Premaxillary Osteotomy and Guided Tissue Regeneration in Secondary Bone Grafting in Children with Bilateral Cleft Lip and Palate

Abstract

Premaxillary osteotomy allows repositioning of the premaxilla to its optimal preplanned position and successful closure of all fistulae. We have found that use of a collagen membrane is a useful adjunct.

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

“…The premaxillary was stabilized using an acrylic bulb, and molar bands to lateral segments which were connected by a stainless steel bar ultimately leads to surgical site infection. After bridging the lateral fragment and PM, alveolar cleft bone graft reinforces stability and vascularity to the repositioned PM [2,4,5]. However, some surgeons prefer bilateral alveolar bone grafting [2,4,5,7].…”

“…After bridging the lateral fragment and PM, alveolar cleft bone graft reinforces stability and vascularity to the repositioned PM [2,4,5]. However, some surgeons prefer bilateral alveolar bone grafting [2,4,5,7]. We preferred two-stage surgery as these techniques employed are new to us.…”

“…The current surgical practice of alveolar bone grafting promotes mobilization and repositioning of the PM between lateral segments [2]. The firm stabilization of the osteotomized and mobilized prolabium is vital for the success of the alveolar bone graft surgery.…”

Social integration and inclusion after pre-maxilla surgical repositioning in patients with bilateral cleft palate and lip

“…Other groups of researchers agree that the premaxilla osteotomy allows for a proper upper arch alignment and creates a better tilt of upper incisive teeth13. As to the type of graft used, there are many donor areas that can be used; the mandible is the best one because it bears similar embryonary origin [14][15][16][17] .…”

Premaxillary osteotomy fixation in bilateral cleft lip/palate: Introducing a new technique

“…In such a situation, osteotomy of the premaxilla to set it back between lateral segments is useful. 1 For fixation of osteotomized premaxilla some techniques and devices have been recommended, such as internal fixation with miniplate to fix it laterally to adjacent lateral segments, Kirshner wire that is inserted above and in between the maxillary central incisors and fixation of the premaxilla posteriorly, between the lateral segments and finally a cortical bone graft as a biologic plate that is secured to both sides of the cleft with a miniscrew. 2,3 Auxiliary devices such as occlusal splints and direct interdental wiring between the premaxillary central incisors and the teeth adjacent to the alveolar cleft margins are also beneficial.…”