Double Level Fixation of Premaxilla during Alveolar Bone Grafting with Premaxillary Osteotomy in Patients with Bilateral Cleft Lip and Palate

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  • Erina TONOUCHI
    Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • Kei-ichi MORITA
    Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • Yosuke HARAZONO
    Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • Eri ANZAI
    Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • Namiaki TAKAHARA
    Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • Tetsuya YODA
    Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University

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<p>  In patients with bilateral cleft lip and palate (BCLP), they sometimes need reposition premaxilla which is severely protruded and twisted as functional and aesthetic treatment. We introduce a surgical method of premaxillary fixation during alveolar bone grafting (ABG) with premaxillary osteotomy (PO). We included 9 patients with BCLP and a patient with bilateral cleft lip and alveolus who underwent ABG with PO in our institution between 2002 and 2020. They usually underwent two-stage ABG from the iliac crest with PO. Contralateral ABG was performed approximately 1 year after initial surgery. It is important to divide the surgery into two stages to perform the surgery more safely and surely. Premaxilla fixation was performed at bone-level from the anterior nasal spine to the maxillary sinus anterior wall with an absorbable plate and on dentition by wiring teeth to the labial archwire. This method provides firm fixation and facilitates feeding and dental cleaning without serious complications.</p>

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