Digital Smile Design In Cleft Lip And Palate Patients

This case presents a patient with a history of cleft lip and palate, who had aesthetic and functional issues with the upper anterior teeth. Digital Smile Design (DSD) was used for personalized aesthetic analysis and treatment planning to optimize aesthetics and restore function in the anterior region. Chief complaint: Unattractive upper anterior teeth for years. Past history: 1. Cleft lip and palate surgery; 2. Orthognathic surgery; 3. Orthodontic treatment. Clinical findings: 1. Poor enamel color of 21 and 22; 2. Loss of gingival papilla between 21 and 22. Radiographic findings: Vertical bone loss between 21 and 22. Occlusal analysis: No protrusive guidance at 12-22 during protrusive movements; Aesthetic analysis: 21 crown shorter and wider than 11, with gingival margin of 21 higher than 11. Treatment Procedure: Full crowns on 21 and 22 increased lengths, reduced width, and improved shape and color, while the crowns and palatal veneers on 11 and 12 restored protrusive guidance for better occlusal stability. This case highlights the value of DSD in cleft lip and palate patients for aesthetic and functional restoration. The focus was on improving the tooth shape and color, while occlusal stability and protrusive guidance were restored to achieve functional and aesthetic balance. Additionally, soft tissue augmentation and gingival contouring were not performed due to bone loss between 21 and 22, patient’s median smile-line, and personal preference. DSD effectively guided anterior aesthetic and functional restoration in cleft lip and palate patients.