Primary Alveolar Cleft Bone Grafting in Unilateral Cleft Lip and Palate

1999 ◽  
Vol 10 (1) ◽  
pp. 58-67 ◽  
Author(s):  
Ronald R. Hathaway ◽  
Barry L. Eppley ◽  
David K. Hennon ◽  
Charles L. Nelson ◽  
A. Michael Sadove
2004 ◽  
Vol 41 (5) ◽  
pp. 571-574 ◽  
Author(s):  
Anh Viet Pham ◽  
Marcelo Abarca ◽  
Albert De Mey ◽  
Chantal Malevez

Objective This case report describes the clinical and surgical management of a patient with a unilateral alveolar cleft and associated extremely atrophied totally edentulous maxilla. Method Two zygomatic implants and four endosseous oral implants were placed under general anesthesia in a compromised maxilla to rehabilitate a 33-year-old patient with cleft lip and palate. The two specially designed zygomatic implants were utilized to avoid the need for bone grafting in the patient. The final prosthetic rehabilitation was an esthetic and functional maxillary overdenture prosthesis supported by implants. Results Preliminary results have shown how dental prostheses supported by endosseous implants in grafted alveolar cleft are a reliable possibility in the dental rehabilitation of this malformation. Conclusion The use of zygomatic implants may be considered a reliable alternative to more resource-demanding techniques such as bone grafting in patients with cleft palate.


1999 ◽  
Vol 10 (1) ◽  
pp. 68-72 ◽  
Author(s):  
Ronald R. Hathaway ◽  
Barry L. Eppley ◽  
Charles L. Nelson ◽  
A. Michael Sadove

2017 ◽  
Vol 55 (2) ◽  
pp. 180-188 ◽  
Author(s):  
Vo Van Nhan ◽  
Le Van Son ◽  
Ta Anh Tuan ◽  
Nguyen Tai Son ◽  
Trinh Dinh Hai ◽  
...  

Objective: To evaluate 2 iliac corticocancellous-block grafting techniques for dental implant placement in residual alveolar clefts. Design: Nonrandomized prospective clinical trial between March 2010 and December 2014. Setting: National Hospital of Odonto-Stomatology, Hanoi, Vietnam. Participants: Thirty-two patients (23 female, 9 male; mean age, 21.28 years; range, 16-31 years) with unilateral complete alveolar cleft after reconstructive surgery for cleft lip and palate (CLP). Interventions: Harvested iliac crest bone was cut into 2 corticocancellous blocks. The smaller block was adapted against the sutured nasal mucoperiosteum and overlaid with cancellous bone; the larger one overlapped the labial cleft margin and was fixed with screws. Endosteal dental implants were placed after 4 to 6 months, and final restorations were delivered 6 months later. Main Outcome Measures: Flap statuses were assessed clinically. Bone formation was assessed using the Enemark scale. Cone-beam computed tomography was used for graft height and width measurements. Implant health was assessed by the Misch criteria. Results: The mean postgrafting follow-up period was 36.7 ± 10.4 (range, 18-53) months. Three patients (9.4%) showed flap dehiscence but no infection 7 days after bone grafting. Twenty-nine patients (90.6%) had 75% to 100% bone fill (Enemark score of 1). The mean graft height and width were 11.4 ± 2.4 and 6.1 ± 1.0 mm, respectively. Sufficient bone for implant placement was noted in 29 patients (90.6%); the others required partially fixed prostheses. All implants functioned for at least 18 months. Conclusion: The proposed technique is reliable to reconstruct the alveolar cleft for implant placement in CLP patients.


1994 ◽  
Vol 31 (3) ◽  
pp. 217-223 ◽  
Author(s):  
Ronald Koole

Bone grafting the alveolar cleft in cleft lip and palate (CLP) patients is widely accepted. A traditional graft is the iliac crest. Other bone graft donor sites are briefly discussed. The ratio for an ectomesenchymal bone graft in alveolar cleft repair Is explained. Aspects of the embryology, bone graft physiology, and reports on mandibular symphysis bone grafting are discussed.


2000 ◽  
Vol 37 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Catherine Aurouze ◽  
Karlind T. Moller ◽  
Richard R. Bevis ◽  
Kelly Rehm ◽  
Joel Rudney

Objective The primary purpose of this study was to evaluate presurgical status of the alveolar cleft site and success of secondary alveolar bone grafting. Design Thirty patient records were retrospectively reviewed. Patients selected for inclusion had isolated cleft of at least the primary palate. Patients with additional anomalies were not selected. The study population consisted of 15 female sites and 16 male cleft sites. There were two bilateral cleft lip and palate (CLP) patients and 28 unilateral CLP patients. The age at the time of the secondary alveolar bone grafting ranged from 7 years to 14 years, 4 months. Setting The study was conducted at the Cleft Palate Clinic at the University of Minnesota, School of Dentistry. Method Presurgical radiographs taken at least 1 month prior to the secondary bone grafting and postsurgical radiographs taken at least 6 months after bone surgery were measured. Measurements included size of the cleft defect and bone support for distal and mesial teeth adjacent to the cleft. Evaluation of success was determined on the basis of postsurgical measurements of satisfactory, intermediate, and unsatisfactory outcomes. Results and Conclusion The size of the cleft defect was not correlated with the success rate of the secondary alveolar bone grafting. If the amount of distal bone support for the mesial tooth was the same as those in a periodontally healthy individual, a satisfactory outcome was 5.8 times more likely. If the amount of mesial bone support for the distal tooth was the same as those in a periodontally healthy individual, the satisfactory outcome was 3.8 times more likely. Although not a primary purpose of the study, it was found that in this study population, if the patient was female, a satisfactory outcome was 3.8 times more likely.


Author(s):  
Jing Guo ◽  
Qifeng Zhang ◽  
Shujuan Zou ◽  
Jianwei Chen ◽  
Qingsong Ye ◽  
...  

2003 ◽  
Vol 40 (6) ◽  
pp. 561-565 ◽  
Author(s):  
Thomas Binger ◽  
Christos Katsaros ◽  
Martin Rücker ◽  
Wolfgang J. Spitzer

Objective To demonstrate a method for reduction of wide alveolar clefts prior to bone grafting. This method aims to facilitate bone grafting and achieve adequate soft tissue coverage of the graft with attached gingiva. Case Report Treatment of a patient with bilateral cleft lip and palate with a severe alveolar defect on the left side is illustrated. Distraction osteogenesis was used to mesialize the left segment so that the alveolar cleft was reduced to a minimum. After a 10-week retention period, bone grafting of the reduced alveolar defect was successfully performed. After consolidation of the bone graft, the alveolar cleft was found to have an osseous closure with adequate soft tissue coverage. Conclusion In patients with a wide alveolar cleft, soft tissue coverage with keratinized mucosa can be more readily assured by reducing the alveolar cleft by callus distraction to mesialize the lateral segment prior to bone grafting.


2003 ◽  
Vol 40 (5) ◽  
pp. 449-452 ◽  
Author(s):  
S. Kamakura ◽  
T. Yamaguchi ◽  
S. Kochi ◽  
A. Sato ◽  
K. Motegi

Objective To overcome the difficulties of one-stage secondary alveolar bone grafting for patients with bilateral cleft lip and palate (BCLP) who have a broad alveolar cleft, the value of two-stage alveolar bone grafting was examined. Patients Three patients (2 girls and 1 boy) with BCLP were treated by two-stage alveolar bone grafting. The procedure consisted of a first-stage surgery (mean age 8 year 6 months ± 7.8 months), which consisted of alveolar bone grafting for one side of the BCLP, and second-stage surgery for the contralateral side several months later. For the postoperative assessment, radiographs of the operated site were examined. Results The average amount of implanted bone per operation and per patient was 6.8 ± 1.1 g and 13.7 ± 1.0 g, respectively. Postoperative clinical and radiographic examinations revealed that an appreciable alveolar bone ridge had formed, and there were no major complications. Conclusions Two-stage alveolar bone grafting, which makes it possible to reduce the amount of implanted bone, could be an optional surgical procedure for patients with BCLP and a broad alveolar cleft.


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