The reconstruction of bilateral clefts using endosseous implants after bone grafting.
This article presents the orthodontic reconstruction of an adult bilateral cleft patient with a severe Class III malocclusion in which endosseous implants were inserted after secondary alveolar bone grafting. The patient was a 21-year-old Japanese male whose lateral incisors were congenitally missing and whose premaxilla was inclined lingually. The occlusion was classified as Angle Class III with an overjet of -8 mm. Orthodontic alignment was initiated to correct the position of the maxillary incisors before bone grafting. After the anterior occlusal relationship was corrected, bilateral alveolar clefts were reconstructed by bone grafting with autogenous particulate marrow and cancellous bone harvested from the iliac crest. ITI-SLA fixtures (Institute Straumann, Waldenburg, Switzerland) (length, 10 mm; diameter, 4.1 mm) were placed into the grafted bone for prosthetic restoration of the missing lateral incisors. The results illustrate that this protocol can be expected to provide an acceptable occlusion and good dentoalveolar stability in adult cleft patients.
Isono
Hiroaki
H
School of Dental Medicine, Tsurumi University, Yokohama, Japan. isono-h@tsurumi-u.ac.jp
Kaida
Kiyokazu
K
Hamada
Yoshiki
Y
Kokubo
Yuji
Y
Ishihara
Masataka
M
Hirashita
Ayao
A
Kuwahara
Yosuke
Y
D000328:Adult; D000543:Alveoloplasty; D000848:Anodontia / Q000628:therapy; D016026:Bone Marrow Transplantation; D016025:Bone Transplantation; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D003481:Cuspid / Q000473:pathology; D015921:Dental Implants; D006801:Humans; D007180:Incisor / Q000002:abnormalities; D008297:Male; D008313:Malocclusion, Angle Class III / Q000628:therapy*; D010347:Patient Care Planning; D011378:Prognathism / Q000628:therapy; D014079:Tooth Eruption, Ectopic / Q000628:therapy; D014087:Tooth Movement Techniques; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D015921:Dental Implants