Outcomes of 44 Consecutive Complete Bilateral Cleft Lip and Palate Patients Treated With Secondary Alveolar Bone Grafting and Premaxillary Osteotomy

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Objective:To report the surgical outcomes of secondary alveolar bone grafting with premaxillary osteotomy in a single surgeon cohort of complete bilateral cleft lip and palate patients.Design:Retrospective review of 44 consecutive patients using hospital notes and radiographs.Setting:Single specialist cleft lip and palate center, UK.Patients:Consecutive patients with complete bilateral cleft lip and palate who were being treated with secondary alveolar bone grafting incorporating premaxillary osteotomy.Outcome Measures:Assessment of success of bone graft by Kindelan score; canine eruption; closure of fistulae and assessment of morbidity.Results:Between January 6, 2000, and August 8, 2013, 44 patients with complete BCLP underwent secondary ABG with a premaxillary osteotomy as a one-stage procedure. The mean follow-up was 7.3 years (range 1.4 to 14.6). Eighty-five percent of ABGs were successful (a Kindelan score of 1 or 2), and canine eruption was 89%. Failure of the ABG occurred in 7%. Fistulae recurrence rate was 11%, all of which were asymptomatic. No premaxillae were devitalized.Conclusion:Incorporating a premaxillary osteotomy into the secondary ABG surgical protocol can be a safe technique that gives excellent surgical exposure for fistula repair.

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