Bilateral alveolar bone grafting: a report of 55 consecutively-treated patients.

A retrospective study was undertaken to evaluate the long-term results of bilateral alveolar bone grafting carried out at Great Ormond Street Hospital from 1983 to 1993. Fifty-five consecutive complete bilateral cleft lip and palate patients (36 males and 19 females) who had the operation were included in this study. The total number of cleft sites was 110. At the time of alveolar bone grafting, the mean age of the patients was 12.3 years with a range of 8.4-19.9 years. Cancellous bone from the iliac crest was grafted into the alveolar cleft areas. The cleft sites were studied in two groups according to whether the cleft canine had erupted prior to bone grafting or not. The erupted canine group was composed of 43 cleft sites and the unerupted canine group of 67 sites. At the time of this study, the cleft canine had subsequently erupted at 101 sites. Anterior occlusal radiographs were taken before and after bone grafting. The minimum period of observation after alveolar bone grafting was one year. Criteria described previously were utilized to assess the height of the interdental septum. The results show that bone grafting before canine eruption has a higher clinical success rate compared with that carried out after canine eruption. The critical variable affecting the quality of bilateral alveolar bone grafting is the timing of the surgery.