Oral and Maxillofacial Surgery

Case of the Month

March 1998


The patient was a 18 y.o. white male refered by his orthodontist for evaluation of his residual cleft lip and palate following primary closure as an infant.


Medical history revealed a well-developed white 18 y.o. male. The patient had no known drug allergies. There were no serious illnesses. The patient was not taking medications. No serious illness was noted in the medical history.

Oral examination revealed carious teeth numbers 3, 8, and 19. Teeth numbers 1, 11, 16, 17, and 32 were noted to be impacted. A Class III malocclusion was noted with maxillary retrognathia and hypoplasia. Pseudomandibular prognathism was present with a concave facial profile. An oral-nasal fistula was noted in the anterior maxillary vestibule located apical to a ponic that had been orthodonticly band for cosmetic replacement of tooth number 8. The orifice of the fistula was aproximately 6 mm in diameter.

Oral-nasal fistula

Occlusal x-ray of cleft

Prior to orthodontic treatment



  1. Maxillary Alveolar Cleft Bone Graft (iliac cancellous marrow)
  2. Closure of Oral-nasal Fistula
  3. Orthodontic treatment


The patient also under went orthognathic surgery for correction of his Class III skeletal deformity.


Patient treated by:
  • Dr. Steven R. Tucker Oral and Maxillofacial Surgery
  • Dr. James A. Wells Orthodontist

 Steven R. Tucker DMD, PSC
 Oral and Maxillofacial Surgery
 909 Scherm Road
 Owensboro, KY 42301
 phone: 1-502-926-4107
 fax: 1-502-926-4166
 url: http://www.srt-psc.com


Last Modified: February 28, 1998

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