Patient-Specific Implants (PSI) in Maxillary Hypoplasia Secondary to Cleft Lip and Palate Deformity
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CASE REPORT
Patient-Specific Implants (PSI) in Maxillary Hypoplasia Secondary to Cleft Lip and Palate Deformity Sandeep Kr. Pachisia1 • Arun Ganguli2 • Sudipta Sahu1 • Chirantan Maity1 Adhiraj Ghosh1 • Saikat Sen1
•
Received: 15 June 2020 / Accepted: 25 August 2020 Ó The Association of Oral and Maxillofacial Surgeons of India 2020
Abstract Maxillary hypoplasia is often evident in cleft patients due to impaired growth and dense scarring from previous cleft surgeries. For these patients, treatment scenario has taken many turns over ages, evolved from orthognathic correction to distraction osteogenesis, with mixed prognosis and outcome depending on severity of the case and other several factors. We are reporting a case of 24-year-old female with maxillary hypoplasia secondary to bilateral cleft lip and palate with hypoplastic prolabium, who has been treated with two patient-specific implants in bilateral maxillary region for facial profile enhancement. Keywords Patient-specific implant Cleft lip and palate Maxillary hypoplasia Secondary deformity
& Chirantan Maity [email protected] Sandeep Kr. Pachisia [email protected] Arun Ganguli [email protected] Sudipta Sahu [email protected] Adhiraj Ghosh [email protected]
Introduction Craniofacial anomalies and secondary deformities have always been psychologically traumatising even if being surgically repaired optimally to establish the function and aesthetics. The patients are likely to go through several surgeries till and beyond the growth age, and this leaves the infancy and childhood psychologically scarred for many of them, making them to quit and settle for easier or less invasive treatment options. For patients with cleft lip and palate, this battle starts with primary cleft lip and palate repairing surgeries and when 25–60% [1–3] of these patients eventually develop maxillary hypoplasia and malocclusion, again they are required to go through surgical interventions for correction of this secondary deformity. Over the decades, this particular group of patients have been majorly treated with orthognathic surgery (Le Fort I advancement osteotomy) [4–7], often with distraction osteogenesis (DO) in maxilla [8–10] and sometimes in combination of both. Depending on severity of the deformity, the results have always ranged from favourable to unfavourable, with questionable predictability. Amidst these popular treatment choices, we are reporting a case of maxillary hypoplasia secondary to primary cleft lip and palate surgery, who was previously tried with DO without much success. We treated the patient with two (left and right) patient-specific implants (PSI) to enhance the hypoplastic maxilla bilaterally.
Saikat Sen [email protected]
Case Report
1
Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, Haldia, WB, India
2
Medica Superspeciality Hospital, Kolkata, India
A 24-year-old female reported to the outpatient department with a complaint of sunken middle part of face. Born with bilateral
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