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Patient Outcomes for Maxillary Cleft Management: Literature Review and Guiding Principles

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Cleft Maxillary Reconstruction
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Abstract

The goal of cleft care is to correct head and neck dysfunctions in the child and achieve optimal facial aesthetics through efficient staged reconstruction and dental rehabilitation of the malformation [1, 2]. Successful management of the cleft skeletal defect/deformity includes closure of the oronasal fistula, achievement of bony unification of the clefted segments, successful eruption of the maxillary canine through the grafted cleft site while limiting maxillary growth disturbances.

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References

  1. Posnick JC, Kinard BE. Challenges in the successful reconstruction of cleft lip and palate: managing the Nasomaxillary deformity in adolescence. Plast Reconstr Surg. 2020;145(3):591e–603e.

    CAS  PubMed  Google Scholar 

  2. Posnick JC, Susarla SM. Improving cleft outcomes: a retrosynthetic analysis approach. J Oral Maxillofac Surg. 2021;S0278-2391(21):00532. https://doi.org/10.1016/j.joms.2021.05.032. Epub ahead of print. PMID: 34171225

    Article  Google Scholar 

  3. Daskalogiannakis J, Mehta M. The need for orthognathic surgery in patients with repaired complete unilateral and complete bilateral cleft lip and palate. Cleft Palate Craniofac J. 2009;46(5):498–502. https://doi.org/10.1597/08-176.1. Epub 2009 Feb 28. PMID: 19929100

    Article  PubMed  Google Scholar 

  4. Good PM, Mulliken JB, Padwa BL. Frequency of Le fort I osteotomy after repaired cleft lip and palate or cleft palate. Cleft Palate Craniofac J. 2007;44(4):396–401. https://doi.org/10.1597/06-075.1. PMID: 17608550

    Article  PubMed  Google Scholar 

  5. Hathaway RR, Daskalogiannakis J. Mercado: The Americleft study: an intercenter study of treatment outcomes for patients with unilateral cleft lip and palate part 2. Dental arch relationships. Cleft Palate Craniofac J. 2011;48:244–51.

    PubMed  Google Scholar 

  6. Mars M, Houston WJB. A preliminary study of facial growth and morphology in unoperated male unilateral cleft lip and palate subjects over 13 years of age. Cleft Palate Craniofac J. 1990;27(1):7–10.

    CAS  Google Scholar 

  7. Brattström V. Craniofacial development in cleft lip and palate children related to different treatment regimes. Scand J Plast Reconstr Surg Hand Surg Suppl. 1991;25:1–31.

    PubMed  Google Scholar 

  8. Ross RB. Treatment variables affecting facial growth in complete unilateral cleft lip and palate. Cleft Palate J. 1987;24:5–77.

    CAS  PubMed  Google Scholar 

  9. Murthy AS, Lehman JA. Evaluation of alveolar bone grafting: a survey of ACPA teams. Cleft Palate Craniofac J. 2005;42(1):99–101. https://doi.org/10.1597/03-045.1. PMID: 15643923

    Article  PubMed  Google Scholar 

  10. Allori AC, Kelley T, Meara JG, et al. A standard set of outcome measures for the comprehensive appraisal of cleft care. Cleft Palate Craniofac J. 2017;54:540–54.

    PubMed  Google Scholar 

  11. Pepper HB, Revington PJ, Deacon S, Thomas S. Impact of secondary alveolar bone grafting on the symptoms of reflux in oronasal of the cleft sites. All alveolar: a patient-related outcome study. Cleft Palate Craniofac J. 2014;51(3):270–3. https://doi.org/10.1597/12-309. Epub 2013 Jun 12. PMID: 23763352

    Article  PubMed  Google Scholar 

  12. Witherow H, Cox S, Jones E, Carr R, Waterhouse N. A new scale to assess radiographic success of secondary alveolar bone grafts. Cleft Palate Craniofac J. 2002;39:255–60.

    CAS  PubMed  Google Scholar 

  13. Nightingale C, Witherow H, Reid FD, Edler R. Comparative reproducibility of three methods of radiographic assessment of alveolar bone grafting. Eur J Orthod. 2003;25:35.

    PubMed  Google Scholar 

  14. Kindelan JD, Nashad RR, Bromige MR. Radiographic assessment of secondary autogenous alveolar bone grafting in cleft lip and palate patients. Cleft Palate Craniofac J. 1997;34:195–8.

    CAS  PubMed  Google Scholar 

  15. Bergland O, Semb G, Abyhold FE. Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment. Cleft Palate J. 1986;23:175.

    CAS  PubMed  Google Scholar 

  16. Rosenstein SW, Long RE, Dado DV, et al. Comparison of 2D calculations from periapical and occlusal radiographs versus 3D calculations from CAT scans in determining bone support for the cleft adjacent teeth following early alveolar bone grafts. Cleft Palate Craniofac J. 1997;34:199–205.

    CAS  PubMed  Google Scholar 

  17. Liang F, Yen S, Imahiyerobo T, et al. Three-dimensional cone beam computed tomography volumetric outcomes of rhBMP-2/demineralized bone matrix versus iliac crest bone graft for alveolar cleft reconstruction. Plast Reconstr Surg. 2017;140:767–74.

    CAS  PubMed  Google Scholar 

  18. Van der Meij AJ, Baart JA, Prahl-Andersen B, Valk J, Kostense PJ, Tuinzing DB. Bone volume after secondary bone grafting in unilateral and bilateral clefts determined by computed tomography scans. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92(2):136–41.

    PubMed  Google Scholar 

  19. Anver TD, Mirzai L, Li P, et al. Long-term postoperative cone-beam computed tomography analysis of secondary bone grafting in 79 patients with unrepaired alveolar cleft. J Oral Maxillofac. 2020;78:1164–70.

    Google Scholar 

  20. De Mulder D, Cadenas de Llano-Pérula M, Jacobs R, Verdonck A, Willems G. Three-dimensional radiological evaluation of secondary alveolar bone grafting in cleft lip and palate patients: a systematic review. Dentomaxillofac Radiol. 2018;48(1):20180047.

    PubMed  PubMed Central  Google Scholar 

  21. Russell K, Long RE, Daskalogiannakis J. A multicenter study using the SWAG scale to compare secondary alveolar bone graft outcomes for patients with cleft lip and palate. Cleft Palate Craniofac J. 2016;53:180–6.

    PubMed  Google Scholar 

  22. Renkielska A, Wojtaszek-Slominska A, Dobke M. Early cleft lip repair in children with unilateral complete cleft lip and palate: a case against primary alveolar repair. Ann Plast Surg. 2005;54(6):595–7. https://doi.org/10.1097/01.sap.0000158067.17992.af. discussion 598–9. PMID: 15900141

    Article  CAS  PubMed  Google Scholar 

  23. Pickrell K, Quinn G, Massengill R. Primary bone grafting of the maxilla in clefts of the lip and palate: a four year study. Plast Reconstr Surg. 1968;41(5):438–43. https://doi.org/10.1097/00006534-196805000-00004. PMID: 4870986

    Article  CAS  PubMed  Google Scholar 

  24. Ghoneima A, Allam E, Kula K. Effects of primary alveolar grafting on alveolar bone thickness in patients with cleft lip and palate. J Craniofac Surg. 2017;28(5):1337–41. https://doi.org/10.1097/SCS.0000000000003735. PMID: 28582305

    Article  PubMed  Google Scholar 

  25. Carbullido MK, Dean RA, Kamel GN, Davis GL, Hornacek M, Segal RM, Ewing E, Lance SH, Gosman AA. Long-term treatment outcomes of primary alveolar bone grafts for alveolar clefts: a qualitative systematic review. Cleft Palate Craniofac J. 2021;25:1055665621995047. https://doi.org/10.1177/1055665621995047. Epub ahead of print. PMID: 33631994

    Article  Google Scholar 

  26. Skoog T. The use of periosteal flaps in the repair of clefts of the primary palate. Cleft Palate J. 1965;2:332–9.

    CAS  PubMed  Google Scholar 

  27. Jabbari F, Hakelius MM, Thor AL, Reiser EA, Skoog VT, Nowinski DJ. Skoog primary Periosteoplasty versus secondary alveolar bone grafting in unilateral cleft lip and alveolus: Long-term effects on alveolar bone formation and maxillary growth. Plast Reconstr Surg. 2017;139(1):137–48. https://doi.org/10.1097/PRS.0000000000002910.

    Article  CAS  PubMed  Google Scholar 

  28. Millard DR Jr. Cleft craft, vol. 3. Boston: Little, Brown; 1980.

    Google Scholar 

  29. Latham RA. Orthopedic advancement of the cleft maxillary segment: a preliminary report. Cleft Palate J. 1980;17:227.

    CAS  PubMed  Google Scholar 

  30. Millard DR Jr, Latham RA. Improved primary surgical and dental treatment of clefts. Plast Reconstr Surg. 1990;86:856–71.

    PubMed  Google Scholar 

  31. Henkel KO, Gundlach KK. Analysis of primary gingivoperiosteoplasty in alveolar cleft repair. Part I: facial growth. J Craniomaxillofac Surg. 1997;25(5):266–9. https://doi.org/10.1016/s1010-5182(97)80064-9. PMID: 9368862

    Article  CAS  PubMed  Google Scholar 

  32. Millard DR, Latham R, Huifen X, Spiro S, Morovic C. Cleft lip and palate treated by presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion (POPLA) compared with previous lip adhesion method: a preliminary study of serial dental casts. Plast Reconstr Surg. 1999;103:1630–44.

    CAS  PubMed  Google Scholar 

  33. Berkowitz S. A comparison of treatment results in complete bilateral cleft lip and palate using a conservative approach versus Millard-Latham PSOT procedure. Semin Orthod. 1996;2:169–84.

    CAS  PubMed  Google Scholar 

  34. Berkowitz S, Mejia M, Bystrik A. 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 I. Dental occlusion. Plast Reconstr Surg. 2004;113:1–18.

    PubMed  Google Scholar 

  35. Berkowitz S. Gingivoperiosteoplasty as well as early palatal cleft closure is unproductive. J Craniofac Surg. 2009;20(Suppl 2):1747–58.

    PubMed  Google Scholar 

  36. Matic DB, Power SM. Evaluating the success of gingivoperiosteoplasty versus secondary bone grafting in patients with unilateral clefts. Plast Reconstr Surg. 2008;121:1356–67.

    Google Scholar 

  37. Matic DB, Power SM. The effects of gingivoperiosteoplasty following alveolar molding with a pin-retained Latham appliance versus secondary bone grafting on midfacial growth in patients with unilateral cleft. Plast Reconstr Surg. 2008;122:863–70.

    CAS  PubMed  Google Scholar 

  38. Power SM, Matic DB. Gingivoperiosteoplasty following alveolar molding with a Latham appliance versus secondary bone grafting: the effects on bone production and midfacial growth in patients with bilateral clefts. Plast Reconstr Surg. 2009;124:573–82.

    CAS  PubMed  Google Scholar 

  39. El-Ashmawi NA, ElKordy SA, Salah Fayed MM, et al. Effectiveness of gingivoperiosteoplasty on alveolar bone reconstruction and facial growth in patients with cleft lip and palate: a systematic review and meta-analysis. Cleft Palate-Craniofac J. 2019;56:438–53.

    PubMed  Google Scholar 

  40. Cutting C, Grayson B. The Prolabial unwinding flap method for one-stage repair of bilateral cleft lip, nose, and alveolus. Plast Reconstr Surg. 1993;91(1):37–47.

    CAS  PubMed  Google Scholar 

  41. Yarholar LM, Shen C, Wangsrimongkol B, et al. The Nasoalveolar molding cleft protocol: Long-term treatment outcomes from birth to facial maturity. Plast Reconstr Surg. 2021;147(5):787e–94e.

    CAS  PubMed  Google Scholar 

  42. Sischo L, Chan JW, Stein M, et al. Nasoalveolar molding: prevalence of cleft centers offering NAM and who seeks it. Cleft Palate Craniofac J. 2012;49:270–5.

    PubMed  Google Scholar 

  43. Santiago PE, Grayson BH, Cutting CB, Gianoutsos MP, Brecht LE, Kwon SM. Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. Cleft Palate Craniofac J. 1998;35(1):77–80.

    CAS  PubMed  Google Scholar 

  44. Hsieh CH, Ko EW, Chen PK, Huang CS. The effect of gingivoperiosteoplasty on facial growth in patients with complete unilateral cleft lip and palate. Cleft Palate Craniofac J. 2010;47(5):439–46.

    PubMed  Google Scholar 

  45. Wang YC, Liao YF, Chen PK. Comparative outcomes of primary gingivoperiosteoplasty and secondary alveolar bone grafting in patients with unilateral cleft lip and palate. Plast Reconstr Surg. 2016;137:218–27.

    CAS  PubMed  Google Scholar 

  46. Uzel A, Alparslan ZN. Long-term effects of presurgical infant orthopedics in patients with cleft lip and palate: a systematic review. Cleft Palate Craniofac J. 2011;48:587–95.

    PubMed  Google Scholar 

  47. van der Heijden P, Dijkstra PU, Stellingsma C, van der Laan BF, Korsten-Meijer AGW, Goorhuis-Brouwer SM. Limited evidence for the effect of presurgical nasoalveolar molding in unilateral cleft on nasal symmetry: a call for unified research. Plast Reconstr Surg. 2013;131(1):62e–71e. https://doi.org/10.1097/PRS.0b013e318267d4a5. PMID: 23271555

    Article  CAS  PubMed  Google Scholar 

  48. Boyne PJ, Sands NR. Secondary bone grafting of residual alveolar and palatal clefts. J Oral Surg. 1972;30:87–92.

    CAS  PubMed  Google Scholar 

  49. Dempf R, Teltzrow T, Kramer FJ, Hausamen JE. Alveolar bone grafting in patients with complete cleft: a comparative study between secondary and tertiary bone grafting. Cleft Palate Craniofac J. 2002;39:18–25.

    PubMed  Google Scholar 

  50. Paulin G, Astrand P, Rosenquist JB, Bartholdson L. Intermediate bone grafting of alveolar clefts. J Craniomaxillofac Surg. 1988;16(1):2–7. https://doi.org/10.1016/s1010-5182(88)80005-2.

    Article  CAS  PubMed  Google Scholar 

  51. Abyholm FE, Bergland O, Semb G. Secondary bone grafting of alveolar clefts. A surgical/orthodontic treatment enabling a non-prosthodontic rehabilitation in cleft lip and palate patients. Scand J Plast Reconstr Surg. 1981;15(2):127–40. https://doi.org/10.3109/02844318109103425. PMID: 7041248

    Article  CAS  PubMed  Google Scholar 

  52. Hall HD, Posnick JC. Early results of secondary bone grafts in 106 alveolar clefts. J Oral Maxillofac Surg. 1983;41:289–94.

    CAS  PubMed  Google Scholar 

  53. Kortebein MJ, Nelson CL, Sadove AM. Retrospective analysis of 135 secondary alveolar cleft grafts using iliac or calvarial bone. J Oral Maxillofac Surg. 1991;49(5):493–8. https://doi.org/10.1016/0278-2391(91)90172-i.

    Article  CAS  PubMed  Google Scholar 

  54. LaRossa D, Buchman S, Rothkopf DM, Mayro R, Randall P. A comparison of iliac and cranial bone in secondary grafting of alveolar clefts. Plast Reconstr Surg. 1995;96(4):789–97. discussion 798–9. PMID: 7652052.

    CAS  PubMed  Google Scholar 

  55. Jia YL, James DR, Mars M. Bilateral alveolar bone grafting: a report of 55 consecutively-treated patients. Eur J Orthod. 1998;20(3):299–307. https://doi.org/10.1093/ejo/20.3.299. PMID: 9699408

    Article  CAS  PubMed  Google Scholar 

  56. Denny AD, Talisman R, Bonawitz SC. Secondary alveolar bone grafting using milled cranial bone graft: a retrospective study of a consecutive series of 100 patients. Cleft Palate Craniofac J. 1999;36(2):144–53.

    CAS  PubMed  Google Scholar 

  57. Rawashdeh MA, Al Nimri KS. Outcome of secondary alveolar bone grafting before and after eruption of the canine in Jordanian patients with cleft lip and palate. J Craniofac Surg. 2007;18(6):1331–7.

    PubMed  Google Scholar 

  58. Herford AS, Boyne PJ, Rawson R, Williams RP. Bone morphogenic protein-induced repair of the premaxillary cleft. J Oral Maxillofac Surg. 2007;65:2136–41.

    PubMed  Google Scholar 

  59. Precious DS. A new reliable method for alveolar bone grafting at about 6 years of age. J Oral Maxillofac Surg. 2009;67:2045–53.

    PubMed  Google Scholar 

  60. Revington PJ, McNamara C, Mukarram S, Perera E, Shah HV, Deacon SA. Alveolar bone grafting: results of a national outcome study. Ann R Coll Surg Engl. 2010;92(8):643–6. https://doi.org/10.1308/003588410X12699663904790. Epub 2010 Jul 2. PMID: 20615302; PMCID: PMC3229369

    Article  PubMed  PubMed Central  Google Scholar 

  61. Benlidayi ME, Tatli U, Kurkcu M, Uzel A, Oztunc H. Comparison of bovine-derived hydroxyapatite and autogenous bone for secondary alveolar bone grafting in patients with alveolar clefts. J Oral Maxillofac Surg. 2012;70(1):e95–e102. https://doi.org/10.1016/j.joms.2011.08.041.

    Article  PubMed  Google Scholar 

  62. Paterson M, Rae J, Paterson P, Gilgrass T, Devlin M, McIntyre G. Secondary alveolar bone grafting (CLEFTSiS) 2007-2010. Cleft Palate Craniofac J. 2016;53(2):141–6. https://doi.org/10.1597/14-093.1. PMID: 26914161

    Article  PubMed  Google Scholar 

  63. McIntyre GT, Devlin MF. Secondary alveolar bone grafting (CLEFTSiS) 2000-2004. Cleft Palate Craniofac J. 2010;47(1):66–72. https://doi.org/10.1597/08-165.1.

    Article  PubMed  Google Scholar 

  64. Lowry CH, Long RE, Russell K, et al. The effect of earlier bone grafting, prior to orthodontic treatment, on SWAG ratings of graft outcomes. Cleft Palate Craniofac J. 2020;58:208–14.

    PubMed  Google Scholar 

  65. Scott R, Scott J, Stagnell S, Robinson S, Flood T. Outcomes of 44 consecutive complete bilateral cleft lip and palate patients treated with secondary alveolar bone grafting and Premaxillary osteotomy. Cleft Palate Craniofac J. 2017;54(3):249–55. https://doi.org/10.1597/15-162. Epub 2016 Mar 31. PMID: 27031266

    Article  PubMed  Google Scholar 

  66. Hammoudeh JA, Fahradyan A, Gould DJ, et al. A comparative analysis of recombinant human bone morphogenic protein-2 with a demineralized bone matrix versus iliac crest bone graft for secondary alveolar bone grafts in patients with cleft lip and palate: review of 501 cases. Plast Recontr Surg. 2017;140:318–25e.

    Google Scholar 

  67. Kumar R, Heggie A, Shand J, Dominguez-Gonzalez S, Kilpatrick N, Shah J. Secondary bone grafting of alveolar clefts: a review of outcome at two centres in Australia and the UK. Br J Oral Maxillofac Surg. 2017;55(5):496–9. https://doi.org/10.1016/j.bjoms.2017.02.002. Epub 2017 Feb 27. PMID: 28245957

    Article  CAS  PubMed  Google Scholar 

  68. Anver TD, Mirzai L, Li P, Powell KK, Waite PD. Long-term postoperative cone-beam computed tomography analysis of secondary bone grafting in 79 patients with unrepaired alveolar clefts. J Oral Maxillofac Surg. 2020;78(7):1164–70. https://doi.org/10.1016/j.joms.2019.10.010.

    Article  PubMed  Google Scholar 

  69. Lundberg J, et al. Outcome after secondary alveolar bone grafting among cleft lip and palate patients at 16 years of age – a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021; https://doi.org/10.1016/j.oooo.2021.04.057.

  70. Lee KC, Costandi JJ, Carrao V, Eisig SB, Perrino MA. Autogenous iliac crest versus rhBMP-2 for alveolar cleft grafting: a 14-year single-institution experience. J Oral Maxillofac Surg. 2020;S0278-2391(20):31303. https://doi.org/10.1016/j.joms.2020.10.025. Epub ahead of print. PMID: 33189650

    Article  Google Scholar 

  71. Guo J, Li C, Zhang Q, Wu G, Deacon SA, Chen J, Hu H, Zou S, Ye Q. Secondary bone grafting for alveolar cleft in children with cleft lip or cleft lip and palate. Cochrane Database Syst Rev. 2011;6:CD008050. https://doi.org/10.1002/14651858.CD008050.pub2. PMID: 21678372

    Article  Google Scholar 

  72. Pan W, Wu C, Yang Z, et al. Secondary alveolar bone grafting and iliac cancellous bone harvesting for patients with alveolar cleft. J Craniofac Surg. 2016;27(4):883–91. https://doi.org/10.1097/SCS.0000000000002603.

    Article  PubMed  Google Scholar 

  73. Scalzone A, Flores-Mir C, Carozza D, d'Apuzzo F, Grassia V, Perillo L. Secondary alveolar bone grafting using autologous versus alloplastic material in the treatment of cleft lip and palate patients: systematic review and meta-analysis. Prog Orthod. 2019;20(1):6. https://doi.org/10.1186/s40510-018-0252-y. PMID: 30740615; PMCID: PMC6369233

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Uribe F, Alister JP, Zaror C, Olate S, Fariña R. Alveolar cleft reconstruction using morphogenetic protein (rhBMP-2): a systematic review and meta-analysis. Cleft Palate Craniofac J. 2020;57(5):589–98. https://doi.org/10.1177/1055665619886142. Epub 2019 Nov 7. PMID: 31698953

    Article  PubMed  Google Scholar 

  75. Pinheiro FHSL, Drummond RJ, Frota CM, Bartzela TN, Dos Santos PB. Comparison of early and conventional autogenous secondary alveolar bone graft in children with cleft lip and palate: a systematic review. Orthod Craniofac Res. 2020;23(4):385–97. https://doi.org/10.1111/ocr.12394.

    Article  PubMed  Google Scholar 

  76. Xiao WL, Jia KN, Yu G, Zhao N. Outcomes of bone morphogenetic protein-2 and iliac cancellous bone transplantation on alveolar cleft bone grafting: a meta-analysis. J Plast Reconstr Aesthet Surg. 2020;73(6):1135–42. https://doi.org/10.1016/j.bjps.2020.01.011. Epub 2020 Jan 21. PMID: 32151557

    Article  PubMed  Google Scholar 

  77. Cooper DC, Peterson EC, Grellner CG, et al. Cleft and craniofacial multidisciplinary team clinic: a look at attrition rates for patients with complete cleft lip and palate and nonsyndromic single-suture Craniosynostosis. Cleft Palate Craniofac J. 2019;56(10):1287–94. https://doi.org/10.1177/1055665619856245.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Dickinson BP, Ashley RK, Wasson KL, et al. Reduced morbidity and improved healing with bone morphogenic protein-2 in older patients with alveolar cleft defects. Plast Reconstr Surg. 2007;121:209–17.

    Google Scholar 

  79. Mahajan R, Ghildiyal H, Khasgiwala A, Muthukrishnan G, Kahlon S. Evaluation of secondary and late secondary alveolar bone grafting on 66 unilateral cleft lip and palate patients. Plast Surg (Oakv). 2017 Aug;25(3):194–9.

    PubMed  Google Scholar 

  80. Obwegeser HL. Chirurgische behandlungsmoglichkeiten von sekundardeformierungen bei spaltpatienten. Fortschr Kieferorthop. 1988;49:272–96.

    CAS  PubMed  Google Scholar 

  81. Obwegeser HL. Orthognathic surgery and a tale of how three procedures came to be: a letter to the next generations of surgeons. Clin Plast Surg. 2007;34:331–55.

    PubMed  Google Scholar 

  82. Posnick JC, Tompson B. Modification of the maxillary Le fort I osteotomy in cleft-orthognathic surgery: the unilateral cleft lip and palate deformity. J Oral Maxillofac Surg 1992;50:666–675; discussion 675–676.

    Google Scholar 

  83. Posnick JC. Cleft orthognathic surgery: the unilateral cleft lip and palate deformity. In: Posnick JC, editor. Orthognathic surgery: principles and practice. St. Louis: Elsevier; 2014. p. 1297–370.

    Google Scholar 

  84. Posnick JC. Cleft orthognathic surgery: the bilateral cleft lip and palate deformity. In: Posnick JC, editor. Orthognathic surgery: principles and practice. St. Louis: Elsevier; 2014. p. 1371–440.

    Google Scholar 

  85. Posnick JC, Ricalde P. Cleft-orthognathic surgery. Clin Plast Surg. 2004;31(2):315–30.

    PubMed  Google Scholar 

  86. Posnick JC, Tompson B. Modification of the maxillary Le fort I osteotomy in cleft-orthognathic surgery: the bilateral cleft lip and palate deformity. J Oral Maxillofac Surg. 1993;51(1):2–11. https://doi.org/10.1016/s0278-2391(10)80379-9. PMID: 8419569

    Article  CAS  PubMed  Google Scholar 

  87. Posnick JC, Tompson B. Cleft-orthognathic surgery: complications and long-term results. Plast Reconstr Surg. 1995;96(2):255–66.

    CAS  PubMed  Google Scholar 

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Kinard, B., Posnick, J.C. (2023). Patient Outcomes for Maxillary Cleft Management: Literature Review and Guiding Principles. In: Ricalde, P. (eds) Cleft Maxillary Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-031-24636-4_11

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