Reconstruction of maxilar clefts with mandibular or illiac crest bone grafts

Alveolar bone grafting is an integral part of the surgical management of oral clefts.

The aim of this study is to compare the results of treatment obtained with mandibular symphyseal and illiac crest bone grafts used for reconstruction of alveolar clefts.

Method: 30 patients, whose age varied from 8 to 13, were randomly divided into two groups:

Group MBG (9.1 years): 15 patients used autogenous bicortical mandibular symphyseal bone graft.

Group ICB (10.3 years): 15 used tricortical cancellous bone graft harvest from the anterior illiac crest by the conventional trapdoor approach.

Results:

  • 1-

    The marginal bone level on cleft-related teeth was similar, no periodontal complications.

  • 2-

    The attached gingiva was evaluated, retention of canines and the morphology of the reconstructed alveolar process too.

Conclusions:

  • 1-

    MBG shows easier access to the donor site, because is intraoral.

  • 2-

    MBG is a good experience with this procedure in minor defects, i.e. cleft lip alveolar process only (CLA) patients with satisfactory results.

The use of ICB is indicated in important defects, i.e. uni o bilateral cleft lip, alveolar and palate (UCLP or BCLP).

  • 1-

    Use of tricortical bone graft revascularizes faster than using bicortical once, regardless of their origin.

  • 2-

    The use of ICB graft without any major morbidity and with an average hospitalization of two days.

  • 3-

    The scar in donor site is not important because the capacity of the osteogenic cells graft to resolve clefts palate is the principal way.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Reconstruction of maxilar clefts with mandibular or illiac crest bone grafts
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