Premaxillary osteotomy and guided tissue regeneration in secondary bone grafting in children with bilateral cleft lip and palate.
OBJECTIVE
To introduce a surgical technique for secondary alveolar bone grafting performed in conjunction with premaxillary osteotomy and guided tissue regeneration in children with bilateral clefts. This paper also looks at the outcomes of this surgery in a series of 15 consecutive patients.


METHODS
Secondary alveolar bone grafting (with a premaxillary osteotomy and guided tissue regeneration with a collagen membrane) is usually carried out in the mixed dentition stage. This retrospective study used patients' medical records, radiographs, and clinical examination to assess the outcome of the surgery. Patients were followed up for an average of 3 years.


RESULTS
Bone grafting was successful in all cases. No premaxillae were lost and there was no long-term morbidity of the donor site. Radiographic assessment of the bone heights showed an average of 94% retention, 3 months postoperatively. Preliminary assessment of maxillary canine eruption is encouraging, with 79% being fully erupted in those patients who are at least 3 years post-bone grafting.


CONCLUSIONS
Premaxillary osteotomy allows repositioning of the premaxilla to its optimal preplanned position and successful closure of all fistulae. We have found that use of a collagen membrane is a useful adjunct.
Scott
Julia K
JK
Department of Oral and Maxillofacial Surgery, Salibury District Hospital, Salisbury, Wiltshire, UK. julesyscott@yahoo.co.uk
Webb
Roger M
RM
Flood
Timothy R
TR
D020341:Absorbable Implants; D000543:Alveoloplasty / Q000379:methods*; D001861:Bone Regeneration; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery*; D003094:Collagen; D003481:Cuspid / Q000503:physiopathology; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008437:Maxilla / Q000002:abnormalities* / Q000601:surgery*; D008567:Membranes, Artificial; D010027:Osteotomy / Q000379:methods; D013524:Surgical Flaps; D016896:Treatment Outcome
C106416:Bio-Gide; D008567:Membranes, Artificial; D003094:Collagen