Tertiary bone grafting with or without premaxilla osteotomy in adult alveolar clefts—Techniques and early outcome

Abstract

The outcome of alveolar bone grafting in adult patients is sparsely reported. Here, we present a description of the surgical techniques used in a Nigerian teaching hospital and a preliminary report of the first five cases of adult alveolar cleft bone grafting accomplished with or without repositioning the premaxilla. Although, evidence of bone resorption was observed within 6 months after the operation, satisfactory bone level and aesthetic outcome was recorded in all cases. We concluded that tertiary alveolar bone grafting is desirable for all cases where alveolar clefts have persisted into adulthood to enhance the psyche of the cleft patients and to motivate them for further rehabilitation. Prompt placement of dental implant into the grafted area is recommended to mitigate subsequent resorption of the bone graft.

Outcome of Using Medical Grade Calcium Sulfate Hemihydrate (DentoGen) in Unilateral Alveolar Cleft Repair

“…The reasons for this result may related to many factors such as: rapid bone resorption due to absence of functional stress on the bone, poor oral hygiene and width of the cleft. 16 The other factor could be the changes in the healing potential with increasing age. 17 These results come in agreement with the findings of study done by Dantana et al 18 , when they found that mean percentage of bone resorption after 3 months of alveolar cleft repair with the cancellous bone and marrow from the anterior iliac crest was 36.46%.…”

“…The major causes for this results may be attributed to the patients themselves and surgical technique not to the graft material, such as poor oral hygiene, the tension of wound closure and extraction of teeth within the cleft site intra-operatively. 16…”