19 years old female had untreated Veau classification class II cleft palate with ectopic eruption of upper right lateral incisor and congenital missing of lower lateral incisors. Upper left lateral incisor, left first molar aid lower left first molar were root restswithperiapicalpathologiclesions. So all root rests were extracted and prosthodontic rehabilitation after orthodontic treatment was planned. She was treated by means of multibanded system with face bow. After 23 months all orthodontic correction were achieved and, as soos as debanding procedure was done she was referred to oral surgeon and prosthodontist for surgical operation and bridge construction.
Classification ; Cleft Palate* ; Female ; Humans ; Incisor ; Molar ; Prosthodontics ; Rehabilitation ; Tooth* ; Young Adult

This clinical report described the oral rehabilitation of a cleft lip and palate patient with removable partial denture. Although implant-supported fixed treatment was presented as part of the optimum treatment plan to achieve the best result, the patient declined this option due to the significant financial burden. Persons with a congenital or craniofacial defect are unique, and oral problems must be evaluated individually to the most ideal treatment. The changes in appearance, function, and psychological wellbeing have an enormous impact on patients' personal lives and are rewarding for the maxillofacial prosthodontist providing this care.
Cleft Lip/*rehabilitation ; Cleft Palate/*rehabilitation ; Dentistry/methods ; Denture Design ; Denture, Overlay ; *Denture, Partial, Removable ; Female ; Humans ; Middle Aged ; Palatal Obturators

Cleft lip and palate is one of the congenital anomalies which need comprehensive and multidisciplinary treatment plan because 1) oral cavity is an important organ with masticatory function as a start of digestive tract, 2) anatomic symmetry and balance is esthetically important in midfacial area, and 3) it is also important to prevent psycho-social problems by adequate restoration of normal facial appearance. There are many different protocols in the treatment of cleft lip and palate, but our department has adopted and modified the Zurich protocol, as published in the Journal of Korean Cleft Lip and Palate Association in 1998. The first challenge is feeding. Type of feeding aid ranges from simple obturators to active orthopedic appliances. In our department we use passive-type plate made up of soft and hard acrylic resin which permits normal maxillary growth. We use Millard's method to restore normal appearance and function of unilateral complete cleft lip. In consideration of both maxillary growth and phonetic problems, we first close soft palate at 18 months of age and delay the hard palate palatoplasty until 4 to 5 years of age. When soft palate is closed, posterior third of the hard palate is intentionally not denuded to allow normal maxillary growth. In hard palate palatoplasty the mucoperiosteum of affected site is not mobilized to permit residual growth of the maxilla. We have treated a patient with unilateral complete cleft lip and palate by Ajou protocol, which is a kind of modified Zurich protocol. It is as follows: Infantile orthopedics with passive-type plate such as Hotz plate, cheiloplasty with Millard's rotation-advancement flap, and two stage palatoplasty. It is followed by orthodontic treatment and secondary osteoplasty to augment cleft alveolus, orthognathic surgery, and finally rehabilitation with conventional prosthodontic treatment or implant installation. The result was good up to now, but we are later to investigate the final result with longitudinal follow-up study according to master plan by Ajou protocol.]]>
Cleft Lip ; Follow-Up Studies ; Gastrointestinal Tract ; Humans ; Intention ; Maxilla ; Mouth ; Orthognathic Surgery ; Orthopedics ; Palate ; Palate, Hard ; Palate, Soft ; Prosthodontics ; Rehabilitation

BACKGROUND AND OBJECTIVES: When screened using cord blood, congenital hearing loss are detected more frequently than other congenital metabolic diseases such as phenylketonuria or congenital hypothyroidism. Newborn hearing screening is important because the early identification and intervention of neonatal hearing loss is beneficial for the language development. We aimed to analyze clinical characteristics including associated diseases and present hearing state, and the effects of speech rehabilitation in the hearing-impaired infants detected by newborn hearing screening program of Ajou University Hospital. SUBJECTS AND METHOD: Seventy nine hundred twelve neonates (6915 well babies and 997 NICU babies) were screened by transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR). Medical records of infants with bilateral hearing loss of more than 60 dB were evaluated, and they were further studied with temporal bone CT scan and follow-up hearing tests using ABR. The exon2 of the connexin26 gene was sequenced to detect the mutation. RESULTS: Fourteen of 7912 infants initially had bilateral hearing loss of more than 60 dB. Associated diseases were prematurity, hyperbilirubinemia, sepsis, low birth weight, chromosomal anomaly, cleft palate, congenital nevus, and congenital aural atresia. Three of 14 infants were revealed to have normal hearing after follow-up hearing test, which were associated with cleft palate, hyperbilirubinemia or prematurity. One of them had 235delC mutation of the connexin26, and the temporal bone CT scan demonstrated the finding of enlarged vestibular aqueduct syndrome (EVAS) in one infant. Two infants participated in the connected speech rehabilitation program and showed significant development of language. CONCLUSION: Follow-up hearing tests are important in case of failures of newborn hearing screening test. The establishment of auditory and speech rehabilitation program connected with newborn hearing screening is essential in treating hearing-impaired neonates.
Cleft Palate ; Congenital Hypothyroidism ; Evoked Potentials, Auditory, Brain Stem ; Fetal Blood ; Follow-Up Studies* ; Hearing Loss ; Hearing Loss, Bilateral ; Hearing Tests ; Hearing* ; Humans ; Hyperbilirubinemia ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn* ; Language Development ; Mass Screening* ; Medical Records ; Metabolic Diseases ; Neonatal Screening ; Nevus ; Phenylketonurias ; Rehabilitation ; Sepsis ; Speech Therapy ; Temporal Bone ; Tomography, X-Ray Computed ; Vestibular Aqueduct