Tooth exposure using closed eruption modification techniques in orthodontic treatment in postgnatoplasty patients

Miftah Dharma Yanthi(1*), Cahya Yustisia Hasan(2), Bambang Dwirahardjo(3)

(1) Program Studi Bedah Mulut dan Maksilofasial Program Pendidikan Dokter Gigi Spesialis, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta
(2) Departemen Bedah Mulut dan Maksilofasial, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta
(3) Departemen Bedah Mulut dan Maksilofasial, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author


Cleft lip, alveolar cleft, and cleft palate are the most common disorder of all congenital abnormalities of the face, with an incidence of 65%. The initial treatment for this patient are labioplasty and palatoplasty that can affect the growth and development of the jaws. The next treatment are alveolar cleft closure and orthodontics treatment that are needed to obtain optimal results. Orthodontics treatment of patient with cleft lip, alveolar cleft, and cleft palate is difficult due to the lack of growth in the vertical and anteroposterior direction, abnormal shape and position of the teeth, impacted and disability of the teeth to erupt spontaneously. Thus, surgical treatment to support the success of orthodontics treatment is needed. Twelve year old female patient with a history of cleft lip, alveolar cleft, and cleft palate was presented. A labioplasty, palatoplasty, and gnatoplasty surgery (alveolar cleft closure procedure) was performed in 2013, when a bone graft from the patients’ iliac bone was placed on the alveolar cleft area. Radiographic examination showed transposition of canine (23) with premolar (24) thus spontaneous eruption was impossible. Surgical intervention of tooth exposure using closed technique modification to move the canine into the expected place was performed. The canine was successfully erupted and moved to its mesial position. This predictable result was found 6 months after surgery


alveolar cleft; impaction; tooth exposure; transposisi

Full Text:



Gorlin RJ, Cohen MM, Hennekam RC. Syndrom of the head and neck. Oxford: Oxford University Press; 2001.

Das D. A multidisciplinary approach in treating a patient with unilateral cleft alveolus. Kathmandu University Medical Journal. 2013; 42(2): 171-174.

Hamsa RPR, Rani TPR, Priya A. Caninus impactions – surgical and orthodontic considerations. International Journal of Dental Clinics. 2011; 3(3): 50-52.

Szarmach IJ, Szarmach J, Waszkiel D. Complication in the course of surgicalorthodontic treatment of impacted maxillary. Advances in Medical Sciences. 2006; 51: 217-220.

Bishara SE. Impacted maxillary canines: a review. American J Orthod Dentofacial Orthop. 1992; 101: 159–171.

Vijayalakhsmi R. Surgical exposure of an impacted maxillary canine and increasing a band of keratinized gingiva. J Indian Soc Periodontol. 2009; 13(3): 164–167.

Rui MR. Evaluation of craniofacial growth in patients with cleft lip and palate undergoing one-stage palate repair. Brazilian Journal of Plastic Surgery. 2011; 26(4): 624-630.

Whitaker ME, Freitas JAdS, Pegoraro-Krook MI, Ozawa TO, Lauris RdCMC, Lauris JRP, Dutka JCR. Relationship between occlusion and lisping in children with cleft lip and palate. The Cleft Palate-Craniofacial Journal. 2012; 49(1): 96-103.

Kokich GV. Surgical and orthodontic management of impacted maxillary canines. J Orthod Dentofacial Orthop. 2004; 126(3): 278-280.

Lawton H, Sandler PJ. The apically repositioned flap in tooth exposure. Dental Update. 1999; 26: 236-238.

Watchel HC. Session 11. In: Lang NP, Karring T, eds. Proceedings of the 1st European Workshop on Periodontology. SurgicalPeriodontal Therapy. London: Quintessence; 1994. 159-171.

Michael E, Kokich GV. Uncovering labially impacted teeth: apically positioned flap-close eruption techniques. The Angle Orthodontist. 1995; 65: 25-31.


Article Metrics

Abstract views : 168 | views : 327


  • There are currently no refbacks.

Copyright (c) 2020 MKGK (Majalah Kedokteran Gigi Klinik) (Clinical Dental Journal) UGM

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Currently, Majalah Kedokteran Gigi Klinik indexed by: