Prosthetic Retreatment of the Patient with Cleft Lip and Palate

Cleft lip and palate develops as a result of embryological and early fetal developmental disorders. The main purpose of the treatment of patients with cleft lip and palate is to treat aesthetic, function and phonation problems. Prosthetic treatment is the final stage in the treatment of adults with cleft lip and palate requiring long-term follow-up and multidisciplinary teamwork. The aim of this case report was to give information about the steps of renewed prosthetic treatment with a cleft lip and palate who has fixed and removable prosthesis that had insufficient retention and stability. A 36-year-old female patient with bilateral cleft lip and palate, treated 17 years ago at Marmara University was referred to the Marmara University Department of Prosthodontics for the complaint of her existing prostheses. The intraoral examination revealed a problem according to the retention and stability of her removable denture. The fixed prosthesis of the patient was desemented and the vitality of the supporting teeth was checked. Mobility was detected in the maxillary left canine tooth. Endodontic treatment was performed on the maxillary canine and second premolar teeth that lost vitality. Soft tissue proliferation under the bar attachment was detected in the defect area. Proliferated tissue was operated by using diode laser. Minor preparation was performed on previously prepared abutment maxillary right/ left canine and premolars. The right and left abutment teeth are connected by a dolder bar to obtain bilateral stabilization. The prosthetic rehabilitation of the patient was completed by the fixed prosthetic treatment and the partial removable denture with precision attachment. The chewing forces is transmitted to the support teeth in a balanced manner to provide ideal occlusion with using the removable and fixed partial dentures together. In conclusion, with this case, it has seen an acceptable aesthetic was provided with the buccal section of the removable partial denture to achieve patient satisfaction. The function, fonation and aesthetics of patients with bilateral cleft lip and palate can be rehabilated by using removable partial denture with precision attachment.