Cleft lip and palate patients deserve to obtain a pleasant facial appearance, an esthetic smile, and excellent function. To reach these goals, the road can be long with numerous pitfalls to avoid. After establishing a careful diagnosis and identifying a problem list, we must coordinate for each patient a custom-made interdisciplinary treatment plan with the CLP team, the different referral specialists, and the patient and his parents. To get successful long-term outcomes, the patient must be involved and considered as a key actor of the team. Treatment objectives need to be specific to each patient and should take into account anatomical parameters, growth direction, expected cooperation, financial considerations and also patient’s demand. Treatment must be efficient, and evidence based to reduce CLP patients burden of care. More specifically for orthodontists, once the orthodontic treatment plan has been established with the CLP team, one needs to design efficient orthodontic/orthopedics mechanics to deliver the proper force system to reach the treatment objectives. Nowadays, progress in cleft primary surgical repair, associated to a better timing of alveolar bone graft before the eruption of the permanent maxillary incisors make orthodontic treatment easier and improve our patients esthetic and functional outcomes. Further, 3D technology from CBCT, 3D impressions and 3D printing help us to conduct efficient orthodontic treatments while simplifying them, with a true benefit for the orthodontist and his patient. Therefore, orthodontists should become now more confident treating these patients with no fear. CLP patients and their families are always truly grateful for their treatment which is very rewarding for the orthodontist and his team. This lecture will go over +30 years of experience on CLP clinical treatment and research to show what we have learned to simplify treatments and to optimize long term functional and esthetics results. Combined surgical, orthodontics and prosthodontics protocoles will be described using clinical illustrations on consecutive and longitudinal cases from birth to end of growth.

Learning Objectives:

1. Cleft Lip and Palate patients need a multi-interdisciplinary team care and a person’s center approach
2. Progress of primary surgery, advances of 3D Technology and optimal timing of the Alveolar Bone Grafting (ABG) before eruption of the permanent maxillary incisors have significantly simplify orthodontic treatment, improve functional and esthetic outcomes, reduce burden of care and enhance patient’s quality of life
3. CLP patients treatment outcomes need to be evaluated at the end of growth