Evaluation of alveolar grafting with tibial graft in adolescent patients

In a resource-limited setting, use of advanced reconstruction procedures for cleft patient is unaffordable. The autogenous graft sites such as iliac or rib are not favored owing to socio-ethno-economic and cosmetic reasons. In such situations, tibial graft is an excellent alternative. There is limited literature on the use of tibial graft from India and this manuscript attempts to address this lacuna.

Archives of a single department on cleft palate cases treated with tibial graft were collected. Cases fulfilling the inclusion and exclusion criteria were selected. The efficiency of treatment was evaluated from the orthopantomogram (OPG) and/or computed tomogram (CT) imaging using previously described methodology. All the data collected were analyzed using Microsoft Excel.

The mean age of the patients was 17.78 ± 3.29 years with a range of 13-23 years. Three patients had been treated with secondary bone grafting, while the remainder had been treated with tertiary bone grafting. The median age of the study population was 17.39 years, while the mode was 17 years. The mean efficiency in terms of preoperative and post-operative size of defects as measured in OPG was 74.32 ± 7.31, while it was 73.15 ± 9.9 as measured in CT. All the patients were comfortable with closure of the defect. Patients treated with secondary bone grafting had a mean efficiency was 79.53 ± 9.07, while for tertiary grafting, it was 71.72 ± 4.86.

The tibial graft offers an excellent alternative to the conventional standard grafts such as iliac crest or rib grafts. The efficiency of the treatment measured at 6 months period on standard OPG or CT is comparable to the results obtained with the rib/iliac crest.