The Double Cleft Defect: Twice as Difficult

Abstract
This lecture focuses on the difficult bilateral alveolar cleft defects. The options for closing large palatal fistula, repositioning the malposed premaxilla, and replacing the missing premaxilla are discussed. The results of autogenous alveolar bone grafting and outcome predictors are reviewed.

Learning Objectives
1). Discuss the indications for premaxillary osteotomy
2). Design the incisions and cuts for a premaxillary osteotomy
3). Plan a premaxillary osteotomy