Aesthetical Reconstruction of an Anterior Tooth in an Alveolar Cleft Site: A Case Report and 3-Year Follow-up Findings

External appearance of the repaired cleft lip. Frontal view (a), and lateral view (b). Palatal view of the edentulous space before orthodontic treatment (c). Frontal and lateral views of the anterior region show a furrowed gingival shape caused by the alveolar cleft on the left side (d–f). Panoramic radiograph before extraction of #9 (g) and after extraction (h). Computerized tomography images of alveolar bone (i, j).

A large bone defect on the palatal side and beam-like bone were observed on preoperative 3-dimensional computerized tomography (CT) (a). Dental CT of the edentulous space (b); the size of the dental implant is indicated adjacent to the bone. Palatal view after orthodontic treatment (c); the edentulous space has been adjusted for 1 tooth. Preoperative frontal and lateral views of the anterior region (d–f). A dental implant has been installed within the host-bone bridge, and the volume of the buccal concavity augmented with bone substitute (g–k).

Figure 3. Panoramic radiograph after implant installation (a). Gingival volume and condition after bone augmentation with bone substitute. (b) A pontic has been bonded to the neighboring teeth prior to attachment of the provisional restoration. Buccal volume is well maintained after reentry surgery (c). The gingival scallop is well maintained during the healing course (d). Figure 4. External appearance after reconstruction; the muscles around the lip are more relaxed with the improved occlusion. Figure 5. Frontal view of the final reconstruction; the shape of the buccal gingiva is almost identical to that of the opposite side. The buccal volume and total aesthetics of the anterior region have been well maintained for 3 years.