TIBIA AS DONOR SITE FOR ALVEOLAR BONE GRAFTING IN PATIENTS WITH CLEFT LIP AND PALATE: LONG TERM EXPERIENCE

Author(s):  
Amin Kalaaji, Jan Lilja, Anna Elander, H
2016 ◽  
Vol 27 (3) ◽  
pp. 598-601 ◽  
Author(s):  
Jonathan Wheeler ◽  
Megan Sanders ◽  
Stanley Loo ◽  
Zac Moaveni ◽  
Glenn Bartlett ◽  
...  

2017 ◽  
Vol 54 (2) ◽  
pp. 137-141 ◽  
Author(s):  
Kavit Amin ◽  
Wee Sim Khor ◽  
Anais Rosich-Medina ◽  
Victoria Beale

Objective Review of patients who underwent secondary alveolar bone grafting for total inpatient stay, postoperative complications, and postoperative analgesic requirements. Design Retrospective analysis of medical records. Setting Tertiary care center as part of a regional cleft lip and palate network. Patients All patients who underwent secondary alveolar bone grafting from the iliac crest. Interventions Local anesthetic was infiltrated overlying the anterior iliac crest. An incision was made to conform to the future skin crease and avoid muscle dissection. The cartilaginous cap was incised and raised, and cancellous bone was then harvested. The cavity was packed with hemostatic cellulose and closed in layers. All patients received postoperative antibiotics. All patients were prescribed regular paracetamol (acetaminophen) and ibuprofen if there were no contraindications. Oral morphine was available when requested. Main Outcome Measures Length of stay, postoperative analgesic requirements, and postoperative donor site and oral complications. Results From 100 consecutive patients, 92 (92%) of the patients were discharged the day after surgery; one (1%) patient required four nights of monitoring for postoperative pyrexia of unknown origin. All patients received regular paracetamol, and the majority (86%) did not require oral morphine. Complications included seroma (4%), superficial donor site abscess (1%), postoperative pyrexia of unknown origin (2%), gingival bleeding (2%), and oral infection (2%). Conclusion The findings suggest that donor site pain may be well controlled with simple, regular analgesia. Children tolerated this procedure well and were safely discharged the day after surgery. Alveolar bone grafting from the iliac crest was found to have low complication rates.


2015 ◽  
Vol 52 (2) ◽  
pp. 210-218 ◽  
Author(s):  
Fatima Jabbari ◽  
Valdemar Skoog ◽  
Eicka Reiser ◽  
Malin Hakelius ◽  
Daniel Nowinski

2021 ◽  
pp. 105566562110026
Author(s):  
Ema Zubovic ◽  
Gary B. Skolnick ◽  
Abdullah M. Said ◽  
Richard J. Nissen ◽  
Alison K. Snyder-Warwick ◽  
...  

Objective: To determine the rate of revision alveolar bone grafting (ABG) in patients with cleft lip and palate (CLP) before and after the introduction of postoperative computed tomography (CT). Design: Retrospective case–control study analyzing the incidence of revision ABG in patients with and without postoperative CT scans for graft success evaluation. Setting: Academic tertiary care pediatric hospital. Patients: Eighty-seven patients with CLP or cleft lip and alveolus treated with autologous iliac crest bone grafting for alveolar clefts over a 10-year period (January 2009 to March 2019) with minimum 6-month follow-up. Fifty patients had postoperative CT evaluation; 37 did not. Interventions: Postoperative CT to determine ABG success, versus standard clinical examination and 2-dimensional radiographs. Main Outcome Measures: Requirement for revision ABG, defined as failure of the original graft by clinical or radiographic examination. Results: Fifty-eight percent of patients underwent a postoperative CT scan at median interval of 10 months after surgery. Patients with postoperative CT evaluation had a 44% rate of revision ABG (22/50) for inadequate graft take, compared to 5% (2/37) in patients without postoperative CT ( P < .001; 95% CT, 31%-58% in the CT group, 1%-16% in the non-CT group). Conclusions: Computed tomography evaluation after ABG is associated with a significantly increased revision rate for inadequate graft take. The presence of a secondary palatal fistula at the time of original ABG is not associated with revision requirement. Lack of standardized dental and orthodontic records complicates the study of ABG outcomes and presents an area for systems-based improvement.


2000 ◽  
Vol 8 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Michel C Samson ◽  
Donald H Lalonde ◽  
Donald Fitzpatrick ◽  
Gerald L Sparkes

Reported beneficial effects of presurgical maxillary orthopedics in cleft lip include reduction of the cleft width, alignment of the maxillary segments, elevation of the alar base on the cleft side, diminished need for alveolar bone grafting and lip closure without tension. Possible adverse effects of presurgical maxillary orthopedics include tooth root damage and inability of periosteoplasty to make bone over the cleft. A series of wide cleft lip patients (n=15) treated with the Latham appliance at the time of lip closure were retrospectively compared with a similar group treated without the Latham appliance. The Latham appliance group (seven unilateral clefts, eight bilateral clefts; mean follow-up 9.5 years; range four to 18 years) was treated between the years 1980 and 1994. None of the 15 patients treated with the appliance had any tooth loss or damage attributable to the pins, and bone formation in the alveolar cleft was observed radiographically in all 13 of the patients who had a periosteoplasty at the time of lip repair, possibly obviating the need for secondary bone grafting. Five of these Latham group patients demonstrated clinical and radiographic evidence of tooth eruption into the periosteoplasty-formed bone. There was no consistent difference in the level of nasal alar base elevation in the two groups.


2018 ◽  
Vol 88 (5) ◽  
pp. 567-574
Author(s):  
Sunjay Suri ◽  
Suteeta Disthaporn ◽  
Bruce Ross ◽  
Bryan Tompson ◽  
Diogenes Baena ◽  
...  

ABSTRACT Objectives: To describe qualitatively and quantitatively the directions and magnitudes of rotations of permanent maxillary central incisors and first molars in the mixed dentition in repaired complete unilateral cleft lip and palate (UCLP) and study their associations with absence of teeth in their vicinity. Materials and Methods: Dental casts and orthodontic records taken prior to orthodontic preparation for alveolar bone grafting of 74 children with repaired UCLP (53 male, 21 female; aged 8.9 ± 1.0 years) were studied. Directions and magnitudes of permanent maxillary central incisor and first molar rotations were recorded. Tooth absence was confirmed from longitudinal radiographic records. Incisor and molar rotations were analyzed in relation to the absence of teeth in their vicinity. Results: Distolabial rotation of the permanent maxillary central incisor was noted in 77.14% on the cleft side, while distopalatal rotation was noted in 82.19% on the noncleft side. Incisor rotation was greater when a permanent tooth was present distal to the cleft side central incisor, in the greater segment. The permanent maxillary first molar showed mesiopalatal rotation, which was greater on the cleft side and when there was absence of one or more teeth in the buccal segment. Conclusions: Presence and absence of teeth were associated with the severity of incisor and molar rotations in UCLP. Crowding of anterior teeth in the greater segment was associated with a greater magnitude of rotation of the cleft side permanent central incisor. Absence of one or more buccal segment teeth was associated with greater magnitude of rotation of the molar.


1998 ◽  
Vol 35 (4) ◽  
pp. 304-309 ◽  
Author(s):  
Mitsuyoshi Iino ◽  
Tomokazu Sasaki ◽  
Shoko Kochi ◽  
Masayuki Fukuda ◽  
Tetsu Takahashi ◽  
...  

Objective This paper introduces a surgical technique for premaxillary repositioning in combination with two-stage alveolar bone grafting for the correction of the premaxillary deformity of patients with bilateral cleft lip and palate (BCLP). The paper also reports on two patients with BCLP who underwent this surgical management. Surgical Procedure The operation is usually performed when the patient is 8 to 14 years of age. In the first stage of surgery, the side more accessible to the septopremaxillary junction is selected, and an osteotomy of the premaxilla and unilateral alveolar bone grafting are performed. Approximately 4 to 12 months after the first stage of surgery, contralateral alveolar bone grafting is carried out. Conclusion We have found that this surgical procedure is highly effective, because it ensures the blood supply to the premaxilla and minimizes the potential for surgical failure. Moreover, it affords wide exposure of the premaxillary bone surface, facilitating sufficient boney bridging and allowing for orthodontic tooth movement.


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