The goal of reconstructive surgery of secondary cleft lip deformity is to restore both the function and the appearance of the lip. These methods have been described since 1756 by Hierzel and Verbos et al. Abbe described his technique of the repair of conspicuous deformity in a man born with a cleft lip and palate. Since that time, Abbe flap reconstruction has been used more frequently to repair the following resection malignancies. The Abbe flap is an axial flap consisting of skin, muscle and mucosa with a pedicle containing the inferior labial artery. However, the design and operative technique vary according to the location and destination of the flap, its shape and size, splitting of the ap and the pedicle management. (Shulte et al., 2001) The Abbe flap is used for lateral upper and lower lip deformities involving one-third to two-thirds of the lip, when the oral commissure is intact. Abbe (lip switch) flaps can also be used when there is a full thickness defect of the upper lip involving the philtral columns with central lip defects. (Culliford et al., 2008)Patients and Methods: Twelve patients: (5 males and 7 females) with secondary cleft lip and nasal deformity received reconstruction using Abbe flap and simultaneous rhinoplasty (rhinoplasty was not performed in two patients under 10 years old) from 2004 to 2008. The age of the patients ranged from 6 to 34 years at the time of the operation, with a mean of 19 years. On the upper lip, the prolabium and lip scars were outlined for excision, continuing up to the bilateral marginal incisions in the nostrils depending on their situation of asymmetry. The width and length of the flap were chosen proportional to that of an anatomically normal philtrum in each patient. Approximately 14 mm in length and up to 9 mm in width on its cutaneous portion. Discussion: Fortunately, the majority of CLP patients had satisfactory results with the initial surgery. However, there were some cases with structural malrelations and malformations following the surgical procedure. The fracture of premaxilla during bilateral complete cleft lip by the surgeon or anesthetist during difficult intubations was the most important reason of necrosis or severe scar of prolabium that must be prevented. Abbe flap will treat the tight upper lip restricting use of orthodontic appliances and will eliminate the restriction of the alveolar tissue expansion. It is designed to replace the entire philtral column and it is lengthening.

Objectives Tooth agenesis or hypodontia is a major problem that may occur in any person in any area of the mouth. However, it is of greater significance in patients with cleft lip and palate (CLP) because of their susceptibility to various problems. This study aimed to investigate the prevalence of tooth agenesis in both jaws among patients with CLP. Methods In this descriptive analytical study, a total of 150 unilateral CLP and 30 bilateral CLP patients (age range, 4-19 years) were randomly selected, and their panoramic radiographs were examined. The collected data were analyzed using Chi-square test, Mann-Whitney test, Fisher’, s exact test, and logistic regression analysis. Results The results of Chi-square test revealed that the prevalence of tooth agenesis was significantly higher in unilateral CLP patients compared to their bilateral CLP counterparts (P=0. 039). The maxillary lateral incisors (26%), followed by right maxillary first premolars (20%), accounted for the highest number of hypodontia. The results of Mann-Whitney test did not indicate any significant differences in the number of hypodontia between unilateral and bilateral CLP patients (P=0. 158). Conclusion The frequency of tooth agenesis in the evaluated CLP population of Isfahan (Isfahan Province, Iran) was similar to that of other populations around the world. According to the present findings, unilateral CLP was more frequent than bilateral CLP, and left-sided CLP was more frequent than right-sided CLP and bilateral CLP.