Functional Approach in Presurgical Infant Orthopedics for the Management of Unilateral Cleft Lip and Palate: A Case Report

Abstract

Presurgical Infant Orthopedics (PSIO) represents a fundamental tool in the early management of infants with cleft lip and palate, as it allows the severity of the defect to be reduced before primary surgery.

The functional approach of this presurgical treatment aims to restore the physiological balance of the stomatognathic system and stimulate maxillary segment growth through neuromuscular tongue activation, promoting alveolar and palatal closure prior to surgery.

This report describes a male patient with right complete unilateral cleft lip and palate, treated from the first day of life using functional presurgical orthopedics based on biological principles.

The treatment involved Functional Plates with transverse grooves on its surface (“Pannaci’s Modification”, 1997) designed to stimulate tongue activity and promote maxillary bone growth.

Anthropometric measurements taken at four stages (T1–T4) demonstrated a complete (100%) reduction of the alveolar gap and a palatal closure with nearly parallel alignment of the segments, accompanied by balanced transverse and sagittal maxillary growth.

These findings confirm the functional corrective effect of the treatment and support its early application as a strategy to reduce cleft severity and restore oral functions before primary surgery.