[Prosthetic rehabilitation with dental implant in cleft lip and palate: a ten-year retrospective study].
BACKGROUND
Two problems need to be faced during cleft lip and palate surgical treatment to gain a functional and esthetic result: restoration of the maxillary bone defect and the missing lateral incisor tooth, which may be replaced by an implant. The aim of our study was to demonstrate that it is possible to successfully place a dental implant after obtaining adequate bone graft volume.


METHODS
12 consecutively treated patients were studied, 7 with unilateral and 5 with bilateral clefts, mean age 21.5 years, with an average follow-up of 5.5 years (range: 1-10 years). Various types of autogenous or alogenous bone grafts were performed to provide adequate bone volume for immediate or secondary implant placement. We studied the number of bone grafts needed to reach this target, and the number of implants placed, focusing on lateral incisor tooth replacement.


RESULTS
Enough cleft bone volume for the implant was obtained in 9 out of 12 cases (75%). All endosseous implants placed in bone graft were successfully restored, 8 out of them for lateral incisor. Some surgical cases are described.


CONCLUSIONS
Global improving of cleft lip and palate surgical treatment by implantology is now feasible. Maxillary defect bone grafting, often in several stages, is strictly necessary to place an implant but also to obtain a good cosmetic result in cleft repair. Length, direction, and cervical implant position have to be considered too. Reconstruction of mucosal anatomy also contributes to the end result.
Lalo
J
J
Service de stomatologie et de chirurgie maxillofaciale, hôpital Tenon, GHU Est, Paris, France. jacques.lalo@tnn.aphp.fr
Kayali
A
A
Toudjine
B
B
Majourau-Bouriez
A
A
Essaddam
H
H
Pavy
B
B
D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D002971:Cleft Lip / Q000534:rehabilitation; D002972:Cleft Palate / Q000534:rehabilitation*; D003758:Dental Implantation, Endosseous; D019250:Dental Implants, Single-Tooth; D003766:Dental Occlusion; D005260:Female; D005881:Gingiva / Q000033:anatomy & histology; D006801:Humans; D007180:Incisor; D008297:Male; D008437:Maxilla; D009042:Motivation; D012189:Retrospective Studies