Cleft Osteoplasty

Maxillary and alveolar cleft formation results from a maladaptive fusion process of the paired maxillary, the medial nasal ridges, and the lateral palatal plates during the first trimester. The treatment goal is to functionally and aesthetically restore the maxillary bone to allow ingrowth of the adjacent teeth and offer a bony support for the lip and nose. A cleft osteoplasty can be performed at different ages; the gold standard, however, is between the ages of 8 and 12. After careful preparation of the defect cavity and reconstruction of the nasal floor, the defect is filled with an autologous bone graft (usually iliac crest bone graft). In cases of double-sided clefts, the incision procedure is the same as for single-sided clefts; both clefts are closed in one surgical session. The cancellous bone blocks are clamped between the lateral jaw segments and the intermaxillary segment. Performed at the right time, long-term satisfying functional and aesthetic results can be expected.