A new device for fixing the premaxilla with osteotomy in a child with complete bilateral cleft lip and palate in the mixed dentition period--a preliminary case report.

In the treatment of a protruded premaxilla associated with complete bilateral cleft lip and palate, some patients require surgical setback of the premaxilla with osteotomy as functional and aesthetic treatment. No satisfactory surgical approaches have been established for the setback because it is usually difficult to fix the premaxilla after osteotomy in the mixed dentition period. This paper reports the new method for fixing the premaxilla with osteotomy in a child with a severely protruded premaxilla in the mixed dentition period. To fix the segment, we fabricated a device consisting of a palatal bite plate and an anterior tray before surgery. The space between the tray and the premaxilla was filled with soft resin during surgery so that the reposition of the premaxilla could be adjusted. This approach produced a favorable result. Our device has several advantages. It allows the adjustment of repositioning of the premaxilla during surgery. It can change the range of the adjustment according to the intended position of the premaxilla. It allows secure fixation of the segment. It is removable for tooth brushing and observation of bone union. Our device can be applied to many children similar to our patient reported in this paper.