Maitre et al: Surgical closure of labial and alveolar cleft defects with a modified Millard technique: A prospective study of ten dogs
Veterinary Surgery 7, 2026

🔍 Key Findings

• Prospective study of 10 puppies: A total of 14 complete labial/alveolar clefts were repaired (6 unilateral and 4 bilateral cases). Four dogs also had complete secondary palate clefts.
• Single-stage surgical reconstruction: The modified Millard-based technique combined nasal and oral mucosal reconstruction using mucoperiosteal flaps, alveoloplasty, and cheilorhinoplasty incorporating triangular lip-lengthening plasty.
• Flap mobilization and vascular preservation were essential: Sulcular and releasing incisions facilitated tension-free reconstruction. For bilateral clefts, the incision over the incisive bone was shortened to reduce ischemic necrosis risk.
• Concurrent secondary palate repair was feasible: Hard-palate defects were repaired using a two-layer modification of the von Langenbeck technique, avoiding overlapping flaps that could compromise vascularity of rostral palatal flaps.
• Dental extraction was unnecessary: All alveolar clefts were reconstructed without removing teeth or performing alveolar bone grafting, including relatively wide defects.
• Complications were generally manageable: No intraoperative surgical complications occurred. Three dogs (30%) developed minor partial dehiscence that healed by second intention within 14 days; one dog (10%) required revision surgery for a hard-palate oronasal communication.
• Functional success was achieved in all dogs: At the minimum 3-month evaluation, all 10 dogs were eating and drinking normally, preoperative clinical signs had resolved, and no residual oronasal communications were detected on intraoral probing.
• CT-based cosmetic outcomes were predominantly good to excellent: Median differences were 13% for nostril height, 12.5% for nostril width, and 16.5% for lip height. The small cohort and limited mid-term follow-up restrict conclusions about long-term outcomes.