Class III malocclusion and midfacial retrusion are major problems in patients
with cleft lip and palate (CLP) because maxillary growth is compromised by
postsurgical scar contraction. As well as dental problems, these patients also suffer from
multiple functional problems, such as suckling, swallowing, speech, and hearing
problems. Successful management of patients with CLP requires a multidisciplinary
approach. In contrast to conventional Class III treatment, treating cleft palate patients
requires attention to multiple functional problems during orthodontic treatment. CLP
patients often have multiple, complex problems that require coordinated and
comprehensive treatment. Although major progress had been made towards the
effective treatment of dentofacial complications, the diversity of approaches to cleft
treatment remains great. Furthermore, there is insufficient clinical data about cleft
palate treatment to establish an evidence-base for treatment of CLP. A European
intercenter comparative study of treatment outcomes in CLP patients provided a
methodology for comparing practices, highlighted the potential for wider collaboration
including opportunities to promote clinical trials, and encouraged intercenter
comparisons. In this chapter, the authors will discuss the problems of cleft palate
patients and the implications for their orthodontic and orthognathic management. The
findings obtained from recent intercenter comparative studies will also be presented.
Keywords: Cleft lip and palate, Velopharyngeal dysfunction, Bone graft,
Maxillary protraction, Maxillary distraction, Orthognathic surgery.
