Surgical Repositioning of the Premaxilla With Bone Graft in 50 Bilateral Cleft Lip and Palate Patients

Secondary alveolar bone graft in patients with bilateral cleft lip and palate submitted to premaxilla repositioning: retrospective study

“…There is a consensus among authors that the clefts are a congenital malformation with a multifactorial etiology, which occurs in the embryonic period (3 rd to 8 th week of intrauterine life) and early fetal period (7 th to 12 th week of intrauterine life), due to disability or lack of fusion between primary and secondary facial and palatal processes [5,9,[21][22][23]29].…”

“…Many authors follow the classification adopted by Spina [27] that uses, as reference element, the incisive foramen, which is characterized by the boundary between the primary and secondary palates -prolabium, premaxilla and cartilaginous septum -dividing the clefts into three types: pre-foramen, post-foramen and trans-foramen [2,7,27]. In this sense, pre-foramen cleft may be unilateral, bilateral and median; the post-foramen cleft is characterized as mainly median cleft palate, that may involve only in the uvula and soft palate, or all hard palate [7,27].…”

“…Still according to Spina's classification, both unilateral and bilateral trans-foramen clefts are more severe, since they affect the lip, alveolar process and palate [6,7,27]. The complete bilateral cleft is the most severe and extensive one, with a prevalence of 14-18% [23].…”

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

“…The firm stabilization of the osteotomized and mobilized prolabium is vital for the success of the alveolar bone graft surgery. Several techniques have been used for fixation of the osteotomized segment, but no single technique is considered the standard [3][4][5]. We describe different techniques used in a tertiary care facility for fixation of the PM following osteotomy.…”

Pilot study of pre-maxilla replacement and bone graft in a patient with lip and palate clefts: transforaminal relationship between upper canines and bone graft

“…Having had a bone graft, or with the assistance of bone graft, changes in upper jaw growth are minimized because the majority of bone growth in the time of repositioning of pre maxilla, is already complete [9]. Treatment of pre maxilla in patients with bilateral clefts there are surgical procedures, such as complete refurbishment of the pre maxilla, promoting a better sealing lip [10], and the repositioning of pre upper jaw with autogenous bone graft [11].…”