Dr. Michael Maroulakos

Treatment of craniofacial anomalies and facial clefts [Round Table]

Patients with craniofacial anomalies and facial clefts require dental, orthodontic and surgery services as a direct result of the medical condition and as an integral part of the habilitation process. Treatment often takes place in phases which may include treatment in infancy, the primary dentition, the transitional dentition and the permanent dentition. The skeletal and dental components should therefore be regularly evaluated to see if a skeletal asymmetry and malocclusion is present or developing. Diagnosis and treatment planning requires a variety of diagnostic records as well as clinical examination. Records are obtained in a serial fashion to monitor dentofacial growth and development as well as the results of ongoing treatment.

Associated problems with craniofacial anomalies and clefts may be: a. dental (missing or supernumerary teeth, peg-shaped, malpositioned, lack of bone support), b. skeletal (maxillary/mandibular deficiency, asymmetry), c. feeding (sucking, swallowing) , d. hearing (recurrent ear infections, middle ear built-up, hearing loss) , e. speech (hypernasality, hyponasality, articulation, resonance) and f. emotional and social issues (low self-confidence, peers teasing, over-estimations of diversity).

An organized craniofacial team based on guidelines from the American Cleft Palate-Craniofacial Association (ACPA) and Cleft Palate Foundation (CPF) is the most appropriate to provide coordinated treatment and care in a consistent manner. The individuals on team are: team coordinator, plastic surgeon, maxillofacial surgeon, orthodontist, speech and language pathologist, dentist, psychologist, social worker, geneticist, otolaryngologist, primary care specialist, audiologist and nurse.

Several craniofacial and cleft cases are presented from the surgical, orthodontic and dental standpoint.

Short Curriculum Vitae

Michalis-Panagiotis Maroulakos is an orthodontist who received his degree in dentistry from the School of Dentistry of the University of Athens (2005) and subsequently completed his training in the specialty of Orthodontics at the School of Dentistry of the University of Athens (2012). He took the exams at the Ministry of Health and received the title of orthodontic specialty (2013). He later retrained in the orthodontic treatment of surgical cases, craniofacial anomalies and special patients at Case Western Reserve University in the USA, receiving a scholarship from the American Dental Society of Europe (2015). During his specialization in the U.S. he was also a visiting assistant professor at Case Western Reserve University, in the Department of Orthodontics. He owns a private practice under the brand name Natural Smiles® in Alimos Attica and specializes exclusively in orthodontics for children, teenagers and adults. He has participated and distinguished himself in numerous works and conferences in Greece and abroad. He is an active member of Greek, American and international scientific organizations and orthodontic societies. In addition, he is a scientific associate in the postgraduate program of Orthodontics at the School of Dentistry of the University of Athens and is a member of the interdisciplinary team of the Hellenic Craniofacial Center, which specializes in the rehabilitation of facial and skull problems.