Evaluation of Alveolar Bone Grafting: A Survey of ACPA Teams

Abstract

There is wide acceptance of secondary bone grafting and there is a consensus for the age of grafting (6 to 9 years) and donor site (iliac crest). The disturbing finding was the lack of postoperative x-ray evaluation of the results. With so much variability in management, the use of a routine, standardized scale to measure postoperative results would allow for better outcome studies in alveolar bone grafting.

rhBMP-2 with a Demineralized Bone Matrix Scaffold versus Autologous Iliac Crest Bone Graft for Alveolar Cleft Reconstruction

“…In recent years, consensus has coalesced around secondary alveolar bone grafting as the preferred treatment at some 90 percent of centers. 15 In contrast, primary alveolar bone grafting, undertaken in the infant at the time of cleft palate repair, is now seldom performed, as it has been associated with subsequent impairment in maxillary growth. 16,17 Primary gingivoperiosteoplasty is an alternative approach also performed in the first year of life that does not rely on bone grafting but rather uses local mucoperiosteal flaps to close the alveolar defect.…”

The Effects of Gingivoperiosteoplasty following Alveolar Molding with a Pin-Retained Latham Appliance versus Secondary Bone Grafting on Midfacial Growth in Patients with Unilateral Clefts

“…25 Some centers, however, do perform gingivoperiosteoplasty to achieve early union of the dentoalveolar arch and possibly reduce the need for later bone grafting. Surgery at the alveolar cleft site has the potential to disrupt facial development.…”

Use of Human Recombinant Bone Morphogenetic Protein Is Associated With Increased Hospital Charges in Children With Cleft Lip and Palate Having Bone Graft Procedures

“…This is consistent with prior studies that have reported the iliac crest to be most popular bone graft source. 10,22 Approximately 2% had bone from the femur, tibia, or ribs. None of the patients had bone grafts from the cranial bones.…”