case_images: PMC4269306_01
case_images: Occlusal radiograph. You can see the cleft through the palate compromising alveolar ridge and hard palate.
case_images: CRID2014-795342.001.jpg
case_images: PMC4269306_01_CRID2014-795342.001.jpg
case_images: fig1
case_images: At orthopantomography and occlusal radiograph (Figure 1), a cleft is observed with a 1.2 agenesis as well as the presence of supernumerary located on the mesial 2.3.
case_images: Type hyrax disjunction device. Intraoral image of disjunctor. You can observe that the exodontia of 1.5 has already been performed, but not the others yet (lateral incisor 1.2 and supernumerary teeth). Behind the device you can see the mucous scar of the cleft.
case_images: CRID2014-795342.002.jpg
case_images: PMC4269306_01_CRID2014-795342.002.jpg
case_images: fig2
case_images: A Hyrax disjunctor (Figure 2) is installed with slow maxillary expansion up to 13 mm.
case_images: PMC4269306_02
case_images: Dental cast at the beginning (a) and at the end (b) of the treatment. You can see the dental crowding in the maxilla, with the presence of 1.5 on the hard palate. Negative discrepancy was solved through extractions and slow maxillary expansion.
case_images: CRID2014-795342.003.jpg
case_images: PMC4269306_02_CRID2014-795342.003.jpg
case_images: fig3
case_images: Intraoral images at the beginning (a) and at the end (b) of the treatment. Canines were remodeled as lateral incisors with composite.
case_images: CRID2014-795342.004.jpg
case_images: PMC4269306_02_CRID2014-795342.004.jpg
case_images: fig4
case_images: Extraoral images at the beginning (a) and at the end (b) of the treatment. No major changes were made after orthodontic treatment. The scar of the upper lip is slightly perceived.
case_images: CRID2014-795342.005.jpg
case_images: PMC4269306_02_CRID2014-795342.005.jpg
case_images: fig5
case_images: There was no major extraoral change after the treatment (Figure 5).
case_images: Smile picture after a two-year followup. There is a harmonic smile and the aesthetic remodeled canines look naturally as lateral incisors.
case_images: CRID2014-795342.006.jpg
case_images: PMC4269306_02_CRID2014-795342.006.jpg
case_images: fig6
case_images: Tongue position remains correct after treatment and speech issues are better after pharyngeal surgery (Figure 6).