Surgical management of grossly protruded bulky remaxilla: A case report

Management of protruding premaxilla is an important aspect of treatment of bilateral cleft lip. Surgical setback, which is considered as the last option in the management of grossly protruded premaxilla has an important role to play in selected cases. The present case had a grossly protruded, bulky premaxilla, which remained protruded even after 3 year following bilateral cleft lip repair. After failure to achieve expansion of maxillary arches by prosthodontic treatment for six month, patient was taken up for surgical setback. In view of the gross disparity between size of the protruding premaxilla and anterior gap between maxillary arches, conventional setback procedure would not have been possible and hence the patient underwent a bulk reduction procedure of premaxilla followed by the setback procedure. At the end of 6 weeks after surgery the premaxilla was stable.