title: Treatment of alveolar cleft performing a pyramidal pocket and an autologous bone grafting.
abstract: Alveolar cleft repair is a debate topic in cleft lip and palate treatment.The aim of this article is to analyze the outcomes and the advantages of the autologous bone grafting performed during the period between 1981 and 2006. In our plastic surgery unit, 468 patients with alveolar clefts have been treated. According to our protocol, the timing for the closure of the alveolar cleft ranged from 7 to 11 years (mean, 9.4 years). Autologous bone was taken from the skull in the 45% of patients, from the iliac crest in 35% of cases, and from the chin in 20% of cases. The surgical technique of creating a pyramidal pocket to secure the bone graft was central to achieving a good result. The postoperative evaluation of the results, using clinical criteria and endoral radiography, orthopantomography, and teleradiography at 3, 6, 12 months after surgery, and more recently, in the last 82 cases by a three-dimensional computed tomography, allows us to assert that we obtained optimal results in 50% of treated cases, good results in 40%, sufficient in 4%, partial failure in 5.4%, and complete failure in 0.6%.
authors.affiliation: Plastic Surgery School, Bologna University, Viale Berti Pichat no. 32, Bologna, Italy. paolo@morselli.info
authors.forename: Paolo Giovanni
authors.initials: PG
authors.lastname: Morselli
authors.forename: Renzo
authors.initials: R
authors.lastname: Giuliani
authors.forename: Valentina
authors.initials: V
authors.lastname: Pinto
authors.forename: Carlo Maria
authors.initials: CM
authors.lastname: Oranges
authors.forename: Luca
authors.initials: L
authors.lastname: Negosanti
authors.forename: Beatrice
authors.initials: B
authors.lastname: Tavaniello
authors.forename: Andrea
authors.initials: A
authors.lastname: Morellini
mesh_terms: D000539:Alveolar Process / Q000002:abnormalities*; D000543:Alveoloplasty / Q000379:methods*; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D002508:Cephalometry; D002648:Child; D002680:Chin; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D003724:Dental Arch / Q000002:abnormalities / Q000601:surgery; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium; D021621:Imaging, Three-Dimensional / Q000379:methods; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery; D009061:Mouth Mucosa / Q000601:surgery; D009297:Nasal Mucosa / Q000601:surgery; D011862:Radiography, Panoramic; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012886:Skull; D013524:Surgical Flaps; D014014:Tissue Adhesives / Q000627:therapeutic use; D020858:Tissue and Organ Harvesting / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives