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Orthodontic treatment of cleft lip and alveolus using secondary autogenous cancellous bone grafting: a case report
Takashi S Kajii1, Mohammad K Alam, Junichiro Iida
1Department of Orthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan. kajii@den.hokudai.ac.jp
Aim:
This paper concerns orthodontic alignment of the maxillary lateral incisor on the cleft side of a lip and alveolar cleft patient after a secondary autogenous cancellous bone graft at the late stage of mixed dentition.
Subject And Treatment:
The patient was a Japanese girl 9 years 7 months of age who presented at the authors' clinic with a repaired lip and alveolar cleft and an incisor crossbite. At 12 years of age, a secondary bone graft of the alveolar ridge was performed using bone harvested from the iliac crest. At 14 years 7 months of age, a conventional fixed appliance was placed.
Results:
The lateral incisor on the cleft side was brought to the line of occlusion by orthodontic alignment. A Class I molar relationship on both sides and a satisfactory facial profile were achieved. After a 2-year retention period, the occlusion and esthetics were maintained. Five years after grafting, however, a satisfactory bone level was not achieved due to positioning of the root of the lateral incisor, which was not completely upright in the bone graft area due to root tipping.
