Abstract
The three-dimensional deformities of the premaxilla are often found in bilateral cleft lip and palate (BCLP) patients following primary repair. It is sometimes necessary to perform osteotomy of the premaxilla, because it is difficult to obtain satisfactory occlusion by orthodontic treatment to the floating premaxilla only, especially the indicated protrusion with an excessive deep bite, or reversed occlusion. Surgical repositioning the displaced premaxilla and simultaneous bone grafting into the alveolar cleft were performed on 9 BCLP patients from 1974 to 1995.
The results were as follows:
1. Good results were achieved, and all patients currently have acceptable results. The usefulness of this surgical procedure was confirmed, as follows:
1) The displaced premaxilla can be repaired th ree-dimensionally as assumed preoperatively by this surgical technique.
2) Since cross-linking of bone occurred in the alveolar cleft portion, orthodontic treatment of not only central incisors but also lateral teeth became easy after this surgical procedure. Therefore, the desirable occlusion can be obtained.
3) The residual oronasal fistula around the premaxilla can be closed simultaneously.
4) The preoperative esthetic deformity and oral functional disorder can be corrected.
2. It is important to have close cooperation between oral surgeon and orthodontist for obtaining long lasting good results.
3. This surgical procedure should be performed actively, because it is valuable and orthodontic treatment is proggressing.
