[The role of autologous parietal bone graft in alveolar cleft]

Autologous bone grafting of alveolar clefts is a well recognized procedure. Calvarium represents an interesting donor site because of the absence of morbidity and the dimensional stability of this membranous bone compared with endochondral bone sources. The authors reponed their experiences with this type of grafting used in 17 patients. Referred to the parameters analized in an important Swedish study, the rate of success was about 80% agree with the results of other authors with the same type of graft. Aspects of general planning, timing, technique and failure are extensively discussed. Pre and post surgical orthodontic treatment is also very important for a good result. The pattern of maxillo-facial growth and the effect of the graft materials on facial development are mentioned. The study of literature indicates that the best grafting results are achieved when free autogenous mandibular symphyseal bone grafts were used. The only true disadvantage is the small quantity of bone tissue available. The authors conclude suggesting the use of chin bone grafting in situations where the technique provides sufficient bone and recommend the use of cranial vault as the alternative source of membranous bone graft, for example, in bilateral clefts, when anterior theeth are not erupted yet and in any other situation where the mandibular bone graft is not possible.