case_images: PMC5299194_01
case_images: Extraoral views.
case_images: CRID2017-7620416.001.jpg
case_images: PMC5299194_01_CRID2017-7620416.001.jpg
case_images: fig1
case_images: Clinically, the patient exhibited multiple craniofacial anomalies, including a fissure on the upper part of the face, encephalocele, corneal opacity of the right eye, hypertelorism, severe hearing loss on the left side, and evident asymmetry (Figure 1).
case_images: (a) Right hand. (b) Right foot.
case_images: CRID2017-7620416.002.jpg
case_images: PMC5299194_01_CRID2017-7620416.002.jpg
case_images: fig2
case_images: The remainder of his body manifested constriction rings and anomalies in hands and feet (amputation and lymphedema) (Figure 2).
case_images: (a) Palate cleft view. (b) The obturator device (the hole was created to permit the recent eruption of the right central incisor). (c) Intraoral placement of the obturator.
case_images: CRID2017-7620416.003.jpg
case_images: PMC5299194_01_CRID2017-7620416.003.jpg
case_images: fig3
case_images: The intraoral clinical examination demonstrated a "Y"-shaped lip-palatal fissure from the soft palate terminating with a bifurcation in the upper lip and nose (Figure 3).
case_images: The patient's facial view, 10 months after the first examination.
case_images: CRID2017-7620416.004.jpg
case_images: PMC5299194_01_CRID2017-7620416.004.jpg
case_images: fig4
case_images: He showed a brachyfacial pattern and midface/maxillary arch hypoplasia (Figure 4) but a poor oral-hygiene level; the obturator had been properly used, and marked improvement in swallowing and feeding during the previous 3 months was manifested.
case_images: (a) Most recent view of the maxillary arch. (b) Adjustments made to the palatal obturator, according to the eruption process of primary teeth. (c) Palatal obturator well adapted in mouth.
case_images: CRID2017-7620416.005.jpg
case_images: PMC5299194_01_CRID2017-7620416.005.jpg
case_images: fig5
case_images: However, the device was not well adapted because the upper primary central incisors and first molars were in the eruption process; therefore, the corresponding acrylic trimmings were performed (Figure 5).