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Fig. 8 | BMC Oral Health

Fig. 8

From: Maxillary anterior segmental distraction osteogenesis to correct maxillary hypoplasia and dental crowding in cleft palate patients: a preliminary study

Fig. 8

A-K Pretreatment extra- and intra-oral photographs, lateral cephalograms and panoramic of #3. A 16-year-old Chinese girl who presented with incomplete cleft palate and had been received palatoplasty in infancy, was referred to our clinic for the correction of a concave facial profile and severe dental crowding. The extraoral examination showed a midface deficiency and protruded mandible with deviation. There was an increased maxillary height on the right and an associated cant in the occlusal plane. The intraoral examination showed an anterior crossbite about 6 mm and bilateral posterior crossbite. She was missing her No.12, 15, 22, 35 and 1E was retained. No.13 was totally labial position. Severe crowding in the upper arch with no crowding in the lower arch was observed. The lower dental midline deviated 1.5 mm to the left relative to the facial midline. The cephalometric analysis showed a skeletal Class III relationship with a retrusive maxilla and a protrusive mandible. The following treatment plan was proposed: (1) No.1E extraction and palatal movement of No.13; (2) maxillary forward advancement with MASDO; (3) alignment of the malposed teeth and space were reserved for the restoration of No.15 and No.25; (4) correction of a class III malocclusion and facial asymmetry with a bimaxillary osteotomy; (5) completion to achieve tight intercuspation; (6) retention

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