Chin Bone Graft for Maxillary Alveolar Cleft

Rahpeyma, Amin; Khajehahmadi, Saeedeh

doi:10.1097/scs.0000000000001132

Cited by 13 publications

(5 citation statements)

References 26 publications

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“…The surgeon should have a special look at the donor site to avoid injury to the incisive nerve and to determine the presence of an unerupted mandibular canine or erupted mandibular permanent incisors. [10] Of the various intraoral donor sites, the harvest of the mandibular ramus bone has the lowest complication rate and is well accepted by the patients. [11] The use of a particulate allograft reduces the need for additional autogenous bone, while the cortical bones protect the particulate material from spilling into the soft tissue.…”

Section: Discussionmentioning

confidence: 99%

Mandibular ramus cortical tenting graft and particulate allograft in the management of unilateral alveolar cleft

Rahpeyma

Khajehahmadi

2019

Ann Maxillofac Surg

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Background:Alveolar bone grafting in the mixed dentition stage is an important step in the management of cleft lip/palate patients. Intraoral donor sites are favored by patients and their parents.Objective:This study investigated a novel bilaminar cortical tenting grafting technique. The technique used a combination of autogenous mandibular ramus cortical bone and particulate allograft in unilateral cleft lip/palate patients during the mixed dentition stage.Materials and Methods:Five patients with nonsyndromic unilateral cleft lip and/or palate, in mixed dentition stage, were included in the study.Results:The operation was performed on five patients, and patients were followed up at least for one-year postoperation. Permanent maxillary canine erupted in the grafted alveolar region spontaneously in 80% of the patients. One wisdom tooth bud that had been exposed during the ramus bone harvest was removed. There was no alteration in the sensation of the lower lip as checked by light static and two discrimination tests.Conclusion:Unilateral alveolar clefts can be repaired using mandibular cortical block ramus bone in the form of bilaminar tenting grafts combined with particulate allografts.

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Section: Discussionmentioning

confidence: 99%

Mandibular ramus cortical tenting graft and particulate allograft in the management of unilateral alveolar cleft

Rahpeyma

Khajehahmadi

2019

Ann Maxillofac Surg

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“…The donor site of block bone could be iliac crest or mandible ( 16 , 17 ). Mandibular bone block could be less resorpted than that from iliac crest for it matched with the embryologic origin on craniofacial bone formation ( 22 , 23 ). However, we preferred bone block from iliac crest rather than from genial or symphysis region, for it could provide adequate bone amount for our cases of wide cleft defect.…”

Section: Discussionmentioning

confidence: 99%

Block iliac bone grafting enhances osseous healing of alveolar reconstruction in older cleft patients: A radiological and histological evaluation

Du¹,

Zhou²,

Pan³

et al. 2018

Med Oral

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BackgroundOlder alveolar cleft patients (&12 years old) often have wide bone defect as well as teeth loss, resulting in poor osseous healing with conventional alveolar bone grafting (ABG). In this study, we investigated a surgical technique of block iliac bone grafting for the alveolar cleft reconstruction and evaluated the clinical and radiological outcomes of these cleft patients.Material and MethodsFifteen patients were included in this study. All cases received preoperative cone bean computed tomography (CBCT) scans for the alveolar cleft evaluation. Osseous outcomes of block iliac bone grafting were assessed at 1 week, 3- and 6-month postoperatively. Volume changes and bone resorption rates were calculated using the measurement modules of Simplant software. Bone samples from one patient undergoing dental implantation were assessed by micro-CT and histological examination. The morbidities of donor-site were analyzed by clinical examination and questionnaire survey.ResultsThe average age of the case series was 18.53±2.50 years. The intraoral incision of thirteen cases healed well. However, two cases had oronasal fistula and graft exposure at 1-week postoperatively. The results of follow-up CBCT scans showed significant resistance to radiation on both sides of the bone graft, suggesting a good osseous healing and new bone formation. The mean residual bone volume was 1.68±0.26 cm3, 1.29±0.23 cm3 and 1.15±0.23 cm3 at 1-week, 3- and 6-month postoperatively. Correspondingly, the mean bone resorption rates in 3- and 6-month postoperative were 21.78±6.88% and 30.66±8.97%, respectively. From micro-CT and HE examinations, the block bone samples exhibited a cancellous structure in which mature bone trabecula and functional blood vessels appeared. The average scores of donor-site morbidities were drastically decreased at 3- and 6-month postoperatively compared with those at 1-week postoperatively.ConclusionsOur results demonstrated that block iliac bone grafting could achieve satisfying osseous outcomes in older alveolar cleft patients, and this technique provided favorable bony condition for further treatments, especially dental implantation. Key words:Alveolar bone grafting, Block bone grafting, Osseous healing, CBCT.

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“…Several extraoral and intraoral sites have been proposed for autologous bone harvesting for reconstructive treatments of the alveolar cleft. The average bone mass provided from mandibular bone block is about 2.3 mL 19 , which is inadequate for large or bilateral alveolar clefts 20 - 22 . Therefore, a combination of these bone blocks and bone substitute material has to be used for larger alveolar defects.…”

Section: Discussionmentioning

confidence: 99%

Cone-beam computed tomographic comparison of chin symphysis bone particles and allograft versus iliac crest bone graft alone for reconstruction of alveolar bone defects in cleft patients

Attar

Soltani

Davari

et al. 2022

JKAOMS

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Objectives The aim of this study was to compare morbidities and duration of surgery, as well as bone formation in alveolar defects reconstructed with symphysis bone combined with allograft and iliac crest bone graft in patients with cleft palate. Patients and Methods This randomized clinical trial was performed with 22 patients with unilateral alveolar cleft with a follow-up period of 12 months. In 12 patients, alveolar defects were reconstructed with chin bone graft plus allograft (Group A), while for the other 10 patients, iliac bone crest was used as donor site (Group B). Duration of surgery as well as occurrence of morbidities and complications were recorded. In addition, cone-beam computed tomographic (CBCT) scans were performed before surgery and 12 months after surgical procedures in order to compare bone formation between the two groups. Results Postoperative CBCT demonstrated a mean bone fill percentage of 76.9% of the alveolar defect in Group A, compared with 77.0% in Group B. Paresthesia in the lower lip or chin did not occur in any patients of Group A. The mean duration of the surgical process was significantly shorter for Group A (40 minutes vs 76 minutes, P <0.001). In addition, patients in Group A regained normal gait faster than patients in Group B (1 day vs 9.5 days). Conclusion Mandibular symphysis bone graft in combination with allograft results in favorable outcomes in patients with unilateral alveolar clefts.

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Chin Bone Graft for Maxillary Alveolar Cleft

Cited by 13 publications

References 26 publications

Mandibular ramus cortical tenting graft and particulate allograft in the management of unilateral alveolar cleft

Mandibular ramus cortical tenting graft and particulate allograft in the management of unilateral alveolar cleft

Block iliac bone grafting enhances osseous healing of alveolar reconstruction in older cleft patients: A radiological and histological evaluation

Cone-beam computed tomographic comparison of chin symphysis bone particles and allograft versus iliac crest bone graft alone for reconstruction of alveolar bone defects in cleft patients

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