{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T12:29:23Z","timestamp":1786883363691,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This case report describes the esthetic\u2010functional rehabilitation of a patient with unilateral complete cleft lip and palate who was managed multidisciplinarily from 10 to 18\u2009years of age, and reports the clinical outcome 5\u2009years after definitive prosthetic rehabilitation, which was undertaken after late secondary alveolar bone grafting had yielded insufficient bone volume for implant placement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Considerations<\/jats:title>\n                    <jats:p>Phased orthodontic treatment from age 10\u201317 (slow maxillary expansion, fixed appliances, growth\u2010coordinated space management) was followed by late secondary alveolar bone grafting at age 17, with concurrent extraction of the periodontally compromised lateral incisor. Although grafting achieved meaningful structural and soft\u2010tissue reconstruction of the cleft zone, postoperative cone\u2010beam computed tomography confirmed that the residual bone height and width remained insufficient for implant placement; after the patient declined further augmentation, a six\u2010unit canine\u2010to\u2010canine monolithic zirconia fixed dental prosthesis incorporating a pink\u2010ceramic\u2010extended ovate pontic was adhesively cemented at age 18 with a 10\u2010methacryloyloxydecyl dihydrogen phosphate\u2013containing dual\u2010cure resin cement, combined with continued dual orthodontic retention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Five years after definitive cementation, the restoration was clinically intact, with non\u2010inflamed abutment periodontal conditions and maintenance of bilateral Class I occlusal relationships, transverse maxillary arch form, and esthetic outcome. Maintenance of the transverse arch form is most plausibly multifactorial and is attributed principally to the sustained orthodontic retention protocol rather than to the anterior restoration. This case illustrates the 5\u2010year performance of cross\u2010arch tooth\u2010supported zirconia rehabilitation combined with prosthetic soft\u2010tissue masking and continued orthodontic retention in a cleft patient in whom implant therapy was not feasible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Significance<\/jats:title>\n                    <jats:p>Cross\u2010arch monolithic zirconia rehabilitation with a pink\u2010ceramic\u2010extended ovate pontic can provide an esthetic\u2010functional pathway in cleft lip and palate patients in whom implant therapy is not feasible. In the present case, transverse maxillary arch form was maintained over 5\u2009years under continued orthodontic retention, indicating that anterior\u2010only prosthetic rehabilitation is compatible with preservation of arch form when retention is sustained.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jerd.70250","type":"journal-article","created":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T11:49:41Z","timestamp":1786880981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Esthetic\u2010Functional Rehabilitation of Unilateral Cleft Lip and Palate With a Cross\u2010Arch Monolithic Zirconia Fixed Dental Prosthesis Following Multidisciplinary Treatment: 5\u2010Year Post\u2010Prosthetic Follow\u2010Up"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9165-8729","authenticated-orcid":false,"given":"Gizem","family":"Altundal","sequence":"first","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry Istanbul Kent University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0655-1598","authenticated-orcid":false,"given":"Sinem","family":"G\u00fcm\u00fc\u015f","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry Istanbul University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1192-9520","authenticated-orcid":false,"given":"Erol","family":"Kozano\u011flu","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul Faculty of Medicine Istanbul University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9013-8155","authenticated-orcid":false,"given":"Sevde \u015eirik\u00e7i","family":"Biberci","sequence":"additional","affiliation":[{"name":"Private Practice  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3450-6643","authenticated-orcid":false,"given":"Asuman Deniz G\u00fcmr\u00fc","family":"\u00c7elikel","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry Istanbul University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,16]]},"reference":[{"issue":"4","key":"e_1_2_12_2_1","article-title":"Orthodontic Treatment of Patients With Cleft Lip and Palate From Birth Through Maturity","volume":"30","author":"Schechter J.","year":"2024","journal-title":"Seminars in Orthodontics"},{"issue":"3","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1590\/1679-775720130127","article-title":"Rehabilitative Treatment of Cleft Lip and Palate: Experience of the Hospital for Rehabilitation of Craniofacial Anomalies\/USP (HRAC\/USP) \u2010 Part 4: Oral Rehabilitation","volume":"21","author":"Freitas J. 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