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Case Reports in Dentistry
Volume 2014, Article ID 480598, 5 pages
Case Report

Repair for Congenital Macrostomia: Vermilion Square Flap Method

1Department of Paedodontics and Preventive Dentistry, Maharaja Ganga Singh Dental College & Research Centre, Sri Ganganagar, Rajasthan 335002, India
2Jeewan Multispeciality Centre, 414/4 Jacobpura, Gurgaon 122001, India

Received 12 February 2014; Revised 7 May 2014; Accepted 13 May 2014; Published 29 May 2014

Academic Editor: Tommaso Lombardi

Copyright © 2014 Renuka Dhingra et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Transverse facial clefts (macrostomia) are rare disorders that result when the embryonic mandibular and maxillary processes of the first branchial arch fail to fuse due to failure of mesodermal migration and merging to obliterate the embryonic grooves between the maxillary and mandibular processes to form the angle of the mouth at its normal anatomic position. Macrostomia may be seen alone or in association with other anomalies. It may be unilateral, extending along a line from the commissure to the tragus or bilateral. It is usually partial but rarely complete. Transverse facial clefts are more common in males and more common on the left side when unilateral. The goal of macrostomia reconstruction is to achieve functional, symmetrical, and accurate oral commissure with minimal scar. In this paper, we present a six-year-old girl with unilateral macrostomia with preauricular skin tags and malformation of pinna on ipsilateral side treated with vermillion-square flap method. The scar is placed at the upper lip. At two-month followup, the oral commissures are symmetric, the scars are inconspicuous, and the overall balance of facial contour and lip is excellent. We recommend this method for patients with mild to moderate macrostomia.