Reconstruction of the alveolar cleft: effect of preoperative extraction of deciduous teeth at the sites of clefts on the incidence of postoperative complications

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

“…Reported rates of infection following alveolar bone grafting vary widely from less than 10 percent to more than 30 percent, with at least some of this variability attributed to inconsistent criteria for defining infection. 6,[26][27][28] We chose to define infection broadly as any patient for whom a prolonged course of postoperative antibiotics was deemed necessary based on the surgeon's clinical judgment at a follow-up clinic visit. We included both lower grade infections that were successfully treated with oral antibiotics and those that progressed to fulminant infection and failure.…”

Tooth Resorption Following an Alveolar Bone Graft in a Patient With Complete Unilateral Cleft Lip and Palate

“…Deciduous extractions in a cleft area after or during ABG can cause wound complications and potentially damage newly formed bone in the cleft site (Almasri, 2012). There are less wound complications in individuals who have deciduous teeth extracted before, rather than at the time of the ABG surgery (Almasri, 2012); however, the location and difficulty of extraction of a supernumerary tooth must be considered, as there are circumstances in which less trauma will be incurred when removed at the time of the ABG. Currently, at the Hospital for Sick Children, unerupted deciduous or supernumerary teeth in the cleft site are removed 6 to 8 weeks prior to the ABG along with any required erupted teeth by an Oral and Maxillofacial Surgeon.…”

Incidence of complications in secondary alveolar bone grafting of bilateral clefts with premaxillary osteotomy: a retrospective cohort study

“…Previous reports used different definitions for reporting complications: insufficient bone height of the alveolar process only or patients with residual fistulas [15,24]. Complication rates after SABG + PO in BCLP patients [8,25] are reported to vary from 10 to 46% and are generally higher in bilateral clefts than those observed in unilateral cleft lip and palate patients [10]. In the present study, we defined all variables resulting in an unsatisfactory outcome of alveolar bone graft surgery-i.e., requiring secondary surgery or conservative measures such as antibiotics-as complications.…”

“…If supernumerary or deciduous teeth are present in the cleft area, some authors advise that these teeth be extracted at least 4-6 weeks before the SABG + PO procedure is performed [11,25]. This renders the flap designing for graft cover easier, with fewer perforations and less risk of wound dehiscence, resulting in fewer immediate postoperative complications [25]. In the present study population, special attention was paid to the preoperative extraction of deciduous teeth.…”