The modified “Wunderer” osteotomy for stabilization of the cleft-premaxilla – A new operative technique

摘要: The operative closure of bilateral cleft lip and palate is a difficult procedure that requires in most cases secondary corrections. Besides aesthetic improvements nose also the rehabilitation teeth, particular maxillary arch important for improvement chewing function well being patient. One disturbing factors construction any type prosthetic devices, like removable denture, fixed bridge or dental implants mobility often malposition premaxilla. This problem can only be solved by insertion bone grafts into gaps anterior arch. however, due to narrowness poor overview complicates nasal mucosa, which precondition success. For facilitating operation premaxilla osteotomized reflected anteriorly according method Wunderer (1962). Then, after much easier mucosa bony defects filled with autogenous cancellous finally oral closed. A preoperatively prepared palatal acrylic plate helps protect tissue stabilizes position blood supply secured sound soft pedicle buccal muco-periosteum. effectiveness was examined experimental studies several authors. Also investigations growth impediments midface revealed early osteotomies will interfere development this region. Therefore it advisable carry out not before patient has reached age 12-14 years, depending on race gender