Prosthodontic Rehabilitation of a Patient with Unilateral Cleft Lip and Alveolus Using an Extracoronal Precision Attachment-Retained Removable Partial Denture: A Case Report

Abstract

Background: Cleft lip and alveolus is one of the most common congenital craniofacial anomalies and is frequently associated with missing teeth, alveolar bone defects, compromised lip support, and aesthetic concerns. Prosthodontic rehabilitation plays a crucial role in restoring oral function, facial appearance, and psychological well-being in affected patients. Precision attachment-retained removable partial dentures offer a viable treatment option when conventional fixed prostheses or implant-supported restorations are limited by anatomical constraints. Case Presentation: A 24-year-old male patient with a history of surgically repaired unilateral cleft lip and alveolus presented with missing maxillary anterior teeth, inadequate lip support, and compromised aesthetics. Clinical and radiographic examination revealed congenital absence of the maxillary left central incisor and significant alveolar ridge deficiency in the cleft region. Considering the extent of the defect and limited bone availability, rehabilitation was planned using an extracoronal precision attachment-retained removable partial denture. The abutment teeth were restored with porcelain-fused-to-metal crowns incorporating the male components of the attachment, while the female components were incorporated into the removable prosthesis. Results: The definitive prosthesis demonstrated satisfactory retention, stability, aesthetics, and functional performance. Restoration of lip support significantly improved the facial profile and smile appearance. The patient reported enhanced comfort, confidence, and overall satisfaction with the treatment outcome. Conclusion: Precision attachment-retained removable partial dentures represent a predictable and aesthetically acceptable treatment option for selected patients with cleft lip and alveolus, particularly when implant therapy is contraindicated or when replacement of both hard and soft tissue structures is required.