Cleft lip and palate patients often are missing one or more front teeth. If you have a cleft palate, having dental implants can be much more difficult. If you’re interested in dental implants for cleft palate, please be aware that unique and complex solutions are needed to manage the way your smile looks and the foundation of the bone. Choosing an experienced dental implants dentist is important.
In this case, the patient has some baby teeth that are decaying along with a cleft. His smile is a bit off because of the cleft lip surgery when he was a child. There appears to be no “center” to the smile. A face scan is a major benefit and a big part of my workflow for patient success.
Cleft Lip Palate -Before -
Cleft Lip Palate Dental Implants -After
A unique solution was needed. He was told implants were not possible and to just have a removable partial. Sometimes rebuilding the cleft bone can be done. I have done this many times before. But another option is to avoid the cleft and implant around it.
The teeth that could not be saved were extracted and bone grafts were done to preserve the bone ridge. At the same time a digitally designed, laboratory fabricated bridge was retrofitted over some of the adjacent teeth that would be crowned into a bridge.
The dental implant was left below the gumline while the natural teeth supported the bridge and the bone healed from the extraction socket preservation grafting.
The patient was allowed to heal for about 3 months.
Overall this patient took about 3 months and a single surgery under IV sleep sedation to complete treatment. There was about 3 total major visits. A very important part of the process is making temporary prototypes in order to test everything before going to the final. Testing prototypes is something I do for every complex case as it allows me and my patient to really see what is going on and how things will look.
The final bridge (made from zirconia) utilized a customized abutment that would be cemented to the bridge. Although it is not normal to connect implants to natural teeth, sometimes patients with cleft lip/palate need unique situations. This can be done by modifying the bridge design connection and can be quite successful.
What do you think?
Comments and questions are welcomed!
Ramsey Amin, DDS
Burbank, California
Hello! I am a 47 year old living on Oregon, born with a cleft palate. I have had a bridge for the past 32 years anchored by my natural canine and front left incisor. Due to extreme gum recession, my canine is loose. Just had a dental appointment and there is no nerve response in that tooth. I already had a bone graft into the cleft when I was 12 years old to strengthen the uppse palate to handle braces and eventually this bridge. I have Oregon Health Plan insurance’ they tell me bridges and implants are not covered, and I am not sure how best to navigate the new dental work I need done. Surely I can push and appeal for exeptions due to my congential birth defect. (?) But it sounds like working with people who have experience with cleft palate patients is better. I can pay out of pocket if I have to due to the blessing of savings.
Is it best to research and look outside of what insurance will cover?
The dead canine will not last in my mouth for long, and at this point I cannot bite into anything or chew in a way that involves the bridge. It is distressing!
Any advice is most welcome!
I wish I could help on this topic. Dental insurance policies generally cover a portion of the cost of most dental procedures, including major procedures such as root canals, crowns, and bridges. However, dental insurance policies often have limits on the amount of coverage they provide for major procedures, and they may require the policyholder to pay a portion of the cost out of pocket. Some dental insurance policies also have exclusions or restrictions on certain types of treatment, such as cosmetic procedures that are not medically necessary.
There are several reasons why dental insurance policies may have limits on coverage for major procedures. One reason is that these procedures can be very expensive, and insurance companies need to balance the cost of providing coverage with the premiums that policyholders pay. Additionally, dental insurance is often designed to cover preventive and routine care, which can help to avoid the need for more costly treatments down the road.
Try seeing someone who has the ability to bill medical but it usually does not work; ;-(
Hi my name is Amanda and I’m cleft lip and pallet I’ve had issues with my teeth since I’ve been a kid now I’m 31 years old and they seem to always hurt me where would be a great place to go to get fake teeth screws in something so I can be confident I live in lexington ky I need help asap
You need to be very careful who you see. Your case is advanced! Do your own research, then call a few offices to ask their experiences in cleft patients. Be sure to have the staff as the doctor as they may not be 100% aware since cleft treatment is not super common.
Hey Dr. Amin. I am also a cleft lip and cleft palate patient. I’m 32 years old now my teeth are failing. considering they said I wouldn’t have them past 18, guess I’m lucky, however what is not lucky is the cost of implants. Just wondering if you know of any organizations that help with cost for cleft patient’s get implants.
I am sorry-I am not sure. I believe somehow you and I connected before because I recall your name but I cannot place you.
Hey Dr. Amin,
I have recently gotten 2 dental implants in the anterior maxilla with a 3 unit bridge. Implant and right central incisor and left lateral incisor with a Pontic in my left central incisor.
I lost the teeth due to trauma(assault).
My question is this, if I was to get hit(punched for example) in that same spot with the implants, what will happen? Obviously I hope I never get assaulted again but I have read online that if you get punched in the same spot that your jaw will break and now I am living in constant fear since that traumatic incident.
Will implants make my jaw(maxilla) more fragile than before? Or stronger?
I know it’s a weird question but I haven’t seen an answer from a implant specialist.
OH gosh. I am so sorry about what happened. Your jaw is unlikely to break! Implants do not make your jaw weaker. You might break the pontic of the bridge if you were really hit hard. I hope this NEVER happens to you again!
Hello. How do you feel about the LAPIP procedure , and how do you feel about laser cleaning around the implants to kill any bacteria around them. My perio who placed my implants is OK with it, my dentist who placed the bridge on the implants says laser around the implant is bad and may cause bone “necrology” I think is the word he used, not sure.
Thanks
LAPIP only if there is some type of problem. Other than that no need!