (34, 44). Postsurgical orthodontics continued for two years, followed by prosthetic rehabilitation. Secondary nasal and lip revisions enhanced esthetics. During retention, minor mandibular spacing was corrected with localized appliances. After more than 12 years of follow-up, skeletal correction and functional occlusion remained stable. Cephalometry showed mandibular clockwise rotation. Facial esthetics improved, with only minor residual prognathism and scar depression, both clinically acceptable. Conclusion: Comprehensive orthodontic and orthognathic treatment, supplemented with soft tissue revision, can provide predictable and stable long-term outcomes in cleft-related midface hypoplasia. Careful interdisciplinary planning and follow-up are essential to minimize relapse and manage residual soft tissue issues.
Recommended Citation
Fang, Jui-Jen; Yu, Hui-Ching; Cheng, Li-Ling; and Chang, Yu-Jen
(2026)
"Long-term Follow-up of Midface Hypoplasia in a Patient with Cleft Lip and Palate,"
Taiwanese Journal of Orthodontics: Vol. 37:
Iss.
2, Article 5.
https://doi.org/10.38209/2708-2636.1380
Available at:
https://www.tjo.org.tw/tjo/vol37/iss2/5
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
