Moussa, A., Maklad, S., Elkholy, M. (2021). The One-Stage Premaxillary Repositioning and Bone Graft Alveoloplasty in Bilateral Alveolar Cleft: A Preliminary Study. The Egyptian Journal of Plastic and Reconstructive Surgery, 45(4), 265-271. doi: 10.21608/ejprs.2021.201641
Ahmed A. K. Moussa; Salah H Maklad; Mohamed A Elkholy. "The One-Stage Premaxillary Repositioning and Bone Graft Alveoloplasty in Bilateral Alveolar Cleft: A Preliminary Study". The Egyptian Journal of Plastic and Reconstructive Surgery, 45, 4, 2021, 265-271. doi: 10.21608/ejprs.2021.201641
Moussa, A., Maklad, S., Elkholy, M. (2021). 'The One-Stage Premaxillary Repositioning and Bone Graft Alveoloplasty in Bilateral Alveolar Cleft: A Preliminary Study', The Egyptian Journal of Plastic and Reconstructive Surgery, 45(4), pp. 265-271. doi: 10.21608/ejprs.2021.201641
Moussa, A., Maklad, S., Elkholy, M. The One-Stage Premaxillary Repositioning and Bone Graft Alveoloplasty in Bilateral Alveolar Cleft: A Preliminary Study. The Egyptian Journal of Plastic and Reconstructive Surgery, 2021; 45(4): 265-271. doi: 10.21608/ejprs.2021.201641
The One-Stage Premaxillary Repositioning and Bone Graft Alveoloplasty in Bilateral Alveolar Cleft: A Preliminary Study
1The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Aswan University,
2The Department of Radiology, Faculty of Medicine, Aswan University.
3The Department of Dentistry, Aswan University Hospitals, Aswan, Egypt
Abstract
This prospective clinical study is designed to present seven consecutive cases with bilateral cleft lip and palate at age of mixed dentition to be managed by simultaneous premaxilla repositioning and bone grafting of their clefts at period between 2014 and 2019 in Plastic Surgery Department, Aswan University. Clinical and cephalometric radiography assessment during follow-up period up to two years' post-operation to evaluate premaxilla position, stability, anterior palatal growth. Indications, contraindications and the pre- and post-operative orthodontic role technique were defined and proved to be a safe procedure. In properly selected patients, it can produce early one-step stable maxillary arch with good aesthetic result. No relapse or major complication were detected. Background: The bilateral alveolar cleft associated with markedly prominent premaxillary segment always possessed a surgical challenge because of the paucity of local flaps for watertight closure and high bone graft alveoloplasty failure rate. The orthodontic workup alone to mold unrestricted growing premaxillary segment could not optimize its position with the unfavorable functional and aesthetic outcome. In addition, the repeated surgical intervention may addon patient suffering and affect maxillary growth rate. Objective: Evaluation of the premaxillary viability, position, bone graft stability, and early growth after simultaneous premaxillary repositioning and alveolar bone grafting inalveolar cleft patients. Patients and Methods: Seven patients aged between 6 and 11 years were subjected to perioperative orthodontic workups to optimize the position of the premaxilla for its surgical correction before bone grafting. Then, the simultaneous premaxillary repositioning and bone graft alveoloplasty technique was done. Surgical indications, contraindications with orthodontic role were evaluated and discussed. Results: This prospective clinical study presents the outcome of seven consecutive pediatric patients who complained ofalveolar clefts with severe premaxillary segment protrusion. It was conducted during the period between 2014 and 2020 in the Plastic Surgery Department, Aswan University Hospitals. The results were assessed by clinical examination and cephalometric tracing for at least two years for evaluating the premaxillary position, functional outcome, upper jaw stability, and early growth affection. Conclusion: This technique proved to be a safe procedure in appropriately selected patients. It can produce an early stable maxillary arch with good aesthetic results besides less 265 surgical interventions. No relapse or significant complications were documented. Clinical Relevance The treatment of wide bilateral cleft alveolus patients is still based on experience and expert opinions. This preliminary study deals with markedly protruded premaxilla with bilateral alveolar cleft by combined orthodontic and one-stage premaxillary repositioning with bone graft alveoloplasty. An extended study period assessment for midfacial and maxillary growth is necessary.
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