Long-term results of segmental repositioning of the maxilla in cleft palate patients without previously grafted alveolo-palatal clefts.

Eleven patients (9 UCLP, 2 BCLP) were treated with segmental osteotomies with or without osteotomies at the Le Fort I level and simultaneous bone grafting of the alveolo-palatal clefts at adult age. These patients were clinically and radiographically evaluated after a mean follow-up period of 59 months (range 39-110 months). One patient showed complete dentoalveolar relapse, whereas the skeletal stability after miniplate fixation proved to be adequate in all cases. Only one patient presented with a persisting oro-nasal fistula. In six cases, the alar base asymmetry had improved to such an extent that further nasal corrections were not necessary. The procedure described is a reliable technique to graft the alveolo-palatal cleft and reposition the dentoalveolar segments simultaneously in those adult cleft palate patients who had no previous alveolar bone grafting.