Comprehensive Rehabilitation of a Patient with a Congenital Facial Anomaly. A Journey of 25 Years

Relevance. Congenital cleft lip and palate is the third most common congenital anomaly in newborns worldwide (among all congenital anomalies). Depending on the region, the incidence ranges from one case per 400 newborns to one case per 1,500 newborns. In Ukraine, on average, one child is born per 650 newborns. This pathology causes serious functional and aesthetic problems for the patient from birth. The significant variability of congenital disorders does not allow for a fully standardized treatment protocol for these patients, requiring an individualized approach to their solution by doctors of different specializations. This study aimed to assess the effectiveness of treating a patient with congenital cleft lip and palate from birth until full dental rehabilitation. Materials and methods. Treatment was conducted from 2001 to 2025 at the Children’s Clinical Hospital No. 7 in Kyiv, the Department of Pediatric Surgical Dentistry and Maxillofacial Surgery of Bogomolets National Medical University, and the Flash Smile private dental clinic. Conclusions. As a result of long-term work (25 years) by many doctors with narrow specializations, we achieved an excellent aesthetic and functional treatment outcome. Chewing efficiency was restored to 100%, and the aesthetics of the smile and appearance were entirely satisfactory for the patient. Pronunciation remained unaffected, with only minor rhinolalia. During the treatment, we encountered several complex problems that required atypical approaches, which were not included in the protocol treatment methods. The primary challenge in the treatment process was the presence of a severe cicatricial deformation of the palate. To prevent it, it is necessary to use minimally traumatic methods of surgical intervention. Removable orthodontic appliances showed their low efficiency. The use of orthognathic surgery enables the effective resolution of bite problems, but it requires a highly qualified surgeon, an extended retention period, and careful postoperative supervision. Only a comprehensive approach, in full cooperation with the patient’s parents, allowed the team of doctors to achieve an excellent result in a challenging situation.