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Late management of secondarily grafted clefts
P J Stoelinga1, P E Haers, R J Leenen
1Department of Oral and Maxillofacial Surgery, Rijnstate Ziekenhuis (Municipal Hospital), Arnhem, The Netherlands.
International Journal of Oral and Maxillofacial Surgery
|April 1, 1990
Summary
Alveolo-palatal bone grafting helps guide teeth into the arch for cleft palate patients. Many achieve uninterrupted arches with orthodontics, though some require surgery for optimal results.
Area of Science:
- Craniofacial surgery
- Orthodontics
- Cleft lip and palate research
Background:
- Residual clefts after primary repair often require bone grafting.
- Guiding eruption of permanent teeth (lateral incisor or canine) into the arch is a common goal.
- Achieving a complete dental archform is crucial for function and aesthetics in cleft patients.
Purpose of the Study:
- To evaluate the long-term outcomes of alveolo-palatal bone grafting in cleft palate patients.
- To assess the effectiveness of different treatment modalities in achieving uninterrupted dental arches.
- To discuss the role of segmental osteotomies and their impact on naso-maxillary growth.
Main Methods:
- Retrospective analysis of 34 patients (40 sides) who underwent alveolo-palatal bone grafting.
- Evaluation of orthodontic treatment, segmental osteotomies, prosthetic restoration, and Le Fort I advancement osteotomy.
- Long-term follow-up to assess dental arch form and occlusal relationships.
Main Results:
- 41% of patients achieved uninterrupted arches with orthodontics alone.
- 38% required segmental osteotomies to close edentulous spaces.
- 20% received bridges, and 25% needed Le Fort I advancement osteotomy.
Conclusions:
- Alveolo-palatal bone grafting is effective in guiding tooth eruption in clefts.
- A combination of orthodontic and surgical interventions is often necessary for optimal archform.
- Segmental osteotomies offer advantages for nasal base support in cleft palate management.