Orthodontic Management Of Full-Arch Crossbite In Cleft Post-Grafting

This case report presents a 16-year-old male with a history of left unilateral complete cleft lip and palate, who underwent alveolar bone grafting and sought orthodontic treatment for full-arch crossbite and dental misalignment. The challenge involved addressing skeletal Class III malocclusion, maxillary hypoplasia, and dental anomalies typical in cleft patients. A 16-year-old male with left unilateral complete cleft lip/palate, post-alveolar bone grafting, presented with concave facial profile, maxillary crowding, bilateral posterior crossbite, and 3 mm anterior crossbite. Radiographs confirmed skeletal Class III with maxillary hypoplasia. Treatment objectives included expanding the maxillary arch, correcting rotations, and preserving space for lateral incisor implants.Results: After 33 months, full-arch crossbite resolved, achieving Class I molar relationship on the left and Class II on the right. Facial profile improved with increased maxillary fullness. Post-treatment radiographs confirmed optimal root alignment and implant space. The integrated approach balanced skeletal and dental corrections, prioritizing long-term functional and esthetic outcomes. Key considerations included managing mandibular growth potential, preserving bone quality for implants, and coordinating orthodontic mechanics with surgical history. This case highlights the importance of personalized, interdisciplinary care in cleft lip and palate patients. The strategy of maxillary expansion with selective extraction and mandibular contraction effectively resolved complex crossbite and dental anomalies, underscoring the role of orthodontics in optimizing outcomes for cleft patients.