Preoperative positioning of the protruding premaxilla in the bilateral cleft lip patient

The rationale and technique for preoperative retraction of a protrusive premaxilla in the bilateral complete cleft lip and palate patient are presented. Two types of pinned intraoral appliances are presented that can expand the palatal shelves while retracting the premaxillary segment. Findings from lateral cephalometric x-ray studies of eight appliance patients and six control patients with bilateral clefts but no appliance treatment are presented at age 15. The data indicate that the cephalometric values at age 15 are within the normal range for most patients. Incisor angulation was quite varied among the subjects.