Vertical Control and Reduction of a Functional Mandibular Shift in Severe Class III Malocclusion With Unilateral Cleft Lip and Palate

Abstract

Severe skeletal Class III malocclusion in repaired cleft lip and palate (CLP) may include fixed maxillary deficiency and a functional mandibular shift. A 15-year-old girl with unilateral complete CLP underwent staged nonsurgical treatment using posterior bite blocks, maxillary alignment, mandibular second-premolar extraction, and sequential unilateral posterior vertical elastics. Positive overjet and overbite, Class I posterior relationships, and profile improvement were achieved, while ANB changed only from −5.67° to −5.15°. The result represents dentoalveolar and functional camouflage, not skeletal correction. At 12 months, clinical examination and photographs showed short-term occlusal maintenance; no quantitative or radiographic retention measurements were obtained.