TY - JOUR
T1 - Secondary alveolar bone grafting using milled cranial bone graft
T2 - A retrospective study of a consecutive series of 100 patients
AU - Denny, Arlen D.
AU - Talisman, Ran
AU - Bonawitz, Steven C.
PY - 1999/3
Y1 - 1999/3
N2 - Objective: The purpose of this study was to evaluate the outcome of secondary bone grafting of alveolar clefts using milled cranial bone graft. Patients: The study included a consecutive series of 100 patients who were operated on between 1986 and 1995 by a single senior surgeon. Measurements: The patients were divided into four groups; (1) unilateral alveolar cleft or (2) bilateral alveolar cleft, (3) before eruption of the canine teeth or (4) after eruption. Follow-up ranged from a minimum of 12 months to 10 years, and evaluation included a physical examination, medical photography, orthodontic reports, and a panorex X-ray and/or a three-dimensional computed tomography scan of the maxilla produced using Denta-scan software. Patient outcomes were judged to be good, acceptable, or poor. Patients who developed any fistula or required regrafting were defined as poor outcomes. Results: The combined good and acceptable outcomes represented 83% of the entire consecutive series. These two groups were defined as successful outcomes. In patients with unilateral and bilateral clefts who were under 12 years old, the success rate was 90% and 88%, respectively. In patients grafted following full canine eruption (>12 years old), success rate decreased to 83% in patients with unilateral and 66% in bilateral clefts, respectively. Conclusions: Our results support the use of milled cranial bone graft, which produces a stable closure of the alveolar cleft with good contour and support for adjacent tooth eruption. Our data further support the conclusion by others that outcomes of early secondary grafting are superior to delayed grafting. The experience presented here, including the success rate, ease of harvesting, and minimal morbidity, makes the cranium our preferred donor site for alveolar cleft grafting.
AB - Objective: The purpose of this study was to evaluate the outcome of secondary bone grafting of alveolar clefts using milled cranial bone graft. Patients: The study included a consecutive series of 100 patients who were operated on between 1986 and 1995 by a single senior surgeon. Measurements: The patients were divided into four groups; (1) unilateral alveolar cleft or (2) bilateral alveolar cleft, (3) before eruption of the canine teeth or (4) after eruption. Follow-up ranged from a minimum of 12 months to 10 years, and evaluation included a physical examination, medical photography, orthodontic reports, and a panorex X-ray and/or a three-dimensional computed tomography scan of the maxilla produced using Denta-scan software. Patient outcomes were judged to be good, acceptable, or poor. Patients who developed any fistula or required regrafting were defined as poor outcomes. Results: The combined good and acceptable outcomes represented 83% of the entire consecutive series. These two groups were defined as successful outcomes. In patients with unilateral and bilateral clefts who were under 12 years old, the success rate was 90% and 88%, respectively. In patients grafted following full canine eruption (>12 years old), success rate decreased to 83% in patients with unilateral and 66% in bilateral clefts, respectively. Conclusions: Our results support the use of milled cranial bone graft, which produces a stable closure of the alveolar cleft with good contour and support for adjacent tooth eruption. Our data further support the conclusion by others that outcomes of early secondary grafting are superior to delayed grafting. The experience presented here, including the success rate, ease of harvesting, and minimal morbidity, makes the cranium our preferred donor site for alveolar cleft grafting.
KW - Alveolar cleft
KW - Secondary bone grafting
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U2 - 10.1597/1545-1569(1999)036<0144:SABGUM>2.3.CO;2
DO - 10.1597/1545-1569(1999)036<0144:SABGUM>2.3.CO;2
M3 - Article
C2 - 10213061
AN - SCOPUS:0033003844
SN - 1055-6656
VL - 36
SP - 144
EP - 153
JO - Cleft Palate-Craniofacial Journal
JF - Cleft Palate-Craniofacial Journal
IS - 2
ER -