OBJECTIVE: To assess and develop a monocortical mandibular bone grafting procedure for reconstruction of alveolar cleft. DESIGN: Prospective study. SETTING: Hokkaido University Hospital. PATIENTS: Forty-two consecutive Japanese patients who had been treated for a total of 48 clefts according to a strict clinical protocol. Mean age at bone grafting was 6 years 11 months. INTERVENTIONS: Bone grafting was performed by harvesting lateral cortical bone plates from the symphysis and/or body and then placing them on the labial and palatal openings of the alveolar process defect. No particulate bone grafts were packed into the bony cavity. Mean follow-up after bone grafting was 37 months. MAIN OUTCOME MEASURES: Status of the grafted area and eruption of cleft-adjacent teeth were assessed prospectively using computed tomography and periapical radiography. RESULTS: At 6 months postoperatively, computed tomography showed sufficient bone bridge formation at the cleft site in 85.4% of clefts. Periapical radiography showed ≥75% of the root surfaces of cleft-adjacent teeth were covered with spanning bone in 83.3% of clefts. In 92.6% of clefts in which the cleft-adjacent canine was uncovered with bone during follow-up, the canines erupted spontaneously. CONCLUSIONS: Monocortical mandibular bone grafting appears extremely effective for sufficient bone bridge formation and facilitation of cleft-adjacent teeth eruption. The procedure is advantageous in that the quantity of bone required per unit volume of cleft defect is relatively reduced, and larger clefts can thus be treated.
OBJECTIVE: To assess and develop a monocortical mandibular bone grafting procedure for reconstruction of alveolar cleft. DESIGN: Prospective study. SETTING: Hokkaido University Hospital. PATIENTS: Forty-two consecutive Japanese patients who had been treated for a total of 48 clefts according to a strict clinical protocol. Mean age at bone grafting was 6 years 11 months. INTERVENTIONS: Bone grafting was performed by harvesting lateral cortical bone plates from the symphysis and/or body and then placing them on the labial and palatal openings of the alveolar process defect. No particulate bone grafts were packed into the bony cavity. Mean follow-up after bone grafting was 37 months. MAIN OUTCOME MEASURES: Status of the grafted area and eruption of cleft-adjacent teeth were assessed prospectively using computed tomography and periapical radiography. RESULTS: At 6 months postoperatively, computed tomography showed sufficient bone bridge formation at the cleft site in 85.4% of clefts. Periapical radiography showed ≥75% of the root surfaces of cleft-adjacent teeth were covered with spanning bone in 83.3% of clefts. In 92.6% of clefts in which the cleft-adjacent canine was uncovered with bone during follow-up, the canines erupted spontaneously. CONCLUSIONS: Monocortical mandibular bone grafting appears extremely effective for sufficient bone bridge formation and facilitation of cleft-adjacent teeth eruption. The procedure is advantageous in that the quantity of bone required per unit volume of cleft defect is relatively reduced, and larger clefts can thus be treated.
Authors: Nard G Janssen; Willem L J Weijs; Ronald Koole; Antoine J W P Rosenberg; Gert J Meijer Journal: Clin Oral Investig Date: 2013-02-22 Impact factor: 3.573
Authors: Pritam Mohanty; N K K Prasad; Nivedita Sahoo; Gunjan Kumar; Debapreeti Mohanty; Sushila Sah Journal: J Int Soc Prev Community Dent Date: 2015 Jan-Feb