Orthognathic Surgery for Cleft-Related Maxillomandibular Discrepancies

Orthognathic surgery is one of the most important interventions for patients with cleft palate (± cleft lip). Pre-surgical management prior to orthognathic surgery includes alveolar bone grafting to address maxillary continuity defects and pre-surgical orthodontic treatment to optimize arch coordination in anticipation of skeletal movements of the midface ± mandible. Surgical approaches are selected based on patient-specific anatomy, functional goals (mastication, breathing), and facial proportions. Computer-assisted surgical planning and patient-specific guides and implants have improved the ability to address the complex skeletal dysmorphologies related to facial clefts.