Management of the Premaxilla/Maxilla in Bilateral Cleft Lip and Palate

Chapter

Abstract

Methods for presurgical management of the prominent premaxilla in bilateral cleft lip and palate are described. Emphasis is on the methods used at UCSF. The later management of the premaxillary/maxillary complex is described and illustrated by patient photos and radiographs. Maxillary expansion in preparation for alveolar bone grafting, maxillary protraction, canine substitution for congenitally missing lateral incisors, management of vertical excess of the premaxilla, implants for missing teeth, and treatment sequencing for maxillary hypoplasia are described. Pertinent published papers are referenced.

Keywords

Cone Beam Compute Tomography Orthodontic Treatment Lateral Incisor Maxillary Central Incisor Bilateral Cleft 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Bartzela T, Katsaros C, Ronning E et al (2011) A longitudinal three-center study of craniofacial morphology at 6 and 12 years of age in patients with complete bilateral cleft lip and palate. Clin Oral Investig. doi: 10.1007/s00784-011-0615-y
  2. Berkowitz S et al (2004) A comparison of the effects of the Latham-Millard procedure with those of a conservative treatment approach for dental occlusion and facial aesthetics in unilateral and bilateral complete cleft lip and palate: part 1. Plast Reconstr Surg 113:1–18PubMedCrossRefGoogle Scholar
  3. Bishara SE, Olin WH (1972) Surgical repositioning of the premaxilla in complete bilateral cleft lip and palate. Angle Orthod 42:139–147PubMedGoogle Scholar
  4. Friede H, Pruzansky S (1972) Longitudinal study of growth in bilateral cleft lip and palate from infancy to adolescence. Plast Reconstr Surg 49:392–403PubMedCrossRefGoogle Scholar
  5. Friede H, Johanson B (1974) A follow-up study of cleft children treated with primary bone grafting. Scand J Plast Reconstr Surg 8:88–103PubMedCrossRefGoogle Scholar
  6. Grayson BH, Cutting CB (2001) Presurgical nasoalveolar orthopedic molding in primary correction of the nose, lip, and alveolus of infants bone with unilateral and bilateral clefts. Cleft Palate Craniofac J 38:193–198PubMedCrossRefGoogle Scholar
  7. Hsin-Yi Hsieh C, Wen-Ching Ko E, Kuo-Ting Chen P, Huang C-S (2010) The effect of gingivoperiosteoplasty on facial growth in patients with complete unilateral cleft lip and palate. Cleft Palate Craniofac J 47:439–446CrossRefGoogle Scholar
  8. Latham RA (1973) Development and structure of the premaxillary deformity in bilateral cleft lip and palate. Brit Plast Reconstr Surg 26:1–11.CrossRefGoogle Scholar
  9. Meazzini MC, Lematti L, Mazzoleni F, Rabbiosi D, Bozzetti A, Brusati R (2010) Vertical excess of the premaxilla in bilateral cleft lip and palate patients: a protocol for treatment. J Craniofac Surg 21:499–502PubMedCrossRefGoogle Scholar
  10. Murthy J (2009) Primary bilateral cleft lip repair with management of premaxilla without preoperative orthopedics. J Craniofac Surg 20:1719–1722PubMedCrossRefGoogle Scholar
  11. Oberoi S, Vargervik K (2005) Hypoplasia and hypodontia in van der Woude syndrome. Cleft Palate Craniofac J 42:459–466PubMedCrossRefGoogle Scholar
  12. Oberoi S, Chigurupati R, Vargervik K (2008) Morphologic and management characteristics of individuals with unilateral cleft lip and palate who required maxillary advancement. Cleft Palate Craniofac J 45:42–49PubMedCrossRefGoogle Scholar
  13. Oberoi S, Chigurupati R, Gill P, Hoffman WY, Vargervik K (2009) Volumetric assessment of secondary alveolar bone grafting using cone beam computed tomography. Cleft Palate Craniofac J 46:503–511PubMedCrossRefGoogle Scholar
  14. Oberoi S, Gill P, Hatcher D, Vargervik K (2010) Three-dimensional assessment of the eruption path of the canine in individuals with bone grafted alveolar clefts using cone beam computed tomography. Cleft Palate Craniofac J 47:507–512PubMedCrossRefGoogle Scholar
  15. Padwa BL, Bagheri SA, Mulliken JB (1999) Children with repaired bilateral cleft lip/palate: effect of age at premaxillary osteotomy on facial growth. Plast Reconstr Surg 104:1261–1269PubMedCrossRefGoogle Scholar
  16. Pena W, Sharma A, Vargervik K et al (2009) The role of endosseous implants in the management of alveolar clefts. J Pediatr Dent 47:318–321Google Scholar
  17. Skoog T (1965) The use of periosteal flaps in the repair of cleft of the primary palate. Cleft Palate J 2:332–339PubMedGoogle Scholar
  18. Trotman CA, Ross RB (1993) Craniofacial growth in bilateral cleft lip and palate: ages six years to adulthood. Cleft Palate Craniofac J 30:261–273PubMedCrossRefGoogle Scholar
  19. Uzel A, Alparslan ZN (2011) Long-term effects of presurgical infant orthopedics in patients with cleft lip and palate: a systematic review. Cleft Palate Craniofac J 48:587–595PubMedCrossRefGoogle Scholar
  20. Vargervik K (1983) Growth characteristics of the premaxilla and orthodontic treatment principles in bilateral cleft lip and palate. Cleft Palate J 20:289–302PubMedGoogle Scholar
  21. Vargervik K, Oberoi S, Hoffman WY (2009) Team care for the patient with cleft: UCSF protocols and outcomes. J Craniofac Surg 20:1668–1671PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of Orofacial Sciences, Center for Craniofacial AnomaliesUniversity of California, San FranciscoSan FranciscoUSA

Personalised recommendations