Orthodontic treatment for a 10-years-old girl, with repaired bilateral cleft lip and left incomplete unilateral alveolar cleft, was performed by moving her right maxillary central incisor across the midline to replace her congenital missing central incisor, and then moving the right lateral incisor toward the midline to act as a new central incisor. A malformed supernumerary tooth, positioned between the right central and lateral incisor, was extracted during incisor movement. Significant lip profile improvement was accomplished by maxillary and mandibular anterior teeth retraction into three-premolar extraction spaces. Not only natural functional occlusion, deviated midpalatal suture along the central incisor, and no obvious root resorption were obtained but also narrowing the alveolar bone cleft which was beneficial for bone continuity supporting dental structures, satisfactory results were possible for the patient with primary palate cleft.

Keywords: Central incisor, Cleft lip, Cleft palate, Midline, Missing tooth, Supernumerary tooth