scholarly journals Dental Reconstruction Using Secondary Bone Graft Followed by Implant Placement in Alveolar Cleft of Patients with Cleft Lip and/or Palate

10.5772/17249 ◽  
2011 ◽  
Author(s):  
Tetsu Takahashi
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Alveolar Cleft ◽  
Implant Placement

A New Technique in Alveolar Cleft Bone Grafting for Dental Implant Placement in Patients With Cleft Lip and Palate

2017 ◽  
Vol 55 (2) ◽  
pp. 180-188 ◽  
Author(s):  
Vo Van Nhan ◽  
Le Van Son ◽  
Ta Anh Tuan ◽  
Nguyen Tai Son ◽  
Trinh Dinh Hai ◽  
...  
Keyword(s):  
Dental Implant ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Cleft ◽  
Implant Placement ◽  
The Mean ◽  
Width Measurements ◽  
A New Technique

Objective: To evaluate 2 iliac corticocancellous-block grafting techniques for dental implant placement in residual alveolar clefts. Design: Nonrandomized prospective clinical trial between March 2010 and December 2014. Setting: National Hospital of Odonto-Stomatology, Hanoi, Vietnam. Participants: Thirty-two patients (23 female, 9 male; mean age, 21.28 years; range, 16-31 years) with unilateral complete alveolar cleft after reconstructive surgery for cleft lip and palate (CLP). Interventions: Harvested iliac crest bone was cut into 2 corticocancellous blocks. The smaller block was adapted against the sutured nasal mucoperiosteum and overlaid with cancellous bone; the larger one overlapped the labial cleft margin and was fixed with screws. Endosteal dental implants were placed after 4 to 6 months, and final restorations were delivered 6 months later. Main Outcome Measures: Flap statuses were assessed clinically. Bone formation was assessed using the Enemark scale. Cone-beam computed tomography was used for graft height and width measurements. Implant health was assessed by the Misch criteria. Results: The mean postgrafting follow-up period was 36.7 ± 10.4 (range, 18-53) months. Three patients (9.4%) showed flap dehiscence but no infection 7 days after bone grafting. Twenty-nine patients (90.6%) had 75% to 100% bone fill (Enemark score of 1). The mean graft height and width were 11.4 ± 2.4 and 6.1 ± 1.0 mm, respectively. Sufficient bone for implant placement was noted in 29 patients (90.6%); the others required partially fixed prostheses. All implants functioned for at least 18 months. Conclusion: The proposed technique is reliable to reconstruct the alveolar cleft for implant placement in CLP patients.

Three-dimensional Finite Element Analysis of the Effect of Alveolar Cleft Bone Graft on the Maxillofacial Biomechanical Stabilities of Unilateral Complete Cleft Lip and Palate

2021 ◽  
Author(s):  
Tao Tian ◽  
Han-yao Huang ◽  
Wei Wang ◽  
Bing Shi ◽  
Qian Zheng ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Element Analysis ◽  
Alveolar Cleft ◽  
The Mean ◽  
Alveolar Arch

Abstract Background: The objective was to clarify the effect of alveolar cleft bone graft on maxillofacial biomechanical stabilities, the key areas when bone grafting and in which should be supplemented with bone graft once bone resorption occurred in UCCLP (Unilateral Complete Cleft Lip and Palate).Methods: Maxillofacial CAD (Computer Aided Design) models of non-bone graft and full maxilla cleft, full alveolar cleft bone graft, bone graft in other sites of the alveolar cleft were acquired by processing the UCCLP maxillofacial CT data in three-dimensional modeling softwares. The maxillofacial bone equivalent (EQV) stresses and bone suture EQV strains under occlusal states were obtained in the finite element analysis software.Results: Under corresponding occlusal states, the EQV stresses of maxilla, pterygoid process of sphenoid bone on the corresponding side and anterior alveolar arch on the non-cleft side were higher than other maxillofacial bones, the EQV strains of nasomaxillary, zygomaticomaxillary and pterygomaxillary suture on the corresponding side were higher than other maxillofacial bone sutures. The mean EQV strains of nasal raphe, the maximum EQV stresses of posterior alveolar arch on the non-cleft side, the mean and maximum EQV strains of nasomaxillary suture on the non-cleft side in full alveolar cleft bone graft model were all significantly lower than those in non-bone graft model. The mean EQV stresses of bilateral anterior alveolar arches, the maximum EQV stresses of maxilla and its alveolar arch on the cleft side in the model with bone graft in lower 1/3 of the alveolar cleft were significantly higher than those in full alveolar cleft bone graft model.Conclusions: For UCCLP, bilateral maxillae, pterygoid processes of sphenoid bones and nasomaxillary, zygomaticomaxillary, pterygomaxillary sutures, anterior alveolar arch on the non-cleft side are the main occlusal load bearing structures before and after alveolar cleft bone graft. Alveolar cleft bone graft mainly affects biomechanical stabilities of nasal raphe and posterior alveolar arch, nasomaxillary suture on the non-cleft side. The areas near nasal floor and in the middle of the alveolar cleft are the key sites when bone grafting, and should be supplemented with bone graft when the bone resorbed in these areas.

Ectomesenchymal Mandibular Symphysis Bone Graft: An Improvement in Alveolar Cleft Grafting?

1994 ◽  
Vol 31 (3) ◽  
pp. 217-223 ◽  
Author(s):  
Ronald Koole
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Iliac Crest ◽  
Cleft Lip And Palate ◽  
Mandibular Symphysis ◽  
Alveolar Cleft ◽  
Graft Donor

Bone grafting the alveolar cleft in cleft lip and palate (CLP) patients is widely accepted. A traditional graft is the iliac crest. Other bone graft donor sites are briefly discussed. The ratio for an ectomesenchymal bone graft in alveolar cleft repair Is explained. Aspects of the embryology, bone graft physiology, and reports on mandibular symphysis bone grafting are discussed.

Bone Graft in Alveolar Cleft Lip and Palate

2017 ◽  
pp. 247-261
Author(s):  
Nivaldo Alonso ◽  
Renato da Silva Freitas ◽  
Julia Amundson ◽  
Cassio Eduardo Raposo-Amaral
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Cleft

scholarly journals Bone grafting and osseointegration in the area of maxillary tooth agenesis. Case report

2017 ◽  
Vol 20 (4) ◽  
pp. 143
Author(s):  
Rodrigo Dias Nascimento ◽  
Paula Elaine Cardoso ◽  
Fabio Silva Matuda ◽  
Fernando Vagner Raldi ◽  
Michelle Bianchi Moraes
Keyword(s):  
Bone Graft ◽  
Dental Implant ◽  
Cleft Lip ◽  
Cortical Plate ◽  
Autogenous Bone ◽  
Implant Placement ◽  
Maxillary Tooth ◽  
Maxillary Lateral Incisor ◽  
The Right ◽  
Ceramic Crown

<p><strong>ABSTRACT</strong></p><p>The high dental implant success rate is directly linked to the presence of adequate bone volume, which enables and maintains the osseointegration of dental implants. This study aimed to report a clinical case of a female with agenesis of the right maxillary lateral incisor (#12), due to cleft lip and palate.Because the  bone and mucosal defects of the area, the treatment planning comprised guided bone regeneration with the association of autogenous bone, platelet rich plasm (PRP), and expanded polytetrafluoroethylene membrane (e-PTFE,Gore-Tex), performed in 2005. After nine months, a new evaluation was carried out and revealed that the area was still not suitable for implant placement. Thus, an allogenous bone graft was planned. Elapsed another nine months, the implant was placed. After six months, the implant was reopened and a metal-ceramic crown was installed. The 5-year following-up appointment showed the presence of fistula with purulent secretion at the buccal cortical plate. We attempted to control the fistula with antibiotics and follow-up clinically and radiographically. The examinations suggested a communication with the right nasal cavity, which decreased until nowadays. The osseointegrated dental implant was in function, without symptomatology. The autogenous bone graft is still more effective than allogenous bone graft. Further studies are necessary to achieve better evaluations.</p><p><strong> </strong></p><p><strong>Keywords</strong></p><p>Bone graft; Dental implant; Osseointegration.</p>

scholarly journals Orthognathic Surgery Combined with Orthodontic Treatment in a Patient with Bilateral Cleft Lip, Palate and Alveolus, Without Alveolar Bone Graft: A Case Report

2021 ◽  
Vol 3 (1) ◽  
pp. 1
Author(s):  
Yudi Siswanto ◽  
Magda Rosalina Hutagalung ◽  
Indri Lakhsmi Putri ◽  
Jusuf Sjamsudin
Keyword(s):  
Bone Graft ◽  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Maxillary Hypoplasia ◽  
Le Fort ◽  
Alveolar Cleft ◽  
Bilateral Cleft Lip ◽  
Cleft Lip Palate

Background: The incidence of cleft lip and palate is 8 in every 10,000 live births. A patient with this condition experiences a deficiency in maxillary growth. Maxillary hypoplasia leads to malocclusion and skeletal disharmony. Orthognathic surgery at skeletal maturity is the standard procedure at the end of the protocol to correct maxillary hypoplasia resulting in malocclusion not correctable with orthodontics alone.Case Presentation and Operation Technique: We report the result of orthognathic surgery performed on a 23 year old male with complete bilateral cleft lip, palate, and alveolus. We proceeded with bimaxillary surgery despite the alveolar cleft. We also recorded a neglected alveolar cleft in which he should have had undergone alveolar bone graft prior to the current procedure. The pre-maxillary segment was stabilized with miniplate followed by Le Fort 1 advancement and mandibular setback guided by an occlusal wafer. Malar augmentation was done by onlay bone grafts. Mandibulo-maxillary fixation was maintained. Postoperatively, a good occlusion and better facial harmony were achieved. He was planned to undergo a septorhinoplasty in the near future.Discussion: Despite adequate treatments following the protocol recommended by many centres, some patients developed some degree of maxillary hypoplasia. A quarter of this population need osteotomies and Le Fort I maxillary osteotomy is the most common procedure to correct retrognathic maxilla.Conclusion: Orthognathic surgery combined with orthodontic treatment in a patient with bilateral cleft lip and palate provided good functional and aesthetic result. However, this procedure cannot replace the standard protocol of having an alveolar bone graft performed before permanent canine eruption to achieve optimal outcomes

scholarly journals Comparative Volume Analysis of Alveolar Defects by 3D Simulation

2019 ◽  
Vol 8 (9) ◽  
pp. 1401 ◽  
Author(s):  
Pang-Yun Chou ◽  
Rafael Denadai ◽  
Rami R. Hallac ◽  
Sarayuth Dumrongwongsiri ◽  
Wei-Chuan Hsieh ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Surgical Simulation ◽  
Intraclass Correlation ◽  
Simulation Methods ◽  
Alveolar Cleft ◽  
Surgical Method ◽  
Volumetric Assessment

A precise volumetric assessment of maxillary alveolar defects in patients with cleft lip and palate can reduce donor site morbidity or allow accurate preparation of bone substitutes in future applications. However, there is a lack of agreement regarding the optimal volumetric technique to adopt. This study measured the alveolar bone defects by using two cone-beam computed tomography (CBCT)-based surgical simulation methods. Presurgical CBCT scans from 32 patients with unilateral or bilateral clefts undergoing alveolar bone graft surgery were analyzed. Two hands-on CBCT-based volumetric measurement methods were compared: the 3D real-scale printed model-based surgical method and the virtual surgical method. Different densities of CBCT were compared. Intra- and inter-examiner reliability was assessed. For patients with unilateral clefts, the average alveolar defect volumes were 1.09 ± 0.24 and 1.09 ± 0.25 mL (p > 0.05) for 3D printing- and virtual-based models, respectively; for patients with bilateral clefts, they were 2.05 ± 0.22 and 2.02 ± 0.27 mL (p > 0.05), respectively. Bland–Altman analysis revealed that the methods were equivalent for unilateral and bilateral alveolar cleft defect assessment. No significant differences or linear relationships were observed between adjacent different densities of CBCT for model production to obtain the measured volumes. Intra- and inter-examiner reliability was moderate to good (intraclass correlation coefficient (ICC) > 0.6) for all measurements. This study revealed that the volume of unilateral and bilateral alveolar cleft defects can be equally quantified by 3D-printed and virtual surgical simulation methods and provides alveolar defect-specific volumes which can serve as a reference for planning and execution of alveolar bone graft surgery.

Effect of Platelet Rich Plasma (PRP) on Bone Graft in Alveolar Cleft Repair

2020 ◽  
Vol 43 (3) ◽  
pp. 417-424
Author(s):  
Omar Osman ◽  
Ibrahim Kamel ◽  
Ahmed Elshereif ◽  
Ahmed Mohamed ◽  
Amr Magdy
Keyword(s):  
Bone Graft ◽  
Platelet Rich Plasma ◽  
Alveolar Cleft
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