Balancing the dental occlusion and facial aesthetic features in cleft orthognathic surgery: Patient-centered concept for computer-aided planning

Abstract

Patients with cleft lip and palate could develop dentofacial deformity characterized by malocclusion, midface retrusion, midline discrepancy and asymmetry. Cleft orthognathic surgery has evolved from the simple maxillary LeFort I advancement with correction of dental malocclusion to the current model of patient-centered approach focusing on skeletofacial reconstruction using computer-assisted diagnosis and planning. Three-dimensional imaging and surgical simulation have provided valuable information for facial aesthetics and surgical feasibility. Surgery-first approach and two-jaw orthognathic surgery have gradually become prevalent replacing the conventional method. A better dentofacial outcome is achieved with reduction of the burden of care.

Keywords: Dental occlusion; Facial aesthetics; Midline; Orthognathic surgery; Skeletofacial reconstruction; Unilateral cleft lip and palate.