scholarly journals A New Technique of Two Iliac Cortical Bone Blocks Sandwich Technique for Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients

2021 ◽  
Author(s):  
Nhan Van Vo ◽  
Nguyen Quan Pham ◽  
Chien Dac Ho ◽  
Son Van Le ◽  
Ha Manh Nguyen
Keyword(s):  
Cortical Bone ◽  
Dental Implant ◽  
Bone Grafting ◽  
Alveolar Bone ◽  
Treatment Protocol ◽  
Sandwich Technique ◽  
Alveolar Cleft ◽  
Initial Stability ◽  
Alveolar Bone Grafting ◽  
A New Technique

Alveolar cleft bone graft in the second stage of surgery was a crucial part of the cleft palate treatment protocol with many advantages: reconstructing bone for tooth eruption, supporting the periodontal structure for the teeth adjacent to the cleft, supporting and lifting the arch and preventing from collapsing of maxillary arch. Grafting technique and material are selected based on the treatment purpose that for orthodontic moving tooth into the arch or for dental implant rehabilitation. Cancellous material provides rapid vascularization and healing facilitating for tooth moving into the cleft site but easy to resorb that unsuitable for dental implant placement. While dense material is difficult to move teeth into the cleft but increase initial stability. Therefore, we offered a method that limit bone resorption, easily obtain the implant initial stability, quick osseointegration called two iliac cortical bone blocks sandwich technique for a purposes of dental implant rehabilitation. Treatment protocol started with orthodontic treatment prior alveolar bone grafting to create proper space for implant restoration. Our clinical experience with 32 cleft sites using two iliac cortical bone blocks sandwich had shown potential clinical application in follow-up time up to 96 months. Evaluation criteria of bone grafting for alveolar cleft included soft tissue condition of graft area, nasal fistula closure, bone grafting outcome, success in osseointegration and implant prosthesis. This chapter described in detail treatment procedure and outcomes of a new technique of two iliac cortical bone blocks sandwich for alveolar cleft in patients with unilateral cleft palate.

Segment Distraction to Reduce a Wide Alveolar Cleft Before Alveolar Bone Grafting

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

Alveolar Bone Grafting Changes the Inclination of Teeth and Affects Malocclusion in Patients With Unilateral Alveolar Cleft

2017 ◽  
Vol 28 (5) ◽  
pp. 1305-1307 ◽  
Author(s):  
Jeenam Kim ◽  
Hyojeong Shin ◽  
Ki-il Uhm ◽  
Donghyeok Shin ◽  
Hyungon Choi
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting

Reduced Need for Alveolar Bone Grafting by Presurgical Orthopedics and Primary Gingivoperiosteoplasty

1998 ◽  
Vol 35 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Pedro E. Santiago ◽  
Barry H. Grayson ◽  
Court B. Cutting ◽  
Mark P. Gianoutsos ◽  
Lawrence E. Brecht ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Primary Study ◽  
Control Group ◽  
Dental Ct ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Presurgical Orthopedics

Objective The purpose of this study was to evaluate if narrowing and approximation of the alveolar cleft through presurgical alveolar molding followed by gingivoperiosteoplasty (GPP) at the time of lip repair reduces the need for a bone-grafting procedure. Design This was a retrospective blind study of patients with unilateral or bilateral alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon. Alveolar bone formation was assessed prior to the eruption of the maxillary lateral incisor or canine by clinical examination, panoramic and periapical radiographs, and/or a dental CT scan. The criterion for bone grafting was inadequate bone stock to permit the eruption and maintenance of the permanent dentition. Setting This study was performed at the Institute of Reconstructive Plastic Surgery by the members of the Cleft Palate Team. Patients All patients with unilateral (n = 16) or bilateral (n = 2) alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon from 1985 to 1988 were studied. The control population consisted of all alveolar cleft patients (n = 14) who did not undergo alveolar modeling or GPP during the same time period. Interventions Presurgical alveolar modeling was performed with an intraoral acrylic molding plate. This plate was modified on a weekly basis to align the alveolar segments and close the alveolar gap. The surgical intervention consisted of a modified Millard GPP. Main outcome Measures The primary study outcome measure was the elimination of the need for a secondary bone graft in patients who underwent presurgical alveolar molding and GPP. Results Of the 20 sites in the 18 patients who underwent GPP, 12 sites did not require an alveolar bone graft. Of the 8 sites requiring a bone graft, 4 presented minimal bony defects. All 14 patients in the control group required bone grafts. Conclusions In this series of 20 alveolar cleft sites treated with presurgical orthopedics and GPP, 60% did not need a secondary alveolar bone graft in the mixed dentition.

Comparison of 2-D Calculations from Periapical and Occlusal Radiographs versus 3-D Calculations from CAT Scans in Determining Bone Support for Cleft-Adjacent Teeth following Early Alveolar Bone Grafts

1997 ◽  
Vol 34 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Sheldon W. Rosenstein ◽  
Ross E. Long ◽  
Diane V. Dado ◽  
Britt Vinson ◽  
Marden E. Alder
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Alveolar Cleft ◽  
Cat Scan ◽  
Alveolar Bone Grafting ◽  
Wide Range ◽  
Palatal Plate ◽  
Primary Bone ◽  
Dental Radiographs

Objective This investigation was conducted to determine the agreement between three-dimensional (3-D) calculations from CAT scans and two-dimensional (2-D) calculations from standard dental radiographs in evaluating bone support for cleft-adjacent teeth after primary bone grafting. Design This retrospective study utilized CAT scans and dental radiographs taken of the alveolar cleft in patients an average of 11 years after primary bone grafting. Setting The subjects were patients treated by the Cleft Palate Team at Children's Memorial Hospital and Loyola University Medical Center, Chicago, Illinois. Patients Fourteen UCLP patients (9 males, 5 females) agreed to participate In this study by undergoing CAT scan assessment of their alveolar cleft sites. They also had to have periapical or occlusal radiographs of the grafted cleft site taken within 6 months of the CAT scan. Interventions All patients underwent primary lip repair, placement of a passive palatal plate, primary alveolar bone grafting (mean age 6.4 months), and palatoplasty before 1 year of age. Major tooth movement through final orthodontics was completed by the time of the radiographic assessment. Main Outcome Measures CAT scan sections were reformatted and reconstructed to three-dimensionally calculate the percentage of root covered by bone support for the 15 teeth adjacent to the grafted cleft sites. Dental radiographs of the same teeth were also traced and digitized. Percentages of root supported by bone were also established using the dental radiographs by dividing the amount of root covered by bone, by the anatomic root length. Results A paired, two-sample t test revealed no significant differences between the two methods of assessment, while linear regression showed a statistically significant correlation between the CAT scan assessment and the percentages found on the radiographs. Conclusions Routine dental radiographs were able to estimate the total 3-D bone support for the roots of cleft adjacent teeth as determined by CAT scan to a statistically significant degree when groups where compared. The clinical significance for evaluation of individual cases was less impressive with a wide range of variability and a level of agreement that required acceptance of differences up to 25%.

A New Technique in Alveolar Cleft Bone Grafting for Dental Implant Placement in Patients With Cleft Lip and Palate

2017 ◽  
Vol 55 (2) ◽  
pp. 180-188 ◽  
Author(s):  
Vo Van Nhan ◽  
Le Van Son ◽  
Ta Anh Tuan ◽  
Nguyen Tai Son ◽  
Trinh Dinh Hai ◽  
...  
Keyword(s):  
Dental Implant ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Cleft ◽  
Implant Placement ◽  
The Mean ◽  
Width Measurements ◽  
A New Technique

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.

scholarly journals Use of Three-Dimensional Computed Tomography to Classify Filling of Alveolar Bone Grafting

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Antonio Jorge V. Forte ◽  
Renato da Silva Freitas ◽  
Nivaldo Alonso
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Three Dimensional ◽  
Unaffected Side ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Grade Ii ◽  
And Function ◽  
Mean Time ◽  
Secondary Alveolar Bone Grafting

Several authors have proposed classifications to analyze the quality over time of secondary alveolar bone grafting. However, little discussion has been held to quantitatively measure the secondary bone grafting for correction of nasal deformity associated to cleft palate and lip. Twenty patients with unilateral alveolar cleft, who underwent secondary alveolar bone grafting, were studied with 3D computer tomography. The height between the inferior portion of the pyriform aperture and the incisal border of the unaffected side (height A) and the affected side (height B) was measured using a software Mirror. A percentage was then obtained dividing the height B by the height A and classified into grades I, II, and III if the value was greater than 67%, between 34% and 66%, or less than 33%. Age, time of followup, initial operation, and age of canine eruption were also recorded. All patients presented appropriate occlusion and function. Mean time of followup was 7 years, and mean initial age for operation was 10 years old. 16 patients were rated as grade I and 4 patients as grade II. No cases had grade III. We present a new grading system that can be used to assess the success of secondary bone grafting in patients who underwent alveolar cleft repair.

The use of 2D radiographs for the assessment of effectiveness of secondary alveolar bone grafting in patients with cleft lip and palate. A literature review

2018 ◽  
Vol 14 (3) ◽  
pp. 199-213
Author(s):  
Marcin Stasiak ◽  
Anna Wojtaszek-Słomińska ◽  
Bogna Racka-Pilszak
Keyword(s):  
Literature Review ◽  
Bone Grafting ◽  
Surgical Procedure ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Treatment Protocol ◽  
Assessment Methods ◽  
Alveolar Bone Grafting ◽  
Secondary Alveolar Bone Grafting

Clefts of the lip and the palate (CLP) represent the most common craniofacial developmental defects. The CLP surgical treatment protocol involves an autogenous secondary alveolar bone grafting (SABG). <b>Aim.</b> The aim of the study was to review the methods for the SABG assessment in CLP patients based on 2D radiographs and the assessment of the effectiveness of the foregoing surgical procedure based on those methods. <b>Material and methods.</b> Papers, published in the years 1981-2018, regarding SABG assessment in CLP patients based on 2D radiographs were reviewed. Nineteen papers in which the material was closely associated with the study assumptions were qualified for the review. <b>Results.</b>major part of the papers under analysis use a single post-operative radiograph. The others are based on two or three radiographic projections. There are seven basic methods and three modified methods used for the assessment of SABG effectiveness. The SABG assessment methods based on 2D radiographs are similar to one another. The main criterion of surgery effectiveness is the position of the alveolar process edge within the cleft with relation to the tooth roots adjacent to the cleft. Said classification results differ in terms of the degree of complexity and the manner of presentation of the surgery outcomes. The Abyholm (Bergland) scale was the most commonly applied assessment method. As demonstrated in all the studies in which 2D radiographs were used, the SABG effectiveness varied from 71% to 95%. <b>Conclusions.</b>1. The SABG assessment methods based on 2D radiographs are a useful manner of surgical procedure assessment. 2. The studies in which the SABG assessment methods based on 2D radiographs are used demonstrate a high effectiveness of the SABG procedure. <b>(Stasiak M, Wojtaszek-Słomińska A, Racka-Pilszak B. The use of 2D radiographs for the assessment of effectiveness of secondary alveolar bone grafting in patients with cleft lip and palate. A literature review. Orthod Forum 2018; 14: 199-213).</b>

Rapid Maxillary Expansion after Alveolar Bone Grafting with rhBMP-2 in UCLP Evaluated by Means of CBCT

2017 ◽  
Vol 54 (4) ◽  
pp. 474-480
Author(s):  
Daniela Garib ◽  
Felicia Miranda ◽  
Renata Sathler ◽  
Anne Marie Kuijpers-Jagtman ◽  
Carlos Alberto Aiello
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Rapid Maxillary Expansion ◽  
Cone Beam ◽  
Collagen Membrane ◽  
Craniofacial Anomalies ◽  
Maxillary Expansion ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting

Objective To demonstrate the feasibility of rapid maxillary expansion (RME) after alveolar bone grafting (ABG) in complete unilateral cleft lip, alveolus and palate (UCLP) without damage to the grafted area. Setting Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo, Department of Orthodontics. Patient A case report of a 10-year-old boy with a complete UCLP who was treated with RME after secondary ABG procedure. RME was performed 1.3 years after the bone grafting with rhBMP-2 in collagen membrane. Result Postexpansion cone-beam computed tomography (CBCT) axial and coronal sections demonstrated the opening of the midpalatal suture in the premaxilla without damages to the alveolar bone grafting region. Postretention CBCT images showed bone formation at the split midsuture of the premaxilla. Conclusion Rapid maxillary expansion performed after ABG with rH-BMP2 led to complete opening of the premaxillary midline suture without compromising the integrity of the grafted alveolar cleft.

Permanent canine eruption into the alveolar cleft region after secondary alveolar bone grafting: Are there prediction factors for impaction?

2018 ◽  
Vol 154 (5) ◽  
pp. 657-663 ◽  
Author(s):  
Isabella Simões Holz ◽  
Roberta Martinelli Carvalho ◽  
José Roberto Lauris ◽  
Steven J. Lindauer ◽  
Daniela Gamba Garib
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Secondary Alveolar Bone Grafting
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