[Comparison of secondary and tertiary cleft jaw osteoplasty. 20 year analysis].
BACKGROUND
The aim of secondary cleft osteoplasty is to provide alveolar bone for the complete eruption of the canine and sometimes of the lateral incisor to the occlusal plane and, thus, preservation of a continuous dental arch. This concept has not changed during the last 20 years in our clinic, providing an opportunity for an analysis of a homogeneous group of cleft patients. This group of patients was compared with a similar group of tertiary osteoplasties, performed during the same time span in our clinic.


METHODS
From 1980 to 1999, 376 cleft osteoplasties were performed in 295 patients, 264 of whom (136 secondary and 128 tertiary osteoplasties) were available for continuous prospective follow-up. Special emphasis was put on preoperative orthodontic treatment with removal of crossbites, oral hygiene, and meticulous disinfection. Autogenous cancellous iliac bone was used exclusively.


RESULTS
The postoperative height of the interalveolar septum (Abyholm classes) was I (1/1, 69.4%/45.8%), II (> 3/4, 28.2%/41.7%), III (< 3/4, 2.4%/10%), and IV (complete failure, 0%/2.5%) (secondary vs tertiary). Complications were infections (6.6% vs 14%), fistulae (0.7% vs 5.8%), and external root resorption (0% vs 7.4%). The lateral incisor was aligned into the arch in 55.5% vs 29.8% and the canine was in the correct position in 100% vs 83.6% (secondary vs tertiary).


CONCLUSIONS
Secondary cleft osteoplasty was more advantageous than tertiary due to better preservation of the neighboring teeth.
Terheyden
H
H
Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Kiel. terheyden@mkg.uni-kiel.de
Müller
A
A
Dunsche
A
A
Härle
F
F
D000293:Adolescent; D000539:Alveolar Process / Q000002:abnormalities / Q000601:surgery; D016025:Bone Transplantation; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D009971:Orthodontics, Corrective; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D014078:Tooth Eruption / Q000502:physiology