Cleft Maxillary Hypoplasia: a Review of Treatment Options

Maxillary hypoplasia is a frequently observed secondary deformity in individuals born with cleft lip and palate. The impairment of maxillary growth coupled with extensive postoperative scarring as a result of multiple previous surgeries brings about maxillary deficiency in all planes viz vertical, horizontal and transverse. The resulting class III skeletal malocclusion together with maxillary hypoplasia produces structural imbalance, functional insufficiency, and aesthetic disharmony. Two types of options are available to manage this deformity viz non-surgical and surgical. The non-surgical options include Orthodontics alone or orthopedic protraction using face mask/ reverse pull headgear. The surgical options include conventional orthognathic surgery at Lefort I level or distraction osteogenesis either complete or anterior maxillary distraction. This article highlights all the options available for managing this complex deformity. An effort has also been made to highlight the merits and demerits of each procedure as well as its adverse effects on speech present if any.