Comprehensive rehabilitation of a patient with unilateral complete cleft lip and palate: a clinical case report
https://doi.org/10.33925/1683-3031-2026-998
Abstract
Relevance. Among congenital maxillofacial malformations, cleft lip and palate (CLP) occupies a special place. The main challenges in the rehabilitation of these patients include altered anatomy, age-related progression of deformity, and scar tissue after previous surgical interventions, which adversely affect the outcomes of subsequent treatment. Failure to follow a staged rehabilitation algorithm, as well as inability to receive timely specialized care, may place many children at risk of social disadvantage.
Clinical Case Descriptiom. This article describes the comprehensive rehabilitation of a female patient with a congenital complete right-sided cleft lip, alveolar cleft, and cleft of the hard and soft palate. Treatment was provided by a multidisciplinary team including maxillofacial surgeons, an orthodontist, a prosthodontist, oral and maxillofacial radiologists, a speech therapist, and other specialists. The patient underwent staged reconstructive treatment including primary cheilorhinoplasty, palatoplasty, alveolar bone grafting of the maxilla, maxillary advancement using distraction osteogenesis devices, orthognathic surgery to restore the occlusal plane in relation to the interpupillary line, as well as long-term orthodontic treatment.
Conclusion. The rehabilitation of patients with cleft lip and palate remains an important multidisciplinary challenge because treatment begins in infancy and often continues into adulthood. Treatment planning should be individualized and based on the patient’s anatomy, medical and surgical history, and other clinical factors. A personalized, staged approach is therefore essential.
About the Authors
R. N. FedotovRussian Federation
Roman N. Fedotov, DDS, PhD, Associate Professor, Department of the Pediatric Maxillofacial Surgery
Moscow
S. V. Yakovlev
Russian Federation
Sergey V. Yakovlev, DDS, PhD, Associate Professor, Department of the Pediatric Maxillofacial Surgery
Moscow
M. I. Shuba
Russian Federation
Maria I. Shuba, DDS, Assistant Professor, Department of the Pediatric Maxillofacial Surgery
Moscow
O. Z. Topolnitsky
Russian Federation
Orest Z. Topolnitsky, DDS, PhD, DSc, Professor, Head of the Department of Pediatric Maxillofacial Surgery
Moscow
D. A. Lezhnev
Russian Federation
Dmitry A. Lezhnev, MD, Professor, Head of the Department of Radiology
Moscow
T. A. Bakshi
Russian Federation
Tatiana A. Bakshi, maxillofacial surgery, Department of the Pediatric Maxillofacial Surgery
4 Dolgorukovskaya Str., Moscow, Russian Federation, 127006
O. T. Zangieva
Russian Federation
Olga T. Zangieva, DDS, PhD, DSc, Associate Professor, Department of the Orthodontics
Moscow
O. V. Loginopulo
Russian Federation
Oksana V. Loginopulo, DDS, PhD, Associate Professor, Department of the Pediatric Maxillofacial Surgery
Moscow
References
1. Andreeva OV. Staged rehabilitation of children with congenital cleft of an upper lip and palate. Vestnik Chuvashskogo universiteta. 2012;(3):269-275 (In Russ.). Available from: https://elibrary.ru/item.asp?id=18195648
2. Vorob'eva T.S., Topol'nitski' O.Z. The state of medical and social rehabilitation of children with congenital cleft lip and palate (review of Russian literature). Russian Journal of Stomatology. 2016;9(2):76-76 (In Russ.). Available from: https://www.mediasphera.ru/issues/rossijskaya-stomatologiya/2016/2/1207264062016021076
3. Imshenetskaya N.I., Lezhnev D.A., Topol’nitskiy O.Z., Petrovskaya V.V. Aspects of Choosing the Technique of Computed Tomography in the Diagnostics of Maxillofacial Dysostosis. Radiology – Practice. 2023;(4):26-39 (In Russ.). https://doi.org/10.52560/2713-0118-2023-4-26-39
4. Chernenko S.V., Korchemnaja O.S., Zheleznyj P.A. Algorithms of orthodontic biometric diagnostics with the use of anatomic educations on jaws. Ortodontiya. 2012;(4):20-27 (In Russ.). Available from: https://elibrary.ru/item.asp?id=22507553
5. Olimov A.M., Mullodzhanov G.E., Gurezov M.R. To question about condition of teeth-alveolar complex of maxilla in patient with cleft of the lip and palate. Vestnik poslediplomnogo obrazovaniya v sfere zdravoohraneniya. 2020;(2):73-78 (In Russ.). Available from: https://elibrary.ru/item.asp?id=44429773
6. Ferri J, Schlund M, Nicot R, Lauwers L, Nazat D, Touzet-Roumazeille S. Secondary Care of Cleft Lip and Palate: Analysis of Dentofacial Orthopedic and Orthognathic Treatments. J Craniofac Surg. 2021;32(4):1346-1353. https://doi.org/10.1097/scs.0000000000007398
7. Rachmiel A, Even-Almos M, Aizenbud D. Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery. Ann Maxillofac Surg. 2012;2(2):127-130. https://doi.org/10.4103/2231-0746.101336
8. Chuykin S. V., Davletshin N.A., KuchukK. N., Chuykin O. S., Grin E. A., Muratov A.M. Analysis of results and complications uranoplasty in children with congenital cleft lip and palate. Actual problems in dentistry. 2020;16(1):133-138 (In Russ.). https://doi.org/10.18481/2077-7566-20-16-1-133-138
9. Khelminskaya N. M., Prityko A. G. Value of rational planning of complex treatment in an aftertreatment ill with inherent defects of cranio-facial area. Pediatric dentistry and dental prophylaxis. 2006;5(3-4):49-51 (In Russ.). Available from: https://elibrary.ru/item.asp?id=9321039
10. Rogozhina Yu.S., Blokhina S.I., Bimbas E.S. Priority areas for the formation of specialized care for children with congenital cleft of the maxillofacial region, complicated by anomalies of other organs and systems. Medical alphabet. 2024;(28):83-91 (In Russ.). https://doi.org/10.33667/2078-5631-2024-28-83-91
Review
For citations:
Fedotov R.N., Yakovlev S.V., Shuba M.I., Topolnitsky O.Z., Lezhnev D.A., Bakshi T.A., Zangieva O.T., Loginopulo O.V. Comprehensive rehabilitation of a patient with unilateral complete cleft lip and palate: a clinical case report. Pediatric dentistry and dental prophylaxis. 2026;26(2):191-202. (In Russ.) https://doi.org/10.33925/1683-3031-2026-998
JATS XML



























