Infant orthopedics in a cleft patient is done at the age of:
In patients with a bilateral cleft, the premaxillary segment is often displaced anteriorly while the posterior maxillary segments are lingually collapsed behind it. If this distortion is severe, surgical closure of lip, will become extremely difficult. So orthodontic intervention to reposition the segments and to bring the protruding premaxillary segment back into the arch may be needed to obtain a good surgical repair of lip. This is achieved by "infant orthopedics".
Infant orthopedics was pioneered by Burston. In a child with bilateral cleft, the maxillary segment requires two movements i.e., lateral expansion and posterior reposition. This movement is accomplished by a Light elastic strap across anterior segment. In infants, the segments can be repositioned surprisingly, quickly and easily, so that the period of active treatment is only a few weeks at most. If pre-surgical movement of maxillary segment is needed, this typically would be done beginning at 3 to 6 weeks of age, so that the lip closure could be carried out approximately 10 weeks. A passive plate similar to an orthodontic retainer is then used for a few months after lip closure.
1 - 2 weeks
3 - 6 weeks
9 - 12 weeks
12 - 15 weeks