FIGURE LEGENDS
Figure 1: Dental casts showing the maxillo-mandibular
relationship (a) and arch form (b) of the patient and
intraoral photograph showing the rotated anterior maxillary segment,
anterior crowding and a centrally placed oro-nasal fistula (c) .
Figure 2: (a) Panoramic radiograph at the beginning of
treatment showing anterior maxillary crowding with impacted teeth(green arrows) . (b) Axial section CT scan
revealing a discontinuity of the maxillary alveolus accompanied by
fistulae (yellow arrows). (c) 3D reconstruction showing
the floating anterior maxillary segment.
Figure 3: Surgical exposure of 13 and orthodontic traction in
order to align the tooth in occlusion (a) . Results by
the end of phase one treatment (b).
Figure 4: Intraoperative photographs showing exposure of the
cleft segment and soft tissue repair of the nasal floor
(a) followed by packing of the bone graft to reconstruct
the alveolus (b). This was followed by adequate soft
tissue cover using a mucoperiosteal flap (c).
Figure 5: The anteriorly based, left dorsal tongue flap design(a). Suturing of flap to palate with adequate pedicle
length while its base remained attached to the tongue, promoting
vascularization and healing (b). Adequate closure of all
oro-nasal fistulae was achieved with no futher complications