Orthodontic Treatment of Unilateral Cleft Lip and Palate Associated with Agenesis of Maxillary Lateral Incisors: A Case Report

Cleft lip and palate (CLP) is a common congenital condition presenting significant orthodontic challenges due to maxillofacial growth disturbances, associated malocclusions, and dental anomalies. Patients with CLP often have complex dental and skeletal issues, requiring a comprehensive, interdisciplinary approach to address functional and aesthetic concerns. An 11-year-old female presented with unilateral cleft lip, alveolus, and palate (UCLP) associated with dental anomalies, which included a skeletal Class I relationship with Angle Class II malocclusion, bimaxillary retrognathia, bidental retroclination, negative overjet, lower dental midline shifting, anterior crossbite, microdontia #12, agenesis #22, and several malpositioned teeth. The patient was treated with fixed orthodontic appliances, including the extraction of remaining deciduous teeth, mesialisation of the teeth on the upper left side to close the space resulting from agenesis, and space management in the mandible. Significant improvements were observed in overjet, dental alignment, occlusion, and aesthetics after a 17-month treatment period. Following orthodontic treatment, restorative procedures were performed on teeth #12 and #23. Adhering to the prescribed retainer schedule is essential to preserving dental esthetics and the stability of the treatment results. Comprehensive orthodontic treatment with fixed appliances effectively addressed the complex dental and skeletal issues of this patient with UCLP. The treatment led to improved dental function and aesthetics, highlighting the importance of a personalised approach in addressing cleft cases.