An Intraoperative Rescue Procedure for the Protruding Premaxilla in the Repair of Complete Bilateral Cleft Lip: Rapid Premaxillary Molding

Chung, Kyung Hoon; Sato, Nobuhiro; Chou, Pang-Yun; Lo, Lun-Jou

doi:10.1177/1055665620938480

Cited by 7 publications

(6 citation statements)

References 34 publications

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“…In some previous studies, various devices and/or surgical techniques have been reported to correct protruding or de-formed premaxilla in patients with CBCL [2][3][4][5][6][7][8][9] .…”

Section: Discussionmentioning

confidence: 99%

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Surgical Premaxillary Setback with Vomerine Ostectomy for Complicated Bilateral Cleft Lip

Oda

Ojima

Ayabe

et al. 2024

JPRS

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Important factors that affect the initial repair of complete bilateral cleft lip (CBCL) include not only the width of the cleft but also the distance between the premaxilla and alveolar bone. We report a case of a patient with CBCL in whom favorable morphological and aesthetical results were achieved by surgical premaxillary setback. The patient was a 5-month-old boy with CBCL, who had a severely protruding premaxilla. Despite repeated lip adhesion before lip closure surgery, wound dehiscence occurred, and therefore, we performed premaxillary setback with vomerine ostectomy. The bone was removed posterior to the vomero-premaxillary suture, and the premaxilla was indirectly stabilized by bilateral mucosal bridging. The procedure for the vomer worked well, and his premaxilla was moved back enough to undergo surgery. The premaxillary setback is thought to be a reasonable option to treat CBCL in patients with a protruding premaxilla. The subsequent long-term follow-up of the midfacial development of these patients is necessary.

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“…In some previous studies, various devices and/or surgical techniques have been reported to correct protruding or de-formed premaxilla in patients with CBCL [2][3][4][5][6][7][8][9] .…”

Section: Discussionmentioning

confidence: 99%

“…For example, Chung et al performed the intraoperative "rapid premaxillary molding" technique to patients with complete bilateral cleft lip and palate and obtained satisfactory results 2) . Their method is as follows: intermittent manual compression to the premaxilla is applied until mobility is achieved.…”

Section: Discussionmentioning

confidence: 99%

Surgical Premaxillary Setback with Vomerine Ostectomy for Complicated Bilateral Cleft Lip

Oda

Ojima

Ayabe

et al. 2024

JPRS

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“…While the absence of surgical repositioning would have had significant consequences, there are some risks to consider SRP during childhood. Firstly, premaxilla necrosis by vascular compromise is a rare but serious complication (Chung et al, 2021). Secondly, pseudoarthrosis is more frequent but can be treated with GPP and alveolar bone grafting.…”

Section: Discussionmentioning

confidence: 99%

“…), SRP is performed to avoid psycho-social (Berkowitz, 2005) and traumatic troubles (da Silva, 2005) related to the premaxilla protrusion. Rapid Premaxilllary Molding is a SPR variation that has been described to setback the premaxilla when one-stage surgery is required during early childhood, especially in developing countries where delayed referrals are more common (Chung et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Surgical Repositioning of the Premaxilla: Incidence, Indications and Growth Study About a 189 Bilateral Cleft Lip ± Palate Population

Drilleaud

Corre

Perrin

et al. 2022

The Cleft Palate Craniofacial Journal

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Objective We aimed to evaluate the rate of patient requiring Surgical Repositioning of the Premaxilla in a population carrying BCL ± P, retrieve age and operative indication. Our secondary objective was to present further facial growth characteristics. Settings This was a retrospective, single-center cohort study conducted in Nantes University Hospital, Oral and Maxillofacial Surgery department, tertiary cleft center. Patients Patients with BCL ± P born between 1980 and 2019 treated at Nantes University Hospital were included. Main outcome measure Our primary outcome measure was the rate of patient requiring SRP. Results Over the whole period, 189 patients with BCL ± P were identified. Three patients (1,58%) underwent SRP. Patients who underwent SRP all had BCLP. SRP was performed during their primary dentition period. The indication for surgical repositioning was always premaxilla vertical overgrowth with an overbite over 10 mm. Facial growth features in the three patients were mostly comparable with a population carrying BCLP who had no premaxillary surgery. Conclusion Our results showed a low incidence of SRP. No SRP was necessary during early infancy (ie, before lip repair) or during adulthood. Surgical repositioning of the premaxilla is beneficial for patient with orthodontically uncorrectable vertical premaxillary excess, even more since facial development compared with other patients with BCLP appears comparable.

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“…Cleft treatment should help our patients to live life as normally as possible. 22 We needed to enable an unoperated 3-year-old asocial boy with a severe case of BCCLP, protruding premaxilla, and facial deformity, to lead a regular life. This paper proposes a successful presurgical orthopedic protocol to achieve this goal.…”

Section: Discussionmentioning

confidence: 99%

Presurgical Orthopedic Treatment of a 3-Year-Old Child with Unoperated Complete Bilateral Cleft Lip and Palate and Protruding Premaxilla

Radojicic

Trifunovic

Cutovic

et al. 2022

The Cleft Palate Craniofacial Journal

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Unoperated patients with bilateral complete cleft lip and palate (BCCLP), who do not receive orthopedic treatment in infancy and present with significant sagittal excess of the premaxilla, are among the most difficult patients to treat. Delay in primary reconstruction reduces the elastic characteristics of the tissues. The resulting rigidity of bony structures accompanied by the wide alveolar and palatal clefts associated with sagittal excess of the premaxilla pose a great challenge for both surgeon and orthodontist. There is no unique protocol for treatment of these conditions. This paper describes the use of orthopedic treatment in an unoperated 3-year-old male child with BCCLP and a protrusive premaxilla whose appearance and function were both severely affected. A modified Meazzini technique, as described in operated BCCLP patients with a downward-displaced premaxilla, was used. The device itself consists of the 2 independent components mutually connected by a 17 × 25 steel arch. The first is an active fan-type expander. The second consists of an acrylic cap covering the premaxilla and 3 brackets used for the steel arch application. They are connected by a rectangular steel 17 × 25 archwire. Reduction of the premaxillary sagittal excess of is carried out with an elastic chain. The use of this orthopedic appliance is a reliable and valuable presurgical treatment in the therapy of children with BCCLP and protrusive premaxilla whose orthopedic and surgical treatment have been delayed.

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An Intraoperative Rescue Procedure for the Protruding Premaxilla in the Repair of Complete Bilateral Cleft Lip: Rapid Premaxillary Molding

Cited by 7 publications

References 34 publications

Surgical Premaxillary Setback with Vomerine Ostectomy for Complicated Bilateral Cleft Lip

Surgical Premaxillary Setback with Vomerine Ostectomy for Complicated Bilateral Cleft Lip

Surgical Repositioning of the Premaxilla: Incidence, Indications and Growth Study About a 189 Bilateral Cleft Lip ± Palate Population

Presurgical Orthopedic Treatment of a 3-Year-Old Child with Unoperated Complete Bilateral Cleft Lip and Palate and Protruding Premaxilla

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