scholarly journals The use of various types of autografts in the bone grafting of the alveolar process

2020 ◽  
Vol 24 (1) ◽  
pp. 69-74
Author(s):  
A. V. Makeev ◽  
O. Z. Topolnitsky ◽  
R. N. Fedotov

Relevance. Fixing a cleft alveolar process is one of the most complicated problems in pediatric maxillofacial surgery. The difficulty lies in the fact that bone grafting of the alveolar process directly affects the growth of the upper jaw, the difficulty of performing surgery, as well as trying to form a sufficient amount of bone regenerate, while it is necessary to restore the anatomical integrity of the alveolar process for subsequent orthodontic treatment or dental implantation. Purpose: To review the literature on the use of autografts from various donor areas in patients with congenital cleft upper lip, alveolar process, hard and soft palate. Materials and methods: A literature review of the data was carried out using the electronic databases “Medline”, “Pubmed”, “Kibeleninka”. The key words in the search were: bone plastic, cleft alveolar process. The selection criteria were the articles in English and Russian containing clinical studies on the use of various types of grafts in bone grafting of the alveolar process cleft. Results: The sources of literature on the use of various autografts for bone grafting of the alveolar outgrowth in children with cleft lip and palate were analyzed. Currently, most authors are inclined to use an iliac crest autograft in surgery. Conclusion: Although more than a century has passed since the first alveolar cleft bone graft surgery was performed, the choice of bone material is still unresolved - due to the severity of complications, the impossibility of taking a sufficient amount of bone material, as well as a high percentage of material resorption, because even with the use of iliac crest bone, the volume of transplant resorption can be over 40%.

2004 ◽  
Vol 41 (4) ◽  
pp. 447-455 ◽  
Author(s):  
Stijn De Muynck ◽  
Anna Verdonck ◽  
Joseph Schoenaers ◽  
Carine Carels

Objective The treatment of a patient with a complete unilateral left cleft lip and palate, agenesis of the left upper second premolar, and a severely malformed left upper lateral incisor is reported. Treatment included placement of an autologous bone graft from the left iliac crest into the alveolar cleft at 8 years of age and transplantation of a lower premolar into the reconstructed alveolar process at 10 years of age. During the succeeding orthodontic treatment, the dental arches were aligned and corrected toward a Class I molar occlusion. One year after the end of treatment, the status of the transplanted premolar was good.


2016 ◽  
Vol 27 (3) ◽  
pp. 598-601 ◽  
Author(s):  
Jonathan Wheeler ◽  
Megan Sanders ◽  
Stanley Loo ◽  
Zac Moaveni ◽  
Glenn Bartlett ◽  
...  

2019 ◽  
Vol 15 (2) ◽  
pp. 89-96 ◽  
Author(s):  
Сергей Чуйкин ◽  
Sergey CHUYKIN ◽  
Наиль Давлетшин ◽  
Nail' Davletshin ◽  
Олег Чуйкин ◽  
...  

Subject: development of an algorithm for the rehabilitation of children with congenital cleft lip and palate in a region with petrochemical ecotoxicants. Objectives: optimization of the algorithm for the rehabilitation of children with congenital cleft lip and palate in the region with ecotoxicants. Methods. A retrospective analysis of the medical records of children with a diagnosis of congenital cleft lip and palate was conducted on the basis of the Republican Children's Clinical Hospital in Ufa in the department of maxillofacial surgery. In the period from January 1, 1985 on December 31, 2018 were surveyed 3463 children with congenital cleft lip and palate. Results. Children born and living in the region with the petrochemical industry have a high percentage of concomitant somatic diseases and deviations from the norm in blood tests. An algorithm was developed for the rehabilitation of children with congenital cleft lip and palate in the region with petrochemical ecotoxicants, optimized by including a toxicologist, anesthesiologist, immunologist, otorhinolaryngologist, gastroenterologist, and endocrinologist in the algorithm of consultation and treatment. The algorithm is aimed at improving the health of the child by increasing the effectiveness of prevention and treatment of somatic diseases in the preoperative period. Conclusions. The proposed algorithm for the rehabilitation of children with congenital cleft lip and palate has been developed taking into account the adverse effects on the body of emissions into the air of large petrochemical enterprises. Children with congenital cleft lip and palate, born and living in a region with petrochemical ecotoxicants, have a high percentage of somatic diseases and contraindications to surgical treatment according to accepted terms due to the presence of comorbidities and disorders in blood tests, and need additional treatment from a toxicologist, anesthesiologist and other specialists.


2017 ◽  
Vol 54 (5) ◽  
pp. 530-534 ◽  
Author(s):  
Macedo Pessoa Erica Alexandra ◽  
Braune Andre ◽  
Ladeira Casado Priscila ◽  
Nivoloni Tannure Patricia

Objective The aim of this study was to investigate clinical aspects and predisposing factors for alveolar bone graft complications in persons born with oral clefts. Design A total of 105 patients, aged 7 to 57 years old, who received alveolar bone graft at the Cranio-maxillofacial Surgery Center in the National Institute of Traumatology and Orthopedics (INTO), Rio de Janeiro (RJ) from 2009 to 2014 were selected. Data were collected concerning the type of oral cleft, family history of cleft, medical and dental exam, donor area, type of graft material, repaired surgical treatment done, and postoperative follow-up examinations. Results Postoperative complications developed in 31 patients (32.9%). The mean age at grafting was 16.79 years for the group without complications (n = 63) and 20.13 years for the group with postoperative complications (n = 31). There was a positive association between age and type of graft and cases with alveolar bone graft complications. Patients aged 12 years or more had a four times more chance of developing alveolar bone graft complications. Particulate bone graft from iliac crest demonstrated better results compared with block graft or mixed graft. Conclusion Patients with cleft lip and palate who were 12 years or older had a greater chance of developing complications after grafting the alveolar bone. Furthermore, particulate alveolar graft from iliac crest had significantly better outcomes.


ASJ. ◽  
2021 ◽  
Vol 1 (50) ◽  
pp. 10-13
Author(s):  
A. Eshiev ◽  
N. Taalaibekov ◽  
E. Derbishev

The aim of the study is to examine the incidence and factors of congenital cleft lip and palate in the southern region of the Kyrgyz Republic, according to the form of clefts and according to the classification of MMDI, as well as their rehabilitation. We studied in detail the case histories of 2116 patients treated in the maxillofacial surgery department of Osh Interregional United Clinical Hospital according to the age and sex, as well as the form of congenital cleft lip and palate. Moreover, a questionnaire was administered to parents of children with CCLP for risk factors during pregnancy. A retrospective study of medical history revealed, among congenital anomalies, clefts of the soft, hard palate, alveolar process and upper lip prevailed - (combined) 891 (42,3%) Congenital cleft of soft, hard palate - 586 (27,7%), then isolated congenital cleft of the maxilla - 415 (19,6%), congenital cleft of the soft palate only 10,5% - 224 children were followed. The results of the questionnaire revealed that the parents of children born with CCLP were influenced by various unfavorable factors in the period of formation of the facial section of the fetus. The survey revealed that the relatives had CCLP, which accounted for 12.9% of all newborns, indicating a rather high role of hereditary predisposition. In addition to the hereditary genetic factor, an important role is played by infectious diseases suffered during the first trimester. It is noted that 12.8% of the children born with CCLP had infectious diseases. The mothers independently took drugs during pregnancy (antibiotics, salicylates, sulfonamides without a doctor's prescription), 17.6% of women were anemic during pregnancy, and 16.3% had severe toxemia. Along with this, it was found that the smallest number of women suffered mental trauma in the first trimester of pregnancy 0.4% of the mothers of children born with CCLP. Further, we registered patients with CCLP in the special software ONYX CEPH-3 from 01.01.2015 to the present, where we enter detailed information about patients with CCLP pathology. It creates convenience for parents both informationally and economically, as well as directly for the doctor in terms of dynamic observation of the functional and aesthetic condition and development of the child. In order to further develop programs to prevent the prevalence of congenital pathology, improve the quality of comprehensive treatment method, as well as medical and social rehabilitation of such patients and work with families of children with CCLP, we have developed a single program ONYX CEPH3 providing dispensary and rehabilitation of children.


2020 ◽  
Vol 16 (1) ◽  
pp. 139-142
Author(s):  
Sergey Chuykin ◽  
Julia Andrianova ◽  
Natal'ya Makusheva ◽  
Oleg Chuykin ◽  
Kristina Kuchuk ◽  
...  

Thing. Studying the frequency of birth of children with congenital malformations in a city with a petrochemical industry. The goal is to identify the effect of industrial emissions from enterprises in Ufa on the frequency of birth of children with congenital cleft lip and palate. Methodology. In the Department of Oral and Maxillofacial Surgery of the Republican Children's Clinical Hospital from 1985 to 2019, the medical documentation of children born in the city with a petrochemical industry with a cleft lip and palate was studied. Results. In industrial areas of Ufa, the average rate of birth of children with clefts is 3.65 ± 0.31 (Kalininsky) and 2.34 ± 0.29 (Ordzhonikidzevsky). According to our studies, it was found that in the industrial zone, the frequency of birth of children with congenital facial pathology is significantly higher than in environmentally safe areas, and ranges from 1: 282 (3.5) in the Kalinin industrial northern region to 1:859 (1.1) in the southernmost, ecologically safe Demsky district (p<0.01). On the whole, in Ufa, the average rates of the birth rate of children with congenital cleft lip and palate were 1:454 (2.204 ± 0.11). Conclusions. The correlation between the value of gross emissions of harmful substances into the atmospheric air and the frequency of congenital cleft lip and palate in the zone with emissions of 135,114―180,120 tons per year, then in the zone with the amount of emissions of 20,000―135,114 tons per year, and the frequency in the zone with emissions of 11,000 is less ― 20,000 tons per year. The average birth rates for children with ARVH in the cities of the Republic of Bashkortostan were per 1000 children born: in cities with NHP ― 2.44; in cities without NHP ― 1.13. The frequency of birth of children with ADV in cities with NHP is more than 2 times higher than the frequency of birth of children with ADV in cities without NHP (p <0.001).


2002 ◽  
Vol 39 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Rupert Dempf ◽  
Thomas Teltzrow ◽  
Franz-Josef Kramer ◽  
Jarg-Erich Hausamen

Objective This investigation evaluated the results of alveolar bone grafting in patients with complete clefts, comparing secondary alveolar bone grafting (during the mixed stage of dentition) versus tertiary bone grafting (after completion of the second stage of dentition). Design This was a retrospective study. Of 140 osteoplasties, which all were operated according to the same standardized surgical technique, a clinical and roentgenological follow-up investigation was carried out in a collective of 85 osteoplasties. Clinically we searched for oronasal fistulae, assessed the periodontal status, determined the extent of the gingival attachment in the area of the osteoplasty, and searched for vertical growth disturbances in the area of the osteoplasty. Roentgenologically the height of the alveolar bone in the former clefted area was ascertained. Setting Records were obtained from a clinical and radiological study of the Department of Oral and Maxillofacial Surgery of the Medical University of Hannover (Germany). Interventions All patients were operated with the same standardized surgical method. The osteoplastic bridging of the alveolar cleft was performed via a vestibular gingival marginal incision and exclusively by grafting of cancellous bone from the iliac crest. Results The best results of alveolar bone grafting in cases of secondary osteoplasty were obtained when the lateral incisor or canine had grown into the transplant and had led to a functional stress of the transplanted bone. Approximately good results were to be found in tertiary osteoplasty when the transplanted bone had been stressed functionally through a dental implant. Comparing the secondary with the tertiary osteoplasty, there was a trend of lower resorption in secondary osteoplasty. Conclusions Secondary osteoplasty should represent an integral component of any concept for the comprehensive treatment of patients with cleft lip and palate.


2021 ◽  
Vol 17 (2) ◽  
pp. 121-126
Author(s):  
Oleg Chuykin ◽  
Galina AKATYEVA ◽  
Natal'ya Makusheva ◽  
Kristina Kuchuk ◽  
Marsel' Gil'manov

Monitoring of congenital malformations and concomitant somatic diseases in children is one of the important indicators of the causal influence of environmental factors on the health of the population. From the moment of birth, a child with congenital cleft lip and palate differs significantly from healthy peers not only externally, but also morpho-functional features of the structure of the primary section of the digestive and respiratory systems and often has a greater number of previous diseases in the history. Purpose: To determine the structure and frequency of somatic morbidity in children with congenital cleft lip and palate in regions with petrochemical ecotoxicants. Materials and methods: During the study, 3463 children from birth to 16 years old with congenital cleft lip were treated and monitored at the Department of Maxillofacial Surgery at the Republican Children's Clinical Hospital, Ufa for the period from January 1, 1985 to December 31, 2019 and / or sky. The diagnosis of concomitant systemic pathology was recorded based on the findings of the district pediatricians, ENT doctor, gastroenterologist, immunologist, allergist, rheumatologist from outpatient and inpatient records of the examined patients. Conclusion. In the course of our study, a direct relationship was noted between the level of environmental pollution by ecotoxicants and the frequency of concomitant somatic diseases in children with congenital cleft lip and palate. This must be taken into account in the pre- and postoperative algorithm for the rehabilitation of children with congenital cleft lip and palate with the involvement of pediatricians to improve the general somatic state of children when planning reconstructive surgery.


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.


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