A patient who is born with a Cleft Lip and/or Palate may also be missing one or more teeth. If there are missing teeth, there will often also be associated defects of the bone and/or soft tissues of the jaws. These patients may have been treated through the public health system, via the Cleft Lip and Palate Scheme, but unfortunately, this program only provides treatment in the form of extractions, orthodontics and removable prostheses. It does not allow for more conventional restorative treatment and hence these patients may present to us requesting alternatives to their removable dentures.
A Maxillo-Facial Prosthodontist may treat these patients with obturators and other removable prostheses when needed. If however, the defects are not too severe, then there is scope for bonded prostheses to be used as in the case below.
This young lady had been through 7 years of Orthodontics and Public Health Treatment. She was wearing a removable partial denture and was seeking a fixed alternative that looked and functioned better.
This photograph shows the hard and soft tissue defect on her left side, and it was very similar on her right side. I coordinated her treatment, and she then saw some colleagues and industry contacts, all of whom gave of their time to help. Her treatment also included some further (private) Orthodontics.
This photo shows some of the veneers and one of the bridges. These all-ceramic restorations were made to increase the length of her teeth, improve their colour, and of course, to close the spaces of the clefts so that she would not need to wear her partial denture any longer.
This photo shows the new bridge (white) and the porcelain veneers, on the model of the patient's teeth. The bridge attached to the underside of the natural canine tooth, without significant change to the surface of this supporting tooth.
With almost no modification to the underlying tooth structure, these veneers and very conservative bridges (one on each of the patient's left and right sides), were bonded into place with the latest dental adhesives.
A beautiful smile was achieved through careful and clever restorative procedures. Thanks must go to Dr Gavin Lenz for gifting the further Orthodontics, Mr Yugo Hatai for giving his time to make these beautiful restorations, and to 3M Oral Care for donating the materials used for the actual veneers and bridges.