Factors Influencing Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients: Prospective Analysis Using CT Image Analyzer

Abstract

In cleft lip and palate patients with a germ of the lateral incisor, it is beneficial to carry out secondary bone grafting to the alveolar cleft at the age of 5 to 7 years, preceding eruption of the canine, in order to form a good bone bridge that will facilitate eruption of the lateral incisor and subsequent normal dentition and occlusion.

Proximal tibial bone graft: the volume of cancellous bone, and strength of decancellated tibias by the medial approach

“…For maxillary sinus grafting, 4-5 ml of cancellous bone graft was used per implant even though the actual volume depends on the degree of maxillary sinus pneumatization and the amount of residual alveolar bone height 5 . In alveolar cleft bone grafting, 1-4 ml of compressed cancellous bone was used 8,17,18 . Although cadavers were used in this study, the surgical technique used was the same as for living patients, so the volume of both non-compressed and compressed cancellous bone graft derived from this study can be clinically applied.…”

Primary osteoplasty using calvarian bone in patients with cleft lip, alveolus and palate

“…It may be performed as a primary procedure at the time of the first closing operations (Rosenstein et al, 1991) or as a secondary procedure late at the age of 9e11 years when the canine root development is between a quarter to two thirds of its final root length. It can also be performed as an early secondary procedure focussing on the goal to support a normal development and eruption of all teeth in the cleft region, the central and lateral incisor and the canine, which is just prior to the eruption of the central incisor at the age of 5e7 years (Sindet-Petersen and Enemark 1985;Amanat and Langdon, 1991;Kortebein et al 1991;Lilja et al, 2000;Rosenstein et al, 2003;Ozawa et al, 2007). Drawbacks of primary bone grafting such as inhibition of maxillary growth and appearance of lateral crossbites, have been reported (Rehrmann et al, 1970;Feifel and Schwenzer, 1991).…”

“…In future, tissue engineering approaches and osteopromotive substances may offer methods with minimal or no donor site morbidity (Jones et al, 2007;Moreau et al, 2007). Resorption is also dependent on functional loading since a long lasting period without tooth migration into the grafted bone will result in further boneloss, because absence of functional loading leads to disuse atrophy of the graft (Bergland et al, 1986;Schultze-Mosgau et al, 2003;Feichtinger et al, 2006, Ozawa et al, 2007. The disadvantages of calvarial bone grafting include the risk of intracranial complications, wound infection, limited bone thickness, lack of cancellous bone, a visible scar in balding patients (Strong and Moulthrop, 2000;Vahtsevanos et al, 2007).…”

“…Despite the almost universal agreement of the desirability of bone grafting, there is little agreement on the optimal time and the kind of bone to be used. The two most common options regarding the time of bone grafting are bone grafting in infancy at the time of primary surgery (Rosenstein et al, 1991) and secondary bone grafting in the mixed dentition (Bergland et al, 1986;Semb and Ramstad, 1999;Ozawa et al, 2007;Zemann et al, 2007). At present the main sources of autogenous bone are iliac crest, calvarium and mandibular symphysis.…”

Dental development of children and adolescents with cleft lip and palate

“…In order to simplify the treatment approach, accurately knowing the time for orthodontic intervention, assessment of dental maturity is of great clinical relevance 2 . Additionally, information concerning the ideal time for alveolar bone grafting is obtained in forehand, enabling a better surgical planning 4,6 . In accordance to the clinical relevance of assessing dental maturity in cleft Braz J Oral Sci.…”