Cleft - Ultimate Treatment
Orthognathic repair for cleft deformities - The ULTIMATE Clinical pearls, continued (2) 8. Osteotomies on Le Fort II (pyramidal) and III level are feasible. In uni- and bi-lateral CLAP and hPsP cases, however, they might jeopardize the midfacial blood supply. Therefore the indication of those types of osteotomies has to be considered carefully. Three months pre-operatively intra-oral soft tissue incisions at the site of future osteotomy lines can be performed to pre-condition perfusion patterns. 9. It is recommended to overextend the anterior position of the maxilla by 20% to compensate for eventual relapse. Additional mandibulo-maxillary elastics should be worn at least for 9 â€“ 15 months after distractor removal. The paperthin distracted bone needs to be stabilised to undergo osteogenesis in order to keep the maxilla in its new position. This stabilisation and final positioning of the jaws is described as callus manipulation when using strong mandibulomaxillary inter-occlusal elastics for final occlusal adjustment.
Book: Cleft Ultimate Treatment -- Oro-facial and Cranio-maxillo-facial Deformities (Second Edition) Authors: Dr. Kurt Butow and Dr. Roger Z...