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

Abstract

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.