ABSTRACT
In minimally displaced premaxilla in the newborn or when the child presents early (at less than 3 months of age), strapping of prolabium with dynaplast or elastics is helpful. In the more displaced premaxilla, nasoalveolar moulding with specially developed plates with nasal prongs to guide premaxilla and lateral segments into position can be fitted. This requires repeated visits to the clinic to adjust the plates. Lip adhesion is a surgical procedure which allows mobilisation of the nasal layer and closure of the lateral segment margins with the prolabium without mobilisation and anastomosis of the orbicularis oris muscle. This allows repositioning of the premaxilla and definitive repair at the second stage some 3 months after the lip adhesion. Primary premaxillary osteotomy is performed using a longitudinal mucosal incision, use of cutting instruments to perform a predetermined oblique ostectomy, separation of the nasal septum from the vomer and retropositioning the premaxilla and stabilisation with resorbable bone plates.
