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Mandibular anterior segmental advancement offers an alternative mode of management for certain patients with Class II dentoalveolar malocclusion. The procedure is ideally indicted in paradoxical occlusal situations wherein Class II malocclusion is associated with a prognathic profile or when total body advancement would produce an unacceptable occlusion or profile. Arch expansion and augmentation genioplasty may be achieved by tailoring the surgical approach. Complications were minimal in the cases presented. Since arch lengthening results, the potential food table is increased, necessitating either fixed or removeable prosthetic care.

Patients with skeletal Class II malocclusions and deep bites can be difficult to manage properly. Dental compensations, mandibular retrognathia, vertical dysplasia of inadequate posterior alveolar growth, and compensating chin effects must be considered if one is to achieve ideal treatment results. The eleven cases presented were managed through a combination of surgery, orthodontics, and rapid extrusion of the posterior dental arches. The rapid extrusion process is begun during the surgical healing phase, thereby decreasing total treatment time. Other advantages include simplicity of the surgical procedure, acceptance by the patient, stability of the facial and dental results, and possible avoidance of additional chin surgery.

The results of secondary bone grafting and orthodontic treatment in 41 patients with bilateral complete clefts of the lip and palate are reported. Good bone formation was found in 98% of the cleft sites grafted before the eruption of the canines, and in 80% of the clefts grafted later. Closure of both cleft spaces by orthodontic means was achieved in 20 of the 21 patients in the first group, and in 14 of the 20 patients in the second group. The bone grafts failed in one cleft site in 4 patients, all of which were regrafted with satisfactory results. In 2 patients one of the canines was later affected by external root resorption, necessitating endodontic treatment. Both the failures and the root resorptions occurred in patients bone grafted at an older age than was considered optimal for bilateral clefts: 10 to 11 years. Seven patients needed a bridge prosthesis, 3 of these over one cleft space only. Even these patients benefited greatly from bone grafting.

A new method for the repair of the cleft alveolus employing the alvolar flap, was carried out in 33 patients with a unilateral total cleft. Alternating primary osteoplastic repairs were performed in in aqual number of patients. The postoperative interval varies between 8 and 9 years. The patients were followed up with attention beng paid to the further growth of the upper jaw.

During the five year period 1980 to 1985 bone grafting was performed in 37 cleft patients before the eruption of the canine tooth (group IBG) and in 30 patients after the eruption of the canine tooth (group SGB). The initial healing was more favourable in the IBG group. In 72.5% of the clefts oro-nasal fistulae were present preoperatively. In all cases the fistulae were successfully closed. In the IBG group with orthodontic closure of the gap in the dental arch the interdental bone height in the grafted area was more than 75% of normal bone height in all clefts. In group SBG this situation was found in only 66% of the bone-grafted areas. There seems to be a clear relation between the age or the developmental stage of the canine tooth on the one hand and the possibility of orthodontic closure of the gap in the dental arch and good interdental bone height on the other hand. This also leads to the suggestion that if bone grafting to the alveolar cleft is required the operation should be performed before the eruption of the canine tooth on the cleft side.

A classification for partially edentulous maxillectomy dental arches is proposed. This classification is based on the frequency of occurrence of maxillary defects in a population of 123 patients.