Orthognathic Surgery Combined with Orthodontic Treatment in a Patient with Bilateral Cleft Lip, Palate and Alveolus, Without Alveolar Bone Graft: A Case Report

Background: The incidence of cleft lip and palate is 8 in every 10,000 live births. A patient with this condition experiences a deficiency maxillary growth. Maxillary hypoplasia leads to malocclusion skeletal disharmony. Orthognathic surgery at maturity the standard procedure end protocol correct resulting not correctable orthodontics alone.Case Presentation Operation Technique: We report result orthognathic performed on 23 year old male complete bilateral lip, palate, alveolus. proceeded bimaxillary despite alveolar cleft. also recorded neglected which he should have had undergone bone graft prior current procedure. pre-maxillary segment was stabilized miniplate followed by Le Fort 1 advancement mandibular setback guided an occlusal wafer. Malar augmentation done onlay grafts. Mandibulo-maxillary fixation maintained. Postoperatively, good occlusion better facial harmony were achieved. He planned undergo septorhinoplasty near future.Discussion: Despite adequate treatments following recommended many centres, some patients developed degree hypoplasia. quarter population need osteotomies I osteotomy most common retrognathic maxilla.Conclusion: combined orthodontic treatment provided functional aesthetic result. However, cannot replace having before permanent canine eruption achieve optimal outcomes