Preliminary Report of Two-Stage Secondary Alveolar Bone Grafting for Patients with Bilateral Cleft Lip and Palate

Abstract

Objective To overcome the difficulties of one-stage secondary alveolar bone grafting for patients with bilateral cleft lip and palate (BCLP) who have a broad alveolar cleft, the value of two-stage alveolar bone grafting was examined. Patients Three patients (2 girls and 1 boy) with BCLP were treated by two-stage alveolar bone grafting. The procedure consisted of a first-stage surgery (mean age 8 year 6 months ± 7.8 months), which consisted of alveolar bone grafting for one side of the BCLP, and second-stage surgery for the contralateral side several months later. For the postoperative assessment, radiographs of the operated site were examined. Results The average amount of implanted bone per operation and per patient was 6.8 ± 1.1 g and 13.7 ± 1.0 g, respectively. Postoperative clinical and radiographic examinations revealed that an appreciable alveolar bone ridge had formed, and there were no major complications. Conclusions Two-stage alveolar bone grafting, which makes it possible to reduce the amount of implanted bone, could be an optional surgical procedure for patients with BCLP and a broad alveolar cleft.

Outcomes of 44 Consecutive Complete Bilateral Cleft Lip and Palate Patients Treated with Secondary Alveolar Bone Grafting and Premaxillary Osteotomy

“…Alternatively, the ABG may be performed unilaterally, with the contralateral ABG being performed several months later. Kamakura et al (2003) report that this may be useful if there is insufficient bone for a single stage procedure, or if there are large alveolar and oronasal fistulae. Two-stage procedures have the disadvantage of undertaking two operations and potentially two donor sites for the bone graft harvest.…”

A Case Report of Multidisciplinary Treatment of an Adult Patient with Bilateral Cleft Lip and Palate

“…Delayed bone healing and a decreased marginal bone level were observed in patients with bilateral clefts compared with unilateral cleft patients because there is less soft tissue for coverage (Sindet-Pedersen et al, 1985). Therefore, we performed two-stage alveolar bone grafting to reduce the strain placed on the soft tissue by the operation and to secure a sufficient blood supply for the covering soft tissue (Kamakura et al, 2003). In addition, the functional stress placed on the grafted bone exerts a strong influence on the volume of the grafted bone, and progressive bone resorption is prevented by movement of the teeth adjacent to the grafted area in the direction of the graft (Bergland et al, 1986).…”

Alveolar Bone Grafting Without Closure Of Oronasal Fistula In Cleft And Palate Patient

“…Kamakura et al (9) has reported a successful 2 stage secondary alveolar bone grafting in bilateral cleft alveolus. The ABG was done one side at a time.…”