BONE-GRAFTING AT THE STAGE OF MIXED AND PERMANENT DENTITION IN PATIENTS WITH CLEFTS OF THE LIP AND PRIMARY PALATE

Secondary bone grafting of a residual alveolar cleft has become a well established procedure. However, little attention has been paid to the benefits of these bone grafts in patients with clefts of the lip and alveolus only. This retrospective and comparative study includes 21 pa tients who had received a secondary or a late secondary bone grafting procedure from tibia and whose mean clinical and radiographic follow-u p after the bane graft was 5.5 years. Eighteen patients treated withou t bone grafting served as controls. Length and width of cleft, presenc e or absence of permanent lateral incisor, size of nasal floor bony de fect, and interdental alveolar bony height in the cleft area were inve stigated. The results showed that bone grafting was indicated particul arly in wide clefts with missing lateral incisors. Eruption of a tooth close to the cleft was facilitated and the bony support for teeth nei ghboring the cleft was improved. In some cases, additional support of the alar base of the nose was achieved and closure of an oronasal fist ula facilitated. A further advantage of bone grafting of clefts of the primary palate was that it might make it possible to insert a titaniu m implant carrying an artificial tooth in the cleft area.