Application of mandibular bone grafts in reconstruction of the alveolar process in cleft palate patients J. R. Carlini, K. U. Gomes, C. Biron, A. Gebert, G. Strujak, M. Romanowski

Rev Bras Cir Traumatol Buco–Maxilo-Facial 2009: 6: 24–28 The authors presented the use of mandibular symphyseal block grafts for alveolar process reconstruction in cleft palate patients. They evaluated the efficacy of this kind of graft in relation to age and morbidities of the donor area. 75 patients from the Cleft Lip and Palate Full Assistance Center of Brazil were recruited for this study. The patients selected were unilateral pre or trans-foramen clefts. Under general anesthesia, the alveolar cleft was exposed through a mucoperiosteal flap; the nasal floor and palatal mucosa were reconstructed. The site to be grafted was prepared with a round bur to reach a suitable dimension to facilitate grafting. Block bone grafts were harvested from the chin and contoured to match the defect and fixed in position by digital pressure or with 1.5 mm screws and/or miniplates. The ideal age for grafting was considered to be 7–12 years old, although the pertinent literature also accepted the time frame of 9–12 years old as considered in this study. Ideally the canines should be unerupted with 1/4 to 1/2 completed root formation. The patients were evaluated clinically and through tracings over periapical radiographs to assess the bone height in the grafted areas after 12 months. The overall success rate was found to be 85.3%. Patients within the ideal age range (35) presented a success rate of 89.7%, whereas patients above the ideal age had a success rate of 80.5%. No permanent sequelae to the donor site were encountered.

MARIO GABRIELLI