title: Alveolar bone grafting in patients with complete clefts: a comparative study between secondary and tertiary bone grafting.
abstract: OBJECTIVE
  This investigation evaluated the results of alveolar bone grafting in patients with complete clefts, comparing secondary alveolar bone grafting (during the mixed stage of dentition) versus tertiary bone grafting (after completion of the second stage of dentition).
  
  
  METHODS
  This was a retrospective study. Of 140 osteoplasties, which all were operated according to the same standardized surgical technique, a clinical and roentgenological follow-up investigation was carried out in a collective of 85 osteoplasties. Clinically we searched for oronasal fistulae, assessed the periodontal status, determined the extent of the gingival attachment in the area of the osteoplasty, and searched for vertical growth disturbances in the area of the osteoplasty. Roentgenologically the height of the alveolar bone in the former clefted area was ascertained.
  
  
  METHODS
  Records were obtained from a clinical and radiological study of the Department of Oral and Maxillofacial Surgery of the Medical University of Hannover (Germany).
  
  
  METHODS
  All patients were operated with the same standardized surgical method. The osteoplastic bridging of the alveolar cleft was performed via a vestibular gingival marginal incision and exclusively by grafting of cancellous bone from the iliac crest.
  
  
  RESULTS
  The best results of alveolar bone grafting in cases of secondary osteoplasty were obtained when the lateral incisor or canine had grown into the transplant and had led to a functional stress of the transplanted bone. Approximately good results were to be found in tertiary osteoplasty when the transplanted bone had been stressed functionally through a dental implant. Comparing the secondary with the tertiary osteoplasty, there was a trend of lower resorption in secondary osteoplasty.
  
  
  CONCLUSIONS
  Secondary osteoplasty should represent an integral component of any concept for the comprehensive treatment of patients with cleft lip and palate.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Medical University of Hannover, Hannover, Germany. Dempf.Rupert@mh-hannover.de
authors.forename: Rupert
authors.initials: R
authors.lastname: Dempf
authors.forename: Thomas
authors.initials: T
authors.lastname: Teltzrow
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Kramer
authors.forename: Jarg-Erich
authors.initials: JE
authors.lastname: Hausamen
mesh_terms: D000328:Adult; D000539:Alveolar Process / Q000000981:diagnostic imaging; D000543:Alveoloplasty / Q000009:adverse effects / Q000379:methods*; D001862:Bone Resorption / Q000209:etiology; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002972:Cleft Palate / Q000000981:diagnostic imaging / Q000601:surgery*; D003481:Cuspid / Q000473:pathology; D015921:Dental Implants; D003818:Dentition, Mixed; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D006801:Humans; D007180:Incisor / Q000473:pathology; D009668:Nose Diseases / Q000209:etiology; D016155:Oral Fistula / Q000209:etiology; D010510:Periodontal Diseases / Q000209:etiology; D011859:Radiography; D016156:Respiratory Tract Fistula / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D014078:Tooth Eruption
chemical_list: D015921:Dental Implants