TIMING AND TRANSPLANT MATERIALS FOR CLOSURE OF ALVEOLAR CLEFTS - A CLINICAL COMPARISON OF 296 CASES

A retrospective study of bone grafting of 296 clefts (165 unilateral a nd 131 bilateral was required) to answer questions about the most favo urable timing and the most appropriate bone graft material. The result s as such are not exceptional in comparison with earlier publications by the same or other authors, but it is of special interest that opera tions with different graft materials applied at different times in dev elopment, in (usually) a sufficient number of cases, can be compared t ogether. The patients have been operated on during a period of 11 year s, by the same surgeons, applying the same principles and techniques. It is shown that early secondary grafting, before the eruption of the canine, results in by far, the highest success rate. Similarly, chin b one is considerably better than any other type of transplant. Aspects of general planning, timing, technique and failures are extensively di scussed. Besides the afore-mentioned most significant findings, it is also concluded that the results of grafting during osteotomies are bet ter than they appear; that tertiary grafting is extremely difficult, a nd requires special surgical skill; that rib grafts score as high as i liac crest grafts and that materials other than these three types of b one should be avoided.