Abstract
SummaryBilateral alveolar process fissure causes important functional and aesthetical limitations and thus difficulties in terms of social and family integration and interaction for these patients.Aim(A) to assess motivations and expectations Treatment-wise and (B) to assess social inclusion and integration brought about by the surgery.Materials and Methodsretrospective observational study involving 50 participants recruited among the patients submitted to the premaxilla repositioning procedure from January of 2003 to July of 2005 at the Centro de Atendimento Integral ao Fissurado Lábio-Palatal in Curitiba (CAIF), Paraná, and an assessment questionnaire was used.Resultsas far as the care protocol is concerned, results show a 90% success rate of surgeries. As to surgical and personal satisfaction rates are concerned, 76% sought treatment for personal satisfaction reasons and 86% reported having had more self-confidence after the surgery.ConclusionsMost of the patients submitted to the maxilla repositioning saw surgery as a continuation of the care previously given, with the expectation of better looks and self-confidence and, 96% of them were pleased with the results attained, which facilitated their social inclusion and re-integration.
Highlights
Patients with bilateral fissure in their alveolar process and pre-maxillary overprojection are victims of prejudice and have relationship difficulties in their social groups
In order to treat the premaxilla in patients with bilateral cleft there are two options: complete removal of the premaxilla and premaxillary repositioning with autogenous bone graft[6,7]
The age for surgery was established based on the position of the upper and lower canine teeth - between 8 and 12 years, and the lower ones - depending on the stage of dental eruption, graft removal from the mandibular symphysis region is done to create space for the osteotomy without damaging the teeth roots with the cutting burr (Photograph 1)
Summary
Patients with bilateral fissure in their alveolar process and pre-maxillary overprojection are victims of prejudice and have relationship difficulties in their social groups. The benefits achieved with maxillary defect reconstruction help with a better cosmetic appearance, and give these children back their biological, psychological and socio-cultural identity. Reconstruction of the maxillary defect with autogenous bone graft has benefited patients with lip-palatal cleft, especially those with unilateral alveolar clefts[1,2,3,4]. In order to treat the premaxilla in patients with bilateral cleft there are two options: complete removal of the premaxilla (causing better lip closure5) and premaxillary repositioning with autogenous bone graft[6,7]. Surgical treatment of patients with bilateral clefts can have severe implications since premaxilla manipulation can impair regional bone growth. There are controversies whether or not the surgical intervention in the premaxilla can be carried out before or after complete facial growth
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