Authors of section

Authors

Scott Bartlett, Michael Ehrenfeld, Gerson Mast, Adrian Sugar

Executive Editor

Edward Ellis III

General Editor

Daniel Buchbinder

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Bilateral cleft lip and/or palate with displaced premaxilla

The actual morphology of the defect / abnormality will depend on the type of cleft and the surgery carried out initially.

Alveolar cleft defects are usually broader at the nasal floor and narrower at the alveolar crest. The bony nasal floor is missing. Usually there is no intact soft tissue floor to the nose with the nasal mucosa occupying the alveolar cleft together with scar tissue and attached to anterior palatal mucosa. The premaxilla is commonly mobile and in this case severely malpositioned. Teeth in the premaxilla are often poorly formed, malpositioned or missing.

Malformed, malpositioned, diminutive, and supernumerary teeth are commonly found within the alveolar cleft defects or in the alveolar bone adjacent to the defects. The most commonly affected teeth are the lateral incisors which may also be missing.

Oronasal fistulae are commonly found and may be located on the palatal side, labial or both. Their presence will be determined largely by the nature of the initial deformity and the initial surgery.

Alveolar bone grafting in the bilateral cleft lip and/or palate patient with premaxillary osteotomy