Management of the Prominent Premaxilla in Bilateral Cleft Lip and Palate

Aburezq, Hisham; Daskalogiannakis, John; Forrest, Christopher R.

doi:10.1597/04-114r.1

Cited by 43 publications

(24 citation statements)

References 10 publications

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“…In their article, Aburezq et al [ 22 ] describe four patients who were treated with an osteotomy of the premaxilla combined with secondary alveolar bone grafting. There was no loss of the premaxilla, and good consolidation was seen in three patients.…”

Section: Resultsmentioning

confidence: 99%

Management of the premaxilla in the treatment of bilateral cleft of lip and palate: what can the literature tell us?

et al. 2015

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ObjectiveIn the treatment of bilateral cleft lip and palate (BCLP) patients, there is discussion about the management of the position of the premaxilla. This literature analysis summarises the literature on managing this condition.Materials and methodsA PubMed, Embase and Cochrane Library search was conducted resulting in 4465 articles which were screened on title and abstract.ResultsSeventy-one articles were available in full text, 16 of which were included in this literature analysis. We searched on keywords timing and technique, complications, growth of the maxilla and results after bone grafting the alveolar process. This literature analysis has shown that there are various ways to correct the position of the premaxilla. These can be divided into primary, early, late secondary and tertiary intervention before the age of 8 years, between the ages of 8 and 12 years and older than 12 years. Correction is done with surgery, orthodontics or a combination, with or without bone grafting.ConclusionsAn osteotomy of the premaxilla in combination with secondary alveolar bone grafting appears to be the most successful technique. Combining early secondary alveolar bone grafting with osteotomy creates more room to ensure a watertight closure of the nasal mucosa resulting in fewer postoperative complications. Before surgery, the orthodontist should try to optimise the position of the premaxilla for its surgical correction prior to bone grafting.Clinical relevanceThe treatment of BCLP patients is still based on experience and expert opinions. This literature analysis tries to give a summery on how to handle the protruded and displaced premaxilla.

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Section: Resultsmentioning

confidence: 99%

Management of the premaxilla in the treatment of bilateral cleft of lip and palate: what can the literature tell us?

et al. 2015

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“…Osteotomy of PM at secondary alveolar bone grafting is considered ideal [6]. Commonly encountered complications in these types of cases where the loss of alveolar bone graft and mobility of PM due to fibrous union or non-union.…”

Section: Discussionmentioning

confidence: 99%

“…It also requires the second stage for removal of an arch bar and maintaining of oral hygiene is difficult so it is our least preferred method of fixation. Alexander et al in 1990 reported a prefabricated appliance aid in stabilization, using that idea we fabricated two different devices, which had been used in second and fifth cases [6]. But challenges faced during surgery were poor control over the osteotomized PM and three-dimensionally inadequate stability of bodily movement of the osteotomized PM.…”

Section: Discussionmentioning

confidence: 99%

Fixation techniques in surgical repositioning of the prognathic pre-maxilla during alveolar bone graft surgery in bi-lateral cleft lip and palate patients

et al. 2018

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“…Some unilateral alveolar clefts will also require premaxilla osteotomy and repositioning where cleft lip repair had been neglected or overly delayed. Some authors advocated the amputation of the premaxilla [21], while others prefer to reposition it [22]. Where possible, it is preferable to pre-serve the native bone of the premaxillary segment so that amputation should be the last resort.…”

Section: Discussionmentioning

confidence: 99%

Tertiary bone grafting with or without premaxilla osteotomy in adult alveolar clefts—Techniques and early outcome

Akadiri¹,

Akinbami²,

Kejeh³

2012

OJST

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The outcome of alveolar bone grafting in adult patients is sparsely reported. Here, we present a description of the surgical techniques used in a Nigerian teaching hospital and a preliminary report of the first five cases of adult alveolar cleft bone grafting accomplished with or without repositioning the premaxilla. Although, evidence of bone resorption was observed within 6 months after the operation, satisfactory bone level and aesthetic outcome was recorded in all cases. We concluded that tertiary alveolar bone grafting is desirable for all cases where alveolar clefts have persisted into adulthood to enhance the psyche of the cleft patients and to motivate them for further rehabilitation. Prompt placement of dental implant into the grafted area is recommended to mitigate subsequent resorption of the bone graft.

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Management of the Prominent Premaxilla in Bilateral Cleft Lip and Palate

Abstract: With appropriate patient selection, bilateral alveolar bone grafting with premaxillary repositioning is a safe procedure and can produce good aesthetic and functional results.

Cited by 43 publications

References 10 publications

Management of the premaxilla in the treatment of bilateral cleft of lip and palate: what can the literature tell us?

Management of the premaxilla in the treatment of bilateral cleft of lip and palate: what can the literature tell us?

Fixation techniques in surgical repositioning of the prognathic pre-maxilla during alveolar bone graft surgery in bi-lateral cleft lip and palate patients

Tertiary bone grafting with or without premaxilla osteotomy in adult alveolar clefts—Techniques and early outcome

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