case_images: PMC4413499_01
case_images: Pre-treatment facial and intraoral clinical presentation
case_images: IJPS-48-89-g001.jpg
case_images: PMC4413499_01_IJPS-48-89-g001.jpg
case_images: F1
case_images: A 21-year-old male with a right-sided complete cleft of primary and secondary palate who had primary surgery in childhood at another hospital was referred to our craniofacial centre for management of his facial skeletal deformities [Figure 1]. Overall the maxilla was severely collapsed in all three-dimensional planes [Figure 1].
case_images: Upper row: clinical photographs of post distraction showing lateral, facial and intraoral views. Lower row: pre-operative and postoperative lateral cephalograms
case_images: IJPS-48-89-g002.jpg
case_images: PMC4413499_01_IJPS-48-89-g002.jpg
case_images: F2
case_images: During the phase of activation, an anterior open bite developed due to anti-clockwise rotation of the maxillary segment [Figure 2].
case_images: Intra oral views after placement and loading of temporary anchorage devices
case_images: IJPS-48-89-g003.jpg
case_images: PMC4413499_01_IJPS-48-89-g003.jpg
case_images: F3
case_images: TADs were loaded immediately, and elastomeric chains were engaged from the mini screw to the pre molars and first molar teeth for intrusion [Figure 3].
case_images: Upper row-open bite reduction following 10 weeks of loading temporary anchorage device lower row-final aesthetic completion of treatment
case_images: IJPS-48-89-g004.jpg
case_images: PMC4413499_01_IJPS-48-89-g004.jpg
case_images: F4
case_images: The continuous force bilaterally intruded the posterior teeth within a span of 10 weeks thus reducing the divergence of the occlusal plane, and a positive overbite was achieved. [Figure 4]. The palatal fistula was closed using a tongue flap.