Organization of treatment and orthodontic procedures in cleft lip and palate rehabilitation

Only competent centres are able to provide the full range of multi-disciplinary specialized therapies that cleft lip and palate rehabilitation requires. Despite some detail differences in conducting treatment, the agreed centres produced consensual treatment philosophy and observe equivalent therapeutic schemes. These sequences, to which orthodontics invariably contributes, are designed to favour the normal outcome of facial development and functions. Beginning early in mixed dentition, orthodontic rehabilitation is designed to afford patients good dental occlusion through orthopaedic and orthodontic therapies. At the end of the growth period, orthodontics prepares for eventual final surgical and prosthetic repair. We avoid extraction of permanent teeth as an adjunct to treatment because it has deleterious effect on final skeletal harmony. We prefer basic appliances for mechanical therapy, and after completion of active treatment, a prolonged retention. A trained orthodontist is able to complete the orthopaedic and orthodontic stages in cleft lip and palate repair if he fully understands and follows the general cleft lip and palate treatment scheme and effectively communicates with the competent rehabilitation team.