How to treat cleft lip and palate sequence?

The treatment of patients with cleft lip and palate is a systematic project, with orthodontic treatment throughout. For patients with complete cleft lip and palate, nasoalveolar molding (PNAM) treatment can be performed prior to cleft lip repair; orthognathic treatment can be performed in the early mixed dentition as well as arch morphology regularization treatment prior to bone graft surgery; and conventional orthodontic treatment can be performed after bone graft surgery (late mixed dentition or early permanent dentition). Most of the patients have obtained considerable results with the above sequence of treatment, and the need for orthognathic surgery can often be dispensed with. For some patients with severe disorders of jaw development, orthodontic treatment before orthognathic surgery is performed around the age of 16 years.