Abstract:

Maxillary transverse growth is inhibited by congenital cleft, early surgical scar strain, and oppression of lip muscles in patients with cleft lip and palate. Clinical manifestations have shown severely constricted maxilla, insufficient maxillary width, mismatch of upper and lower dental arches, and crossbite. Alveolar bone graft and arch expansion can effectively correct the deficiency in maxillary width. This paper discusses the timing and success rate of alveolar bone graft, as well as the relationship between alveolar bone graft and arch expansion. Secondary alveolar bone graft is optimally performed before permanent canine eruption, especially when the teeth have formed between half and three quarters of their roots. Rapid maxillary expansion prior to alveolar bone graft is beneficial because this process increases the gap of the cleft, expands bone graft, and reduces the difficulty. However, the stability of this process remains controversial. Small-scale studies have reported that rapid maxillary expansion after alveolar bone graft can open the midpalatal suture without bone graft loss. Slow maxillary expansion can provide continuous light forces to reconstruct the bone. However, these studies are coordinated with fixed orthodontic treatment. Further research is necessary to determine the effects of maxillary expansion on long-term stability of teeth.

Key words: cleft lip and palate, alveolar bone graft, rapid maxillary expansion, slow maxillary expansion