Surgical repositioning of the premaxilla in combination with two-stage alveolar bone grafting in bilateral cleft lip and palate.
OBJECTIVE
This paper introduces a surgical technique for premaxillary repositioning in combination with two-stage alveolar bone grafting for the correction of the premaxillary deformity of patients with bilateral cleft lip and palate (BCLP). The paper also reports on two patients with BCLP who underwent this surgical management.


METHODS
The operation is usually performed when the patient is 8 to 14 years of age. In the first stage of surgery, the side more accessible to the septo-premaxillary junction is selected, and an osteotomy of the premaxilla and unilateral alveolar bone grafting are performed. Approximately 4 to 12 months after the first stage of surgery, contralateral alveolar bone grafting is carried out.


CONCLUSIONS
We have found that this surgical procedure is highly effective, because it ensures the blood supply to the premaxilla and minimizes the potential for surgical failure. Moreover, it affords wide exposure of the premaxillary bone surface, facilitating sufficient boney bridging and allowing for orthodontic tooth movement.
Department of Dentistry and Oral Surgery, Saku Central Hospital, Nagano, Japan.
M
M
Iino
T
T
Sasaki
S
S
Kochi
M
M
Fukuda
T
T
Takahashi
T
T
Yamaguchi
D000293:Adolescent; D000543:Alveoloplasty / Q000379:methods*; D016025:Bone Transplantation; D002648:Child; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008437:Maxilla / Q000098:blood supply / Q000601:surgery*; D009297:Nasal Mucosa / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery; D017090:Occlusal Splints; D016910:Orthodontic Brackets; D010027:Osteotomy / Q000379:methods; D010521:Periosteum / Q000601:surgery; D014087:Tooth Movement Techniques; D016896:Treatment Outcome; D014945:Wound Healing